Read the overview and complete the activities that follow. A 41-year-old African
ID: 149883 • Letter: R
Question
Read the overview and complete the activities that follow.
A 41-year-old African American male complaining of feeling sick over the past 3 months was seen by his physician. His main complaints were feeling very weak and having periodic bouts of dizziness. The patient was 6' 1" and weighed 155 pounds. He reported that he was not always this thin, and said that he lost over 20 pounds during the previous 3 months. His body temperature was 98.6 F. An examination of his oral cavity showed no redness or swelling, but his gums and oral mucosa were darker in color than normal (hyperpigmentation). His blood pressure when seated was 100 mmHg systolic pressure/70 mmHg diastolic pressure (normal 120/80 mmHg), but when the nurse tried to take a second reading while he was standing systolic pressure fell to 80 mmHg and diastolic pressure fell too low to be accurately determined. Blood was drawn, and the following results came back from the lab:
Serum [Na+] = 125 mEq/L (normal 135–148)
Serum [K+] = 6.5 mEq/L (normal 3.5–5.3)
Serum [Cl-] = 98 mEq/L (normal 96–100)
Serum [HCO3-] = 17 mEq/L (normal 20–26)
Serum [creatinine] = 1.5 mg/dL: (normal 0.7–1.4)
Serum pH = 7.31 (normal 7.35–7.45)
Serum [glucose] = 76 mg/dL (normal 80–110
________________
Which of the following is the most likely cause of the increased serum [K+] in this patient?
A- High aldosterone secretion
B- Low aldosterone secretion
C- Low sympathetic nervous system activity
D- Low cortisol secretion
E- Low thyroid hormone secretion
Explanation / Answer
It is the option D - LOW CORTISOL SECRETION is the most likely cause of the increased serum K+ in this patient
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