Pathology EMQ template.

Name: PHUA Chee Kiang

Candidate number:

Theme: Pituitary

 

OPTION LIST

 

A	Primary Hypothyroidism	I	Nelson’s syndrome
B	Secondary Hypothyroidism	J	Mendelson’s syndrome
C	Adrenal tumour	K	Sheehan’s syndrome
D	Pituitary-dependent Cushing’s Disease	L	Phaeochromocytoma
E	Addison’s disease	M	Conn’s syndrome
F	Ectopic ACTH	N	SIADH
G	Primary Hyperthyroidism	O	Steroids
H	Secondary Hyperthyroidism	P

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. A 40 year old lady complains of weight gain, hirsutism, menstrual irregularities and depression. Investigations revealed a raised ACTH and cortisol. Cortisol levels were partially suppressed in a high-dose dexamethasone suppression test.

 

2. A 35 year old lady presents with weight loss, reduced appetite and heat intolerance. She had a low TSH and raised T4 and T3.

 

 

3. A 50 year old lady presents with lethargy, weight gain and cold intolerance. Investigations revealed raised TSH and low T4.

 

 

4. Mrs Jones with Cushing’s disease had bilateral adrenalectomy. She later presents with increased skin pigmentation.

 

 

5. A 40 year old lady presents with weight loss, abdominal pain and hyperpigmentation. Investigations revealed hyperkalaemia and hyponatraemia.

 

 

ANSWERS

1. D

2. G

3. A

4. I

5. E