Question

Part II - Mary Smith Carefully inspect the test results below and use the information togel the patient and answer the following questions Smith, M. Lab Red - Dr. Gupta, M.D. ofmation together with you learned from Part I to diagnose Test Random bloed ( md) Fasting blood sugar (mg/dl) GIT glucose a 2 h Fasting morning cortisol (ug/dl) DEX challenge cortisol (ed) DEX challenge ACTH (pg/ml) Result 155 110 180 28 Normal Range - 140 75-105 <200 5-23 100 6 Hemoglobin Alc peptide (ng/ml) Antibodies instances Testosterone ( dl) Non-ovulatory estrogen (pg/ml) Urinary glucose (und 1.3 normal 90 45 15 175 104 10 65 0.5 to 2 normal 15-75 40-50 0-15 0-180 .6-12 8 T4 (ug/dl) DEX Challenge: Mary was given 1 mg of DEX at 11 PM and then a blood sample was collected at 8 AM for analysis of cortisol and ACTH. MR Results: Mary's brain MRI was clear but the MRI of her body showed lumps in her peritoneal cavity. Questions 5. What would you expect DEX to do to Mary's ACTH and cortisol levels Decrease them. 6. Compare the results of Mary's DEX challenge to her baseline hormone values. What do Mary's baseline post. DEX levels tell you about her HPA axis? Time Cortisol Level (ug/dD ACTH (pg/ml) Fasting morning 28 - 9-hr post DEX 27 100 7. What diagnosis do the baseline and post-DEX results suggest? 8. What are the results of Mary's MRI scan? What does this tell you about Mary's HPA axis? 9. What is your specific diagnosis for Mary? Which data support this? 10. What treatment would you recommend for this patient? "Living the Sweet Life" by Breanna N. Harris

questions 5-10

Answer 1

Yes Dex reduces the level of ACTH and cortisol.... dexamethasone reduces the ACTH from the pituitary gland which in turn reduces cortisol production from adrenal gland...