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Postgraduate Medical Journal 2005;81:138; doi:10.1136/pgmj.2004.021485
© 2005 BMJ Publishing Group Ltd and The Fellowship of Postgraduate Medicine.
Postgraduate Medical Journal 2005;81:138
© 2005 Fellowship of Postgraduate Medicine

SELF ASSESSMENT QUESTIONS

Endocrinology

A tale of three tumours

S Bhaskaran, A G Unnikrishnan, H Kumar, V Nair, R V Jayakumar

Department of Endocrinology and Diabetes, Amrita Institute of Medical Sciences, Cochin, Kerala, India

Correspondence to:
Correspondence to:
Dr A G Unnikrishnan
Department of Endocrinology, Amrita Institute of Medical Sciences, Cochin 682026, Kerala, India; unnikrishnanag@aimshospital.org

Submitted 1 March 2004

Accepted 24 March 2004


Answers on 140.

The first 150 words of the full text of this article appear below.

A 42 year old man presented with a three month history of diabetes and hypertension. Over the past six months, he had a backache and increased skin pigmentation. On examination, there was increased pigmentation of the face, neck, and hands. The rest of the physical examination was normal, except for proximal muscle weakness of the lower limbs. The 24 hour urinary free cortisol was 4533 nmol (normal range 99–378 nmol/day). Serum cortisol concentration after a 1 mg dexamethasone suppression test was 618 nmol/l. After a high dose dexamethasone suppression test, the serum cortisol was 556 nmol/l. The rest of the pituitary functions were normal. The midnight cortisol concentration was 737 nmol/l and a concomitant ACTH measurement was 32.5 pmol/l. Serum potassium was 1.7 mmol/l; otherwise electrolytes and renal function tests were normal. Magnetic resonance imaging of the pituitary was carried out and computed tomograms of the chest and the . . . [Full text of this article]


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A tale of three tumours
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