A 32-year-old woman presents to the emergency department wit…
A 32-year-old woman presents to the emergency department with a 1-month history of heat intolerance, a racing heart, unintentional 4-pound weight loss, and sweating. She states she is generally healthy and only takes a multivitamin. Her temperature is 100°F (37.8°C), blood pressure is 122/82 mmHg, pulse is 120/min, respirations are 17/min, and oxygen saturation is 100% on room air. Physical exam is notable for a nontender and enlarged thyroid. HEENT exam is notable for the finding shown (see image), which is mild. The patient’s urine hCG is negative. Laboratory values are notable for a TSH of 0.1 mIU/L. What is the most appropriate definitive treatment for this patient?
Read DetailsA 42-year-old female, who loves food laden with salt, is ver…
A 42-year-old female, who loves food laden with salt, is very puzzled about her recent unexplained weight loss. She also has complaints of lethargy. She has had several recent episodes of nausea and vomiting. Because of her symptoms, she goes to her primary care physician. Upon questioning, she is surprised that her doctor asks her about salt craving but acknowledges this. On physical examination, there is a hyperpigmentation to her skin and mucous membranes. Her blood pressure is 85/60 mmHg. Her laboratory results show hyponatremia and hyperkalemia. Her serum ACTH level is elevated. Based on this information, which of the following conditions is the most likely diagnosis for this patient?
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