A 43-year-old woman presents with for evaluation of unintend…

A 43-year-old woman presents with for evaluation of unintended weight gain of nearly 10.3 kg (22lb) over the past year. Her blood pressure is 160/100 mmHg, height 160 cm (5’3”) and weight 77 kg (170 lb). On physical examination, her face is round and flushed, and her weight is concentrated around her abdomen. Her arms and legs are comparatively thinner. Findings of her breast and pelvic examinations are unremarkable, except for thick, reddish-purple streaks around her breasts. Laboratory findings show an abnormal overnight dexamethasone suppression test and high 24-hour urine-free cortisol. Her adrenocorticotropic hormone (ACTH) level is 3 pg/mL (Reference value >10 pg/mL). Which of the following is the most likely diagnosis?

A 34-year-old male with Type I diabetes, presents for an acu…

A 34-year-old male with Type I diabetes, presents for an acute office visit complaining of uncontrolled blood sugars, with high and low readings throughout the day and night.  When he called to make the appointment, he was advised to bring in his blood glucose log, and to check a few 3:00AM blood sugar levels.  His current daily insulin regimen is 40 units NPH insulin and 20 units of Regular insulin before breakfast, and 20 units of NPH insulin and 10 units of Regular insulin before dinner. Time 7am 11 am 5 pm 11 pm 3 am Average blood glucose mg/dL 393 210 175 140 50 Which of the following insulin adjustments is most appropriate, based on the patient’s average glucose readings?

Adult bone cannot increase in length when stimulated by an e…

Adult bone cannot increase in length when stimulated by an excess of growth hormone because of the lack of epiphyseal cartilage, but they do increase in width by periosteal growth.  In adults, an excess of growth hormone causes which of the following conditions?

A 9-year-old boy is brought to the clinic due to his short s…

A 9-year-old boy is brought to the clinic due to his short stature. The mother is concerned that her son is not as tall as his classmates, causing him stress. On physical exam, there is macrocephaly with frontal bossing, shortening of the arms and legs, and lumbar lordosis. Which of the following physiologic processes is most likely disrupted in this patient’s condition?

You are asked to evaluate a 72-year-old female patient who c…

You are asked to evaluate a 72-year-old female patient who complains of recent onset of polyuria, constipation, and nausea. Physical examination is essentially unremarkable, and laboratory studies are ordered including a complete metabolic profile and routine urinalysis.  Results of tests are as follows: Urinalysis: negative for nitrite, glucose, leukocytes, blood, ketones, and bilirubin, leukocyte esterase, protein, and urobilinogen. Metabolic profile: (abnormal results in boldtype): Serum Ca+2     13.2 (8.2-10.2 mg/dL)Serum PO4−3    1.8 (2.5-4.5 mg/dL)Serum albumin 4.0 (3.5-5.0 g/dL) The patient has normal renal function, and no other abnormalities are noted on results of complete metabolic profile.                                                          Based on these initial laboratory results, which of the following additional laboratory test results would be helpful in establishing a diagnosis of primary hyperparathyroidism?