A 48-year-old woman, gravida 4, para 3, comes to the office for a follow-up visit. She reports no major complaints, although she has been feeling more fatigued than usual. She is currently taking medication to manage a pituitary adenoma which was diagnosed one month ago. Serum levels of some pituitary hormones are obtained. Follicle-stimulating hormone (FSH): 18.3 mIU/mL, Luteinizing hormone (LH): 14.7mIU/mL, Prolactin: 0.68 ng/mL, Thyroid-stimulating hormone (TSH): 4.5 μU/mL. Which of the following medications is the patient most likely taking for her adenoma?

Which of the following is False about Hashimoto's disease?

A 25-year-old lactating mother presented with a 2-week history of palpitations and heat intolerance. She delivered her child 3 months ago following an uncomplicated pregnancy and delivery. She has no history of serious illness and takes no medications. She is 163 cm (5 ft 4 in) tall and weighs 54 kg (120 lb); BMI is 21 kg/m2. Temperature is 37°C (98.6°F), pulse is 106/min, respirations are 20/min, and blood pressure is 124/68 mm Hg. Examination shows moist palms and bilateral lid lag. No exophthalmos is noted. The thyroid gland is enlarged and nontender. No murmurs are heard on cardiac examination. Deep tendon reflexes are 3+. TSH is undetectable, T4=20 μg/dL (N= 5–12 μg/dL), and T3=275 ng/dL (N=100-200). Which of the following is the most likely mechanism of this patient's symptoms?

Ultrasound of the neck of a patient reveals a solid lesion measuring 1.39 cm in diameter with irregular margins. Ultrasound-guided fine needle aspiration reveals malignant cells and histology shows multiple finger-like projections or papillae with fibrovascular cores lined with differentiated epithelial cells with clear nuclei with intracytoplasmic inclusions that appear as holes. Which of the following types of thyroid cancer does this patient most likely have?

Which of the following is not the indication where surgery is preferred over radioiodine in Grave's disease?

A 46-year-old man seeks evaluation for fatigue and “skin changes” that began 5 months ago. Past medical history: hypertension and asthma. He is currently taking propranolol and uses a budesonide inhaler intermittently. The patient’s BMI is 35 kg/m2. His temperature is 37.2°C (99.0°F), blood pressure is 152/83 mmHg, pulse is 67/min, and respiratory rate is 15/min. There are scattered ecchymoses and purple abdominal striae. There is symmetric muscle weakness in the upper and lower extremities. There is deposition of fat on the back of his neck. The patient’s ACTH=4 pg/mL (normal range: 5-20 pg/mL). Which of the following is the most likely explanation of the patient’s findings?

A 32-year-old woman reports feeling restless and constantly sweating even though it is the middle of winter since 5 months. She has also experienced a 4.5 kg (10 lb) weight loss since her last examination despite making no changes to her diet or exercise routine. Her temperature is 37.8°C (100.0°F), pulse is 83/min, and blood pressure is 119/77 mmHg. A technetium-99 pertechnetate scan shows hot nodule in left lobe. Laboratory testing reveals a TSH level of 0.3 U/L and a thyroxine level of 19 µg/dL. A partial thyroidectomy is recommended, and Lugol’s solution is given preoperatively. Which of the following surgical complications does this treatment aim to prevent?

A 3-day-old female newborn is brought to the hospital because of a yellowish, milky fluid leaking from both nipples. She was delivered at term to a 20-year-old woman. Pregnancy and delivery were uncomplicated. Examination of the newborn is otherwise unremarkable. Which of the following hormones is the most likely cause of this finding?

