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  1. #1
    IMG SURVIVOR's Avatar
    IMG SURVIVOR is offline Moderator 536 points
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    Dx this

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    A 26-year-old woman presents to her physician's office with multiple complaints for the last few months. She has been feeling very anxious and will sometimes feel that her heart is racing. She also has been feeling really hot despite the fact that it is the middle of winter. She has been feeling very hungry, and has not been able to sleep for more than 3 hours a day. Her last menstrual period was "months ago" and she has been sexually active without using any contraception. Her medical history is significant for an episode of untreated depression 2 years ago. She denies taking any medications. On examination, she appears agitated and is rocking her legs throughout the entire interview. She is talking very rapidly, and interrupts the interviewer frequently. Her blood pressure is 146/80 mm Hg, and her pulse is 103/min. Her examination is significant for some staring and a slightly enlarged and firm thyroid. Routine laboratory studies, a urinary pregnancy test, and an ECG are obtained.
    Which of the following is the most likely preliminary diagnosis?
    / A. Anxiety attacks
    / B. Goiter
    / C. Hyperthyroidism
    / D. Manic episode of bipolar illness
    / E. Supraventricular tachycardia
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

  2. #2
    IMG SURVIVOR's Avatar
    IMG SURVIVOR is offline Moderator 536 points
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    Which of the following tests is the best to establish the diagnosis in this patient?
    / A. Radioactive iodine uptake and scan
    / B. Serum antithyroglobulin antibodies
    / C. Serum anti-thyroid peroxidase antibodies
    / D. Serum thyroid stimulating hormone (TSH)
    / E. UItrasound of the neck
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

  3. #3
    rose.82 is offline Junior Member 510 points
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    Hello IMG SURVIVOR,

    I think the answer is C. Hyperthyroidism and D. Serum thyroid stimulating hormone (TSH)

  4. #4
    smu05 is offline Permanently Banned 510 points
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    Wow, ROSE.82. We're thinking along same line. Did you write your STEP 2 already. I am gonna go with Rose.82 answers (Hyperthyroidism and TSH is the best intial work-up).

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