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Course management (2025/26)

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A 70 year old man with toxic multinodular goiter. He was treated with radioiodine therapy. Two years later, hypothyroidism developed. He was on thyroxine. In the thyroid clinic thyroid function shows the following results:

FT3 - 1.3 pmol/L (normal 1.1 to 3.2).

FT4 - 160 pmol/L (normal 9 to 23).

TSH – 1.5 mIU/L (normal 0.3 to 5).

GP asked the lab for the label used in competitive binding assay to measure FT4

What is the best answer for the GP

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A 67 year old man has a rapidly enlarging nodule in his neck. Fine needle aspiration cytology shows large pleomorphic cells with numerous giant cells. Which is the most likely diagnosis of this thyroid nodule?

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A 43-year-old woman, visits the internal medicine outpatient clinic complaining of easy fatigue, weight loss and intolerance to cold weather. On examination she has thyroid swelling and dry skin. Ultrasonography shows diffuse symmetric thyroid gland enlargement. She has low T3 and T4 as well as elevated anti-TPO and anti-TG serum levels. 

What is the most likely diagnosis of this case?

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A 37-year-old man presented with symptoms of hyperthyroidism and was diagnosed with Grave's disease. He started on methimazole and propranolol. Which of the following is a serious toxicity that can occur, though rarely, in patients taking methimazole?  

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Mrs. Soha Hazem is diagnosed with hypothyroidism. 

What are the most likely set of symptoms that she may have? 

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A 6-year-old non-obese girl is referred to the emergency unit after fainting. Her serum glucose and insulin were elevated with absent β-cells antibodies. Her father’s history is positive for diabetes mellitus. Her physical examination revealed normal growth and no hearing problems.  

What is the single best diagnosis of this case? 

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A 70-year-old man is diagnosed with pancreatic tumor and is successfully treated with a long-acting somatostatin analogue.  

What is the most likely gastrointestinal endocrine action of this treatment? 

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A 60-year-old woman is diagnosed with a glucagon secreting tumor at the tail of the pancreas.  

What is the most likely metabolic process that will be exaggerated? 

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A 28-year-old woman presents with hearing impairment, impaired glucose tolerance and a maternal history of diabetes mellitus.  

What is the most likely diagnosis of this case? 

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A 55-year-old woman with ten years history of diabetes mellitus starts to report to her physician recently developed blurred vision 

What is the most likely underlying cause of this complaint 

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