A 25-year-old female patient comes to the clinic complaining of amenorrhoea. Upon conducting blood tests, the following results were obtained:
Prolactin 320 IU/L (<230) Oestrogen 900 pmol/L (100-400 follicular phase) LH <1 IU/L - FSH 2 IU/L – Based on these findings, what is the most probable diagnosis?
A 16-year-old girl presents to the clinic with complaints of agitation and weight gain. She is accompanied by her mother who reports that her daughter has been increasingly agitated with poor sleep over the last two months. Although her progress at school has been fine up until recently, she has become apathetic. The patient has no significant medical history. On examination, her blood pressure is 112/70 mmHg and her BMI is 20. The GP’s letter reveals the following results: TSH 3.2 mU/L (0.4-5.0), Total T4 250 nmol/L (55-144), Free T4 12.9 pmol/L (10-22), Total T3 3.2 nmol/L (0.9-2.8), Free T3 3.8 pmol/L (5-10). What is the likely diagnosis?
A 54-year-old man with type 1 diabetes presents to the hospital with a day of vomiting and diarrhea. He experienced indigestion earlier in the day, which he treated with antacids, but the burning pain in his chest and throat persisted for four hours. Despite several insulin boluses, his blood glucose continued to rise. He denies any missed doses of insulin, changes in exercise, or skipped meals. He smokes 20 cigarettes a day and manages his diabetes with a basal bolus regimen and correction doses based on carbohydrate counting.
During the examination, the patient appears sweaty with dry mucosa. His heart rate is 125/min, respiratory rate is 28/min with prolonged expiration phases, blood pressure is 110/90 mmHg, and temperature is 37ºC. The nurse measures his blood glucose, which is 27 mmol/l, and his blood ketones, which are 4 mmol/l.
Lab results show Hb 130 g/l, Na+ 133 mmol/l, Platelets 356 * 109/l, K+ 4.5 mmol/l, WBC 9.8 * 109/l, Neuts 7.5 * 109/l, Lymphs 1.0 * 109/l, Eosin 0.1 * 109/l, Urea 6.2 mmol/l, Creatinine 98 µmol/l, CRP 34 mg/l, and HbA1c 48 mmol/mol (normal range <42). The ECG shows deep T-wave inversion in V1-V4, and the chest x-ray shows no acute abnormalities. What is the most likely cause of this patient’s presentation?
A 67-year-old man presents to the emergency department with sudden onset epigastric pain that radiates to his back and has been unremitting for the past day. He has also been experiencing headaches, low mood, and nocturia for several months. He appears unwell on examination with dry mucous membranes and tachycardia. Urinalysis shows glucose, protein, and ketones. His blood work reveals elevated glucose, creatinine, and low bicarbonate and albumin levels. Which diagnostic test would be most helpful in determining his diagnosis?
A 42-year-old woman complains of decreased sexual desire, dryness in her vagina, and absence of menstruation for the past 6 months. Recently, she has noticed milk leakage from her breasts with minimal nipple stimulation. She has a history of taking birth control pills. Her prolactin level is 4800 micro IU/L, and she insists that she cannot be pregnant as she has taken a home pregnancy test, which came back negative. Her blood pressure is 130/70 mmHg, pulse is 72/min and regular, and her BMI is 24. Which test is most likely to provide a diagnosis?
A 35-year-old married man presents to the Endocrine Clinic with recent symptoms of sweating, weight loss and palpitations. He tells you that his father has a history of thyroid disease.
On examination, he has a BMI of 22, there is no palpable goitre and a tremor is noted.
Investigations:
Haemoglobin (Hb) 128 g/l 135 – 175 g/l
White cell count (WCC) 7.2 × 109/l 4.0 – 11.0 × 109/l
Platelets (PLT) 250 × 109/l 150 – 400 × 109/l
Sodium (Na+) 142 mmol/l 135 – 145 mmol/l
Potassium (K+) 4.0 mmol/l 3.5 – 5.0 mmol/l
Creatinine (Cr) 80 μmol/l 50 – 120 μmol/l
Glucose 6.2 mmol/l 3.9 – 7.1 mmol/l
Thyroid-stimulating hormone (TSH) < 0.05 mu/l 0.5 - 4.0 mu/l
Free Thyroxine (FT4) 32.1 pmol/l 10 – 22 pmol/l
Thyroid scintography revealed decreased uptake
Which of the following is the most appropriate next investigation?
A 31-year-old woman has been diagnosed with a phaeochromocytoma by her general physicians and is now seeing you for a specialist endocrinology appointment. She is currently taking phenoxybenzamine for adrenergic blockade and awaiting surgery. During her visit, her doctors express concern over her elevated calcium levels, which are at 2.75 mmol/l. Upon examination, you detect a hard mass on the right side of her thyroid and her blood pressure is elevated at 148/88 mmHg. What is the most crucial test for confirming her diagnosis?
A 60-year-old man presents to clinic with complaints of tiredness, weakness, and loss of body hair. He recently went through a divorce and attributes the loss of sexual function as one reason for the split. He has a history of mild essential hypertension and takes amlodipine. On examination, his pulse is 90 bpm and BP is 100/50 mmHg. He has normal secondary sexual characteristics, but his body hair is fine and sparse. Additionally, he has bitemporal hemianopia. Routine bloods show mildly elevated potassium of 5.5 mmol/l, and TSH is within the normal range. What would be the most useful test from those listed?
A 48-year-old female patient presents with the following thyroid function test results:
TSH <0.03 IU/L (0.5-4.5)
fT4 18.8 pmol/L (12.0-16.0)
fT3 6.2 pmol/L (3.5-5.0)
What is the probable diagnosis for this patient?
A 50-year-old man presents to his GP with a persistent cough and shortness of breath for the past 2 weeks. He is a smoker of 15 cigarettes per day for the past 30 years. The GP initially diagnosed a mild viral chest infection but the patient returned 2 weeks later with symptoms of thirst, polyuria, and muscle weakness. His blood pressure was elevated and ankle oedema was present. Blood tests revealed hyperglycaemia and abnormal electrolyte levels. What is the most probable diagnosis?