05-13-2007, 04:39 PM
A 44-year-old, female, presents to fast track complaining of a headache. She states that she has not been feeling well for the past four months, with increased fatigue. She has also noted weight gain, and states she has recently noted stretch marks on her abdomen, similar to when she was pregnant. She states, however, that she could not be pregnant since she has had a hysterectomy.
Physical exam reveals an obese woman, who appears older than her stated age.
Vital signs reveal: BP 160/90; pulse 90; respiration 13; Temp 37.8° C (100.4° F).
HEENT exam reveals PERRLA and normal oral mucosa.
Neck is supple, however, it is very thick and full, especially along her back and upper shoulders.
Lungs are clear. Cardiac exam is unremarkable.
Abdomen is obese with several large purple stria. Extremities show multiple bruises.
Neurologic exam is normal.
Laboratory studies reveal: Chem 7: Na 149; K 3.6; Cl 108; HCO3 28; Glucose 210.
The most likely cause of this patient's constellation of symptoms is
|||||||||
A
Nelson's syndrome
|||||||||
B
Nephrotic syndrome
|||||||||
C
Fanconi's syndrome
|||||||||
D
Cushing's syndrome
|||||||||
E
Addison's disease
Physical exam reveals an obese woman, who appears older than her stated age.
Vital signs reveal: BP 160/90; pulse 90; respiration 13; Temp 37.8° C (100.4° F).
HEENT exam reveals PERRLA and normal oral mucosa.
Neck is supple, however, it is very thick and full, especially along her back and upper shoulders.
Lungs are clear. Cardiac exam is unremarkable.
Abdomen is obese with several large purple stria. Extremities show multiple bruises.
Neurologic exam is normal.
Laboratory studies reveal: Chem 7: Na 149; K 3.6; Cl 108; HCO3 28; Glucose 210.
The most likely cause of this patient's constellation of symptoms is
|||||||||
A
Nelson's syndrome
|||||||||
B
Nephrotic syndrome
|||||||||
C
Fanconi's syndrome
|||||||||
D
Cushing's syndrome
|||||||||
E
Addison's disease