The Quizzes about Endocrinology disease – Part 1 (20 test)

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The Quizzes about Endocrinology disease – Part 1 (20 test)
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Select the ONE answer that is BEST in each case.

A 42-year-old woman has noticed dry skin, fatigue, and weight gain over the past 3 months. Her blood pressure is 110/70 mm Hg, pulse 60/min, and heart and lungs are normal. Her skin feels rough and dry, but the rest of the examination is normal. Her biochemistry is normal but the thyroid-stimulating hormone (TSH) is 39 mU/L (0.5–5 mU/L). Which of the following is the most likely cause for her elevated TSH?

Primary hypothyroidism is the most common cause of hypothyroidism in adults. Primary hypothyroidism is several times more common in women than in men and occurs most often between the ages of 40 and 60. Postablative hypothyroidism (radiation or surgery induced) is also very common.

 

See all quizzes of  the Endocrinology disease at here:

Part 1Part 2 | Part 3 | Part 4| Part 5 |

 

1. A 42-year-old woman has noticed dry skin, fatigue, and weight gain over the past 3 months. Her blood pressure is 110/70 mm Hg, pulse 60/min, and heart and lungs are normal. Her skin feels rough and dry, but the rest of the examination is normal. Her biochemistry is normal but the thyroid-stimulating hormone (TSH) is 39 mU/L (0.5–5 mU/L). Which of the following is the most likely cause for her elevated TSH?
(A) trauma
(B) radioactive iodine ingestion
(C) primary hypothyroidism
(D) parathyroid surgery

(E) antithyroid chemicals

2. A 53-year-old man has had gout for many years, and usually experiences 4–5 attacks a year. He is not on any medications for gout prophylaxis, and takes an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) to treat his flares. On examination, there are no active joints presently, but he does have some tophaceous deposits on his left hand. As part of his complete evaluation, screening for renal complications is performed. Which of the following findings is most likely compatible with chronic gouty nephropathy?

(A) nephrotic syndrome
(B) decrease urinary concentrating ability and proteinuria
(C) acute renal failure
(D) acute tubular necrosis (ATN)
(E) malignant hypertension

3. Which of the following is the most common presentation of anterior pituitary hyposecretion in a 26-year-old woman?
(A) occurrence of myxedema
(B) decreased melanin pigmentation
(C) emaciation and cachexia
(D) loss of axillary and pubic hairs
(E) amenorrhea

4. A 19-year-old woman presents with primary amenorrhea. Her physical examination is normal, and she has female sex characteristics and breast development. The only abnormality is the absence of body hair. Genetic testing reveals an XY chromosome pattern. Which of the following mechanisms is most likely to explain her phenotypic pattern and amenorrhea?
(A) estrogen receptor defect
(B) excess hormone production
(C) androgen receptor defect
(D) decreased hormone production
(E) abnormal hormone production

5. A 17-year-old woman has skin photosensitivity since childhood but has gotten worse recently. Her skin appears fine indoors, but within a short period of sun exposure, she develops burning, redness, and itching. A diagnosis of erythropoietic protoporphyria is made by a dermatologist. Which of the following treatments is most likely to be helpful? (See Fig. 3 1.)
(A) phenobarbital
(B) corticosteroids
(C) high carbohydrate diet
(D) beta-carotene
(E) chlorpromazine

 

6. A 23-year-old woman presents for evaluation of irregular periods and infertility. Her clinical examination is entirely normal. Biochemical tests show a reduced estradiol and folliclestimulating hormone (FSH) levels. She is diagnosed with central hypogonadism. Which of the following is the most important function of FSH?
(A) causes ovulation
(B) encourages progesterone secretion
(C) causes the secretory phase of the uterine mucosa

(D) inhibits estrogen secretion
(E) encourages maturation of the follicle

7. A healthy 42-year-old woman is found on routine blood testing to have a calcium level of 12 mg/dL. She feels well, and her physical examination is normal. Further investigations reveal a parathormone (PTH) level of 750 pg/mL (230–630 pg/mL). Which of the following findings is also associated with this disorder?
(A) osteoblastic lesions of bone
(B) polycythemia
(C) prolonged QT interval on electrocardiogram (ECG)
(D) orthostatic hypotension
(E) cystic bone lesions

8. A 32-year-old woman is feeling unwell because of muscle cramps and generalized fatigue. Her blood pressure is 120/70 mm Hg, pulse 100/min, and the heart and lungs are normal. Muscle strength and bulk are normal but the reflexes are increased symmetrically. She had a previous thyroidectomy for a goiter 3 years ago. Her serum calcium level is 7 mg/dL (8.4–10.2 mg/dL), TSH 3 mU/L (0.5–5 mU/L)and albumin 4 g/dL (3.5–5.5 g/dL). Which of the following is the most likely explanation for her low calcium?
(A) idiopathic
(B) familial
(C) postradiation
(D) end-organ resistance
(E) surgical removal

9. A 27-year-old woman presents with weight loss, fatigue, and weakness. She also experiences nausea and vomiting but no dysphagia. Her physical examination is normal except for increased generalized skin pigmentation. Her serum sodium is low and potassium is high. Which of the following features is also most likely to be present? (See Fig. 3–2.)
(A) the skin is shiny and pale
(B) a diabetic glucose tolerance is characteristic
(C) water diuresis is impaired
(D) the urinary steroids are high
(E) the serum calcium is elevated

