Question

Which of the following causes hypokalemic metabolic alkalosis with hypertension?

• A. Liddle syndrome
• B. Bartter syndrome
• C. Gitelman syndrome
• D. Renal tubular acidosis

Hint:

Which inherited tubular disorder raises blood pressure while lowering potassium via overactive ENaC?

Answer 1

The Correct Option is A

Step 1: The question asks for hypokalemic metabolic alkalosis combined with hypertension. The presence of hypertension is the key discriminator, because it implies sodium and volume retention.
Step 2: Liddle syndrome is a rare hereditary disorder caused by increased activity of the epithelial sodium channel (ENaC) in the distal nephron. The kidney retains excessive sodium and water and excretes potassium, producing low potassium, alkalosis and hypertension.
Step 3: Therefore Liddle syndrome is the answer, as it uniquely combines all three features in the list.
Step 4: The distractors are wrong because Bartter and Gitelman syndromes both cause hypokalemic metabolic alkalosis but with normal or low blood pressure, and renal tubular acidosis causes a metabolic acidosis, not alkalosis. Hence Liddle syndrome.