Quiz On CPC Certification Exam! Trivia Questions

The most likely diagnosis in this case is a thyroid adenoma. This is supported by the presence of a nodular swelling over the right lobe of the thyroid, which is a characteristic feature of adenomas. Additionally, the fact that the patient's hyperthyroidism is not responding to treatment suggests that the underlying cause may be a benign tumor such as an adenoma.

Middle aged patient with typical features of hypothyroidism, commonest cause is Hashimoto's. Note she has no goitre.

Note the exopthalmos typical of Graves disease with proptosis and staring gaze.

Thyroid hormones increase metabolism, increase cardiac rate and output. Deficiency of thyroid hormones cause low output and Bradycardia.

Papillary carcinoma with good prognosis (98% 10 year survival) is the most common type 75%. Next is follicular having worst prognosis in about 10-20% cases.

The most likely pathology in this case is Addison's disease. Addison's disease is a condition characterized by the insufficient production of hormones by the adrenal glands. Symptoms include weight loss, pigmentation (hyperpigmentation), tiredness, hypotension (low blood pressure), and hypokalaemia (low potassium levels). Adrenal cortical carcinoma is a type of cancer that affects the adrenal glands and typically presents with different symptoms. Cushing's syndrome is characterized by excessive cortisol production, leading to weight gain and other symptoms. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, and hypoparathyroidism is a condition where the parathyroid glands do not produce enough parathyroid hormone. These conditions do not match the symptoms described in the case.

Myxoedema is the most likely diagnosis in this case because it is commonly associated with delayed relaxation phase of deep tendon reflexes. Myxoedema refers to severe hypothyroidism, which can cause a variety of symptoms including fatigue, weight gain, cold intolerance, and slowed reflexes. This condition can be seen in individuals with chronic illnesses, and the delayed relaxation phase of deep tendon reflexes is a characteristic finding. Peripheral neuropathy, hypokalaemia, meningioma of the falx cerebri, and autonomic neuropathy are not typically associated with this specific reflex abnormality.

The most likely diagnosis for this patient is Hashimoto's disease. This is supported by the findings of a diffusely enlarged thyroid gland, low levels of T3 and T4, and the presence of peripheral edema. Hashimoto's disease is an autoimmune disorder that leads to chronic inflammation of the thyroid gland, resulting in hypothyroidism. The thyroid biopsy may reveal lymphocytic infiltration and destruction of thyroid follicles, confirming the diagnosis. Acute necrotizing thyroiditis, multinodular goitre, papillary carcinoma, and thyroid adenoma are less likely based on the clinical presentation and laboratory findings.

Note the prominent proliferation of lining cells of the follicle with peripheral vacuolation of colloid in the lumen suggestive of hyperactivity of the gland as in Graves disease.

The most likely diagnosis for the 75-year-old woman with confusion, blurred vision, muscle weakness, hypothermia, bradycardia, and a high blood sugar level is hypothyroidism. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone, leading to a decrease in metabolism. Symptoms of hypothyroidism include confusion, blurred vision, muscle weakness, and hypothermia. The high blood sugar level could be due to impaired glucose metabolism caused by the decreased thyroid hormone levels. The normal CT scan of the brain suggests that the symptoms are not due to any structural abnormalities in the brain.