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Jane (52 year old female) presents to her primary physician after a 6-month history of unexplained weight loss (approximately 12 lbs), increased appetite, and fatigue. She describes episodes of palpitations, heat intolerance, and excessive sweating. She denies significant changes in bowel habits or vision problems. Past Medical History: Hypertension (controlled with lisinopril). No prior thyroid issues. Family History:Mother had a history of goiter, no known thyroid malignancies. Medications: Lisinopril 10 mg daily. Occasional ibuprofen for headaches. Social History:Non-smoker, moderate alcohol use. Works as an elementary school teacher. Physical Examination General: Thin, anxious-appearing woman. Vital Signs: BP: 140/85 mmHg HR: 105 bpm (irregular) Temp: 99.5°F RR: 18/min Neck: Palpable multinodular goiter, non-tender. Cardiovascular: Irregularly irregular rhythm, no murmurs. Neurological: Fine tremor in both hands. Dermatologic: Warm, moist skin. Eyes: No proptosis, no lid lag. Laboratory Findings Test Result Reference Range TSH

Maple syrup urine disease is characterized by and increase in which of the following urinary amino acids?

In which of the following disorders is a bilirubin transport disturbance due to defective transport of bilirubin from plasma to hepatocyte?

Which of the following cardiac markers is useful in the diagnosis of congestive heart failure?

Which statement best describes the utility of b-type natriuretic peptide (BNP)?

Which of the following would be the routine screening test for Diabetes Mellitus during an annual exam?

What happens to blood gases when the blood is exposed to room air?

The most active of the the thyroid hormones is 

The type of enzyme assay in which all of the substrate is converted to product.

A factor, other than average plasma glucose concentration, that can affect the hemoglobin A1c level is: