Luis is a 48-year-old employee of a local moving company. Over the…

Question Answered step-by-step Luis is a 48-year-old employee of a local moving company. Over the… Luis is a 48-year-old employee of a local moving company. Over the past 2 years, he had gained 30 pounds, mostly around his “middle,” face, and shoulders, although his arms and legs had become very thin. Besides, he had purple stretch marks on his abdomen. His appetite had always been good, but in the past 2 years, it had become enormous! He made an appointment to see his physician because he was having trouble doing the heavy lifting that is required in his job. In the physician’s office, Luis’s blood pressure was significantly elevated at 165/105. He had centripetal (truncal) obesity with thin extremities, a buffalo hump (interscapular fat accumulation), a “moon” face, and purple stretch marks (striae) on his abdomen. Laboratory results were obtained in the fasting state.Serum Na+ 140 mEq/L (normal, 140 mEq/L)Serum K+ 3.0 mEq/L (normal, 4.5 mEq/L)Fasting glucose 155 mg/dL (normal, 70-110 mg/dL)Serum cortisol IncreasedSerum ACTH UndetectableACTH, adrenocorticotropic hormone QUESTIONS: 6Luis had Cushing’s syndrome. He had an adrenal adenoma that secreted large amounts of adrenocortical hormones, primarily cortisol and aldosterone. The increased levels of cortisol were responsible for Luis centripetal obesity, buffalo hump, muscle wasting, striae, and hyperglycemia (increased blood glucose concentration). How is each of these abnormalities caused by increased circulating levels of cortisol?Why was Luis’s serum adrenocorticotropic hormone (ACTH) level so low? Which etiologies of hypercortisolism were ruled out by his decreased serum ACTH level?How would a healthy person respond to a low-dose dexamethasone test? Was Luis’s response normal? If not, why not?Why was Luis arterial pressure increased?Why was Luis’s serum K+ concentration decreased? Health Science Science Nursing Share QuestionEmailCopy link Comments (0)

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