Malindi Boys High School has been closed indefinitely after some students allegedly attempted to set a classroom block on fire last Saturday. The fire was quickly extinguished after smoke was spotted coming from one corner of the building.
🚨🎙️ Sergio Agüero:
“People have no idea what it’s really like. In England, it feels like everyone journalists, TV channels, and fans supports Manchester United.”
“Everywhere I go, I seem to run into United supporters. It’s unbelievable!” 😅
[@sportbible]
Pelé (6) currently holds the record for the most assists in a single World Cup campaign.
After breaking the Premier League assists record, could Bruno Fernandes do it? 🤔
Watu wa tweeting for fun wamelipwa $8 I am hearing after all controversial tweets wapate engagements! Football twitter without blue badge we remain undefeated
Kuna wakati @TuvaJr alikuwa ame subscribe hio blue badge kila asubuhi nilikuwa nampata hapo Kwa Fabrizio ashaanza ukulima Kisha wakamlipa Mia mbili 😭😭😭
A 42-year-old man presents with progressive fatigue, weight loss (8 kg over 6 months), darkening of the skin, dizziness on standing & recurrent abdominal pain.
He reports craving salty foods. Examination reveals BP 88/56 mmHg lying and 70/40 mmHg standing, diffuse hyperpigmentation of the buccal mucosa and palmar creases, and generalized weakness.
Laboratory results:
Na⁺: 124 mmol/L
K⁺: 6.1 mmol/L
HCO₃⁻: 18 mmol/L
Glucose: 3.1 mmol/L
Hb: 11.2 g/dL
Eosinophils: 9%
Morning serum cortisol: 2 μg/dL (normal 10–20)
Plasma ACTH: markedly elevated
Questions✅
What is the most likely diagnosis?
Explain the pathophysiology behind:
-Hyperpigmentation
-Hyponatremia
-Hyperkalemia
What test would confirm the diagnosis?
List four causes of this condition.
How would you manage this patient acutely if he presented with shock?
What long-term hormone replacement therapy is required?
Let me know when you are done.