Author Question: A 22-year-old female patient complains of excessive thirst, feeling shaky when she misses meals and ... (Read 128 times)

appyboo · **on:** Jun 25, 2018

A 22-year-old female patient complains of excessive thirst, feeling shaky when she misses meals and increased frequency of urination. Family history is positive for cardiovascular disease, cerebrovascular disease, and diabetes.

The patient denies use of tobacco, alcohol, or other drugs. She takes no medication. Daily diet is fast food, and the patient does not exercise regularly. On physical examination, there are no significant findings except obesity, demonstrated by a BMI of 35 and blood pressure of 145/ 90. The signs and symptoms are characteristic of:
A. Type 2 diabetes mellitus
B. Chronic fatigue syndrome
C. Cushing's disease
D. Clinical depression

Question 2

A 54-year-old male complains of loss of appetite, weakness, fatigue, and unintentional weight loss of 10 pounds over the last month. His wife recommended that he get a physical examination.

On physical examination, you do not find significant signs of a specific disorder. The CBC with differential shows anemia. A serum metabolic panel has all normal findings. Which diagnostic test(s) would you recommend to obtain more information?
A. Cystoscopy
B. Digital rectal exam
C. Colonoscopy
D. B and C

daiying98 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: D
The incidence of hypothyroidism is greater in women and more common in people over 40 years of age. Because the onset of hypothyroidism can be insidious, patients may not be aware that their thyroid levels have diminished. Common signs and symptoms include fatigue or lack of energy, puffy face, constipation, intolerance to cold, hypotension, bradycardia, dry skin, menorrhagia, modest weight gain, diminished deep tendon reflexes (DTRs), and dulled cognition.

Answer to Question 2

ANS: A
Patients with mild renal dysfunction are generally asymptomatic, but as the disease progresses, vague symptoms appear. Fatigue and weakness are early signs, as are decreased cognitive functioning and irritability. Patients may complain of nocturia, which is due to the kidney not concentrating the urine at night. Many of these early signs are nonspecific, and patients often pass them off as a normal part of aging. GI complaints, such as nausea, vomiting, and anorexia, are common and contribute to the muscle wasting and fatigue. Patients may complain of a metallic taste in the mouth. Hypertension may develop from fluid overload and can result in CHF. Pericarditis may develop, producing a friction rub. Neurological symptoms include muscle cramps and twitching, peripheral neuropathy, difficulty concentrating, and sleep disturbances.