Endocrinology - PACKRAT-afterReview | 40 Questions with 100% Correct Answers | Updated & Verified

History & Physical/Endocrinology A 26-year-old obese female complains of a 3-4 month history of discrete erythematous plaques on the pretibial areas of her legs. The lesions have increased in size, become darker, and are painful. She is concerned because the centers of the lesions have become ulcerated. This patient should be screened for which of the following? Answers A. Hypothyroidism B. Diabetes mellitus C. Melanoma D. Scleroderma - ANS - Explanations (u) A. In hypothyroidism the skin of the pretibial area may thicken leading to edema. This is a diffuse finding, involving the face and eyelids, without discrete lesions. (c) B. The description of the skin lesions is characteristic of necrobiosis lipoidica diabeticorum, one of the dermatologic manifestations of diabetes mellitus. (u) C. The lesions of melanoma are typically not painful and do not ulcerate. (u) D. Scleroderma is marked by thickening of the skin, with swelling of the fingers and hands. The swelling may involve the forearms and face; the lower extremities are relatively spared. Diagnostic Studies/Endocrinology A solitary thyroid nodule is noted on physical examination. The TSH level is normal. The next step in the evaluation is Answers A. measurement of T4 and free T3 levels. B. a radionuclide thyroid scan. C. a fine needle biopsy. D. a surgical excision. - ANS - Explanations (u) A. Measurement of T4 and T3 levels would not be of benefit in the evaluation of a solitary thyroid nodule with a normal TSH level.