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Make the Dx: Headaches and hypertension

MDlinx Nov 23, 2023

Can you diagnose this mystery illness?

A 28-year-old man is undergoing evaluation because of a 2-month history of headaches. He has a history of hypertension treated with three antihypertensives.

The physical examination is unremarkable; however, his blood pressure is 170/110 mmHg.

An abdominal CT scan shows an enlarged right adrenal gland. 

Results of laboratory studies include: 

Sodium: 149 mmol/L

Potassium: 3.3 mEq/L

Chloride: 102 mEq/L 

Bicarbonate: 29 mmol/L

Plasma aldosterone concentration to plasma renin activity (PAC:PRA): 42


So, what's the most likely diagnosis? Click here to find out.

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