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The following results were found in a hypertensive patient exhibiting truncal obesity, a very round face, and a prominent fat lump between the shoulders.
1. What general condition is most likely occurring in this patient? What specific disease may be present? 2. Describe the disease process and how it produces each symptom and parameter above? 3. Based on your diagnosis, what further testing should be done and describe how those tests could be used to confirm or further the diagnosis? |
1. The patient is suffering from cushings syndrome.
Cushings syndrome is characterised by increased production of cortisol. The disease is characterised by hypertension, abdominal obesity with thin extremities, stretch marks that are red in color and round red face. A round lump is present between the shoulders or at the back.
The 24 hour urine test gives high level of cortisol.
2. Cushings syndrome is caused due to excessive production of cortisol.
Hypercortisolism results in hypertension. Excessive production of fat leads to moon face and fat lump between the shoulders.
3. Salivary cortisol : late evening salivary examination can show high levels of cortisol
Low dose dexamethasone suppression and high dose dexamethasone suppresion
CT scan
MRI
Serum ACTH levels
The following results were found in a hypertensive patient exhibiting truncal obesity, a very round face,...
The following lab results were reported for a 15-year-old male. His mother told the physician the he had lost weight recently even though his appetite and thirst had increased dramatically. She also said she believed her son to be extremely fatigued because he would get up to use the bathroom in the middle of the night. Plasma Urine Glucose: 165 (80-150 mg/dL) (fasting) Specfic Gravity: 1.040 Sodium: 139 (135-145 mEq/L) pH: 6.5 Potassium: 4.2 (3.0-5.0 mEq/L) Glucose: 4+ Chloride: 102...