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Old 01-22-2012
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Question A PPD Positive Immigrant with Abdominal Pain

A 55-year old woman comes to the physician because of weakness, fatigue, abdominal pain and nausea.She recently immigrated to the United States. Her blood pressure is 70/55 mm Hg while sitting and 55/45 mm Hg while standing. A PPD test is positive. Which of the following additional findings is most likely in this patient?

A. Hypernatremia
B. Increased daily excretion of 17-hydroxysteroids
C. Increased daily excreition of 17-ketosteroids
D. Increased skin pigmentation
E. Increased volume of extracellular fluid
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Old 01-22-2012
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ANs .. D ...Addisons disease due to TB .......
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Old 01-22-2012
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Tuberculosis is the most common cause of adrenal deficiency in the developing countries..

in USA its auto immune..
so agree with HITMANS answer of D due to increased ACTH which has BETA MSH activity and hence causes increased pigmentation
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Old 01-22-2012
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Increased skin pigmentation
Adrenal glands affected by Tb
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Old 01-22-2012
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it is d
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Old 01-22-2012
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D is rite....
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Old 01-23-2012
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d addison due to TB
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Old 01-23-2012
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Addisons disease - hyperpigmentation..
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Old 01-23-2012
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its D...increased skin pigmentation...
coz of correlation btw Addison disease and TB.
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Old 01-23-2012
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D, but is immigration and positive ppd enough for TB dx?
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