Internal Medicine

0521779407-08 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:11

644 Gonorrhea Gordon Syndrome

■Epididymitis: uncommon; unilateral testicular pain and swelling;

consider testicular torsion; treat with Ceftriaxone or Ofloxacin plus

Doxycycline

■Other: all uncommon; prostatitis, inguinal lymphadenitis, penile

edema lymphangitis or thrombophlebitis, seminal vesiculitis, acces-

sory gland infections, urethral stricture

Female urogenital infection

■PID: in 10–20% of acute infections; lower abdominal pain, cervical

motion, uterine and adenexal tenderness; fever, elevated WBC, ESR

or C-reactive protein; check pregnancy test to rule out ectopic; treat

with broad-spectrum antibiotics; consider hospitalization

■Other: tubo-ovarian abscess, perihepatitis, Bartholin’s gland abscess

(<10% of urogenital infections)

➣DGI

➣Perihepatitis, endocarditis (1–3% of cases), meningitis (rare)

GORDON SYNDROME (PSEUDOHYPOALDOSTERONISM

TYPE 2)

MICHEL BAUM, MD

history & physical

■Gordon syndrome (or pseudohypoaldosteronism type 2) is an auto-

somal dominant cause of hypertension and hyperkalemia.

tests

■Hyperkalemia

■Aldosterone levels are normal or low.

differential diagnosis

■Due to mutation in WNK1 or WNK4 kinase resulting in increase

in thiazide-sensitive NaCl cotransporter activity and a reduction in

potassium channel (ROMK) activity

■Hypertension associated with other causes of hyperkalemia

management

■Low-sodium diet

■Thiazide diuretics

■Low-potassium diet

specific therapy

■NA