Maxemo EMREE 26-27

💡 EXPLANATION: Lid lag and restrictive ophthalmoplegia (upgaze deficit) combined with palpitations suggests thyroid eye disease/thyrotoxicosis. Thyroid function tests (TFTs) are the gold standard for diagnosis. Myasthenia gravis typically presents with ptosis, not lid lag.

💡 EXPLANATION: In an older smoker with weight loss and unilateral effusion, malignancy (lung cancer) is the most probable cause. While TB is possible, the smoking history and age favor neoplasm. CHF typically causes bilateral transudates.

💡 EXPLANATION: Laparoscopic cholecystectomy is minimally invasive, resulting in reduced tissue trauma. Key advantages over open surgery include decreased postoperative pain, earlier mobilization, shorter hospital stays, and faster return to daily activities.

💡 EXPLANATION: In children with burns <10% TBSA who are hemodynamically stable and tolerating oral intake, oral rehydration is the standard of care. IV fluid resuscitation (Parkland formula) is generally indicated for burns >10% TBSA in pediatrics.

💡 EXPLANATION: The clinical triad of hyperpigmentation, fatigue, and orthostatic hypotension indicates Primary Adrenal Insufficiency (Addison's disease). Aldosterone deficiency leads to renal sodium loss (hyponatremia) and potassium retention (hyperkalemia).

💡 EXPLANATION: Hypothyroidism in the elderly often presents with 'pseudodementia' (social withdrawal), accompanied by somatic signs like weight gain, constipation, and dry skin (myxedema). These physical findings distinguish it from primary depression.

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💡 EXPLANATION: A ranula is a mucus extravasation cyst arising primarily from the sublingual gland. It typically presents as a frog belly-like, translucent blue swelling on the floor of the mouth due to trauma or obstruction causing mucin leakage into tissue.

💡 EXPLANATION: Significant splenomegaly (4 cm) combined with thrombocytopenia suggests a secondary cause like Malaria or malignancy. Splenomegaly is atypical for ITP (diagnosis of exclusion) and HELLP syndrome. Gestational thrombocytopenia is mild (>70k) and asymptomatic.

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💡 EXPLANATION: While primary hypothyroidism causes hyperprolactinemia, a level of 90 ng/mL is disproportionately high for a TSH of 7 mIU/L. MRI is warranted to exclude a pituitary adenoma or stalk compression.