Breast and endocrine surgery: Conn syndrome: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Breast and endocrine surgery: Conn syndrome

Sample item

A 45-year-old with resistant hypertension, hypokalaemia and a high aldosterone-renin ratio has a 1.5 cm left adrenal adenoma on CT. What should be done before surgery to confirm lateralisation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Adrenal venous sampling, then laparoscopic adrenalectomy

Primary hyperaldosteronism from a unilateral adenoma is cured by laparoscopic adrenalectomy. Adrenal venous sampling distinguishes unilateral adenoma from bilateral hyperplasia, which is treated with mineralocorticoid antagonists.

Option by option

  • A. Spironolactone for life only

    Medical therapy is for bilateral hyperplasia or unfit patients.

  • B. Pituitary surgery

    The pituitary is not involved.

  • C. Adrenal venous sampling, then laparoscopic adrenalectomy (correct)

    Correct. AVS guides unilateral adrenalectomy.

  • D. Bilateral adrenalectomy

    Bilateral removal is not needed for an adenoma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Adrenal venous sampling, then laparoscopic adrenalectomy. Primary hyperaldosteronism from a unilateral adenoma is cured by laparoscopic adrenalectomy.

Why is "Spironolactone for life only" not the answer?

Medical therapy is for bilateral hyperplasia or unfit patients.

Why is "Pituitary surgery" not the answer?

The pituitary is not involved.

Why is "Bilateral adrenalectomy" not the answer?

Bilateral removal is not needed for an adenoma.

What concept does this question test?

It tests Breast and endocrine surgery: Conn syndrome in General Surgery. Adrenal venous sampling distinguishes unilateral adenoma from bilateral hyperplasia, which is treated with mineralocorticoid antagonists.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Breast and endocrine surgery: Conn syndrome?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.