Reference no: EM134036742

Question

Case Study:

A 45 year-old woman is evaluated for a 6-month history of weakness, menstrual irregularities, hirsutism, insomnia, and emotional liability. She also reports an 8.0kg (17.6lb) weight gain during this period. She was previously healthy. She takes no medications.

On physical examination, temp is 96.8, BP is 172/90, pulse is 78 and respiratory rate is 16. BMI is 32. The patient has a rounded, plethoric face with increased supraclavicular and dorsal fat pads. There are areas of unexplained ecchymoses over the upper and lower extremities. Abdominal examination reveals purple striae. She has proximal muscle weakness. Results of routine laboratory studies are normal except for a serum potassium of 3.4 mEq/L.

1. What is the relevant objective and subjective assessment data from the case study?

2. What does this data indicate? What conclusions can you make? Using Nieman (2018) "Recent updates on the diagnosis and management of Cushing's syndrome", what additional diagnostic testing is indicated? What is your preliminary diagnosis(es)?

3. What is the underlying pathophysiology that produce the clinical manifestations in this case study? You can use text, flowchart or outline to provide a detailed discussion. Please use your own words and do not "cut and paste" from a reference.

4. Based on the pathophysiology, what clinical course and complications could you anticipate?

5. What patient education and follow up is required for the case study patient?