10. A patient with polyuria and polydipsia is newly diagnosed with central diabetes insipidus (DI). Which of the following is the most likely finding on magnetic resonance imaging (MRI) of the brain?
(A) hypothalamic tumor
(B) hyperintense signals in the cerebral cortex
(C) agenesis of the corpus callosum
(D) lack of hyperintense signals from the posterior pituitary
(E) communicating hydrocephalus

11. A 17-year-old man is 5’7” tall and weighs 370 lb. No medical cause for this “essential obesity” is found. Which of the following abnormalities can he also be expected to have?
(A) normal mortality risk
(B) hypothyroidism
(C) low PCO2 values
(D) hypertriglyceridemia
(E) hyperadrenocorticalism

12. A 56-year-old man presents with a change in skin color, fatigue, and abdominal pain. He has also noticed increased urine output and thirst. On examination, his skin appears bronze in color, his liver span is 16 cm, and there is loss of body hair, and testicular atrophy. His ferritin is 600 ng/mL (15–200 ng/mL), aspartate amino transferase (AST) 130 U/L (8–20 U/L), alanine amino transferase (ALT) 150 U/L (8–20 U/L), and total bilirubin 0.5mg/dL (0.1–1 mg/dL). Coagulation tests and albumin level are normal but the random glucose is elevated at 250 mg/dL. Which of the following is the most likely diagnosis?
(A) diabetes mellitus (DM)
(B) amyloidosis
(C) Wilson’s disease
(D) hemochromatosis
(E) Addison’s disease

13. A 35-year-old man has had recurrent attacks of abdominal pain and proximal motor neuropathy since puberty. The episodes are precipitated by infections and certain medications. During one of the attacks, the plasma porphobilinogen levels were increased. Which of the following medications is not considered safe in patients with this condition?
(A) chlorpromazine
(B) sulfonamide antibiotics
(C) penicillin and derivatives
(D) narcotics
(E) glucocorticoids

14. A 43-year-old man weighs 85 kg and is 1.8 m tall. His calculated body mass index (BMI) is 23 kg/m2. Which of the following conditions is he most likely at risk for?
(A) DM
(B) hyperlipoproteinemia
(C) abnormal growth hormone response
(D) atherosclerosis
(E) no increased risk for mortality

15. A 47-year-old woman with bipolar disorder develops new symptoms of polyuria and polydipsia. She has been on lithium for a long timeto control her illness. Which of the following is the most likely explanation for this complication of lithium treatment?

(A) impairing glucose absorption at the cellular level
(B) decreasing production of vasopressin
(C) increasing production of vasopressin
(D) causing a solute diuresis
(E) impairing vasopressin action at the tubular level

16. The 2-year-old daughter of a Jewish couple, whose parents emigrated from Russia, develops progressive loss of motor skills. There is macular pallor on ophthalmic examination, and she has a short stature, thin limbs, but full cheeks. She is also prone to developing hypoglycemia and lactic acidosis. Which of the following metabolic abnormalities is most likely associated with this disorder?
(A) glycogen storage
(B) ganglioside accumulation
(C) amyloid accumulation
(D) corneal deposits
(E) cholesterol accumulation

17. A 63-year-old man develops edema, and dyspnea on exertion. He has no prior cardiac or renal conditions, and his examination is significant for macroglossia, elevated jugular venous pressure (JVP), hepatomegaly, and 3+ pedal edema. His investigations reveal 3.5 g/d of protein in the urine, anemia, normal fasting glucose, and serum immunoelectrophoresis is positive for a monoclonal immunoglobulin. Which of the following is the most characteristic neurologic finding associated with this condition? (See Fig. 3–3.)
(A) peripheral motor and sensory neuropathy
(B) spinal cord compression in the lumbar region
(C) spinal cord compression in the thoracic region
(D) a peripheral neuropathy associated with cerebral manifestations
(E) a Guillain-Barré-type syndrome

18. A30-year-old man presents with recurrent flushing, diarrhea, and weight loss. His examination is normal. Lab investigations reveal an elevated urinary 5-hydroxyindoleacetic acid. Which of the following is the most likely diagnosis?
(A) phenylketonuria
(B) alkaptonuria
(C) malignant melanoma
(D) carcinoid syndrome
(E) disseminated carcinomatosis

19. A 25-year-old woman presents with symptoms of polyuria and polydipsia. So far investigations have ruled out psychogenic causes and diabetes. A fluid deprivation test is performed. At the end of the test, the urine osmolality is 240 mOsm/kg and the serum antidiuretic hormone (ADH) level is elevated. Which of the following is the most likely diagnosis?
(A) adrenal cortex defect
(B) nephrogenic diabetes insipidus
(C) central (posterior pituitary) diabetes insipidus
(D) acute tubular necrosis (ATN)
(E) Addison’s disease

20. A 40-year-old man has lipid investigations suggesting familial hypercholesterolemia (increased cholesterol, increased low-density lipoprotein [LDL], and normal triglycerides). This condition is characterized by increased risk for premature atherosclerosis and by the occurrence oftuberous and tendon xanthomas. Before making the assumption of familial hypercholesterolemia, secondary causes need to be considered. Which of the following conditions is most likely to cause secondary hyperlipidemia?
(A) cholestatic liver disease
(B) alcoholism
(C) estrogen replacement
(D) malabsorption syndromes
(E) chronic lung disease

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