MODULE 20

CASE- BASED
LEARNING
EXERCISES
ALESTE, JANUS RAY AGUSTIN
CASE 1
52 year old male
Severe weakness and pallor
BP was palpatory at 80 mmHg
Drowsy
Sought for about two days with no associated
fever.
Medication history: Prednisone 5 mg per day.
Crackles on the right mid lung zone and the
palpatory BP.
1. Based on the meager information
available at this time, what is your
working diagnosis? Explain
Adrenal Insufficiency
Cortisol and
Secondary to Chronic Aldosterone
Corticosteroid Use.

Mineralocorticoid
Sodium conservation
Potassium secretion
Water retention
References:
1. Berne, Robert M.,, Koeppen, Bruce M.Stanton, Bruce, A. (Eds.)
(2008) Berne & Levy physiology.Philadelphia : Mosby/Elsevier
2. Addison, T. On the Constitutional and Local Effects of Disease of the
Supra-Renal Capsules (1855) 1980Birmingham, AL: Classics of
Medicine Library
3. Laureti S., Vecchi, L., Santeusanio, F., Falorni, A. Is the prevalence of
Addison's disease underestimated? JCEM 1999; 84: 1762
4. Becker, K.L., Bilezikian, J.P., Bremmer, W.J., et al. Principles and
Practice of Endocrinology and Metabolism. Philadelphia: Lippincott
Williams and Wilkins; 2002. CD-ROM.