A 52‐year‐old nurse seeks medical retirement because of a “heart condition.” She complains of disabling attacks of tachycardia and palpitations. The physical examination and electrocardiogram studies confirm that indeed her pulse is between 100 and 105/min at all times, and she is in and out of atrial fibrillation. It is also noted that she is fidgety and constantly moving, and various examiners remark that she arrives for tests lightly dressed when it is rather cold outside. Thyroid function studies show elevated free thyroxine (T4) and undetectable levels of thyroid stimulating hormone (TSH). Her thyroid gland is not clinically enlarged or tender. Which of the following is the most appropriate next step in diagnosis?
- A. Fine needle aspiration cytology of the thyroid gland
- B. MRI of the pituitary area
- C. Radioactive iodine uptake
- D. Serum levels of C peptide
- E. Serum levels of triiodothyronine (T3)
0 voters
A 57‐year‐old man comes to the physician because of “erectile problems”. He says that he has not been able to have an erection in months. He has seen so many television commercials lately that he expects a cure in the form of a “little blue pill”. He is married, has 3 children, works as a trader on the stock exchange, and is an avid cyclist. He takes no medications, does not drink alcohol, and has had no serious medical conditions. Physical examination is unremarkable. Which of the following questions is most likely to help determine the cause of this patient’s condition?
- A. “How often do you ride your bicycle?”
- B. “Are you sexually attracted to your wife?”
- C. “Are you feeling unusually anxious lately?”
- D. “Do you have nocturnal or early morning erections?”
- E. “Do you love your wife?”
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