new_n_lost
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Alright Guys i m almost done with Endo Path section have to revise it have given it a first reading then i m gonna to move to Pharma section of it..........
I m falling back on my speed have to inc speed somehow
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Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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Here r some questions on Endo
[left]1. A 46-year-old woman complains of increasing irritability, hot flashes, and an increasingly irregular menstrual cycle over the past 12 months. She has had three uncomplicated pregnancies and has no other problems other than varicose veins.[/left]
[left] Which of the following findings would be expected?
A. Increased FSH
B. Decreased LH
C. Increased bone density
D. Decreased total cholesterol
E. Increased estradiol levels[/left]
[left]2. A 19-year-old unmarried woman complains that she is “too hairy.” She has a history of severe irregular menstrual cycles; worsening acne; and hair growth on the face, breasts, and lower abdomen. She is sexually active, uses condoms for contraception, and is otherwise well. Laboratory values revealed normal levels of testosterone, cortisol, 17-hydroxyprogesterone, and DHEA but elevated LH levels. She is, however, depressed about the new hair growth.[/left]
[left] Which of the following is the most likely cause for these symptoms?
A. Congential adrenal hyperplasia
B. Sertoli-Leydig cell tumor of the ovary
C. Polycystic ovarian disease
D. Cushing syndrome
E. Constitutional hirsutism[/left]
[left] [/left]
[left]3. A 34-year-old female patient has an 8-year history of menorrhagia (abnormal bleeding) and anemia. Symptoms of tiredness and inability to concentrate caused her to lose her job. She also complains of cold intolerance, constipation, and weight gain. Upon examination her skin is pale, cold, dry, and scaly. Laboratory results indicate low plasma T4 levels and elevated plasma TSH levels.[/left]
[left] Which of the following is the most likely diagnosis?
A. Graves disease
B. Multinodular toxic goiter
C. Hypothyroidism of hypothalamic origin
D. Primary hypothyroidism
E. Diffuse toxic goiter[/left]
[left]4. A 32-year-old previously healthy woman has a 1-year history of palpitations, sweating,heat intolerance, and intermittent diarrhea. She has lost 12 lb despite a good appetite. Her niece had neonatal hypothyroidism. Physical examination reveals an anxious woman with a pulse rate of 120/min and blood pressure of 120/80 mm Hg. She exhibits a fine tremorof the hands and has moist, warm palms. Laboratory investigation shows elevated free T3 and T4 as well as increased plasma TSH levels.[/left]
[left] Which of the following is the most likely diagnosis?
A. Graves disease
B. Multinodular toxic goiter
C. Hypothyroidism of hypothalamic origin
D. Primary hypothyroidism
E. Myxedema[/left]
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Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| focusmle
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Keepgoing: yes i agree with Indidoc & i really admire u too. Dont know much about Jaide so cant comment on him/her.
I like this thread too, its like home so will post something here too at times to keep it alive.
TC
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| new_n_lost
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Focus u took the words out of my mouth. Its True this thread feels like home n nothing feels like except HOME.
No KG not all ..........................
Focus can u tell me how many of us r doing endo ??
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Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| indidoc1
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Hmmm... yeah.. i do kinda feel nostalgic abt this thread.. miss all we did here... So will keep posting here too... but fr studies... i guess the active thread is it.
hey nnl... as far as i know.. focus n mytime r abt to finish endo.. can't remember exactly abt others.. Don't bother... any Q u have... POST IT.. JUST POST IT.. as long as its not NBME (u know why)
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"Whether you think you can or you think you can't, you're right!" ~ Henry Ford
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| indidoc1
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nnl wrote:
No KG not all ..........................
HEY!! ws that not at all fr leaving this thread or fr the gr8 god listening?? 
