رجل عمره ٤٥ سنة عنده ارتفاع ضغط لا ينضبط رغم ٣ أدوية، وتشنجات عضلية وضعف. البوتاسيوم ٢٫٩ بدون إسهال أو مدرات بول، والصوديوم ١٤٥. ما الحالة التي يجب التفكير فيها؟

A 45-year-old man has hypertension uncontrolled on three drugs, with muscle cramps and weakness. Potassium 2.9 without diarrhoea or diuretics; sodium 145. Which condition should be considered?

1. Primary hyperaldosteronism
2. Hypothyroidism
3. Nephrogenic diabetes insipidus
4. Primary adrenal insufficiency

Answer: A) Primary hyperaldosteronism. Resistant hypertension with unexplained hypokalaemia suggests primary hyperaldosteronism. The aldosterone-to-renin ratio is measured; spironolactone or surgery for an adenoma is used.