Below is your mom’s report in the same structure and tone as the earlier PDF—kept simple and patient-friendly.

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Field | Details | Result | Why

Title | Left adrenal adenoma with high blood pressure, menopause on HRT, gout and prior kidney stone | — | Brings all key issues into one line so the plan is clear.

One-sentence summary | Blood pressure runs a little high. The adrenal lump looks benign. Cholesterol and sugar are okay. Next steps are to finish the hormone tests, fine-tune BP, and keep gout/kidney-stone prevention going. | Mixed | We’ll lock down the cause of hypertension, then tighten control safely. 

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PATIENT CONTEXT – DEMOGRAPHICS

Item Value Result Why

Age, sex 57-year-old woman — Age and sex guide targets and screening.

Height 177 cm — Needed for BMI and dosing.

Weight 79 kg (BMI ≈ 25.2) Borderline A small loss improves BP and gout risk.

Waist ~75 cm Good Below risk cut-off for women; keep it here.

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PATIENT CONTEXT – SYMPTOMS

Symptom Start Result Why

Hot flashes / sweating Ongoing in menopause Watch Common on menopause; HRT helps. We’ll still rule out other causes when we do adrenal tests.

Headaches Occasional Watch Track timing; can relate to BP, tension, or hot flashes.

Palpitations Rare Watch Uncommon; if more frequent, we’ll check thyroid, anemia, and rhythm.

Abdominal weight gain Recent, central only Needs work Typical after menopause; small lifestyle steps make a difference.

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IMAGING – ADRENALS & LIVER

Finding Size / Side Result Why

Left adrenal adenoma (lipid-rich) 2.2 × 1.7 cm Reassuring “Lipid-rich” pattern is classic benign; slow growth over 4 yrs fits this.

Right adrenal Normal Good No lesion on the right.

Liver hemangiomas (benign) 1.7 cm (segment VII), 1.3 cm (segment V), and 0.5 cm flash-filling (segment VI) Good Typical harmless blood-vessel growths; no action needed unless symptoms.

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BLOOD PRESSURE – GOAL & PLAN

Item Value Result Why

Typical reading (when checked) ~135/90 Needs work Aim < 130/80 if tolerated to protect heart, brain, and kidneys.

Medicine CoAprovel 150/12.5 mg every morning Good Irbesartan + low-dose HCTZ works well; watch uric acid (gout).

Home monitoring Not regular Needs work Check AM and PM for 7 days, then 2–3×/week; bring the log to visits.

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HORMONAL SCREEN – WHAT’S DONE / WHAT’S NEXT

Test Current info Result Why

Renin (upright) 5.7 – within given range Good Needed for aldosterone-renin ratio (ARR).

Aldosterone Not available (the screenshot shows aldolase, a muscle enzyme) Missing Please obtain plasma aldosterone (same day as renin) to compute ARR.

Cortisol excess (1-mg overnight dexamethasone test) Not done Needed Screens for mild cortisol overproduction that can raise BP and sugar.

Pheochromocytoma screen (plasma free metanephrines) Not done Needed One-time screen for adrenaline-type tumors when an adrenal mass is present.

DHEA-S Not done Optional Helps characterize adrenal lumps in select cases.

What it means now: Imaging looks benign. If hormones are normal, we monitor the nodule (repeat imaging per your doctor). If aldosterone is high relative to renin, that’s a treatable cause of high BP; your team will discuss meds vs. surgery depending on results.

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CARDIOMETABOLIC GOALS (PRIMARY PREVENTION)

Measure Goal Current Result Why

Blood pressure < 130/80 mmHg ~135/90 Needs work Lowering BP cuts heart-attack and stroke risk.

LDL (“bad” cholesterol) < 100 mg/dL (or lower if risk rises) 114 Borderline Close to goal; food/activity can tip it under 100.

Non-HDL cholesterol < 130 mg/dL 131 Borderline Falls as LDL and TG fall.

HbA1c (sugar) < 5.7% 5.0% Good No diabetes; keep up current habits.

Potassium 3.6–5.0 mmol/L 4.5 Good Stay hydrated; avoid K-salt substitutes.

eGFR ≥ 60 ~95 Good Healthy kidneys.

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LATEST LABS (most recent panel)

Test Value Result Why

Total cholesterol 199 OK Near normal overall.

