Question Easy:
A 55-year-old woman presents with symptoms of fatigue, weight gain, and cold intolerance. On examination, she has dry skin and periorbital puffiness. Which of the following is the most likely diagnosis? 🔍
A) Graves’ disease
B) Addison’s disease
C) Hypothyroidism
D) Cushing’s syndrome
E) Hyperparathyroidism
Explanations & Answers:
Question Easy Answer: C) Hypothyroidism
Question Easy Explanation: The patient’s symptoms of fatigue, weight gain, cold intolerance, dry skin, and periorbital puffiness are indicative of hypothyroidism, a common endocrine disorder where the thyroid gland is underactive. According to NICE guidelines, clinical presentation and laboratory evaluation of thyroid function (elevated TSH, low free T4) confirm the diagnosis.
Question Medium:
A 30-year-old man presents to the clinic with recurrent headaches, sweating, and palpitations. His blood pressure is markedly elevated. Which investigation would most likely confirm the diagnosis of a pheochromocytoma? 🧐
A) MRI of the brain
B) 24-hour urinary catecholamines
C) Serum cortisol levels
D) Fasting blood glucose
E) Serum creatinine
Explanations & Answers:
Question Medium Answer: B) 24-hour urinary catecholamines
Question Medium Explanation: The paroxysmal symptoms of headaches, sweating, and palpitations along with hypertension suggest pheochromocytoma, a rare catecholamine-secreting tumor usually found in the adrenal gland. The NICE guidelines recommend measuring 24-hour urinary catecholamines and metanephrines for diagnosis.
Question Hard:
A 40-year-old woman has been experiencing difficulty walking, and her left eye appears to have a dropped eyelid (ptosis). She states that these symptoms worsen with activity and improve with rest. What is the most likely pathophysiological cause of her symptoms? 😓
A) Autoimmune destruction of nicotinic receptors
B) Cerebral demyelination
C) Excessive cholinergic activity
D) Dopamine deficiency
E) Autoimmune destruction of acetylcholine receptors
Explanations & Answers:
Question Hard Answer: E) Autoimmune destruction of acetylcholine receptors
Question Hard Explanation: This presentation is consistent with myasthenia gravis, an autoimmune neuromuscular disorder characterized by fluctuating muscle weakness, particularly after exertion. The condition is attributed to antibodies targeting acetylcholine receptors at the neuromuscular junction, leading to impaired synaptic transmission. NICE guidelines discuss the management of this condition with acetylcholinesterase inhibitors and immunosuppressive therapies.
Medical fact of the day: Did you know that the endocrine system and the neurological system are intricately linked through the hypothalamic-pituitary axis? This axis is vital for the regulation of hormones that control a variety of body functions, including stress response, growth, and reproduction. 🧠🔄🕹️
Quote of the day: “In the compassion we show to patients, we find courage for ourselves. Every day is a chance to learn, heal, and grow.” 🌟