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NEW QUESTION: 1
An 18-year-old man, whose ambition was to become a member of the elite armed forces, presented with gynaecomastia. His weekly alcohol consumption was 35 units.
On examination, he had normal secondary sexual characteristics, a well-developed, muscular physique and modest, slightly tender bilateral gynaecomastia. Testes were 10 mL with soft texture.
Investigations:
haemoglobin160 g/L (130-180)
MCV96 fL (80-96)
serum dehydroepiandrosterone sulphate4 umol/L (2-10)
serum oestradiol180 pmol/L (<180)
serum testosterone (09.00 h)6.0 nmol/L (9.0-35.0)
plasma follicle-stimulating hormone1.0 U/L (1.0-7.0)
plasma luteinising hormone0.7 U/L (1.0-10.0)
serum prolactin420 mU/L (<360)
What is the most likely diagnosis?
A. oestrogen-secreting testicular tumour
B. persistence of pubertal gynaecomastia
C. primary hypogonadotrophic hypogonadism
D. androgen abuse
E. alcohol excess
Answer: D
NEW QUESTION: 2
A. Option C
B. Option A
C. Option D
D. Option B
Answer: A,C
NEW QUESTION: 3
A. Option C
B. Option D
C. Option A
D. Option B
Answer: A
Explanation:
Explanation
The Microsoft Database Engine Tuning Advisor (DTA) analyzes databases and makes recommendations that you can use to optimize query performance. You can use the Database Engine Tuning Advisor to select and create an optimal set of indexes, indexed views, or table partitions without having an expert understanding of the database structure or the internals of SQL Server. Using the DTA, you can perform the following tasks.
Troubleshoot the performance of a specific problem query
Tune a large set of queries across one or more databases
Perform an exploratory what-if analysis of potential physical design changes Manage storage space References:
https://docs.microsoft.com/en-us/sql/relational-databases/performance/database-engine-tuning-advisor