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 Best of Five 101

 

   

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BOF: 101

A 75-year-old male presents with lethargy and dizziness on standing. He gives a history of having had treatment for tuberculosis when he was young.

On examination he looks underweight, his skin is pigmented and there is pigmentation of his buccal mucosa and pigmentation of the palmar creases. His nipples and areola are pigmented. There is no vitiligo. His blood pressure is 120/70 lying down and 90/60 on standing.

His blood urea 10.3 mmol/L, Na 120 mmol/L, K 5.9 mmol/L

Which of the following investigations is most likely to identify the aetiology of his condition?

a)      0900 ACTH level

b)      Short synacthen test

c)      Abdominal X-ray

d)      Long ACTH stimulation test

e)      Serum aldosterone /plasma renin activity

 

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