BOF: 86
A 56 year old male is admitted to the
emergency ward in a collapsed state. He had a febrile illness a few days prior
to admission. There was a history of meningitis 2 years prior to this
admission and since then he has felt generally unwell, tired and listless and
has had loss of libido. His GP practitioner had put this down to depression
and treated him with an antidepressant.
On examination he looked pale, his
skin was hairless his BP 70/50. Heart sounds were normal, lungs were clear
abdomen was normal on examination and there were no neurological
abnormalities.
Investigations
Hb11g/dL
WBC 6.5 x109/L
Platelets 160 x109/L
Urea 4 mmol/L
Sodium 131 mmol/L
Potassium 3.9 mmol/L
Glucose 3.8 mmol/L
TSH 0.2mU/L
In this patient which one of the
following would be your first line of management?
a)
Intravenous ACTH
b)
Intravenous hydrocortisone
c)
Intravenous TSH
d)
Intravenous glucose
e)
Recombinant human growth hormone
