25th August 2020

A 47-year-old man is referred to an endocrinology clinic, by his GP

A 47-year-old man is referred to an endocrinology clinic, by his GP. He was diagnosed with hypertension by his GP around six months ago, and his blood pressure remains consistently high despite treatment with an ACE inhibitor, calcium channel blocker, and thiazide diuretic. He is fit and well but complains that he has put on a lot of weight recently, despite no change to his diet – and he thinks this is making his face “puffy”. He has also been having a lot of headaches, which his GP has attributed to his high blood pressure. When reaching out to shake hands, he is noted to have very large hands, out of keeping with the rest of his body habitus. 

For the case above, please select the SINGLE most likely cause of the condition described. Select ONE option from the list above.