American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is a common metabolic effect of hyperaldosteronism?

1. Hyperkalemia

2. Hypocalcemia

3. Metabolic acidosis

4. Metabolic alkalosis

The correct answer is: Metabolic alkalosis

Hyperaldosteronism is a condition characterized by an excess of the hormone aldosterone, which plays a crucial role in regulating electrolyte balance and fluid homeostasis in the body. One of the primary effects of increased aldosterone is enhanced reabsorption of sodium in the renal tubules, coupled with increased excretion of potassium and hydrogen ions. The reabsorption of sodium leads to increased extracellular fluid volume and can cause hypertension. At the same time, the increased excretion of hydrogen ions contributes to a rise in blood pH, resulting in metabolic alkalosis. This condition is particularly evident in primary hyperaldosteronism (Conn's syndrome), where patients frequently present with elevated blood pressure, low serum potassium levels (hypokalemia), and a tendency towards metabolic alkalosis due to the loss of hydrogen ions. Hence, the metabolic effect of hyperaldosteronism is best described as metabolic alkalosis, as the excessive aldosterone not only affects sodium and potassium levels but also disrupts acid-base balance, favoring an alkaline state in the blood.