A 14-year-old boy was brought to the physician by his father because of vision problems. He
is a quarterback at his local high school but has been increasingly tackled down from left and
right without noticing. He says his vision started to decrease in the lower corners but has
creeped upwards. He has grown 5 cm (2 inches) in the past year. Physical examination
shows the pupils are equal, round, and reactive to light. Goldman visual field test reveals
bilateral hemianopia. Serum lab results are shown.
Sodium: 142 mmol/L
Potassium: 3.9 mmol/L
Glucose: 71 mg/dL
Cortisol: 2.3 ug/dL
Growth hormone (GH): 30 ng/mL
Insulin-like growth factor-1 (IGF-1): 327 ng/mL
What is the most likely diagnosis?
- A. Retinoblastoma
- B. Medial and lateral rectus palsy
- C. Pituitary adenoma
- D. Pituitary adenocarcinoma
- E. Craniopharyngioma
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A 28-year-old woman was brought to the physician by a friend because of paranoia and
hallucinations for the past 3 days. The friend says that for the past two years the patient has
lost her affection for animals and no longer speaks with sophistication. She is prescribed an
antipsychotic. One month later the patient comes back to the physician by herself
complaining of impaired vision and a feeling of dizziness. An electrocardiogram (ECG) is
done and the result is shown.
Which medication was most likely prescribed?
- A. Chlorpromazine
- B. Thioridazine
- C. Fluphenazine
- D. Haloperidol
- E. Amitriptyline
0 voters
A 64-year-old man visits his physician because of fatigue and chronic dry coughs that have
persisted for a month. He is having increasing difficulty climbing the stairs to his apartment
due to shortness of breath. He admits to being a moderate smoker at social gatherings, but
smokes no more than one or two cigarettes a week. Physical examination shows clubbing of
the fingers. A pulmonary function test shows the following graph.
What is the most likely diagnosis?
- A. Emphysema
- B. Bronchitis
- C. Bronchiectasis
- D. Idiopathic pulmonary fibrosis (IPF)
- E. Asthma
0 voters