system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 40-year-old woman comes to the physician for the evaluation of fatigue, poor appetite, and an unintentional 10-kg (22-lb) weight loss over the past 6 months. The patient also reports several episodes of nausea and two episodes of non-bloody vomiting. There is no personal or family history of serious illness. Menses occur at regular 27-day intervals and last 6 days. Her last menstrual period was 3 weeks ago. She is sexually active with her husband, but states that she has lost desire in sexual intercourse lately. Her temperature is 37°C (98.6°F), pulse is 100/min, and blood pressure is 96/70 mm Hg. Physical examination shows no abnormalities. Laboratory studies show:
Hemoglobin 13.5 g/dL
Leukocyte count 7,000/mm3
Serum
Na+ 128 mEq/L
Cl- 96 mEq/L
K+ 5.8 mEq/L
HCO3- 23 mEq/L
Glucose 70 mg/dL
AM Cortisol 2 μg/dL
Which of the following is the most appropriate next step in management?"
assistant
Cosyntropin administration
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