Endocrinology

A patient presents to the clinic with complaints of unintentional weight gain, on going fatigue for the last 3 months, and muscular weakness. On clinical exam, the nurse practitioner notices that the patient appears to have excess weight in the abdomen and face but the patient’s extremities are very thin. The patient’s yearly labs are also concerning for the development of pre-diabetes.

Which hormone system is likely malfunctioning?

• Cortisol

• Insulin

• Parathyroid

• Epinephrine

A patient presents to the clinic with complaints of new onset onset anxiety. Vitals are significant for tachycardia (HR 115) and hypertension (BP 156/94). On physical examination, it is noted that the patient has hyperreflexia and there seems to be an abnormal swelling around the patient’s throat.

Based on these findings, what is the most likely diagnosis?

• Hyperparathyroidism

• Hypoparathyroidism

• Hyperthyroidism

• Hypothyroidism

Continuing from the previous question, what is the most common cause of hyperthyroidism in the United States?

• Iodine Deficiency

• Hashimoto's thyroiditis

• Graves Disease

• Thyroidectomy

A 27 year of female with past medical history of stage 1 thyroid cancer s/p thyroidectomy one week ago present to the emergency department with new onset seizures. Patient has one tonic clonic seizure in the hospital which resolves after 1 minute and she returns back to normal mental baseline. Upon recovery, she complains of feeling jittery and anxious. Physical exam is significant for hyperreflexia and a positive Trousseau's sign.

• Hyperthyroidism

• Hypothyroidism

• Hyperparathyroidism

• Hypoparathyroidism

6 year old male presents to the emergency department after he was found unconscious by his mother. Upon EMS arrival, patient is noted as being in respiratory distress with an unusual deep and rapid breathing pattern. Patient is immediately intubated and brought to the ED. History is extremely limited.

CMP is significant for elevated serum glucose, hypernatremia, and hypokalemia

Urinalysis is positive for ketones

Arterial blood gas is significant for pH 6.9

Patient is treated with IV fluids, sodium bicarbonate, and insulin.

2 hours later, patient sustains cardiac arrest.

What happened?

Tags

NGSS.MS-PS1-2