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Old 07-31-2011
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Default skin pigmentation

Your colleague reveals that she has become increasingly depressed over the past 3 months. She describes fatigue, loss of energy and loss of appetite. However, she also notes having increasingly hair loss in her pubic regions and that she has stopped having normal menstrual periods. You notice that there is bronze pigmentation of her skin and suggest that she may be experiencing an endocrine disorder. Which lab analysis below would be supportive of your presumptive diagnosis?
A. Na up, K up, CL down , Bicarbonate down
B. Na down, K up, CL up, Bicarbonate up
C. Na down, K up, CL down, bicarbonate down
D. Na down, K down, CL up, Bicarbonate down
E. Na normal, K down, Cl up, Bicarbonate up
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Old 07-31-2011
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Originally Posted by ricko335 View Post
Your colleague reveals that she has become increasingly depressed over the past 3 months. She describes fatigue, loss of energy and loss of appetite. However, she also notes having increasingly hair loss in her pubic regions and that she has stopped having normal menstrual periods. You notice that there is bronze pigmentation of her skin and suggest that she may be experiencing an endocrine disorder. Which lab analysis below would be supportive of your presumptive diagnosis?
A. Na up, K up, CL down , Bicarbonate down
B. Na down, K up, CL up, Bicarbonate up
C. Na down, K up, CL down, bicarbonate down
D. Na down, K down, CL up, Bicarbonate down
E. Na normal, K down, Cl up, Bicarbonate up
addison dis. ANS C
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Old 07-31-2011
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C. Na down, K up, CL down, bicarbonate down---> Addison's Disease
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Old 08-01-2011
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addisons - so c
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Correct Answer

The correct answer is C.
Primary adrenal insufficiency may manifest as vague depressive symptoms. However, bronze pigmentation of the skin is atypical for depression. Furthermore, losing pubic and underarm hair with menstrual disturbances is suggestive of an adrenal insufficiency. Hypochloremic metabolic acidosis is seen in adrenal insufficiency.
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Old 06-21-2012
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The correct answer is C.
The hypotension is due to hyponatremia (low sodium). If sodium is low, the potassium will be high (hyperkalemia). When there is a state of hyperkalemia, the body will send the potassium ions into the cell (from the blood) and send H+ ions outside of the cell, which causes the metabolic acidosis state. This suggests the bicarb is low.

Hope this makes sense!
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