A 32-year-old woman comes to the physician because of a 2-month history of fatigue, muscle weakness, paresthesias, headache, and palpitations. Her pulse is 75/min and blood pressure is 152/94 mm Hg. Physical examination shows no abnormalities. Serum studies show: Sodium 144 mEq/L Potassium 2.9 mEq/L Bicarbonate 31 mEq/L Creatinine 0.7 mg/dL Further evaluation shows low serum renin activity. Which of the following is the most likely diagnosis?
AAldosteronoma
BCushing syndrome
CRenal artery stenosis
DPheochromocytoma
ELaxative abuse
A 45-year-old woman comes to the physician because of fatigue, irregular menses, and recurrent respiratory infections for the past 6 months. Her blood pressure is 151/82 mm Hg. Physical examination shows a round face, thinning of the skin, and multiple bruises on her arms. Further studies confirm the diagnosis of an ACTH-secreting pituitary adenoma. This patient is at greatest risk for which of the following?
AWeight loss
BEosinophilia
CBitemporal hemianopsia
DHypoglycemia
EPathologic fracture
A 69-year-old woman is brought to the emergency department because of fatigue and lethargy for 5 days. She has also had weakness and nausea for the last 3 days. She has sarcoidosis, major depressive disorder, and hypertension. She had a stroke 5 years ago. Current medications include aspirin, nifedipine, prednisolone, fluoxetine, and rosuvastatin, but she has not taken any of her medications for 7 days due to international travel. Her temperature is 36.1°C (96.9°F), pulse is 95/min, and blood pressure is 85/65 mm Hg. She is lethargic but oriented. Examination shows no other abnormalities. Her hemoglobin concentration is 13.4 g/dL and leukocyte count is 9,600/mm3. Both serum cortisol and ACTH levels are decreased. This patient is most likely to have which of the following additional laboratory abnormalities?
AHyperglycemia
BHyperkalemia
CHyponatremia
DHypokalemia
ENormal anion gap metabolic acidosis
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