A female presents with anorexia, weight loss, hyperpigmentation, bowel changes, and light headedness on standing. The cosyntropin stimulation test shows random serum coisol of 11 mcg/dL (normal is greater than or equal to 20 mcg/dL). Serum coisol 1 hour after 0.25 mg cosyntropin N is 14 mcg/dL. (The rise in coisol is expected to be > 7 mcg/dL). Aldosterone level is 10 ng/dL. Which of the following is an appropriate treatment for this patient?
Whenever in endocrine question if Hyperpigmentation is mentioned: ADDISON'S disease * Coisol levels are || in patients * Cosyntropin test is not proper as in Normal post Cosyntropin test the rise of coisol levels should be >7meq/dl but here in the question its from (11 to 14meq/dl only) Therefore, here the adrenal gland fails to respond as it may be damaged d/t TB Diagnosis: 1deg ADDISON's disease For Addison disease (DOC): HYDROCOISONE Medically manage the patient by maintaining the BP so given.
Hydrocoisone 15 mg daily for life
Prednisone 5 mg daily for life
Hydrocoisone 15 mg and fludrocoisone 0.1 mg daily for life
Prednisone 60 mg daily tapering to 10 mg a day and fludrocoisone 0.1 daily mg for life
Endocrinology