~--.; ::22 ; ;;a
XIX
A 40 year s old fema le pati ent complains of ante
rior neck swelling, b·ulging of eyes,
tion, she has TSH of0.05 ml U/L,
trem or and palp itati on for last 3 months. On investiga
T4 of 21 mcg /dL and T3 of 340 ng/dL.
1) Grave's disease (hyperthyroidism)
2) normal thyroid cells+ genetic factor
a. wha t is the mos t prob able diagnosis? (1)
failure to self tolerance
b. Briefly desc ribe abou t its path ogen esis. (2)
development of autoimmunity
ition? (1)
c. Wha t are the long term com plica tion s of this cond
1) thyroid stimulating IgG
2)thyroid growth stimulating IgG
3)TSH binding inhibition
hyperthyroidism
3) pregnancy issues,
heart disease(eg.CHF),
brittle bones
, XVIII
A 30 year old female patient presented with mid line neck swelling. cold ir.toten~ce.
weight gain and menstrual abnormality. She also has history of primary i~.fer-:~:: '::J.
a. what is the most probable diagnosis? (1)
b. How will you investigate to confirm the diagnosis? (1)
c. what are the primary and secondary causes of this condition? (2)
1) hypothyroidism
2) T3 , T4, TSH
2) primary: hashimoto's thyroiditis
secondary: pituitary & hypothalamic failure
, I
X1
10 Years n1ale child ,-vith H/0 repeated blood transfusion. On clinical examination there
is yello,vish discolouration of the conjuctiva.
Q.1. "·hich type of jaundice the patient is suffering from? (1)
Q.2. ,vhich fraction of Bilirubin is increased in this condition? (1)
Q.3. ,vhat is the colour of urine and stool in this condition and why? (2)
1) hemolytic jaundice
2)unconjugated bilirubin
3)urine- normal-acholuric (as no
bilirubin)
urobilinogen is present \
stool- dark(as stercobilinogen)
, xz
r,
46 • Years old fen1ale \Vith abdon1ina\ pain, and anorexia. On c ,lil examination there
is yello,vish discolouration or the conjuctivc1.
Serun1 Bilirubin - 10.4 n1g/dl 1) hepatocellular jaundice
S.G.P.T- 221U/L 2)urine- dark-choluric(bilirubin present)
urobilinogen is also present
S.G.0.T- 181U/L stool- dark
3) both conjugated & unconjugated bilirubin
Serum alkaline phosphatise - WNL 4) hepatitis,cirrhosis,
HBS Ag - Positive
Q.l. \Vhich type of jaundice the patient is suffering from (1)
Q.2. \Vhat is the colour of urine and stool in this condition (1)
Q.3. \Vhich fraction of the Bilirub!n is increased? (1)
'lt4 . ."-te.,Vl-,'oi.v t,,.1-e c..n:.p, ,'c,,.,h'o..,,, of -1,...,',s c,~"+,·IJ.., [o/.. -t\]
XIX
A 40 year s old fema le pati ent complains of ante
rior neck swelling, b·ulging of eyes,
tion, she has TSH of0.05 ml U/L,
trem or and palp itati on for last 3 months. On investiga
T4 of 21 mcg /dL and T3 of 340 ng/dL.
1) Grave's disease (hyperthyroidism)
2) normal thyroid cells+ genetic factor
a. wha t is the mos t prob able diagnosis? (1)
failure to self tolerance
b. Briefly desc ribe abou t its path ogen esis. (2)
development of autoimmunity
ition? (1)
c. Wha t are the long term com plica tion s of this cond
1) thyroid stimulating IgG
2)thyroid growth stimulating IgG
3)TSH binding inhibition
hyperthyroidism
3) pregnancy issues,
heart disease(eg.CHF),
brittle bones
, XVIII
A 30 year old female patient presented with mid line neck swelling. cold ir.toten~ce.
weight gain and menstrual abnormality. She also has history of primary i~.fer-:~:: '::J.
a. what is the most probable diagnosis? (1)
b. How will you investigate to confirm the diagnosis? (1)
c. what are the primary and secondary causes of this condition? (2)
1) hypothyroidism
2) T3 , T4, TSH
2) primary: hashimoto's thyroiditis
secondary: pituitary & hypothalamic failure
, I
X1
10 Years n1ale child ,-vith H/0 repeated blood transfusion. On clinical examination there
is yello,vish discolouration of the conjuctiva.
Q.1. "·hich type of jaundice the patient is suffering from? (1)
Q.2. ,vhich fraction of Bilirubin is increased in this condition? (1)
Q.3. ,vhat is the colour of urine and stool in this condition and why? (2)
1) hemolytic jaundice
2)unconjugated bilirubin
3)urine- normal-acholuric (as no
bilirubin)
urobilinogen is present \
stool- dark(as stercobilinogen)
, xz
r,
46 • Years old fen1ale \Vith abdon1ina\ pain, and anorexia. On c ,lil examination there
is yello,vish discolouration or the conjuctivc1.
Serun1 Bilirubin - 10.4 n1g/dl 1) hepatocellular jaundice
S.G.P.T- 221U/L 2)urine- dark-choluric(bilirubin present)
urobilinogen is also present
S.G.0.T- 181U/L stool- dark
3) both conjugated & unconjugated bilirubin
Serum alkaline phosphatise - WNL 4) hepatitis,cirrhosis,
HBS Ag - Positive
Q.l. \Vhich type of jaundice the patient is suffering from (1)
Q.2. \Vhat is the colour of urine and stool in this condition (1)
Q.3. \Vhich fraction of the Bilirub!n is increased? (1)
'lt4 . ."-te.,Vl-,'oi.v t,,.1-e c..n:.p, ,'c,,.,h'o..,,, of -1,...,',s c,~"+,·IJ.., [o/.. -t\]
