A 43-year-old male patient, who is a heavy drinker, has been admitted to the hospital due to a variceal bleed. The patient requires a blood transfusion as his blood is clotting very slowly. It is suspected that his excessive alcohol consumption is hindering the liver’s ability to recycle vitamin K, which is essential for coagulation. Can you identify the clotting factors that are dependent on vitamin K?
A 65-year-old man is on warfarin for recurrent deep vein thrombosis. His INR is usually stable at 2.5. However, during a recent clinic visit, the doctor noticed a significant decrease in the effectiveness of his warfarin. The doctor suspects that the patient may have consumed more vitamin K than usual. Can you identify a food that is high in vitamin K?
For a healthy adult, how much moderate-intensity physical activity is recommended per week by the World Health Organization?
What is the safest method to prevent needlestick injury when obtaining an arterial blood gas sample?
A 29-year-old woman presents to her GP complaining of a tingling sensation around her mouth and intermittent cramps in her legs. Trousseau’s sign is positive. Blood results are shown below.
Urea 4.0 mmol/L (2.0 – 7.0)
Creatinine 80 µmol/L (55 – 120)
Calcium 1.95 mmol/L (2.1-2.6)
Phosphate 1.2 mmol/L (0.8-1.4)
Vitamin D 150 nmol/L (50-250)
Parathyroid hormone (PTH) 1.7 pmol/L (1.6-8.5)
Derangement of what substance may be responsible for this patient’s presentation?
A 14-year-old girl is referred to the endocrine clinic by her GP due to bed wetting episodes. She experiences constant thirst and frequent urination. A dipstick test reveals diluted urine with low osmolality, and her blood tests show hypernatremia with high serum osmolality. Her family has a history of diabetes insipidus. What is the most suitable follow-up examination?
A 26-year-old woman presents to the emergency department with complaints of severe abdominal pain, polyuria, polydipsia, and lethargy. The pain started suddenly 2 hours ago and is spread across her entire abdomen. She has a medical history of appendicectomy eight years ago and type 1 diabetes mellitus. Upon examination, her pH is 7.25 (normal range: 7.35-7.45) and bicarbonate is 9 mmol/L (normal range: 22-29mmol/L). What additional investigations are necessary to confirm the most probable diagnosis?
A 55-year-old male visits his GP for an insurance medical. The GP observes that the patient has rough facial features, an enlarged tongue, and greasy skin. The patient is also experiencing profuse sweating. Which hormone excess is likely to be accountable for these symptoms?
A 34-year-old male presents with tingling in his thumb, index, and middle finger, along with complaints of excessive fatigue and snoring. Upon examination, he displays a prominent brow ridge and significant facial changes over time. Following blood tests and an MRI scan, the patient is prescribed octreotide. What is the mechanism of action of this medication?
A 39-year-old woman presents to the endocrine clinic after being referred by her GP due to a blood pressure reading of 178/101 mm Hg. Upon blood tests, it is discovered that she has hypernatremia and hypokalaemia, along with an elevated aldosterone level. An inconclusive CT scan of the abdomen has been performed to determine if there is an adenoma present.
What is the most suitable investigation to identify if one of the adrenal glands is producing an excess of hormones?