A 35- year old lady complains of weight gain with normal appetite, she noticed her skin is bruising easily and her face is growing more hair. Her periods are less frequent or even absent. She also noticed that she has had difficulty climbing the stairs lately. On examination her B.P. is 160/100 mmHg with purple stretch marks over her abdomen.

       What is the first screening test you will order for this patient

A 32-year-old woman presents with amenorrhea, facial hair and acne, and back pain. She had previously been diagnosed with polycystic ovarian syndrome. Cushing's disease is suspected and is confirmed with the results of high urinary cortisol.

What is the most probable key enzyme catalyzing  the rate limiting step in cortisol synthesis?

A 52 years old man, has a round face, acne, and a large hump of fat on the back of his neck. He complains that he is too weak . His labs show : fasting blood glucose level  of 170 mg/dL (NR: 80 -100 mg/dL), plasma cortisol levels of 62 g/mL (NR: 3 -31 g/mL) and  plasma ACTH level of  0 pg/mL (NR: 0 -100 pg/mL). Based on the information given,

What is the single most likely diagnosis from the following?

16 year old girl consults her primary care doctor  for primary amenorrhea and absence of breast development. Clinical examination reveals a male morphotype, signs of virilization with hypertrophy of the clitoris. Pelvic ultrasound confirmed the presence of the uterus and ovaries. 17- hydroxyprogesterone levels were elevated and the diagnosis of congenital adrenal hyperplasia is confirmed

 What is the  most likely enzyme deficiency responsible for this condition?

A 43 year old man presents to his physician with persistent dizziness when standing quickly. He also has been exhibiting chronic fatigue,  muscle weakness, and an unusual craving for salty foods. The physician notices that the patient has a constant “bronze, tan,” and blood obtained during the visit demonstrated normal cholesterol levels but also hypoglycemia, hyperkalemia, and hyponatremia.

What is the most likely underlying cause for these problems ?

A 35 year old woman presents with central obesity, a buffalo hump, type 2 diabetes, abdominal striae, and moon facies. A hormone is being overproduced in this syndrome .

What is the most likely precursor for the overproduced hormone?

A 40 year old woman with asthma has been using a beta-agonist inhaler daily for several weeks. Despite continued use, she notices that the inhaler is becoming less effective. Her physician explains that this could be due to a desensitization of her airway receptors.

What type of desensitization is most likely occurring with repeated use of the same agonist?

A 55 year old woman is diagnosed with pheochromocytoma.

What is the single most likely lab investigation that confirmed the diagnosis?

A 40 year old woman complaint of hypothyroidism on replacement therapy and diagnosed as having autoimmune thyroiditis.

      What is a typical thyroid scan finding in Hashimoto's thyroiditis?

A 42-year-old woman has been referred from an endocrinologist for weight gain especially around the waist. She also has striae over the abdomen and a rounded appearance of her face, a picture suspecting Cushing disease. Which metabolic element is expected to be decreased in this patient?