Q: 34 year old male with no medical access in past presented to ER with severe hypertension. On lab workup found to have hypokalemia and metabolic alkalosis. Your first diagnosis?

Hint: Triad of HTN, Hypokalemia and metabolic alkalosis

Answer: Primary hyperaldosteronism

Aldosterone hypersecretion acts on the cortical collecting duct to stimulate potassium secretion into the tubular fluid, enhancing renal potassium wasting.The metabolic alkalosis is due to increased renal hydrogen ion loss mediated by hypokalemia and aldosterone.