Usmle Step 3: Uworld Practice Test 2: Exam Questions And Answers

31 yo M has 3 month hx of progressive tiredness, weight gain, lethargy. Stopped going to gym a few wks ago due to fatigue&mm aches. ED&loss of libido. Sister has hypothyroidism treated w/levothyroxine. BMI 26. Delayed mm relaxation on DR testing. TSH 3.4, free T4 0.6(low), Testosterone 234(low), LH 4, cortisol 10, prolactin 36. management? {Ans: *order pituitary MRI* dx: central hypothyroidism -low free T4 w/low-inappropriately normal TSH -most common cause: pituitary mass -ACTH(Corticotropin) stimulation test should be done before initiating tx b/c levothyroxine can precipitate adrenal crisis in pts w/undiagnosed adrenal insufficiency}high pleural fluid/serum glucose ratio~1 {Ans: transudative effusions uncomplicated parapneumonic other infxn(viral) PE Post-CABG}why is desmopressin used w/von willebrand disease? {Ans: synthetic ADH that promotes release of vWF Factor -used in those w/vWF disease before surgery or to control mild bleeding episodes}71 yo F has 1 wk hx fever, dry cough, SOB. Over past year, 2 episodes shingles &feels tired constantly. Occasional loose stools, joint pains, 4.5 kg(10 lb) weight loss over past year. T 100.4F, R 24/min, Recently received pneumococcal and zoster vaccines. Drinks glass of wine w/dinner every evening. pulse ox 90% RA. Exam: enlarged LN in cervical & inguinal regions &small white