MCQ Day 13

Topic 23. Diseases of the thyroid gland. Hyperthyroidism Hypothyroidism of Parаthyroid glands Etiology, pathogenesis, clinical picture, diagnosis, principles of treatment.

Topic 24. Diseases of the adrenal glands and pituitary gland. Etiology, pathogenesis, clinical picture, diagnosis, principles of treatment.

1) Group number
2) Full name
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75-year-old woman consulted a family physician because of her dramatic weight loss on the background of poor appetite, apathy, muscle weakness. Objectively: the patient was lethargic, with decreased nutrition. Cardiac tones were irregular, atrial fibrillation. BP 150/70 mm Hg. Her abdomen was soft and painless. The liver was enlarged by 3 cm. Swelling of the legs. Large tremors in the fingers of the outstretched hands. On palpation of the thyroid gland - a node 1.5 cm in diameter in the right lobe. Make a preliminary diagnosis:
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A 47-year-old woman with stage II obesity was diagnosed with diabetes mellitus two months ago. The patient was recommended a reduced-calorie diet and dosed physical activity. The fasting glycemia level was 9.0 mmol/L. Which blood glucose-lowering drug might be recommended for the patient?
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A 52-year-old patient who consulted a gastroenterologist for a gastric ulcer is found to have dysplastic obesity, striae on the abdomen and thighs. Blood pressure -170/100 mmHg. Laboratory examination revealed elevated cortisol levels, moderately decreased ACTH levels Establish a diagnosis:
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A 32-year-old woman complains of constant irritability, palpitations, pain in the eyes, lacrimation, weight loss by 1 kg in 4 months. Objectively: warm, moist skin, mild exophthalmus, positive symptoms of Grefe, Kocher, Mebius. Thyroid gland is diffusely enlarged, which is visible on swallowing, painless. Pulse - 180 / min, BP - 140/66 mm Hg. A slight tremor in the fingers of the hands. Your diagnosis?
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A 63-year-old patient underwent surgery for an oversized multinodular euthyroid goiter. Subtotal resection of both thyroid lobes was forced with technical difficulties. On the 4th day after the operation, cramps of the facial muscles and upper extremities, abdominal pain appeared. Chvostek’s and Trousseau’s signs were positive. What is the most likely cause of this condition of the patient?
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Patient, 73 years old, complains of weakness, sleepiness, chills, sharp memory impairment, hair loss, constipation, edema. Objectively: normal nutrition. Skin was dry, yellowish. Face, extremities swollen, no pressure pits. Cardiac tones muffled, bradycardia. The heart size is enlarged. The volume of the thyroid gland was reduced. Hb 85 g/l, cholesterol 8.5 mmol/l; TSH 20.5 μmol/l. Make a preliminary diagnosis:

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A 27-year-old man complains of a feeling of thirst, increased urination, general weakness, weight loss. Objectively: dry skin, red cheeks, vesicular breathing. Heart sounds. Tongue dry. There are no symptoms of peritoneal irritation. Which test is the most informative to clarify the diagnosis?
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In the brain matter of the adrenal glands are produced:
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To diagnose pheochromocytoma, the determination of:
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Causes of the development of primary chronic adrenal insufficiency may include:
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The clinical manifestations of a pheochromocytic crisis are not include:
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A 35-year-old patient underwent bilateral adrenalectomy for a malignant tumor 1.5 years ago. He is receiving supportive treatment with prednisolone, cortisone. For the last 3 days, he had been taking 2 tablets of phenobarbital at night due to worsening of sleep. The day before she had done heavy physical work, after which she had pronounced weakness, nausea, vomiting, abdominal pain, headache, dizziness, tinnitus. At attempt to rise from the bed, brief loss of consciousness. On examination: patient lethargic, speaks softly, slowly. Acrocyanosis, profuse sweat, cold extremities. Pulse 105 bpm, weakly filled, soft. AT 60/20 mmHg. Heart tones weakened, rhythmic. Abdomen painful on palpation in epigastrium, abdominal wall resistance. Stools were frequent and liquid. What condition has developed in the patient? Your actions :  

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40-year-old patient complains of periodic (once a month) increase of BP up to 280/160 mm Hg. He is accompanied by main pain, weakness, heart pain, tremor, paresthesia, fear, palpitations, sweating. From anamnesis: BP increases suddenly, after physical or psycho-emotional exertion, changes of body position. Blood pressure increase lasts during 15-25 min. and passes on its own. What is the most probable diagnosis? 
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A 12-year-old unconscious child was admitted to the intensive care unit. The day before the loss of consciousness he had frequent vomiting, diarrhea, lethargy. From the anamnesis - since the age of 11 years, the boy is registered for tuberculosis. Obedience: pigment spots on the skin, BP 60/20 mmHg, BP 28/min. Heart rate 62 beats per minute. Serum potassium 6 mmol/L, sodium 102 mmol/L. Your previous diagnosis ? 
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What diseases  are not accompanied by hypertension:
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