I agree wth u if its the 1st n strongly disagree if its the 2nd
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"Whether you think you can or you think you can't, you're right!" ~ Henry Ford
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| Novak75
Forum Senior
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Hey You guys, here are my answers:
1. A. Increased FSH
2. C. Polycystic ovarian disease
3. D. Primary hypothyroidism
4. A. Graves disease
So I started with biochem again, I am re-reading and starting from scratch, so yesterday I read 2.5 chapters, so I guess the firts 4 or 5 chapters are going to be like my second read, today, right now I am going to start again, and I plan to study all day and tomorrow too, after reading some chapters I will read biochem from first aid.
I see that most of you are nostalgic of leaving this thread so I don't know what to do, I guess I will keep posting here, aldo I do read the other thread once and a while, I loved the rapidsharefiles someone posted of some books.
Good luck to everyone!!!!!! I will post soo
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| new_n_lost
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the Answers to the Questions
1. A => the lady is experiencing early menopause so thats y she will have inc FSH
2. C => the abnormal hair growth n irregular menstrual history points to Polycystic Ovary disease
3. D => its easy
4. A => Its Hyperthyroidism Graves disease it cud have been B also if n only the Pt was morethan 50yrs old Mutinodular Toxic Goiter occurs in Elderly Pts.
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Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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So its decided that we will kep this thread alive although we might have to double post things but its good to keep home alive so i m going to that U guys r welcome to do as u wish i.e u can post there alone or here both as per u wish as i will be posting there as well n also looking over on that thread, to keep u with the Study Guru
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Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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oky ppl Today i was really tired of Endo so changed tracks n Started on Beh Sc listen to chapters 3-6 in the 4hrs like i m spending 1hr on each chapter givng to the details took a 5 mins break n came here to report my progress
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Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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U Guys a huge Mistake done my part Damn How cud i have missed this point Yes Jole is right if u have Hyperthyroidism how come the TSH levels r increased they shud be low in every aspect of the Gland hyperactivity. I have posted the question on the Forum n i m looking and discussing the Answers with ppl lets c wht happens.
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Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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Alright i think its now safe to say that after an extensive research just to be sure abt the entire topic i think its A CLEAR MISPRINT in the Questiosn cos if the Answer is Graves disease then i can assure u that the TSH LEVEL SHUD BE LOW IF AND ONLY IF the cause is Primary And if we find that the TSH levels r Increased then its Definitely Sec.Hyperthyroidism n the casue is more central i.e Pitutary tumors. the TMNG (Toxic MultiNodular Goiter) does fit the description but its more in the above 50yrs age grp. so it sitll doesnt fit in the scenario
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Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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But Mytime Graves Specifically implies that te disease is an auto immune disorder n there is no way it can be termed as the Pitutary Linked Hyperthyroidism Pituitary Adenoma which is a TSH producing is a 2% of all the Pituitary Adenomas
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Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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here r some more questions (P.S This time i will make sure that no controversy occurs)
1. A patient has an insulin-secreting tumor that is localized to the tail of the pancreas. Which of the following would most likely be an associated finding during fasting?
A. Glycosylated hemoglobin level is increased
B. Plasma concentration of C peptide is decreased
C. Plasma concentration of glucagon is decreased
D. Plasma concentration of glucose is increased
E. Plasma concentration of proinsulin is increased
2. A 7-year-old patient presents with a mass in the anterior midline of the neck, slightly above the larynx. The mass is mobile and elevates upon protrusion of the tongue. This mass is most likely a cyst that developed from which of the following embryonic structures?
A. First pharyngeal cleft
B. First pharyngeal pouch
C. Second pharyngeal cleft
D. Second pharyngeal pouch
E. Thyroglossal duct
3. A 25-year-old man presents to a physician because of multiple small nodules on his lips. The clinician notes that the patient has a marfanoid habitus. Biopsy of one of these nodules demonstrates a mucosal neuroma. Which of the following screening tests is indicated?
A. Pentagastrin-stimulated calcitonin
B. Serum gastrin
C. Serum insulin
D. Serum parathyroid hormone
E. Serum vasoactive intestinal peptide
4. A pregnant woman in her second trimester complains of heat intolerance and palpitations. Physical examination reveals a slightly enlarged, non-tender thyroid gland, and a normal cardiac exam. The serum thyroxine (T4) level is increased; however, the serum thyroid-stimulating hormone (TSH) is normal. Which of the following best explains the laboratory findings in this patient?
