MSRA-0410
Which of the following is most commonly associated with the syndrome of inappropriate ADH secretion?
Archives: MSRA
MSRA-0411
A 42-year-old female presents to the GP with a two-week history of feeling generally unwell. She reports experiencing hot flashes and sweating, as well as difficulty sleeping at night. Her husband has also noticed that she seems more agitated and on edge than usual. The patient has no significant medical history but reports having had flu-like symptoms six weeks ago that have since resolved. On examination, there is a tender goitre present. Thyroid function tests reveal a TSH level of 0.5 mU/L (normal range 0.5-5.5) and a free T4 level of 21 pmol/L (normal range 9.0-18). What is the first-line management for the most likely diagnosis?
MSRA-0412
A 30-year-old woman presents with neck pain and swelling. She reports having symptoms of an upper respiratory tract infection followed by neck pain and swelling for the past 2 weeks. During examination, she appears anxious, her heart rate is 98/min, and her thyroid gland is tender and diffusely swollen.
Her blood tests reveal the following results:
Thyroid-stimulating hormone (TSH) 0.4 mU/L (0.5-5.5)
Free thyroxine (T4) 42 pmol/L (9.0 – 18)
ESR 65 mm/h (1-20)
What is the most likely diagnosis?
MSRA-0413
A 43-year-old woman complains of muscle cramps and fatigue. Upon examination, her neck’s front is tender and swollen to touch. She has no medical history and does not take any regular medication. Her blood results show a TSH level of 12.3 mU/L (0.5-5.5) and a free T4 level of 4.2 pmol/L (9.0 – 18). What is the probable diagnosis?
MSRA-0414
A 32-year-old woman presents to the endocrine clinic with thyroid function test results indicating palpitations, excessive sweating, unintentional weight loss, and a notable thyroid goitre that is tender upon palpation. The test results show a TSH level of 9.4 mU/L (normal range: 0.5-5.5) and a free T4 level of 6.4 pmol/L (normal range: 9.0-18). What is the probable diagnosis?
MSRA-0415
A 52-year-old man has been diagnosed with type two diabetes and prescribed medication by his GP. The medication functions by binding to its receptor and closing the potassium ion channels, which reduces potassium efflux from the cell and causes depolarization. This, in turn, leads to calcium ion influx and insulin release. What medication has the patient been prescribed?
MSRA-0416
A 70-year-old man is admitted to the acute medical unit with an infective exacerbation of chronic obstructive pulmonary disease (COPD) which has failed to improve despite a course of antibiotics and steroids. He has a medical history of type 2 diabetes and hypertension and takes aspirin, simvastatin, amlodipine, and metformin. His random blood glucose on admission is 12.3mmol/l and a HbA1c test is ordered, which shows an IFCC-HbA1c of 45 mmol/mol and HbA1c of 6.3%. What is the best course of action?
MSRA-0417
A 65-year-old woman comes in for a check-up with her doctor. She has a history of hypothyroidism and is currently taking 100mcg of levothyroxine. She reports feeling well and has no notable symptoms. Her last TFTs were normal 6 months ago.
Free T4 18.5 pmol/l
TSH 0.1 mu/l
What should be done next?
MSRA-0418
A 42-year-old woman presents to her GP with complaints of ongoing fatigue and tiredness. She has a medical history of hypertension and eczema, and no significant family history. Upon conducting a blood test, the following results were obtained:
– Hb: 141 g/l
– Platelets: 222 * 109/l
– WBC: 6.3 * 109/l
– Neuts: 3.9 * 109/l
– Lymphs: 1.2 * 109/l
– Na+: 140 mmol/l
– K+: 4.1 mmol/l
– Urea: 4.9 mmol/l
– Creatinine: 83 µmol/l
– CRP: 4.1 mg/l
– TSH: 6.2 mu/l
– Free T4: 6 pmol/l
What is the most likely pathology causing her symptoms?
MSRA-0419
A 25-year-old man presents to the emergency department with abdominal pain and lethargy. He has areas of skin hyperpigmentation and hypopigmentation consistent with vitiligo. His blood pressure is 96/58 mmHg. Laboratory tests reveal the following results, and treatment is initiated.
Hemoglobin: 138 g/L (Male: 135-180, Female: 115-160)
Platelets: 210 * 109/L (150-400)
White blood cells: 11.5 * 109/L (4.0-11.0)
Sodium: 133 mmol/L (135-145)
Potassium: 5.8 mmol/L (3.5-5.0)
Urea: 6.5 mmol/L (2.0-7.0)
Creatinine: 95 µmol/L (55-120)
C-reactive protein: 4 mg/L (<5)
Fasting blood sugar: 4.4 mmol/L (4-7)
What is the most appropriate diagnostic test for the likely diagnosis?