A 40-year-old male complains of increasing weakness, fatigue, weight loss, abdominal pain and nausea over the last month. He appears thin, his BP is 90/55mmHg with a postural drop of more than 20mmHg in systolic blood pressure and has hyperpigmented gums and palmer creases. Normal cardiac and abdominal exam. Which of the following is best diagnostic step in evaluation?
سؤال مجاني 6 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Am serum cortisol, ACTH +/- Cosyntropin test
The picture (weight loss, GI symptoms, postural drop, hyperpigmented gums and palmar creases) is primary adrenal insufficiency. Work-up is AM serum cortisol and ACTH as the initial test, with the cosyntropin (ACTH stimulation) test as confirmation. CBC/iron, ESR, cultures and thyroid tests do not diagnose it.
ليش كل خيار صح أو غلط
-
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 AI), the ACTH stimulation (Synacthen) test is the confirmatory test, and the ACTH level determines the cause.
✓ RT - Adrenal.pdf · p. 12
- المصدر
- Adrenal disorders (2).pdf · p. 5
RT - Adrenal.pdf · p. 12 - المحاضرة
- Adrenal Insufficiency · Endocrinology · Module B
- ظهر في
- Endo bank