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148312 Medicine

A 29-year-old woman is found, on routine annual blood testing, to have a small increase in unconjugated bilirubin. There is no evidence of hemolysis and her liver enzymes and function tests are otherwise normal. She has no prior history of liver disease and is not taking any medications. Her physical examination is completely normal with no signs of chronic liver disease. Which of the following is the most likely diagnosis?

ACrigler-Najjar syndrome
BDubin-Johnson syndrome
CRotor syndrome
DGilbert syndrome
Medicine
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148313 Medicine

A 46-year-old woman presents for her annual examination. Her main complaint is frequent sweating episodes with a sensation of intense heat starting at her upper chest and spreading up to her head. These have been intermittent for the past 6 to 9 months but are gradually worsening. She has three to four flushing/sweating episodes during the day and two to three at night. She occasionally feels her heart race for about a second, but when she checks her pulse it is normal. She reports feeling more tired and has difficulty with sleep due to sweating. She denies major life stressors. She also denies weight loss, weight gain, or change in bowel habit. Her last menstrual cycle was 3 months ago. Physical examination is normal. Which treatment is most appropriate in alleviating this woman’s symptoms?

ALevothyroxine
BEstrogen
CEstrogen plus progesterone
DCitalopram
Medicine
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