A 30-year-old male presents atier 24 hours of persistent vomiting, not keeping anything down. He is confused, looks sweaty and unwell. He denies any significant past medical history. Initial observations are as follows :

  • HR 120
  • BP 80/50
  • RR 24
  • Sats 99% on RA
  • T 37.2
Initial lab results:
  • Hb 158 g/L (110-165)
  • WCC 13.3 x109/L (3.5-11)
  • Plt 239 x109/L (140-400)
  • Na 130 mmol/L (135-145)
  • K 5.2 mmol/L (3.5-4.5)
  • Cl 101 mmol/L (100-110)
  • HC03 18 mmol/L (22-33)
  • Urea 10.7 mmol/L (3-8)
  • Creat 94 umol/L (50-100)
  • BSL 2.5 mmol/L

1. Give the most likely endocrine diagnosis and (3) salient lab findings which support this. 4 marks

2. List (4) differential diagnoses for this presentation 4 marks

3. State (4) priorities in your management of this patient. 4 marks

4. List (6) potential underlying causes for this condition in general. 6 marks