TJ

Taxpayer | Shin city | @ManUtd

[TJ @TuvaJr]

Baleba Kazungu njoo OT tuandikishe historia pamoja mwenehu

[Mwakirunge Global @mwakirunge]

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.

[Bwogo🇰🇪 @1Clinton2]

Maths teachers realizing that cells multiply by dividing 💀😂

[TJ @TuvaJr]

@SimplyUtd @sportbible He knows we're big

[SimplyUtd @SimplyUtd]

🚨🎙️ 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]

[Football on TNT Sports @footballontnt]

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? 🤔

[Mwawasi 🏆 EPL CHAMPIONS @Mwawasi__]

Watu wa tweeting for fun wamelipwa $8 I am hearing after all controversial tweets wapate engagements! Football twitter without blue badge we remain undefeated

[ESPN UK @ESPNUK]

Kai Rooney putting in the work 💪👏

[TJ @TuvaJr]

In my prime I used to have early mornings and late nights at Elon's farm but sometimes hardwork doesn't pay

[TJ @TuvaJr]

@coolkid__8 We know you🤣🤣🤣

[TJ @TuvaJr]

@rigathi Nitolee upuzi kwa Tl yangu

[TJ @TuvaJr]

@Halimaprinces Hebu hiyo namba

[TJ @TuvaJr]

@Is_javan 😂😂😂

[JaVO😉🇩🇪🇲🇦 @Is_javan]

Mwawasi sai anatwiti kutumia lugha iliyokuja na meli

[TJ @TuvaJr]

@coolkid__8 Wewe kuliendaje😂😂

[TJ @TuvaJr]

@Mwawasi__ Naisha

[TJ @TuvaJr]

Mikoba niliachia @Mwawasi__ 😂😂

[Njuguna @coolkid__8]

Kuna wakati @TuvaJr alikuwa ame subscribe hio blue badge kila asubuhi nilikuwa nampata hapo Kwa Fabrizio ashaanza ukulima Kisha wakamlipa Mia mbili 😭😭😭

[TJ @TuvaJr]

Mikoba niliachia @Mwawasi__ 😂😂

[🗿 🇫🇷🇵🇹🇪🇸 @jhonte_]

friendly with my G bana nilikua naisha jana usiku😂😂😂

[Dr Gacikira 🕹️ @gacikiraMD]

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.

[TJ @TuvaJr]

We all gonna win