Tony Robinson is a 42 year old sales executive who presented himself to the GP with the following symptoms:
Decreased cold tolerance
Increased pigmentation of both exposed and non-exposed portions of the body
The GP referred Tony to the Endocrine Unit at Hope Hospital, Salford where he underwent further analysis. His Clinical Biochemistry results were as follows:
Analyte Patient Result Reference Range
Plasma sodium 128 mmol/l 135-142 mmol/l
Plasma potassium 6.3 mmol/l 3.5-5.3 mmol/l
Blood glucose 5.2 mmol/l 5.0-6.0 mmol/l
Plasma cortisol 172 nmol/l 250-650 nmol/l
Plasma ACTH 120 ng/l 10-50 ng/l
1.For each of the analytes in Table 1, briefly comment on Tony Robinson’s biochemistry results. (15%)
2.Provide a diagram of the hypothalamic-pituitary-end organ axis associated with the production of cortisol and describe the regulation of that axis. (20%)
3.Identify the range of hormones synthesised by the adrenal glands and compile a table detailing individual hormones and their function in the body. (25%)
4.Explain how the loss of adrenal function could be the cause of Tony’s hyponatraemia and hyperkalaemia. (35%)
5.What could be the diagnosis for Tony’s condition ? (5%)
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