Question Easy:
A 45-year-old man presents with fatigue, weight gain, and cold intolerance. On physical examination, he has dry skin and generalized edema. Which of the following is the most likely diagnosis? 🩺
A) Hyperthyroidism
B) Hypothyroidism
C) Addison’s disease
D) Cushing’s syndrome
E) Pheochromocytoma
Question Medium:
A 60-year-old woman with a 30-year history of hypertension presents with a severe headache, sweating, and palpitations. Her blood pressure is 210/120 mmHg. Which hormonal condition is most likely responsible for her symptoms? 🚨
A) Hyperaldosteronism
B) Thyroid storm
C) Pheochromocytoma
D) Primary hyperparathyroidism
E) Acromegaly
Question Hard:
A 34-year-old woman presents with episodes of flushing, diarrhea, and wheezing. She also reports a long-standing history of asthmatic symptoms. Lab results show increased levels of 5-hydroxyindoleacetic acid (5-HIAA) in the urine. What is the most likely diagnosis? 🔍
A) Carcinoid syndrome
B) Zollinger-Ellison syndrome
C) Cushing’s syndrome
D) ACTH-secreting pituitary adenoma
E) MEN type 1
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: The symptoms described – fatigue, weight gain, cold intolerance, dry skin, and edema – are classic signs of hypothyroidism. According to NICE guidelines, hypothyroidism is confirmed through elevated TSH and low free T4 levels. It’s a common endocrine disorder, easy to overlook due to its wide range of non-specific symptoms.
Question Medium Answer: C
Question Medium Explanation: The combination of paroxysms of severe hypertension, headache, sweating, and palpitations strongly suggests a pheochromocytoma, a catecholamine-secreting tumour of the adrenal glands. According to BNF guidelines, it presents with episodic symptoms due to excess adrenaline. Early diagnosis and management are crucial to prevent hypertensive crises.
Question Hard Answer: A
Question Hard Explanation: Carcinoid syndrome results from the extra release of serotonin from a neuroendocrine tumour, leading to symptoms like flushing, diarrhea, and bronchospasm. The elevated 5-HIAA in the urine is a classic marker and aligns with NICE’s diagnostic approach for this condition.
Medical fact of the day: Cushing’s syndrome often requires a detailed diagnostic pathway including overnight dexamethasone suppression testing, as recommended by UK guidelines, to differentiate it from similar conditions like obesity or depression.
Quote of the day: “In the tapestry of life, healers are the weavers who mend the broken threads, creating patterns of hope and renewed strength.”