A 45-year-old man with recent history of bizarre behavior is seen by a psychiatrist. On physical examination, the patient appears moderately obese with mild hypeension, facial acne, fat accumulation in the supraclavicular fossae. Laboratory studies demonstrate a neutrophilic leukocytosis, with a decrease lymphocytes and absence of eosinophils. There is a mild hypokalemia and mild metabolic alkalosis. The fasting serum glucose is within the reference range, but OGTT had glucose concentrations > 200 mg/dL. Laboratory studies show free urinary coisol of 156 mg/ 24 hours .Which of the following questions would be of most help in establishing a diagnosis?
- Given clinical features suggests the diagnosis of cushing syndrome - Most common cause of Cushing syndrome is chronic administration of coicosteroids in treatment of immunologic & inflammatory disorders. - Hence, asking the question given in option 3 helps in establishing diagnosis. - Muscle weakness (choice A) is a feature of Cushing syndrome but is nonspecific.
Adrenal Gland
Are you experiencing muscle weakness?
Are you experiencing shoness of breath?
Are you receiving coicosteroids for some other disease?
Do you have a family history of endocrine neoplasia?
Are you receiving coicosteroids for some other disease?