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Correct! An increased frequency of urination, and thirst, weakness, fatigue are common manifestations of diabetes mellitus. The patient also has increased BMI, which puts him at the risk of developing diabetes mellitus.
The American Endocrine Society recommends, HbA1C 6.5% or higher as the primary criterion for the diagnosis of diabetes mellitus. Therefore, the most likely diagnosis is diabetes mellitus. +
Incorrect! A person with MS can have almost any neurological symptom or sign; with autonomic, visual, motor, and sensory problems being the most common. The specific symptoms are determined by the locations of the lesions within the nervous system, and may include loss of sensitivity or changes in sensation such as tingling, pins and needles or numbness, muscle weakness, very pronounced reflexes, muscle spasms, or difficulty in moving; difficulties with coordination and balance (ataxia); problems with speech or swallowing, visual problems (nystagmus, optic neuritis or double vision), feeling tired, acute or chronic pain, and bladder and bowel difficulties, among others. Difficulties thinking and emotional problems such as depression or unstable mood are also common. Uhthoff's phenomenon, a worsening of symptoms due to exposure to higher than usual temperatures, and Lhermitte's sign, an electrical sensation that runs down the back when bending the neck, are particularly characteristic of multiple sclerosis. +
'''Incorrect''' - After diagnosing papillary carcinoma of thyroid with a histopathological analysis, ultrasound of the neck is the primary modality that is used for staging the disease. CT scan of the neck and the chest might be valuable only if the disease is recurrent or metastatic. +
Invasion beyond the muscular propria indicates a T3 tumor. T2 tumors include those that have invaded, but not extended beyond the muscular propria. +
A lateral chest radiograph can cause the 2D projection of the stomach and the lung to be overlapping and may confuse interpretation of the position of the tube. +
A white blood cell count greater than 16,000 is one of the Ranson's criteria on initial presentation. +
Throwing injuries place large amounts of stress on the posterior aspects of the should. Throwing most often injures the muscles of the rotator cuff and would result in an anterior shoulder dislocation rather than a posterior shoulder dislocation. +
The waxing/waning fever in this patient is suggestive of ''Brucella'' infection. Meningitis has been reported as a very rare complication of brucellosis, but it is not considered a common feature of infection. +
Methotrexate is the preferred first line therapy for primary CNS lymphoma. The presence of multiple enhancing lesions in this patient's MRI make the diagnosis of primary CNS lymphoma less likely than Toxoplasmosis. +
Central cord syndrome is defined as injury to the central portion of the spinal cord. It is typically caused by hyperextension injuries in the cervical spine (eg whiplash). It typically causes weakness in a cape-like distribution along the upper extremities. +
Mannitol is an effective agent for lowering intracranial pressure, but it is cleared by the kidneys and can precipitate renal failure. In a patient with pre-existing renal compromise mannitol would not be the best choice. +
IgA nephropathy (Berger’s disease) is the most common primary glomerulonephritis worldwide. It is characterized by deposition of IgA in the glomerular mesangium leading to mesangial proliferation. The IgA1 is almost always the subclass involved and contains O-glycans deficient in galactose. +
One could obtain this number by using the ratio of the serum PAH to serum creatinine. However, this does not reflect any standard physiologic parameter. +
Protein kinase A mediates the phosphorylation of the myosin light chain kinase and subsequently inactivates it. Myosin light chain kinase inactivation results in vasodilation. +