Explain cortisol was tested at two different times

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Reference no: EM133264090

Assignment:

A 36-year-old man presented to his primary care physician complaining of muscle weakness, significant weight gain without noticeable dietary or lifestyle changes, and noted that he had begun to bruise easily. He told his PCP that he has seen these symptoms develop slowly over the years, but now he also notices that he gets sick more often. His medical history shows that he was stated as being prediabetic a year ago, while experiencing the aforementioned symptoms. His PCP suspects that there may be an endocrine cause for this disorder and refers this patient to his endocrinology clinic. His thyroid appears normal on the exam. Your physical exam of him shows.

Blood pressure is 160/80; the pulse is 98 bpm
Abdomen with pigmented striae (striae) and the abdomen protruded with thin arms and legs
Several bruises on the hip

You order blood tests and obtain the following results

Serum sodium: 145 mEq/L (normal 135-145 mEq/L)

Serum potassium: 3.1 mEq/L (normal: 3.5-4.5 mEq/L)

Glucose (without fasting: 162 mg/dL (normal 70-140 mg/l) dl)

Glucose (in fasting: 143 mg/dL (normal: 70-100 mg/dL)

Cortisol (fasting 10 AM): 29 ug/dl (normal: 5-25 ug/dL)

Cortisol (11 PM 28 ug/dL (normal: 3-12ug/dL)

PLEASE ANSWER ALL OF THE FOLLOWING QUESTIONS and EXPLAIN YOUR REASONING so I can follow your train of thought:

1) What is your suspected diagnosis and why? Explain in detail why you think this. is what is going on and behind his symptoms.

2) Based on what you know, what additional hormones, tests, scans, procedures would you like to try and why? Explain thoroughly why you want to test these?

3) Explain why cortisol was tested at two different times and the significance of the results received during these times?

4) Is this patient hypertensive? What other disorders is the patient at risk based on laboratory tests if he does not receive appropriate treatment?

5) How would you treat him? Include all treatment possibilities (both pharmaceutical and lifestyle changes) and include your resoning for each. Explain your reasoning behind your suggestions.

Reference no: EM133264090

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