Which is True among the following

Contraindication of Breast Conservation Surgery is

A 37-year-old woman presents to the emergency department with a 2-day history of severe palpitations, dyspnea, restlessness, and fever. She also reports intermittent episodes of diarrhea over the past 2 days. She has a history of Graves' disease but has been taking her prescribed methimazole inconsistently. Temperature is 39.6°C (103.2°F), pulse is 150/min and irregular, blood pressure is 145/95 mm Hg, respiratory rate is 26/min, and oxygen saturation is 92% on room air. She appears agitated and diaphoretic and has fine tremors and hyperreflexia. Her skin is warm and moist to the touch, and she has an enlarged, non-tender thyroid gland. Lab= decreased TSH, increased free T4, and increased T3. An ECG shows atrial fibrillation. Intravenous fluids are initiated. Which of the following is the best next step in management?

A 35-year-old woman presents with unintentional weight loss, diarrhea, excessive sweating, and occasional diplopia. Past medical history is unremarkable. Temperature is 37.4°C (99.3°F), blood pressure is 152/78 mmHg, pulse is 120/min, respiratory rate is 18/min, and oxygen saturation is 98% on room air. Her thyroid gland is diffusely enlarged without nodules and non-tender, and her eyes exhibit significant proptosis with restrictive extraocular movements. Laboratory tests reveal a decreased TSH, elevated free T4, and positive thyroid-stimulating immunoglobulin. Which of the following is the best next step in management?

A 68-year-old woman comes with an abnormal screening mammogram. She does not have breast pain, nipple discharge, breast lumps or unintentional weight loss. Her family history includes breast cancer in her mother at age 58. Temperature is 37.0°C (98.6°F), pulse is 82/min, respiratory rate is 18/min, and blood pressure is 134/82 mmHg.  Chaperoned examination of the breasts reveals a smooth contour to the skin of both breasts without masses, firmness, or areas of asymmetry. There is no adenopathy in the axillae bilaterally. A diagnostic mammogram and ultrasound show a spiculated 2.1 cm mass in the right breast reported as a BI-RADs 5. Which of the following is the next best step in management?

True about Neuroblastoma

You are posted in Postoperative ward. Kantabai has underwent Total thyroidectomy for Papillary cancer. Which of the following signs/symptoms will alter you first to suspect hypocalcemia

A 63-year-old woman presents to the clinic because she has noticed a change in her voice recently and she has been having difficulty swallowing. She felt a lump in the anterior neck yesterday. She does not have anorexia, odynophagia, weight loss, or difficulty breathing. She has no significant past medical history. Vitals are normal. There is a palpable, solitary, immobile anterior neck mass. Which of the following additional findings, if present, would suggest malignancy in this patient?

A 34-year-old woman presents with tender right breast lump. She noticed the lump three weeks ago right before menstruation, and it has not changed in size since that time. She does not have nipple discharge. She does not take any daily medications. She has regular menses and uses condoms for birth control. Temperature is 36.4°C (97.5°F), pulse is 75/min, blood pressure is 125/72 mmHg, and respirations are 14/min. The skin of the right breast is normal, and there is no nipple discharge. Breast examination reveals a 1-cm smooth, mobile, mildly tender mass in the upper outer quadrant of the right breast. There is no  bilateral axillary lymphadenopathy. Which of the following is the best next step in management?

A 35-year-old woman has excessive sweating, anxiety, and weight loss despite an increased appetite. Her past medical history is notable for a toxic thyroid adenoma, for which she has been prescribed multiple medications. However, the patient reports that her symptoms have been poorly controlled. In the office, her temperature is 37.8°C (100.0°F), pulse is 87/min, and blood pressure is 127/76 mmHg. Physical examination is notable for mild eyelid retraction, and a non-tender, solitary nodule is palpated in the left thyroid lobe. Cardiovascular, pulmonary, and abdominal exams are non-contributory. The physician recommends that the patient undergo treatment that will improve her condition but may cause side effects of hypothyroidism, xerostomia, and sialadenitis. Which of the following best describes this treatment option’s mechanism of action?

A 50-year-old woman comes for a follow-up meeting after she was diagnosed with invasive ductal carcinoma breast cancer. A 2-cm spiculated lesion was seen on mammography and confirmed with biopsy. She would like to know what the prognosis is for her condition. Which among the following findings is the worse prognostic factor for her conditions?

