AKT-4768
A 50-year-old woman with type 2 diabetes mellitus presents with a sodium level of 127 mmol/l. She doesn’t smoke. Which medication is the most probable cause of this abnormality?
Archives: MRCGP AKT
AKT-4769
A 35-year-old woman with type 1 diabetes mellitus is being evaluated. Despite regularly missing her hospital diabetes appointments, her HbA1c control is currently within target. What is the recommended frequency for monitoring her HbA1c levels?
AKT-4770
A 57-year-old man comes in for his yearly diabetes check-up. He was diagnosed with type two diabetes 3 years ago and is currently taking metformin 500mg tds. He reports no adverse effects and is compliant with medication instructions. There is no notable medical history.
His latest HbA1c reading was 53 mmol/mol. You contemplate modifying his current medication.
What is the desired HbA1c level for this individual?
AKT-4765
A 50-year-old female presents with similar symptoms as the previous case, including irritability, tremors, unexplained weight loss, diarrhoea, palpitations and fatigue. On examination, her pulse rate is 120/min and regular. Her thyroid gland is also noted to be symmetrically enlarged but non-tender.
Blood tests reveal the following:
Thyroid stimulating hormone (TSH) 0.1 mU/L (0.5-5.5)
Free thyroxine (T4) 26 pmol/L (9.0 – 18)
TSH receptor antibodies (TRAb) 16 IU/L (<1.7)
What medication can be prescribed to manage the patient’s symptoms quickly while she awaits her appointment with the endocrinologist?
AKT-4779
The following blood result is reported for an 85-year-old woman with a medical history of hypertension, diverticulitis, and hypothyroidism. She is currently taking amlodipine, ramipril, and levothyroxine. The result shows a TSH level of 0.01 mU/L (0.5-5.5) and a free T4 level of 22 pmol/L (9.0 – 18). What potential complication could she face if this condition remains untreated?
AKT-4775
A 42-year-old man visits his doctor complaining of fatigue and feeling cold all the time. Upon conducting blood tests, the following results are obtained:
– Thyroid stimulating hormone (TSH) 9.8 mU/L (0.5-5.5)
– Free thyroxine (T4) 8.9 pmol/L (9.0 – 18)
– Anti-thyroid peroxidase antibodies (anti-TPO) 280 IU/ml (<100)
What other clinical symptom may be associated with his condition?
AKT-4783
A 54-year-old Muslim man with a history of type 2 diabetes seeks guidance on managing his diabetes medications during Ramadan. He is currently taking metformin 500mg three times a day. What advice should be given to him?
AKT-4781
A 29-year-old woman had presented with occasional palpitations, sweating and restlessness. An ECG had shown sinus tachycardia.
Her blood tests had showed:
Thyroid stimulating hormone (TSH) 0.2 mU/L (0.5-5.5)
Free thyroxine (T4) 23 pmol/L (9.0 – 18)
You had started her on a beta-blocker and referred her to secondary care for specialist treatment. However, the patient returns to you stating that her appointment is in 4 months’ time and she cannot carry on with her symptoms for that long.
What is the most appropriate course of action?
AKT-4776
A 75-year-old man visits your clinic with complaints of fatigue, excessive thirst, insomnia, muscle weakness, and constipation. Upon examination, his full blood count, renal function tests, and liver function tests are all normal. However, the following blood test results were obtained:
Calcium 3.4 mmol/L (2.1-2.6)
Phosphate 0.7 mmol/L (0.8-1.4)
Magnesium 0.9 mmol/L (0.7-1.0)
Thyroid-stimulating hormone (TSH) 3.8 mU/L (0.5-5.5)
Free thyroxine (T4) 11 pmol/L (9.0-18)
Parathyroid hormone (PTH) 60 pg/mL (14-65)
Vitamin D 180 ng/ml (≥30)
What is the probable diagnosis of this patient?
AKT-4780
A 44-year-old woman presented with complaints of constant fatigue and underwent a blood test. All results were within normal range except for her thyroid function test (TFT) which revealed:
TSH 12.5 mU/l
Free T4 7.5 pmol/l
What would be the most suitable course of action?