Archives: Medical Student Finals

MSFinals-1145

A 58-year-old woman visited her doctor after fracturing her humerus in a minor accident. She reported feeling fatigued, weak, and depressed. The doctor conducted the following tests:
Total Ca2+ 3.22 mmol/l (2.12–2.65 mmol/l)
Albumin 40 g/l (35–50 g/l)
PO43− 0.45 mmol/l (0.8–1.5 mmol/l)
Alkaline phosphatase 165 iu/l (30–150 iu/l)
Based on these results, what is the likely diagnosis?

MSFinals-1146

At a routine occupational health check, a 30-year-old man is found to have mild hypercalcaemia. He is anxious because the problem failed to resolve in his father, despite neck surgery. 24-hour urinary calcium excretion levels are low.
Which of the following is the most likely diagnosis?

MSFinals-1147

A 63-year-old woman visits her GP complaining of palpitations and weight loss. Her thyroid function tests reveal the following results:
TSH <0.03 mU/L (0.35 - 5.5)
Free T4 46 pmol/L (10 – 19.8)

What condition do these thyroid function tests suggest?

MSFinals-1148

A 42-year-old woman comes to the clinic with complaints of cold intolerance, constipation, weight gain, hair loss, and irregular periods. Her thyroid function tests reveal low levels of both serum T4 and serum thyroid-stimulating hormone (TSH). Despite administering thyrotropin-releasing hormone (TRH), there is no expected increase in TSH. What is the most probable reason for the patient’s hypothyroidism?

MSFinals-1149

A 30-year-old man is being evaluated by his physician for possible issues with his hypothalamic-pituitary-thyroid axis. The following findings were recorded:
Thyroid-stimulating hormone (TSH) 5.5 mu/l (0.4-4.0 mu/l)
fT3 3.5 pmol/l (3.0-9.0 pmol/l)
What condition is indicated by these results?

MSFinals-1150

A 36-year-old woman visits her new GP for routine blood tests after recently moving locations. She mentions that her previous GP had told her she had a ‘thyroid problem’ and had prescribed medication, but she cannot recall any further details. Her blood test results are as follows:
Investigation Result Normal value
Thyroid-stimulating hormone (TSH) 18 mu/l 0.5–5.5 mu/l
Free thyroxine (T4) 9.2 pmol/l 9–18 pmol/l
What could be the possible cause of these biochemical results?

MSFinals-1151

A 67-year-old woman visits her GP with complaints of constipation that has been ongoing for a month. She requests medication to alleviate the symptoms. The patient reports feeling more fatigued than usual and has noticed recent weight gain. During the examination, the GP observes dry scaly skin. The patient’s medical history indicates recent consultation with an endocrinologist.
What would lead to elevated thyroid-stimulating hormone (TSH) levels and normal T4 in this case?

MSFinals-1121

A 21-year-old is brought unconscious to the Emergency Department. An alert ambulance attendant notes that the patient’s breath smells like fruit punch. The patient was found holding a glass containing clear liquid and the ambulance attendant had noted a syringe on the patient’s coffee table and a pool of vomit near the patient.
With which of the following would this presentation be most consistent?

MSFinals-1122

A 20-year-old female with a BMI of 35 presents with heavy and irregular menstrual bleeding. What is the most probable diagnosis for her condition?