A 20-year-old student nurse was admitted after her third collapse in recent months. She was noted to have a blood sugar of 0.9 mmol/l on finger-prick testing and responded well to intravenous glucose therapy.
Venous blood taken at the same showed a markedly raised insulin level, but her C-peptide levels were normal.
What diagnosis fits best with this clinical picture?
A 20-year-old woman presents for review. She is concerned due to absence of menstruation for 5 months.
She is 1.76 m in height and weighs only 43.7 kg (7 stone).
A pregnancy test is negative and thyroid function testing is normal.
Which of the following is the diagnosis of this case?
A 22-year-old woman presents with anxiety and weight loss with increased appetite.
Thyrotoxicosis is suspected and various investigations are performed.
Which of the following findings is most consistent with Graves’ disease?
A 23-year-old man who works as a clerk presents for review. He is 6 feet 2 inches tall, with delayed puberty and infertility. On examination, he has small testes with scanty pubic hair.
Blood results are shown below:
Follicle-stimulating hormone (FSH) 40 U/l (1-7)
Testosterone 4 nmol/l(9-35)
What is the most probable diagnosis?
A 23-year-old woman presents with hirsutism and oligomenorrhea for the last five years. She is very anxious about her irregular menses and worried as her mother was diagnosed with uterine cancer recently. She is a lawyer and does not want to conceive, at least for the next couple of years.
The examination is essentially normal except for coarse dark hair being noticed under her chin and over her lower back.
Investigations done during the follicular phase:
Serum androstenedione 10.1 nmol/l (0.6-8.8)
Serum dehydroepiandrosterone sulphate 11.6 ىmol/l (2-10)
Serum 17-hydroxyprogesterone 5.6 nmol/l (1-10)
Serum oestradiol 220 pmol/l (200-400)
Serum testosterone 3.6 nmol/l (0.5-3)
Serum sex hormone binding protein 32 nmol/l (40-137)
Plasma luteinising hormone 3.3 U/l (2.5-10)
Plasma follicle-stimulating hormone 3.6 U/l (2.5-10)
What is the most appropriate treatment?
A 24-year-old woman develops hyperthyroidism 6 weeks after delivery. On examination, she has a painless, firm enlarged thyroid gland.
Which of the following statements is most correct regarding her probable diagnosis?
A 25-year-old man wants to start a relationship but is concerned about his small phallus. He also has difficulty becoming aroused. On examination, he is slim and has gynecomastia. There is a general paucity of body hair, his penis and testes are small.
Which diagnosis fits best with this history and examination?
A 25-year-old obese woman is diagnosed with polycystic ovarian syndrome (PCOS). Which of the following findings is most consistently seen in PCOS?
A 25-year-old woman comes to the endocrine clinic for her regular follow up. She has hypertension, controlled by a combination of Ramipril and indapamide and was diagnosed with 11-beta hydroxylase deficiency since birth when she was found to have clitoromegaly.
Which of the following is most likely to be elevated?
A 25-year-old woman is found to have a blood pressure of 170/100 mmHg during a routine medical check. She is otherwise well and her physical examination is unremarkable.
Blood tests show:
Na+ 140 mmol/l
K+ 2.6 mmol/l
Bicarbonate 31 mmol/l
Urea 3.4 mmol/l
Creatinine 77 µmol/l
Which one of the following investigations is most likely to be diagnostic?