endocrinology AKT Dr Jawaid

A 44-year-old woman has lost weight over 12 months. She has also noticed episodes where her heart beats rapidly and strongly. She has a regular pulse rate of 90bpm. Her ECG shows sinus rhythm. What is the most appropriate investigation to be done?

A 45-year-old type1 diabetes mellitus patient had an annual check-up. Ophthalmoscopy showed dot and blot haemorrhage + hard exudate and multiple cotton wool spots. What is the next step in management?

A 38-year-old patient presented with tingling, numbness, paraesthesia, respiratory stridor and involuntary spasm of the upper extremities. She has undergone surgery for thyroid carcinoma a week ago. What is the most likely diagnosis?

A 44-year-old patient has sudden onset of breathlessness and stridor few minutes after extubation for thyroidectomy. The patient had longstanding goitre for which he had the surgery. What is the most likely diagnosis?

A 54-year-old woman has presented with episodes of abdominal ache, vomiting and postural hypotension. She also has a dark pigmentation of her skin. A diagnosis of Addison’s disease was made. What is the most likely electrolyte abnormality expected in this patient?

An elderly patient who is known to have DM presents to the hospital with drowsiness, tremors and confusion. What investigations should be done to help in further management?

A 34-year-old woman is referred to the endocrine clinic with a history of thyrotoxicosis. At her 1^st appointment she is found to have a smooth goitre, lid lag and bilateral exophthalmos with puffy eyelids and conjunctival injection. She wants to discuss the treatment of her thyroid problem as she is keen to become pregnant. What is the most likely treatment you would advise?

A 29-year-old woman presents to her GP with a history of weight loss, heat intolerance, poor concentration and palpitations. Which of the following is most likely to be associated with diagnosis of thyroiditis associated with viral infection?

A 67-year-old male presents with polyuria and nocturia. His BMI=33, urine culture = negative for nitrates. What is the next diagnostic investigation?

A 29-year-old lady came to the ED with complaints of palpitations that have been there for the past 4 days and also feeling warmer than usual. Exam: HR=154bpm, irregular rhythm. What is the treatment for her condition?

A 60-year-old man with a 4 years history of thirst, urinary frequency and weight loss presents with a deep painless ulcer on the heel. What is the most appropriate initial investigation?

A patient presents with weight loss of 5kgs despite a good appetite. He also complains of palpitations, sweating and diarrhea. He has a lump in front of his neck which moves on swallowing. What is the most appropriate diagnosis?

A 45-year-old man with colon cancer now develops increased thirst, increased frequency in urination and weight loss. His fasting blood glucose=9mmol/L. what is the most appropriate management?

A 60-year-old diabetic patient on anti-diabetic medication developed diarrhea. What is the most likely cause for his diarrhea?

A 79-year-old woman has been diagnosed with T2DM. Her BMI is 22. RBS are 8 and 10mmol/l. Her BP is 130/80mmHg. Her fasting cholesterol is 6.7mmol/l. She is currently symptom-free but has microalbuminuria. What is the single most appropriate drug management?

A 46-year-old woman has weight gain, sensitivity to cold, pulse 50bpm, heart is enlarged with murmur. What is the single most likely diagnosis?

A 27-year-old woman with anxiety and weight loss has tachycardia, tremor and mild proptosis. What single mechanism accounts for her weight loss?

A 19-year-old man presents with weight loss, increasing thirst and increasing frequency of going to the washroom. His father, grandfather and 2 sisters have been diagnosed with Diabetes Mellitus. He feels generally unwell and feels confused What is the most likely type of DM this he suffers from?

A 60-year-old diabetic lady presents with severe peri-anal pain and swelling for 3 days. Her temp is 38.2. What’s the cause?

A 60-year-old woman has tiredness. She has noticed that her skin looks permanently tanned and she describes dizziness on standing up. What is the single most likely electrolyte pattern to be found?

A 43-year-old woman has been feeling lethargic and tired. Her BP is 160/90mmHg.

Bloods test:

Na+ 140mmol/L, K+ 3.1mmol/L. What is the most likely diagnosis?

A 68-year-old man with DM and HTN was noted to have cholesterol level of 3.4mmol/l. he was also noted to have microalbuminuria. What is the best drug to add to his regimen?

A female patient with HTN and serum K+=2.7mmol/l. which hormone would you be likely responsible for this presentation?

A 36-year-old male diagnosed with glioblastoma since last 5months has cerebral oedema and is on dexamethasone. He has diarrhea and vomiting for the last 3days. He has been suffering from repeated falls today. What could be the possible cause for his falls?

