A 46-year-old woman complains of weakness, fatigue, loss of appetite and weight loss, increase in thirst and increased urination. She also suffered occasional dizziness, particularly when standing. She has no prior medical history and is not taking any medication. On examination, supine blood pressure was normal, but a marked postural hypotension was noted on standing. Following some basic blood tests (see below), the GP makes a provisional diagnosis of Addison's Disease. Variable Urea (mm) Creatinine (mM) Glucose (mm) Na* (mm) K+ (MM) Cortisol (nM) ACTH (PM) Aldosterone (nM) Result 7.6 73 3.3 121 6.4 40 200 34 Reference Range 2.5-7.0 60-120 3.5-5.5 (fasting) 134-147 3.5-5.0 138 - 690 <26 90 - 200 The patient was referred by the GP for follow up tests with the endocrinologist. The tests included measurements of cortisol, ACTH and aldosterone levels (shown in the table) and a test for antibodies against 21-hydroxylase which was shown to be positive. a) Do you agree or disagree with the provisional diagnosis by the GP? Briefly explain your answer. (30 words)
A 46-year-old woman complains of weakness, fatigue, loss of appetite and weight loss, increase in thirst and increased urination. She also suffered occasional dizziness, particularly when standing. She has no prior medical history and is not taking any medication. On examination, supine blood pressure was normal, but a marked postural hypotension was noted on standing. Following some basic blood tests (see below), the GP makes a provisional diagnosis of Addison's Disease. Variable Urea (mm) Creatinine (mM) Glucose (mm) Na* (mm) K+ (MM) Cortisol (nM) ACTH (PM) Aldosterone (nM) Result 7.6 73 3.3 121 6.4 40 200 34 Reference Range 2.5-7.0 60-120 3.5-5.5 (fasting) 134-147 3.5-5.0 138 - 690 <26 90 - 200 The patient was referred by the GP for follow up tests with the endocrinologist. The tests included measurements of cortisol, ACTH and aldosterone levels (shown in the table) and a test for antibodies against 21-hydroxylase which was shown to be positive. a) Do you agree or disagree with the provisional diagnosis by the GP? Briefly explain your answer. (30 words)
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
Problem 1SRQ
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Transcribed Image Text:A 46-year-old woman complains of weakness, fatigue, loss of appetite and weight loss, increase in thirst and
increased urination. She also suffered occasional dizziness, particularly when standing. She has no prior medical
history and is not taking any medication. On examination, supine blood pressure was normal, but a marked postural
hypotension was noted on standing. Following some basic blood tests (see below), the GP makes a provisional
diagnosis of Addison's Disease.
Variable
Urea (mm)
Creatinine (mm)
Glucose (mm)
Na* (mm)
K+ (mm)
Cortisol (nM)
ACTH (pM)
Aldosterone (nM)
Result
7.6
73
3.3
121
6.4
40
200
34
Reference Range
2.5-7.0
60 - 120
3.5-5.5 (fasting)
134-147
3.5-5.0
138 - 690
<26
90 - 200
The patient was referred by the GP for follow up tests with the endocrinologist. The tests included measurements of
cortisol, ACTH and aldosterone levels (shown in the table) and a test for antibodies against 21-hydroxylase which was
shown to be positive.
a) Do you agree or disagree with the provisional diagnosis by the GP? Briefly explain your answer. (30
words)
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Explain why addisons disease leads to symptoms of orthostatic hypotension
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