The blood results of a 55-year-old woman were obtained and the following values were recorded in her plasma: Total Ca2+ was 1.80 mmol/l (2.12–2.65 mmol/l), Albumin was 40 g/l (35–50 g/l), PO43− was 2.0 mmol/l (0.8–1.5 mmol/l), Alkaline phosphatase was 120 iu/l (30–150 iu/l), and Parathyroid hormone (PTH) was 75 ng/l (15–65 ng/l). Based on these results, what condition is this consistent with?
A 28-year-old woman is being evaluated by her physician for potential issues in her hypothalamic-pituitary-thyroid axis. The following findings were noted: TSH <0.1 mu/l (0.4-4.0 mu/l), fT4 32 pmol/l (9.0-26.0 pmol/l), fT3 12 pmol/l (3.0-9.0 pmol/l). What condition is indicated by these results?
A 72-year-old patient is found to have an HbA1c of 43 mmol/mol at a recent chronic disease health check after being assessed as being at high risk of diabetes mellitus. The patient is being called in to discuss the result with her registered general practitioner. How should the patient’s diagnosis be coded in her notes?
A 28-year-old woman is found to have a phaeochromocytoma. Which of the following is expected to be elevated in her urine levels?
A 28-year-old woman visited her GP with complaints of low mood, weight gain, and irregular menstrual cycles. The GP conducted some tests and referred her to the hospital. The results of the investigations are as follows:
– Sodium: 150 mmol/l (normal value: 135-145 mmol/l)
– Potassium: 2.5 mmol/l (normal value: 3.5-5.0 mmol/l)
– Fasting blood glucose: 7.7 mmol/l (normal value: <7 mmol/l)
– 24-hour urinary cortisol excretion: 840 nmol/24 h
– Plasma ACTH (0900 h): 132 ng/l (normal value: 0-50 ng/l)
– Dexamethasone suppression test:
– 0800 h serum cortisol after dexamethasone 0.5 mg/6 h orally (po) for two days: 880 nmol/l (<50 nmol/l).
– 0800 h serum cortisol after dexamethasone 2 mg/6 h PO for two days: 875 nmol/l (<50 nmol/l).
What is the most likely diagnosis for this 28-year-old woman?
A 35-year-old teacher presents at the Thyroid Clinic with a swelling in her neck that has been present for 4 months, along with a weight loss of 5 kg. During examination, a diffuse smooth swelling of the thyroid gland is observed, and she is found to be in atrial fibrillation. Lid lag and proximal myopathy are also noted, along with a rash on the anterior aspects of her legs, indicative of pretibial myxoedema. Which clinical sign is most indicative of Graves’ disease as the underlying cause of her hyperthyroidism?
A 45-year-old male with type 2 diabetes is struggling to manage his high blood pressure despite being on medication. His current treatment includes atenolol, amlodipine, and ramipril, but his blood pressure consistently reads above 170/100 mmHg. During examination, grade II hypertensive retinopathy is observed. His test results show sodium levels at 144 mmol/L (137-144), potassium at 3.1 mmol/L (3.5-4.9), urea at 5.5 mmol/L (2.5-7.5), creatinine at 100 mol/L (60-110), glucose at 7.9 mmol/L (3.0-6.0), and HbA1c at 53 mmol/mol (20-46) or 7% (3.8-6.4). An ECG reveals left ventricular hypertrophy. What possible diagnosis should be considered as the cause of his resistant hypertension?
A 55-year-old man with a history of hypertension presents with pruritus and lethargy. His serum biochemistry results show low calcium, high phosphate, and raised parathyroid hormone levels. His blood test results are as follows:
Investigation Result Normal value
Sodium (Na+) 138 mmol/l 135–145 mmol/l
Potassium (K+) 4.8 mmol/l 3.5–5.0 mmol/l
Urea 15.5 mmol/l 2.5–6.5 mmol/l
Creatinine 590 μmol/l 50–120 mmol/l
What is the most likely diagnosis for this patient?
A 72-year-old woman takes medication for hypertension and raised cholesterol. At her annual check-up, she reports that she is feeling well. Among the results of her blood tests are the following: serum calcium 2.90 mmol/l (2.1–2.8 mmol/l), serum phosphate 0.80 mmol/l (1.0–1.5 mmol/l) and alkaline phosphatase 215 iu/l (53–128 iu/l).
Which of the following is the most likely explanation of these results in this woman?
A 38-year-old patient presents with excessive thirst and abdominal pain.
Bloods show:
Investigation Result Normal value
Calcium (Ca2+) 3.02 mmol/l 2.20–2.60 mmol/l
Phosphate (PO43–) 0.42 mmol/l 0.70–1.40 mmol/l
Alkaline phosphatase (ALP) 324 IU/l 30–130 IU/l
Looking at these blood results, which of the following is the most likely cause?