The Gland Slam (Endocrine Pathology)
This condition is the most common cause of hyperthyroidism and is characterized by diffuse goiter and exophthalmos.
What is Graves’ disease?
This autosomal recessive disorder, caused by mutations in the ATP7B gene, leads to copper accumulation in tissues and presents with hepatic, neurologic, and psychiatric symptoms.
What is Wilson disease?
This nephritic syndrome often follows a streptococcal infection and presents with cola-colored urine.
What is poststreptococcal glomerulonephritis?
This drug class reduces gastric acid secretion by irreversibly inhibiting the H+/K+ ATPase in stomach parietal cells.
What are proton pump inhibitors?
What do I want to be when I grow up? (Specific)
Orthopedic Spine Surgeon
This autoimmune thyroid condition initially presents with hyperthyroid symptoms but progresses to hypothyroidism as follicles are destroyed.
What is Hashimoto thyroiditis?
This condition is characterized by transmural inflammation and skip lesions, often affecting the terminal ileum.
What is Crohn disease?
This type of acidosis presents with a normal anion gap and hyperchloremia
What is Type 2 (proximal) renal tubular acidosis?
This monoclonal antibody prevents bone resorption by inhibiting RANK ligand
What is denosumab?
I competed in this track and field event during college.
Decathlon
This adrenal enzyme deficiency results in virilization in females and salt-wasting crises due to impaired cortisol and aldosterone synthesis
What is 21-hydroxylase deficiency?
This gastric condition is associated with hypertrophy of the rugal folds, protein-losing enteropathy, and an increased risk of gastric cancer
What is Menetrier disease?
This kidney stone type is associated with urease-producing bacteria like Proteus mirabilis and forms staghorn calculi.
What are struvite (ammonium magnesium phosphate) stones?
This non-selective beta-blocker is used to manage the symptoms of thyroid storm by controlling heart rate and inhibiting peripheral conversion of T4 to T3.
What is propranolol?
What is my birth month?
April
This rare pituitary condition, often seen in postpartum women, results in panhypopituitarism due to ischemic necrosis following severe blood loss.
What is Sheehan syndrome?
This pancreatic condition is most commonly seen in patients with chronic alcoholism and presents with epigastric pain radiating to the back, steatorrhea, and diabetes
What is chronic pancreatitis?
This congenital condition leads to cystic dilation of the renal collecting ducts and is associated with a “swiss cheese” appearance on imaging and recurrent urinary tract infections.
What is medullary sponge kidney?
This antibiotic is used in hepatic encephalopathy as an adjunct to lactulose by reducing ammonia-producing gut bacteria. It is also commonly used to treat traveler’s diarrhea caused by non-invasive E. coli.
What is rifaximin? (neomycin may also be correct)
What is my greatest fear?
Sharks
A 35-year-old man presents with hyperpigmentation, fatigue, and hypotension. Laboratory evaluation shows hyponatremia, hyperkalemia, and a low cortisol level that does not respond to ACTH stimulation. A CT scan reveals bilateral adrenal atrophy. Which of the following is the most likely cause of this patient’s condition?
A) Congenital adrenal hyperplasia
B) Autoimmune adrenalitis
C) Tuberculosis infection
D) Pituitary adenoma
E) Adrenal hemorrhage
Correct Answer: B) Autoimmune adrenalitis
Explanation: Autoimmune adrenalitis is the most common cause of primary adrenal insufficiency (Addison’s disease) in developed countries. It leads to adrenal atrophy and decreased production of aldosterone and cortisol, resulting in hyperpigmentation, hyponatremia, hyperkalemia, and hypotension.
A 48-year-old man presents with epigastric pain, weight loss, and greasy stools. Laboratory testing reveals elevated amylase and lipase levels. A CT scan shows calcifications in the pancreas. Which of the following is the most likely underlying cause?
A) Gallstones
B) Chronic alcohol use
C) Cystic fibrosis
D) Autoimmune pancreatitis
E) Hypertriglyceridemia
Correct Answer: B) Chronic alcohol use
Explanation: Chronic alcohol use is the most common cause of chronic pancreatitis in adults. It leads to progressive fibrosis and calcification of the pancreas, resulting in exocrine insufficiency (steatorrhea) and epigastric pain.
A 65-year-old man presents with hematuria and a right-sided flank mass. A CT scan reveals a large mass in the right kidney with invasion of the renal vein. Laboratory findings show hypercalcemia. Which of the following is the most likely diagnosis?
A) Urothelial carcinoma
B) Renal cell carcinoma
C) Wilms tumor
D) Angiomyolipoma
E) Squamous cell carcinoma of the bladder
Correct Answer: B) Renal cell carcinoma
Explanation: Renal cell carcinoma often presents with a triad of hematuria, flank pain, and a palpable mass. It is associated with paraneoplastic syndromes, such as hypercalcemia (due to ectopic PTHrP secretion).
A 55-year-old man with a history of gout presents with acute onset flank pain and hematuria. Imaging reveals a radiolucent kidney stone. Which of the following medications could have contributed to this condition?
A) Hydrochlorothiazide
B) Allopurinol
C) Furosemide
D) Febuxostat
E) Probenecid
Correct Answer: E) Probenecid
Explanation: Probenecid increases uric acid excretion, potentially leading to precipitation of uric acid in the urine and the formation of uric acid stones, which are radiolucent. Furosemide, while it can increase calcium excretion and promote stone formation, is more closely associated with calcium-containing stones, which are radiopaque.
What are the names of my cats?
Charley and Roger