Case 3 Oscar T. a 45-year-old male from the Midwest presented with the following symptoms during February: weakness, fat

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Case 3 Oscar T A 45 Year Old Male From The Midwest Presented With The Following Symptoms During February Weakness Fat 1 (93.97 KiB) Viewed 42 times

Case 3 Oscar T. a 45-year-old male from the Midwest presented with the following symptoms during February: weakness, fatigue, orthostatic hypotension, weight loss, dehydration, and decreased cold tolerance. His blood chemistry values follow: - Serum sodium 128mEq/L (normal = 135−146mEg/L ) - Serum potassium 6.3mEq/L (normal =3.5−5mEq/L ) - Fasting blood glucose 65mg/dL (normal =65−100mg/dL ) Hematology tests resulted in the following values: Hematocrit 50% (normal is 42-52\%); Leukocytes 5000/cumm (normal is 4300−10800/cumm ) Oscar also noticed increased pigmentation (tanning) of both exposed and nonexposed portions of the body and back. A plasma cortisol determination indicated a low cortisol level. Following administration of ACTH, plasma cortisol did not rise significantly after sixty and ninety minutes. Endogenous circulating levels of ACTH were later determined to be significantly elevated. 1. What is orthostatic hypotension? 2. What hormone from which organ is most likely involved with Oscar's serum electrolyte imbalance? 3. Is Oscar anemic? Which of the test results answers this question? 4. Does Oscar have an infection? Which of the test results answers this question? 5. Which hormone is most likely associated with the symptoms of weaknesss, fatigue, weight loss and decreased cold tolerance? 6a. What endocrine organ is the site of the malfunction? 6b. What hormones are normally secreted from this gland? 6c. Is more than one hormone deficient in Oscar? 7. How is it possible for Oscar's plasma glucose to be within the normal range? 7. What is the name of this disorder? 8. In a normal person, how would plasma cortisol levels be affected following administration of ACTH? What do Oscar's ACTH test results imply? 9. Is this a primary or secondary disturbance? Explain your answer. 10. Why is Oscar's endogenous circulating level of ACTH significantly elevated? 11a. What is the cause of Oscar's hyperpigmentation? 11b. How is hyperpigmentation related to his high levels of ACTH? 12. What type of replacement therapy would be required for Oscar? Will the