Endocrine Pathology - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 04-02-2015
spasemaster's Avatar
USMLE Forums Addict
 
Steps History: CK Only
Posts: 146
Threads: 18
Thanked 80 Times in 64 Posts
Reputation: 90
Question Endocrine Pathology

A previously healthy 35 year old male comes with the complaint of neck pain that started yesterday and has progressively increased. On examination you find that the thyroid is tender on palpation and mildly enlarged, you also notice prominent cervical lymphadenopathy (multiple on the right and left side each measuring 2-3cm). His temp. is 39.5C, pulse is 110, BP is 130/80. The patients workup shows:
Increased Free T3 and T4
Decreased TSH
You perform radioactive iodine uptake and it shows diffuse decreased uptake.
What is the patient's most common cause of this pathology?

A-Bacterial infection
B-Viral Infection
C-Autoimmune antibodies
D-Fibrous Tissue replacement of the gland
E-1ry Malignancy
__________________
A question a day keeps the USMLE stress away
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Last edited by spasemaster; 04-02-2015 at 01:51 PM. Reason: add some small details to the case
Reply With Quote Quick reply to this message
The above post was thanked by:
accelerate (04-05-2015), WannabeMD8 (05-23-2016)



  #2  
Old 04-02-2015
Hassan8's Avatar
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 142
Threads: 27
Thanked 51 Times in 33 Posts
Reputation: 61
Default

B viral infection. Diagnosis is subacute granulomatous thyroiditis.

Last edited by Hassan8; 04-02-2015 at 01:34 PM.
Reply With Quote Quick reply to this message
  #3  
Old 04-05-2015
spasemaster's Avatar
USMLE Forums Addict
 
Steps History: CK Only
Posts: 146
Threads: 18
Thanked 80 Times in 64 Posts
Reputation: 90
Correct Answer

Correct answer is bacterial infection causing "actue thyroiditis".

I just realized this was a stupid question b/c the only thing about bacterial is that it causes PROMINENT adnopathy (unlike viral subactue).



anyways, here's a better endocrine pathology question:

A 35 year old female develops DKA and is managed. 12 hours after management the patient has normal urine output (1ml/kh/hour) and her serum K+ and Na+ are normal. She develops muscle pain, hemolysis her urine shows myoglobin. What caused the patient's pathogenesis:

A-Increased phosphate
B-Decreased phosphate
C-Increase Selenium
D-Decreased Selenium
E-Increased Magnesium
F-Decreased Magnesium
__________________
A question a day keeps the USMLE stress away
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
The above post was thanked by:
accelerate (04-05-2015)
 
  #4  
Old 04-05-2015
Hassan8's Avatar
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 142
Threads: 27
Thanked 51 Times in 33 Posts
Reputation: 61
Default

Thanks for the explanation .. I think the answer to this one is B decreased phosphate

Last edited by Hassan8; 04-05-2015 at 02:00 AM.
Reply With Quote Quick reply to this message
  #5  
Old 04-05-2015
USMLE Forums Scout
 
Steps History: ---
Posts: 16
Threads: 7
Thanked 1 Time in 1 Post
Reputation: 11
Default taking a guess


a guess >>> decreased phosphate
Quote:
Originally Posted by spasemaster View Post
Correct answer is bacterial infection causing "actue thyroiditis".

I just realized this was a stupid question b/c the only thing about bacterial is that it causes PROMINENT adnopathy (unlike viral subactue).



anyways, here's a better endocrine pathology question:

A 35 year old female develops DKA and is managed. 12 hours after management the patient has normal urine output (1ml/kh/hour) and her serum K+ and Na+ are normal. She develops muscle pain, hemolysis her urine shows myoglobin. What caused the patient's pathogenesis:

A-Increased phosphate
B-Decreased phosphate
C-Increase Selenium
D-Decreased Selenium
E-Increased Magnesium
F-Decreased Magnesium
Reply With Quote Quick reply to this message
  #6  
Old 04-05-2015
USMLE Forums Scout
 
Steps History: CK+CS
Posts: 26
Threads: 2
Thanked 17 Times in 6 Posts
Reputation: 27
Default

selenium is required by g6p dehydrogenas,decrease selenium,decreased g6pd,decreased nadph =oxidative stress and hemolysis
Reply With Quote Quick reply to this message
  #7  
Old 04-05-2015
spasemaster's Avatar
USMLE Forums Addict
 
Steps History: CK Only
Posts: 146
Threads: 18
Thanked 80 Times in 64 Posts
Reputation: 90
Correct Answer

Yup, the correct answer B-decreased phosphate.

Decreased phosphate would lead to decreased ATP "adenosine tri-phosphate" which is important in RBCs Na-K channel (the cause of hemolysis, it's also needed in abundance in muscles (cause of muscle breakdown and release of myoglobin in urine).

Now, what is the cause of decrease phosphate in this patient:
A-Increased urinary excretion
B-Used up in phosphorylation of glucose
C-Destroyed by the patient's acidic PH
D-Secondary Hyperparathyroidism
E-Decreased intestinal absorption
__________________
A question a day keeps the USMLE stress away
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
  #8  
Old 04-05-2015
Hassan8's Avatar
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 142
Threads: 27
Thanked 51 Times in 33 Posts
Reputation: 61
Default

I think B . The insulin given to this patient may have caused increased glucose uptake in insulin sensitive tissues leading to decreased phosphate left fot insulin independent tissues like rbc, brain

Last edited by Hassan8; 04-05-2015 at 09:50 AM.
Reply With Quote Quick reply to this message
  #9  
Old 04-05-2015
USMLE Forums Scout
 
Steps History: Not yet
Posts: 50
Threads: 12
Thanked 7 Times in 6 Posts
Reputation: 17
Default

I also think it's B
And thanks spasemaster for these refreshing questions
Reply With Quote Quick reply to this message
  #10  
Old 04-06-2015
spasemaster's Avatar
USMLE Forums Addict
 
Steps History: CK Only
Posts: 146
Threads: 18
Thanked 80 Times in 64 Posts
Reputation: 90
Correct Answer

Yes, correct. The correct answer is B-Used up in phosphorylation of glucose as Hassan8 explained.

I'm glad that you're liking the question. This motivates me to keep on posting questions.

Just tell me to further elaborate if answer isn't clear.
__________________
A question a day keeps the USMLE stress away
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message



Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Endocrine - Pathology - Biochemistry concept hope007 USMLE Step 1 Forum 0 03-21-2014 08:39 AM
Robbins Basic Pathology vs Goljan RR Pathology ReggieMiller USMLE Step 1 Forum 1 12-01-2012 04:24 PM
Endocrine Pathology- Most Commons Infinity-MD USMLE Step 1 Forum 0 02-08-2012 09:31 AM
endocrine pathology Q2 menatallah Elgohary USMLE Step 1 Forum 6 01-19-2012 06:08 AM
endocrine pathology Q menatallah Elgohary USMLE Step 1 Forum 6 01-19-2012 05:44 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)