A 51-year-old woman presents with fatigue and weakness since last 6 months ago. She has hypertension and type 2 diabetes mellitus. The patient is currently taking lisinopril and metformin. She consumes 4-6 beers per week. Her pulse is 86/min and blood pressure is 152/94 mmHg. BMI is 32 kg/m2. Physical examination reveals bilateral muscle weakness in the upper and lower extremities. Truncal obesity is present. There are some coloured striae on her lower abdomen and back. Which of the following best describes the pathophysiology of this patient’s skin findings?

True about Pheochromocytoma

40-year-old lady was on anti-thyroid medications which she stopped for 2 weeks. She presented in emergency with high grade fever and hypotension. What is not a part of further management?

Which one of the following familial carrier syndromes is associated with mutation in BRCA genes?

The human body obtains vitamin D either from the diet or from sun exposure. Which of the following changes will enhance the production of an active form of vitamin D?

A 34-year-old woman has consistent diarrhea for the last 2 months. The patient has experienced watery, tea-colored diarrhea that happens even when she has not eaten anything. She denies any associated abdominal pain or difficulty swallowing. The patient feels fatigued and weak with muscle cramps which she attributes to being dehydrated. Medical history includes hyperparathyroidism and nephrolithiasis. The patient’s temperature is 37.0°C (98.6°F), pulse is 100/min, respirations are 20/min, and blood pressure is 100/60 mmHg. Physical examination shows dry mucous membranes and decreased skin turgor without abdominal tenderness. Laboratory tests show the following: Sodium 144 mEq/L, Potassium 2.5 mEq/L, Chloride 93 mEq/L, Bicarbonate 21 mEq/L, Calcium 12 mg/dL, Glucose 250 mg/dL, Parathyroid hormone 350 pg/mL. Which of the following is the most likely mechanism of this patient’s symptoms?

There are some other cells in thyroid. These will secrete a hormone which is not associated with hyper or hypothyroidism. These cells are associated with calcium and phosphorus metabolism through which action?

A 52-year-old woman has discharge from the left nipple since three weeks. The discharge is mostly clear, but it sometimes appears red. There is no associated breast pain, breast lump, fever, or weight loss. The patient’s last screening mammogram was ten months ago and was normal. Temperature is 37.0°C (98.6°F), pulse is 70/min, respiratory rate is 18/min, and blood pressure is 128/83 mmHg. Chaperoned exam of the left breast reveals a smooth contour to the skin without erythema or warmth. No masses are palpated. Serosanguineous fluid can be manually expressed from the nipple. Which of the following is the most appropriate next step in diagnosis?

The human body obtains vitamin D either from the diet or from sun exposure. In Kidney, which of the following represents the conversion of vitamin D derived from dietary animal sources to its active form ?

A 54-year-old woman noticed a right breast lump on self-examination. The last mammography from 5 years ago was normal. She has no significant past medical history and currently does not take any medications. Right breast examination reveals a hard irregular-shaped fixed mass that is 2 cm in the upper outer quadrant. The overlying skin is tethered with skin dimpling. Multiple palpable axillary lymph nodes are noted bilaterally. Core needle biopsy shows invasive ductal carcinoma. Which of the following historical features would be most consistent with this patient's underlying condition?

A 14-month-old girl is brought to the pediatrician due to constipation and poor feeding over the past week. She has not had a bowel movement in several days and has been eating and drinking significantly less than before. Prior to these symptoms, the patient had been developing normally. The temperature is 38.0°C (100.4°F), pulse is 118/min, and blood pressure is 135/96 mm Hg. There is a palpable right-sided immobile abdominal mass that crosses the midline. Elevated levels of catecholamine byproducts are detected in the urine. A mutation in which of the following genes is most likely responsible for this patient’s condition?