Differential Diagnosis for Hypertension in a 52-year-old Female with DM and Knee Osteoarthritis
- Single most likely diagnosis
- C. NSAIDs induced HTN: The patient has been using NSAIDs to relieve pain from knee osteoarthritis. NSAIDs are known to cause hypertension by inhibiting prostaglandin synthesis, leading to vasoconstriction and sodium retention. This is a common and well-documented side effect, especially in patients with pre-existing conditions like diabetes mellitus.
- Other Likely diagnoses
- A. Essential HTN: Essential hypertension is a common condition, and its prevalence increases with age. Although the patient's age and diabetes mellitus status make her more susceptible to developing hypertension, the recent onset of high blood pressure in the context of NSAID use suggests that essential hypertension might not be the primary cause at this moment.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- D. Primary hyperaldosteronism: This condition, characterized by excessive aldosterone production, can lead to severe hypertension and hypokalemia. Although the patient's potassium level is described as borderline, primary hyperaldosteronism is a critical diagnosis to consider due to its potential for severe consequences if left untreated.
- B. Phaeochromocytoma: Although rare, phaeochromocytoma is a life-threatening condition that can cause episodic or sustained hypertension. It is crucial to rule out this diagnosis due to its potential for catastrophic outcomes if missed.
- Rare diagnoses
- Other rare causes of hypertension, such as Cushing's syndrome, thyroid disorders, or renal artery stenosis, could be considered but are less likely given the information provided. These conditions would typically present with additional symptoms or findings beyond hypertension alone.