[內科] Medical Challenge就在明天!!!

[minihair (小毛)]

栗子剛剛告訴我
他發現內科主任室外的佈告欄有
Medical challenge
但是我和栗子都不知道, 也許有很多同學也不知道

裡面的題目如下

36F gradual body weight gain 40kg over 10 years

Hx: round face, thickened shoulder, comedo

Q1: How do you approach the patient with body weight gain?
    (Please focus on history taking and PE)

PE: moon face, bufflo hump, striae, obesity, ...

Lab: ACTH & cortisol indicate ACTH-dependent Cushing's syndrome
     CBC, BCS, U/A, EKG, CXR

Q2: What further test would you like to order

Q3: How to interpret the results?

Futher lab: tyroid function; ACTH & cortisol, overnight dexamethasone test,

Q4: How to interpret the test:

Further: Low dose dexamethasone test

Q5: How to interpret the test?

Q6: Which exam is the first priority for the patient?
    A. Pituitary MRI
    B. Chest HRCT
    C. Adrenal CT

Q7: What is you management for the positive finding
    on the previous image study?


只有這樣~




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