Male 40 y o comes to the office First scheduled the appointm

Male, 40 y o. comes to the office. First scheduled the appointment for a nasty cold\" which has since seemed to be resolving, but he kept the appointment anyway. He complains (aside from resolving cold sxs) of occasional headaches sometimes quite bad. He uses Motrin (600mgs) maybe 4 timesweek for these. He also has episodes of profuse sweating and anxiety, accompanied by pounding heart. He doesn\'t like the suggestion these are \"panic attacks he says his mom had those \"she was a real basket case-- we didn\'t get on on very wel\" Mom is deceased age 65. dlt stroke) occasionally he gets dizzy on standing rapidly. Sometimes constipation is a problem. Symptoms have been present as an adult-- more with age, had been attributed to stress at work, but wants another opinion. His work is described as \'stressful\" around the end of the quarter (he\'s an accountant) but \"not all that bad\" between-times. He works out (running and weights) 4week. Describes himself as pretty fit, and basically looks it. sleeps 5-8 hours/night. Sometimes better than others. No prescription drugs. Has \"a couple beer on the weekend, marijuana 1-2/year, denies other drug use. Says he avoids coffee, especially espresso \"makes me too jittery\" Physical Ht, 6\'0 wt. 160 BP 136 90 HR 74 \"Resp 20 Reflexes (patellar, achilles) strong. A slight tremor appears present in the arms when held out and still. No abdominal or neck masses on palpation. no abdominal tenderness. Heart sounds are normal. rythm regular, no murmur. Lungs- some wheeze on forced exhalation; al lobes seem clear, CBC shows Inc. RBCs, normal morphology and hemoglobin Normal WBC count, but with lymphocytosis Platelets unremarkable TSH is normal Blood calcium is elevated. Blood glucose is slightly elevated UA shows a trace of glucose in the urine

Solution

Answer: (Diagnosis related to the endocrine system)

An analysis of the symptoms above suggest insulin resistance or decreased secretion of insulin as the primary cause of the ailments. The symptoms and their relation to insulin have been stated below:

(1) Increased levels of glucose in blood due to stressful conditions can lead to a decrease in the amount of insulin necessary to maintain healthy blood glucose level.

(2) A common sypmtom of high blood glucose due to diabetes is headache.

(3) Dizziness and constipation are also common problems in diabetics.

(4) Lymphocytosis have been found in people with diabetes.

(5) Alterations of insulin levels increases calcium levels in the blood.