A 48-year-old woman who was diagnosed with primary atrophic hypothyroidism 6 months ago has undergone recent thyroid function tests (TFTs):
TSH 10.8 mU/l
Free T4 15 pmol/l
She is currently prescribed 50mcg of levothyroxine daily. What is the interpretation of these results?
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?
A 45-year-old woman presents for a routine blood pressure check. During a recent blood test, she was found to have a blood pressure of 160/80 mmHg and her home blood pressure diary shows similar results. She has no significant medical history and is not taking any medications. Her BMI is 24kg/m2. Her blood results are as follows: Na+ 139 mmol/L (135 – 145), K+ 3.2 mmol/L (3.5 – 5.0), Urea 5.0 mmol/L (2.0 – 7.0), Creatinine 61 µmol/L (55 – 120), and TSH 1.2 mU/L (0.5-5.5). What investigation would be most appropriate to request?
A 50-year-old man with type 2 diabetes is brought to the clinic by his spouse for exhibiting strange behavior and acute confusion during questioning. He was recently initiated on insulin therapy for his diabetes. Upon assessment, the following vital signs were obtained:
– Blood pressure: 145/87 mmHg
– Heart rate: 110 beats per minute
– Temperature: 37.2ºC
– Oxygen saturation: 99% on room air
– Respiratory rate: 18 breaths per minute
– Capillary blood sugar level: 2.1 mmol/L
What is the most appropriate course of action for managing this patient?
A 50-year-old female comes to her doctor with a complaint of feeling tired for the past two months. Upon conducting blood tests, the following results were obtained:
Na+ 128 mmol/l
K+ 5.6 mmol/l
Urea 5.3 mmol/l
Creatinine 99 µmol/l
Total T4 66 nmol/l (70 – 140 nmol/l)
Which diagnostic test is most likely to reveal the underlying condition?
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?
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?
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?
A 25-year-old female patient complains of tremors and excessive sweating. Upon conducting thyroid function tests, the results are as follows:
TSH <0.05 mU/l
Free T4 25 pmol/l
What is the leading cause of this clinical presentation?
A 65-year-old man with a history of myocardial infarction, congestive heart failure, and chronic obstructive pulmonary disease presents for a diabetes check-up at his GP’s office. He has been diagnosed with type 2 diabetes mellitus and his HbA1c remains high at 56 mmol/mol despite attempts to modify his lifestyle. The GP decides to initiate drug therapy.
Which of the following medications would be inappropriate for this patient?