Question

A 42-year old woman presents with weight loss associated with nausea and anorexia. She is unable to complete her housework because of progressive fatigue, and had an episode of severe dizziness on arising after weeding her flower beds. On physical examination she appeared thin. Her supine blood pressure was 110/70 mmHg, dropping to 90/60 sitting, and 80/55 standing. Her pulse rate was 100 beats/min. She appeared tanned, although it was January and she had not recently been on any vacations to a sunny destination.

1. What is the most likely explanation of the patient’s symptoms? [1 mark]
2. What laboratory tests would you perform to help support your diagnosis, and what values would you expect? [4 marks]
3. What is the cause of the patient’s skin pigmentation? [1mark]

Answer 1

1. A fall in blood pressure along with a decrease in glucose and Sodium ions may be the reason behind fatigue and dizziness

2. a. Measurements of blood pressure (100/70)

b. Measurement of serum sodium and potassium (80-100 mEq/l and 2 mEq/l)

c. Measurement of blood glucose (40-60 mg/dl)

3. The skin pigmentation could be sign of poor blood circulation due to which poor oxygenation of tissues/skin took place and appeared to be pale and pigmented.