A. Decreased estrogen
B. Increased free thyroxine (T4)
C. Increased progesterone
D. Increased serum triiodothyronine (T3)
E. Increased thyroid-binding globulin (TBG)
___________________
Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| indidoc1
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Posts: 1,255
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posted 2 answers in the other thread..
Hey KG, will i get a candy if i get 2/2 coz i tried only 2??
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| zade
Forum Senior
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Posts: 179
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Hi guys:
Had a reall sick week. Just emerging from the flu. Has to find my books again. Did not do anything all week.
Have not done endo as of yet but will attempt q's tonite.
U R right this is home and I reall do not mind posting here also.
Will chat later
CU
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| ramraka
Forum Newbie
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i would like to join you guys too.i am living in virginia.plaz help me bcz i have been in usa for a short time.
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| new_n_lost
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Topics: 732
Posts: 6,453
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From today i m starting Resp. system wise lets c how that works n i m starting from Physio taking each n every line into consideration. Anatomy will be tomorrow .
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Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| indidoc1
Forum Guru
Topics: 68
Posts: 1,255
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I hope zade's better now n found her books 
Novak's studying.. no report? Same fr lily
nnl not posting answers
KG.. 1 on this thread n 2 on the other I m happy now
Edited by indidoc1 on 02/06/07 - 10:20 AM
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"Whether you think you can or you think you can't, you're right!" ~ Henry Ford
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| new_n_lost
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1. A patient has an insulin-secreting tumor that is localized to the tail of the pancreas. Which of the following would most likely be an associated finding during fasting?
A. Glycosylated hemoglobin level is increased
B. Plasma concentration of C peptide is decreased
C. Plasma concentration of glucagon is decreased
D. Plasma concentration of glucose is increased
E. Plasma concentration of proinsulin is increased
The correct answer is E. Hypersecretion of insulin by a pancreatic b cell tumor is a major cause of fasting hypoglycemia (plasma glucose is not increased, choice D). Symptoms are related to neuroglycopenia and could include recurrent central nervous system dysfunction during fasting or exercise. While proinsulin only makes up approximately 20% of plasma immunoreactive insulin in normal individuals, in patients with an insulinoma it contributes 30-90% of the immunoreactive insulin. Hence, plasma levels of proinsulin are increased. The increased secretion of insulin by the tumor will also lead to an increase in C peptide secretion (not decreased, choice B) since b cells secrete insulin and C peptide on a one-to-one molar ratio. Given the prolonged hypoglycemia, the amount of glycosylated hemoglobin may also be decreased, although this is not a universal finding. Certainly, an increase in Glycosylated hemoglobin would not be expected (choice A). Glucagon secretion is increased by hypoglycemia and its plasma level in a patient with an insulinoma would be expected to be increased compared to normal (not decreased, choice C).
2. A 7-year-old patient presents with a mass in the anterior midline of the neck, slightly above the larynx. The mass is mobile and elevates upon protrusion of the tongue. This mass is most likely a cyst that developed from which of the following embryonic structures?
A. First pharyngeal cleft
B. First pharyngeal pouch
C. Second pharyngeal cleft
D. Second pharyngeal pouch
E. Thyroglossal duct
The correct answer is E. The thyroglossal duct develops as an evagination of the floor of the pharynx in the region where the tongue develops. The adult foramen cecum of the tongue marks the site of this evagination. The distal end of this duct normally forms the thyroid gland; the proximal part of the duct normally degenerates. Failure of a part of the duct to degenerate may lead to a thyroglossal duct cyst or median cervical cyst, as seen in this patient.
The first pharyngeal cleft (choice A) forms the external ear canal. This cleft normally remains patent.
