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)

Biomedical Instrumentation Systems

1st Edition

ISBN:9781133478294

Author:Chatterjee

Publisher:Chatterjee

Chapter19: Biomedical Laboratory Instrumentation

Section: Chapter Questions

Problem 1CS

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