A 68-year-old woman presents with weight loss and heat intolerance. Her lab results show elevated free T4 and free T3 levels, and a suppressed TSH level. She is currently on medications for atrial fibrillation, ischaemic heart disease, and type 2 diabetes. Which medication is the most likely culprit for these abnormal thyroid function tests?
A 50-year-old man comes to the clinic complaining of gynaecomastia. He is currently undergoing treatment for heart failure and gastro-oesophageal reflux. Which medication that he is taking is the most probable cause of his gynaecomastia?
The blood results of a 58-year-old man were analyzed, revealing the following plasma values: Total Ca2+ at 2.80 mmol/l (normal range: 2.20–2.60 mmol/l), Albumin at 40 g/l (normal range: 35–55 g/l), PO43− at 0.25 mmol/l (normal range: 0.70–1.40 mmol/l), Alkaline phosphatase at 170 iu/l (normal range: 30–130 IU/l), and Parathyroid hormone (PTH) at 8 ng/l (normal range: 10–65 ng/l). Based on these results, what condition is this patient likely experiencing?
What role does adrenocorticotrophic hormone (ACTH) play in the body?
In addition to its effects on bone, PTH primarily acts on which organ?
A 46-year-old man with type 1 diabetes for 20 years presents with an ulcer on his right foot. The ulcer is located on the outer aspect of his right big toe and measures 2 cm in diameter. Despite having palpable peripheral pulses, he experiences peripheral neuropathy to the mid shins. The ulcer has an erythematosus margin and is covered by slough. What is the most probable infective organism?
A 26-year-old man with a 10-year history of type I diabetes presents with a 1-day history of vomiting and a 4-day history of myalgia and sore throat. He appears dehydrated, BP 120/74 mmHg, pulse 101 bpm, temperature 37.9 °C, oxygen saturation 97% on room air. There is mild erythema in his throat and nil else to find on clinical examination. The following are his laboratory investigations:
Investigation Result Normal value
pH 7.12 7.35–7.45
Ketones 5 mmol/l <0.6
Glucose 32 mmol/l 4–10 mmol/l
Potassium 4.2 mmol/l 3.5–5 mmol/l
Bicarbonate 10 mmol/l 24–30 mmol/l
Base excess -5 mEq/l −2 to +2 mEg/l
C-reactive protein (CRP) 22 mg/l 0–10 mg/l
White Cell Count (WCC) 12.7 × 109/l 4-11
Which of the following initial treatment plans should be commenced?
A 15-year-old boy was diagnosed with Reifenstein syndrome. He had hypospadias, micropenis and small testes in the scrotum.
What would be the next course of treatment?
What is the recommended course of treatment for a 16-year-old boy with Reifenstein syndrome who has hypospadias, micropenis, and small testes in the scrotum?
A 65-year-old male with a diagnosis of lung cancer presents with fatigue and lightheadedness. Upon examination, the following results are obtained:
Plasma sodium concentration 115 mmol/L (137-144)
Potassium 3.5 mmol/L (3.5-4.9)
Urea 3.2 mmol/L (2.5-7.5)
Creatinine 67 µmol/L (60-110)
What is the probable reason for his symptoms based on these findings?