Pls help 1. Sandra is 50 years old. She has gained weight over the last year but
ID: 82023 • Letter: P
Question
Pls help 1.Sandra is 50 years old. She has gained weight over the last year but has felt too tired and weak to exercise. She takes no medicine, but has tried taking vitamins with no response. During a physical examination, her physician notes the following signs:
Rounded “moon-shaped” face
Obesity of the trunk
Slender limbs
Muscular weakness
Blood pressure: 140/95 (normal = 120/80)
On the basis of these signs, which of the following ONE disorders would you suspect AND WHY? RULE OUT the OTHER FOUR disorders by providing detailed anatomical & physiological descriptions, based on the clinical diagnostic data provided, along with specific clinical manifestations.
Addison’s disease
Cushing’s disease
Pheochromocytoma
Hypoaldosteronism
Hyperthyroidism
Diagnostic and laboratory tests are ordered, and an appointment with an endocrinologist is arranged. A few of the pertinent test results are listed below:
Plasma cortisol levels: 40 g/dL (taken at 7:00 am)
Plasma ACTH: 100 pg/mL (taken at 7:00 am)
X-ray of skull: erosion of the sella turcica (sphenoid bone)
MRI of pituitary gland: abnormal mass detected
What is the probable cause of Sandra’s disorder? WHY?
Explanation / Answer
Sandra’s probabily caused by the Cushing’s disease. Because as mentioned in the question Cushing’s disease symptoms are-Adipose tissues accumulates in the abdominal are'' Obesity of the trunk'','' Moon shaped'' face,slender limbs ,fat between the shoulders (buffalo hump),Pink or purple stretch marks ,Muscular weakness and endurance.
Over production of glucocorticoids by the adrenal cortex cause the above sypmtoms and cause the normal pattern of Fat tissues.
Diagnostic and laboratory tests shows that Plasma ACTH-100pg/ml (taken in morning)Normal range-20-80 pg/ml in morning and 10-40 pg/ml in afternoon and Plasma cortisol levels: 40 g/dL (taken at 7:00 am) Increased level occured in Cushing desease Normal range-5-23 microgram /dl
Oversecretion of ACTH at the anterior lobe of the pituitary gland (MRI of pituitary gland: abnormal mass detected) in Cushing's desease cause the pituitary adenoma (abnormal mass or benign tumor of glandular origin detected).
cushion's desease normally caused by the high levels of the hormone cortisol ,most common reason is overuse of corticosteroid medications such as prednisone.
other cause include-
complications are as follow-
Cushing's Disease Diagnosis by-
Cushing's Disease Treatment options include: