History A 64-year-old man goes to his general practitioner (GP) because he has become increasingly overweight. He has gained 8 kg in weight over the past 6 months. He has noticed that he is constantly hungry. He has found that he is bruising easily. He finds it difficult to get up from his armchair or to climb stairs. He feels depressed and finds himself waking early in the mornings. He has had no previous physical or psychiatric illnesses. He is a retired miner and lives with his wife in a terraced house.
He smokes 30 cigarettes per day and drinks 15 units of alcohol per week. Examination He is overweight, particularly in the abdominal region. There are purple stretch marks on his abdomen and thighs. His skin is thin, and there are spontaneous bruises. His pulse is 76/min, regular, and blood pressure is 168/104 mmHg. There is peripheral edema. Otherwise, examination of his heart,…
