Name: Ashwin Algudkar

Theme: Adrenal

 

OPTION LIST

 

A

Addison’s Disease

I

Iatrogenic Addison’s Syndrome

B

Adrenal Adenoma

J

Iatrogenic Cushing’s Syndrome

C

Adrenal Carcinoma

K

Phaeochromocytoma

D

Carney’s Syndrome

L

Pseudo-Cushing’s Syndrome

E

Congenital Adrenal Hyperplasia

M

 

F

Conn’s Syndrome

N

 

G

Cushing’s Disease

O

 

H

Ectopic ACTH secretion

P

 

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. A 57 year old Type 1 diabetic woman presents with weight loss, weakness and depression. Examination reveals postural hypotension, hyperpigmentation in the palmar creases and widespread patchy vitiligo. Full blood count is unremarkable but U&Es reveal Na+ 130 mmol/l, K+ 6.0 mmol/l, Urea 7.4 mmol/l and Ca 2+ 2.70 mmol/l.

 

2. A 32 year old woman presents with a one year history of weight loss, fatigue and hirsutism. Examination reveals thin skin, easy bruising, purple abdominal striae and a supraclavicular fat pad. Plasma cortisol and ACTH levels are both raised but suppress after high dose dexamethasone suppression test.

 

3. A 64 year old man, who is known to suffer from ulcerative colitis, presents with a long history of weight gain, fatigue and depression. Examination reveals a moon-shaped face, centripetal obesity, thin skin and easy bruising. Serum cortisol levels are elevated and fail to suppress after low dose dexamethasone suppression test.

 

4. A 21 year old man presents with rapid palpitations associated with chest tightness, severe headache, tremor and sweating. History reveals that the man had just consumed a large amount of alcohol.

 

5. A 27 year old woman presents with a three month history of weight gain, deepening voice and secondary amenorrhoea. Examination reveals cliteromegaly, acne, greasy skin and hirsutism. Serum cortisol is grossly elevated and ACTH levels are undetectable.

 

 

 

ANSWERS

1. A

2. G

3. J

4. K

5. C