CASE PRESENTATION

HISTORY
• 49 year old female presented to the
Outpatient department with c/o
• Generalised weakness
• Dyspnea on exertion
• Palpitations
• Patient was apparently alright 6 months ago
after which she developed generalised
weakness associated with muscle cramps,
dyspnea on exertion and palpitations
 HISTORY
• H/O intermittent episodes of headache were
present
-H/O Palpitations Present
No H/O excessive sweating

• No H/O Anxiety
• NO H/O nausea and vomitting
• NO H/O hematuria/pyuria/lithuria
• NO h/o fever
No H/O Loss Of Apetite And Weight

• No H/O Jaundice/Back Pain/Cough

• No H/O Seizure/Hemoptysis

• No H/O Dm / Tb
• No H/O Previous Surgeries
• Family History- Not Significant
 HISTORY
The patient is a known hypertensive since 2014. She is
on
Tab.Spironolactone50mg I-0-1/2.
Tab.Telmisartan + metoprolol 40/25mg 1-0-0.
Tab.Telmisartan 40mg 0-0-1
 EXAMINATION
• Ecog 0
• Height- 150cm, Weight-64kg
• VITALS- BP-160/9O Mmhg, PR-86/MIN
• No Pallor / Clubbing /
Icterus/Cyanosis/Lymphadenopathy/Neck Swelling
• No Pedal Edema
• Cvs /Rs – Nad
• P/A- No Visible Stria Or Pigmentation
Soft, Non-tender, No Organomegaly
• Per vaginum:- No discharge noted. No
palpable masses felt.
• DRE:- Normal
• CVS:- S1&S2 +, No murmurs.
• RESPIRATORY:- Bilateral normal vesicular
breath sounds heard.
• CNS:- No neurological deficits
 INVESTIGATIONS
Heamoglobin:- 12.8mg/dl
• Serum Creatinine:- 0.63mg/dl
• Blood Urea:- 18mg/dl
• Serum Sodium:- 143mmol
• Serum potassium:- 2.83mmol
 INVESTIGATIONS
Aldosterone:- 17.2ng/dl
• Plasma renin activity:- <0.10
 MANAGEMENT
Left Open Adrenalectomy
Post adrenalectomy investigations
-Hemoglobin:- 11.5mg/dl
• Serum Creatinine:- 0.82mg/dl
• Blood Urea:- 29mg/dl
• Serum Sodium:- 141mmol
• Serum potassium:- 3.43mmol