LDL 114 Borderline Slightly above target < 100.

HDL 68 Good Protective.

Triglycerides 78 Good Healthy level.

Fasting glucose 90 Good Normal.

HbA1c 5.0% Good Confirms normal average sugar.

Creatinine / eGFR 0.73 / ~95 Good Kidneys working well.

Sodium / Potassium / Bicarbonate 142 / 4.5 / 26 Good Balanced electrolytes.

AM Cortisol ~9 µg/dL OK Typical morning value.

ACTH Slightly low Watch Interpret with the dex suppression test result.

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CURRENT MEDICINES (how to take & what to watch)

Medicine Dose & timing Purpose Result Why

CoAprovel (irbesartan / HCTZ) 150/12.5 mg AM BP Good Good first-line; HCTZ can raise uric acid—flag if gout flares increase.

Estradiol 750 mcg AM HRT Good Controls hot flashes; review yearly that benefits > risks.

Micronized progesterone 100 mg at night Uterine protection Good Helps sleep; take consistently.

Cipralex (escitalopram) 10 mg AM Mood/anxiety Good Long-term use OK; may contribute to sweating and mild weight gain.

Magnesium Night Sleep/constipation Good Gentle aid; can support bowel regularity.

Vitamin B-complex Daily Supplement Optional Keep dose standard; high doses usually just excreted.

Collagen Night (pill) Joint/skin Optional Neutral for labs.

Evening primrose oil Daily Hot flashes/breast comfort Optional Benefit varies; safe at normal doses.

Thyroid Medication not listed Hypothyroidism Info needed Please confirm drug & dose (e.g., levothyroxine). Dose affects weight, heart, and lipids.

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LIFESTYLE SNAPSHOT

Area Current Result Why

Steps 1,000–2,000/day Needs work Build toward 6,000/day over 6–8 weeks; two 10-min post-meal walks help BP and lipids.

Sleep 7–8 h/night Good Supports appetite control, BP, and mood.

Alcohol None Good Helps BP and gout risk.

Nicotine Vapes Needs work Quitting lowers BP and heart risk; plan taper + supports.

Hydration Variable Needs work Target 2–2.5 L/day unless restricted—prevents stones and gout.

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NEXT STEPS WITH DATES (simple checklist)

Task Date How Why

Start home BP log (AM & PM × 7 days, then 2–3×/week) This week Use an automatic cuff; record seated, arm at heart level Confirms average and guides dosing.

Plasma aldosterone (same day as renin) Next lab draw Morning, seated; keep current meds unless your doctor advises otherwise Completes the ARR for aldosterone work-up.

1-mg dexamethasone test (overnight) As scheduled Take 1 mg dex at 11 pm → 8 am cortisol draw Screens for mild cortisol excess.

Plasma free metanephrines As scheduled Resting blood test One-time screen for adrenaline-type tumor (unlikely but standard).

Lipids + basic panel In 3–6 months Fasting 8–12 h Track LDL, non-HDL, K, creatinine.

Uric acid level With next labs — Gout risk while on HCTZ.

Stone prevention Ongoing Hydration; moderate salt and animal protein; normal calcium in diet Cuts recurrence risk.

DEXA bone density When convenient Outpatient scan Baseline due to menopause + long-term SSRI.

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RED FLAGS – SEEK CARE NOW

Symptom Action Why

Chest pressure with sweating, short breath, or nausea Emergency services if >5 minutes Possible heart attack.

Fainting, one-sided weakness, slurred speech Emergency services Possible stroke.

Severe flank pain or blood in urine Same-day urgent care Possible kidney stone.

Big-toe joint becomes suddenly red, hot, very painful Call doctor same day Possible gout flare—early treatment helps.

New severe headache with very high BP Same-day care Prevent complications.

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MISSING INFO TO COMPLETE THE FILE

Item Why needed

Aldosterone result (not “aldolase”) To compute aldosterone-renin ratio and finish adrenal work-up.

Thyroid medication and dose To confirm proper replacement and targets.

Home BP log To set the right BP target and dosing.

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Bottom line: Your adrenal lump looks benign. We’ll finish the hormone tests, tighten blood-pressure control, and keep up gout/stone prevention. Small daily changes (steps, hydration, salt awareness, nicotine taper) will move the numbers the right way.