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134723 Pathology

A 45-year-old man with recent history of bizarre behavior is seen by a psychiatrist. On physical examination, the patient appears moderately obese with mild hypeension, facial acne, fat accumulation in the supraclavicular fossae. Laboratory studies demonstrate a neutrophilic leukocytosis, with a decrease lymphocytes and absence of eosinophils. There is a mild hypokalemia and mild metabolic alkalosis. The fasting serum glucose is within the reference range, but OGTT had glucose concentrations > 200 mg/dL. Laboratory studies show free urinary coisol of 156 mg/ 24 hours .Which of the following questions would be of most help in establishing a diagnosis?

AAre you experiencing muscle weakness?
BAre you experiencing shoness of breath?
CAre you receiving coicosteroids for some other disease?
DDo you have a family history of endocrine neoplasia?
Pathology
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134724 Medicine

A 77-year-old man is brought to the hospital by his granddaughter for evaluation of confusion. He has no focal findings and his neuro-imaging studies are normal. Further investigations reveal a urinary tract infection, and the man improves somewhat after treatment, but still exhibits poor judgment and bizarre behavior. Pressing the family for information, the intern unearths a history of 8 years of progressive bizarre behavior. The man has undressed himself and made sexual advances to young female relatives, has urinated in hallways, and pushed food into his mouth with alarming speed. Which of the following is the most likely diagnosis?

AAlzheimer's disease
Bfrontotemporal dementia
Cdementia with diffuse Lewy bodies
Dvascular dementia
Medicine
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