The first pharyngeal pouch (choice B) forms the middle ear cavity and the auditory tube. This pouch normally remains patent.
The second pharyngeal cleft (choice C) normally does not remain patent. It is typically covered over by the overgrowth of the second pharyngeal arch. If part of this pouch does remain patent, it may form a lateral cervical cyst, which is seen on the lateral side of the neck along the anterior border of the sternocleidomastoid muscle.
The second pharyngeal pouch (choice D) forms the tonsillar fossa of the pharynx. The pharyngeal mucosa in this area arises from the endoderm of the pouch. Ingrowth of mesoderm cells results in the formation of the palatine tonsil.
3. A 25-year-old man presents to a physician because of multiple small nodules on his lips. The clinician notes that the patient has a marfanoid habitus. Biopsy of one of these nodules demonstrates a mucosal neuroma. Which of the following screening tests is indicated?
A. Pentagastrin-stimulated calcitonin
B. Serum gastrin
C. Serum insulin
D. Serum parathyroid hormone
E. Serum vasoactive intestinal peptide
The correct answer is A. The presence of mucosal neuromas, particularly when multiple and when the patient has a marfanoid syndrome, is a marker for multiple endocrine neoplasia type Iib (MEN IIb). MEN IIb predisposes for medullary carcinoma of the thyroid and pheochromocytoma. Pentagastrin-stimulated calcitonin studies may suggest the presence of thyroid C cell hyperplasia, which may precede frank medullary carcinoma.
High serum gastrin (choice B) suggests pancreatic or duodenal gastrinomas, which may be a component of MEN I.
High serum insulin (choice C) or vasoactive intestinal peptide (choice E) also suggest pancreatic endocrine tumors, which may be a component of MEN I.
Parathyroid hyperplasia or adenomas with parathyroid hormone secretion (choice D) can be seen in MEN I and MEN IIa, but are not part of MEN IIb.
4. A pregnant woman in her second trimester complains of heat intolerance and palpitations. Physical examination reveals a slightly enlarged, non-tender thyroid gland, and a normal cardiac exam. The serum thyroxine (T4) level is increased; however, the serum thyroid-stimulating hormone (TSH) is normal. Which of the following best explains the laboratory findings in this patient?
A. Decreased estrogen
B. Increased free thyroxine (T4)
C. Increased progesterone
D. Increased serum triiodothyronine (T3)
E. Increased thyroid-binding globulin (TBG)
The correct answer is E. The total serum thyroxine (T4) represents the sum of the T4 bound to thyroid-binding globulin (TBG) and the free T4. An increased total T4 may be due to an increase in TBG or an increase in free T4, the latter leading to signs of thyrotoxicosis. A decreased total T4 may be secondary to a reduction in TBG or in free T4, the latter leading to signs of hypothyroidism. In a euthyroid state, one-third of the binding sites on TBG are occupied by T4. An increase in estrogen (pregnancy, birth control pills) increases the synthesis of TBG. Since one-third of the binding sites on TBG will be occupied, the T4 bound to the additional TBG increases the total serum T4. The addition of extra TBG does not alter the free T4 level because of the equilibrium between the serum concentration of T4 and thyroid gland T4 production. Since the free T4 level is normal, there is no stimulus to release thyroid-stimulating hormone (TSH) from the pituitary gland. Regarding the patient's enlarged thyroid gland, heat intolerance, and palpitations, these are normal findings in pregnancy and do not indicate an overactive thyroid gland.
Estrogen is increased (not decreased) in pregnancy (choice A).
The serum free T4 (choice B) is normal in pregnancy. This explains why the serum TSH is normal in the presence of an elevated serum T4, which reflects the increase in TBG normally occurring in pregnancy.
The increase in progesterone (choice C) during pregnancy has no effect on TBG levels.
Although the serum T3 (choice D) concentration is increased in pregnancy for the same reason as serum T4 (more T3 is bound to TBG), it is not responsible for the increase in synthesis of TBG that leads to the increase in serum T4.
___________________
Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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