5th April 2024

A 52-year-old baker is referred to the Endocrine clinic by his GP after the results of his blood and urine tests:

A 52-year-old baker is referred to the Endocrine clinic by his GP after the results of his blood and urine tests: 

His past medical history includes hypertension, type two diabetes, depression, neuropathic pain, trigeminal neuralgia and epilepsy. His current medications include amitriptyline 10mg ON, duloxetine 60 mg OD, amlodipine 5mg OD, carbamazepine 100mg BD, metformin 500mg BD and lamotrigine 100mg BD. He smokes 20 cigarettes a day and drinks 20 units of alcohol per week. 

On examination, his blood pressure is 125/82 mmHg, heart rate 65 beats per minute, oxygen saturation 97% on room air, respiratory rate 15 breaths per minute and temperature is 37.1 degrees Celsius. Physical examination reveals non pitting pedal oedema but is otherwise unremarkable with an euvolemic fluid status. His thyroid function and 9 am cortisol results are normal. 

Which of the following is not responsible for this gentleman’s blood and urine results? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.