A 45-year-old lady complains of expressible galactorrhea, decreased libido and amenorrhea, weight gain and easy fatigue. Her serum prolactin levels are 1100um/l. what is the likely cause of hyperprolactinemia?

A young girl who is known to have T1DM (type 1 diabetes mellitus) presented with drowsiness and deep breathing. Her sugar level 20. Her BP 120/80mmHg and her mucous membranes are dry. What would be the next appropriate step?

A known DM was admitted with sudden LOC. What is the initial investigation?

A patient was admitted with erectile dysfunction, reduced facial hair and galactorrhea. What is the most probable diagnosis?

A 32yo man has been repeatedly admitted to hospital for what was described as anxiety or panic attacks and palpitations. On occasions he is found to be hypertensive. A persistent weight loss is noted. What is the most probable dx?

A 35-year-old man with T1DM (type1 diabetes mellitus) is dehydrated with BP of 90/50mmHg. What is the single most appropriate initial investigation?

A 62-year-old man diagnosed with T2DM with BMI 33. Lifestyle modifications have failed to control blood sugar. Laboratory investigations: urea 3.6mmol/l, creatinine 89mmol/l. what is the next appropriate management?

A 68-year-old woman diagnosed with Type2 DM and BMI 33. Laboratory investigations: GFR 29, urea 13, creatinine 390mmol/L. what is the next appropriate management?

A 29-year-old woman presents with lid lag, lid retraction and diplopia. What is the most appropriate next step?

A 72-year-old presents with polyuria and polydipsia. The fasting blood sugar is 8 and 10mmol/l. BP=130/80mmHg and the level of cholesterol 7.7mmol/l. There is microalbuminuria. What is the single most appropriate next management?

A 49-year-old woman presents to the OPD. Her oral glucose test after 2hours of glucose intake vs plasma level in 2 different tests are 6mmol/l and 10mmol/l. This situation can be categorized as:

A 54-year-old male patient of diabetes mellitus with BMI 33 who has been treated using dietary control up till now presents to his GP with a fasting blood sugar of 14mmol/l and creatinine=90mmol/l. Urine shows glycosuria. No other abnormalities are found. What is the best next step in management?

A 34-year-old woman presents with truncal obesity, easy bruising, hyperglycaemia, high BP and depression. Which of the following investigation will be most helpful in localizing the cause for Cushing’s syndrome?

A 38-year-old female presents with difficult in looking upward and on examination she was found to have lid lag as well. She also complains of her heart racing at times. Which test will help in diagnosis?

A patient was admitted with abdominal pain, diarrhea, pigmented palmar creases and buccal mucosa. What is the most probable diagnosis?

A 45-year-old man presented to his GP with vague symptoms of headache, proximal muscle weakness and nocturia. Test results show him to be severely hypertensive (230/130mmHg) and hypokalaemia. What is the most probable diagnosis?

A 35-year-old man with type 1 DM is dehydrated with BP 90/50mmHg. What is the single most appropriate initial investigation?

A patient presents with a lid lag, bulging eyes, ophthalmoplegia and thyroid bruit. What investigation will you do?

An 18-year-old lady in her 30th week of pregnancy is brought to the hospital in an altered sensorium. She is taking slow, shallow breaths and her breath has a fruity smell. On examination, AnABG: pH 7.20, urine ketones: +ve. What is the most probable diagnosis?

A patient presents with skin pigmentation, diarrhea, vomiting, abdominal pain and postural hypotension. What electrolyte abnormality is likely to occur?

A 56-year-old male who presented with epilepsy like symptoms has been diagnosed with an intracranial space occupying lesion. He now complains of thirst and mild dehydration. His blood glucose is also increased. What is the single most appropriate immediate treatment?

A man with diabetes mellitus comes to the emergency department after he collapsed at home. His GCS 10. What should be the next initial investigation for this man?

A 60-year-old DM patient presented with easy fatigability, weakness and numbness of hands and swollen feet. Examination: pedal oedema, sensory neuropathy and palpable liver and spleen. Urine: proteinuria. US abdomen: enlarged kidney. Renal biopsy: amorphous homogenous substance that stained red with congo-red. What is the diagnosis?

A 46-year-old woman has gained weight. She is sensitivity to cold. Her pulse regular at 50bpm and heart is enlarged. What is the single most likely underlying mechanism for this condition

A 15-year-old man presents with bitemporal hemianopia and spade-like hands. What is the definite test to confirm the diagnosis?

You suspect Cushing’s disease in a 50-year-old woman who has attended clinic with glycosuria, hypertension and a suggestive body habitus. Initial investigations point you towards a diagnosis of Cushing’s disease. Which of the following findings would be against this diagnosis?