A male client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client’s hypertension is caused by excessive hormone secretion from which of the following glands?
A. Adrenal medulla
B. Pancreas
C. Adrenal cortex
D. Parathyroid
Correct Answer: C. Adrenal cortex
Excessive secretion of aldosterone in the adrenal cortex is responsible for the client’s hypertension. This hormone acts on the renal tubule, where it promotes reabsorption of sodium and excretion of potassium and hydrogen ions. Primary hyperaldosteronism (PA) is an underdiagnosed cause of hypertension. The classic presentation of PA includes hypertension and hypokalemia. However, in reality, most patients will present without hyperkalemia. The two primary causes are aldosterone-producing adenomas and bilateral adrenal hyperplasia of the zona glomerulosa.
Option A: The adrenal medulla secretes the catecholamines — epinephrine and norepinephrine. The adrenal gland is made up of the cortex and medulla. The cortex produces steroid hormones including glucocorticoids, mineralocorticoids, and adrenal androgens, and the medulla produces the catecholamines, epinephrine, and norepinephrine.
Option B: The pancreas mainly secretes hormones involved in fuel metabolism. The pancreas is a composite organ, which has exocrine and endocrine functions. The endocrine portion is arranged as discrete islets of Langerhans, which are composed of five different endocrine cell types (alpha, beta, delta, epsilon, and upsilon) secreting at least five hormones including glucagon, insulin, somatostatin, ghrelin, and pancreatic polypeptide, respectively.
Option D: The parathyroids secrete parathyroid hormone. The parathyroid is comprised of 4 small glands embedded in the posterior aspect of the thyroid gland. Its main function is the production and secretion of parathyroid hormone (PTH), a polypeptide hormone responsible for maintaining serum calcium homeostasis.
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