Questions and Answers
What is the likely diagnosis of a patient with a low testosterone level and low LH and FSH levels?
A patient presents with severe pain in the right side, unchanged erythrocytes in the urine, and normal body temperature. What is the most likely diagnosis?
A urinalysis reveals protein, erythrocyte casts, and changed erythrocytes. What is the most likely diagnosis?
A patient has a low estradiol level and high LH and FSH levels. What is the most likely diagnosis?
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What is the diagnosis of a patient with a low testosterone level and high LH and FSH levels?
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A patient presents with shortness of breath, palpitations, and headache after suffering a severe form of angina. What is the most likely diagnosis?
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What is the diagnosis of a patient with a low testosterone level and normal LH and FSH levels?
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A urinalysis reveals protein and erythrocytes in the urine. What is the most likely diagnosis?
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What is the diagnosis of a patient with a low estradiol level and normal LH and FSH levels?
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A patient presents with pain in the lumbar region and shortness of breath. What is the most likely diagnosis?
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Study Notes
Adrenogenital Syndrome
- Characterized by:
- Masculine body structure
- Male-type hair growth
- Low and rough voice
- Amenorrhea
- Clitoris size: 4 cm
- Laboratory studies: 46XX chromosomes
- High levels of 17-hydroxyprogesterone, 17-ketosteroids, androstenedione, and ACTH in blood serum
- Reduced 21-hydroxylase activity
- Leading link in pathogenesis: decreased cortisol synthesis and increased ACTH production
Acute Kidney Injury
- Patient's condition deteriorates 2 days after admission with:
- Low diuresis (300 ml/day)
- High serum creatinine (300 µmol/l)
- Most likely cause: development of acute renal failure
Chronic Glomerulonephritis
- Patient suffers from chronic diffuse glomerulonephritis for 5 years with:
- Aching pains in the heart
- Palpitations
- Pronounced edema
- Urinalysis: granular and waxy cylinders in large numbers
- Blood test: high residual nitrogen, low total protein and albumins, hyperlipidemia
- Edema caused by: decrease in oncotic blood pressure
Chronic Renal Failure
- Patient presents with:
- Drowsiness during the day
- Insomnia at night
- Nausea
- Diarrhea
- Skin itching
- High blood pressure
- Expansion of heart borders to the left
- Pericardial rub
- Low erythrocytes, hemoglobin, and leukocytes
- Low clearance of endogenous creatinine
- Low diuresis
- Most likely diagnosis: uremia
Urinary Tract Infection
- Patient presents with:
- Body temperature 38°C
- Dysuria
- Pain in the lumbar region
- Numerous neutrophils and leukocyte casts in urine
- Bacteriological examination: >105 bacteria/ml of urine
- Most likely diagnosis: pyelonephritis
Nephrotic Syndrome
- Patient presents with:
- Aching pains in the heart
- Palpitations
- Pronounced edema
- Urinalysis: daily diuresis 1000 ml, relative density 1.042, protein 3.3%
- Microscopy of urine sediment: granular and waxy cylinders in large numbers
- Blood pressure 170/95 mmHg
True Puberty
- Girl presents with:
- Enlargement of mammary glands
- Female-type hair growth
- Menstruation at 6 years 11 months
- High concentration of gonadoliberin, FSH, and estradiol
- Most likely diagnosis: true puberty
Hypogonadism
-
Boy presents with:
- Low testosterone (4.6 nmol/l)
- Low LH (0.3 mIU/ml)
- Low FSH (0.8 mIU/ml)
-
Most likely diagnosis: secondary hypogonadism
-
Girl presents with:
- Low estradiol (90.6 pmol/l)
- High LH (78.5 mIU/ml)
- High FSH (60.4 mIU/ml)
-
Most likely diagnosis: primary hypogonadism
Urolithiasis
- Patient presents with:
- Persistent, severe pain in the right side
- Normal body temperature
- No dysuria
- High blood pressure
- Tachycardia
- Unchanged erythrocytes in urine
- Most likely diagnosis: urolithiasis
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Description
Identify the leading link in the pathogenesis of a syndrome characterized by masculine body structure, amenorrhea, and hormonal imbalances. Laboratory studies reveal specific changes in hormone levels and enzyme activity.
