For each item, select the ONE best lettered option that is most closely associated with it. Each lettered heading may be selected once, more than once, or not at all. A 42-year-old obese woman complains of hirsutism, amenorrhea, and difficulty becoming pregnant.
Answer(s): J
Polycystic ovarian syndrome is characterized by infertility, hirsutism, obesity, and amenorrhea or oligomenorrhea. These patients have chronic anovulation and experience withdrawal bleeding after progestogen administration.
For each item, select the ONE best lettered option that is most closely associated with it. Each lettered heading may be selected once, more than once, or not at all. A 47-year-old man complains of fatigue and dizziness. On laboratory evaluation, he is noted to have significant hyponatremia and hyperkalemia.
Answer(s): B
Addison disease, or primary adrenocortical deficiency, commonly results in a low serum Na+, a low serum Cl-, and a high serum K+. Aldosterone deficiency causes loss of sodium in the urine and contributes to the hyperkalemia. The original description of Addison disease summarizes well the key clinical findings:general languor and debility, feebleness of the heart's action, irritability of the stomach, and a peculiar change of the color of the skin. The hyperpigmentation of the skin is often seen on the elbows and in the creases of the hands.
For each item, select the ONE best lettered option that is most closely associated with it. Each lettered heading may be selected once, more than once, or not at all. A 55-year-old woman is having episodic palpitations, headaches, and sweating. On examination, her BP is elevated.
Answer(s): F
Pheochromocytoma is a secondary cause of hypertension. Pheochromocytomas secrete catecholamines; 80% are unilateral, solitary tumors, most often located in the adrenal gland. Patients present with episodes of headache, palpitations, sweats, and a sense of apprehension.
For each item, select the ONE best lettered option that is most closely associated with it. Each lettered heading may be selected once, more than once, or not at all. A 48-year-old man is being evaluated for diabetes and hypertension. On examination, he has mandibular enlargement and large hands.
Answer(s): G
Acromegaly is caused by oversecretion of growth hormone, usually from a pituitary adenoma. Clinical manifestations are indolent, often not diagnosed for 10 or more years. Acral bony overgrowth leads to frontal bossing, increased hand and foot size, and mandibular enlargement. Growth hormone excess also commonly affects the cardiovascular system. Upper airway obstruction with sleep apnea is present in up to 60% of patients.
For each item, select the ONE best lettered option that is most closely associated with it. Each lettered heading may be selected once, more than once, or not at all. A 35-year-old woman complains of constipation, hair loss, and dry skin.
Answer(s): E
The most common symptoms seen in patients with hypothyroidism include tiredness, weakness, dry skin, feeling cold, hair loss, difficulty concentrating with poor memory, constipation, and weight gain.
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