40-year-old man presenting with hx of weakness, fatigue, weight loss, abdominal discomfort and nausea for a month, on examination patient looking thin, his bp lying 91/50 and 70/50 standing, he also had gum and palmer crease hyperpigmentation. What is the most important test to establish your dx?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: C. morning cortisol and ACTH
Weight loss, GI upset, postural hypotension and gum/palmar crease hyperpigmentation = primary adrenal insufficiency. The key initial test is morning serum cortisol with ACTH: low cortisol confirms hypocortisolism and a high ACTH shows the adrenal itself is the problem (Addison's). CBC/iron, CRP and thyroid tests do not establish this diagnosis.
ليش كل خيار صح أو غلط
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A
ليش غلط
A CBC can show eosinophilia in adrenal insufficiency, but that is only a general finding; the best initial test for hypocortisolism is a morning serum cortisol (or ACTH) level.
✓ Adrenal disorders (2).pdf · p. 5 -
C
ليش صح
Cortisol is the initial test (low in adrenal insufficiency) and ACTH then shows the cause: high in Addison disease (primary), low in secondary AI.
✓ RT - Adrenal.pdf · p. 12
- المصدر
- Adrenal disorders (2).pdf · p. 5
RT - Adrenal.pdf · p. 12 - المحاضرة
- Adrenal Insufficiency · Endocrinology · Module B
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- Endo bank