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Select the ONE answer that is BEST in each case.
A 62-year-old man is seen in the office. Routine blood testing reveals elevated LDL cholesterol. Which of the following is the most likely cause for the elevated LDL?
In Western societies, most dyslipidemias are secondary. The most common predisposing cause is diet, and the second common is DM. Hypothyroidism, renal disease, alcoholism, and anorexia nervosa are also associated with secondary dyslipidemias. Many drugs (e.g., estrogen, glucocorticoids) can also cause secondary dyslipidemias.
See all quizzes of the Endocrinology disease at here:
41. A 62-year-old man is seen in the office. Routine blood testing reveals elevated LDL cholesterol. Which of the following is the most likely cause for the elevated LDL?
(A) an autosomal dominant disease
(B) an X-linked recessive disease
(C) a polygenic disease
(D) a poor diet
|42. Which of the following dietary abnormalities is most commonly associated with elevated cholesterol levels?
(A) inadequate fiber
(B) excess calories resulting in obesity
(C) excess dietary cholesterol
(D) excess total fat intake
(E) excess trans-fatty acid intake
|43. A 63-year-old asymptomatic woman is investigated for a high alkaline phosphatase (ALP) level. X-rays of the pelvis show multiple porotic and sclerotic lesions with characteristic whorls of trabeculation. Her excretion of urinary hydroxyproline is also elevated. Which of the following is the most likely diagnosis?
(A) rickets and osteomalacia
(B) osteogenic sarcoma
(C) vitamin D deficiency
(D) Paget’s disease of bone
(E) metastatic cancer
|44. A 20-year-old man develops symptoms of weakness with numbness and tingling in his hands. The physical examination is normal, but his calcium is 7.4 mg/dL (8.4–10.2 mg/dL). Which of the following additional serum values is most consistent with the diagnosis of vitamin D deficiency?
(A) low vitamin D, low phosphate, high PTH
(B) low vitamin D, low phosphate, low PTH
(C) low vitamin D, high phosphate, low PTH
(D) normal vitamin D, low phosphate, high PTH
(E) normal vitamin D, high phosphate, high PTH
|45. A 19-year-old woman develops weight loss, tremor, and heat intolerance. On examination, she has goiter, warm skin, and a fine tremor of her hands. Her TSH is low and her free T4 and T3 are elevated. Which of the following cardiac findings is most likely to occur in her?
(A) atrial fibrillation
(B) sinus tachycardia
(D) increase in heart size
(E) pericardial effusion
|46. A thyroid nodule is found on a 40-year-old woman on routine evaluation. She has no prior history of thyroid disease and clinically feels well. There is a 15-mm nontender nodule on the right lobe of the thyroid with no associated lymphadenopathy. Thyroid function tests are normal. Which of the following is the most appropriate next step in management?
(A) thyroid scan
(B) fine needle aspiration (FNA) biopsy
(C) repeat assessment in 6 months
(D) partial thyroidectomy
(E) complete thyroidectomy
|47. Which of the following mechanisms is responsible for the release of vasopressin (antidiuretic hormone)?
(A) toxicity of the blood perfusing the liver
(B) phosphate levels in the renal plasma
(C) cerebrospinal fluid pressure
(D) calcium levels in the cerebral inflow
(E) volume receptors in the left atrium
|48. A 40-year-old woman develops light-headed episodes associated with sweating, palpitations, and hunger whenever she misses a meal. Her physical examination is normal, and she is not taking any medications. On one such episode, while in hospital, her blood glucose level was 30 mg/dL and the symptoms resolved with giving her juice. Which of the following is the most likely diagnosis?
(A) excess growth hormone
(B) Cushing’s disease
(D) tumor of the pancreatic beta-cells
(E) gastrin deficiency
|49. A 63-year-old has newly diagnosed light-chain amyloidosis (AL). In which of the following organs, is deposition of amyloid protein most likely to cause symptoms?
(B) red cells
|50. A 25-year-old woman presents with intermittent symptoms of sweating, palpitations, and hunger. During each episode, her glucose level is less than 40 mg/dL. Her insulin level is low and glucagon level is high. Which of the following best describes the hormone function of glucagon?
(A) promotes glycogenolysis and gluconeogenesis
(B) a carbohydrate in structure
(C) effective in lowering blood sugar levels
(D) antigenically similar to insulin
(E) effective in decreasing cyclic adenosine monophosphate (cAMP) in target cells
|51. A 34-year-old woman notices lumps on her elbows and yellow patches below her eyelids. On examination, she has tendon xanthomas on her elbows and xanthelasma under the eyelids. Her lipid profile is consistent with a diagnosis of familial hypercholesterolemia (increased LDL). Which of the following statements regarding the treatment of this condition is correct?
(A) dietary therapy is usually sufficient
(B) cholestyramine is as effective as hepatic hydroxymethylglutaryl-coenzyme A
(HMG-CoA) reductase inhibitors (statins)
(C) ninety percent of patients can be controlled with a statin
(D) a statin is the only type of medication suitable for monotherapy
(E) combined therapy is frequently required
|52. Which of the following is the most common manifestation of multiple endocrine neoplasia, type I (MEN I)?
(A) Zollinger-Ellison syndrome
(B) an adrenal adenoma
(C) primary hyperparathyroidism
(E) testicular cancer
|53. A 51-year-old woman is experiencing irregular periods for the past 6 months as well assymptoms of hot flashes and night sweats. Her physical examination is normal. Hormone replacement therapy (HRT) is prescribed for her symptoms. Which of the following is the most likely additional benefit of HRT?
(A) decreased CAD
(B) a decreased risk of Alzheimer’s disease
(C) reduced venothromboemolism
(D) decreased breast cancer risk
(E) decreased osteoporosis-related fractures
|54. A 37-year-old woman presents with symptoms of fatigue, muscle weakness, and weight gain. She has no past medical history and is not taking any medications. On examination, her blood pressure is 164/92 mm Hg and pulse 84/min. She has multiple skin bruises, facial fullness, and trunkal obesity with red “stretch marks.” Muscle strength in the proximal muscles is 4+/5 and reflexes are normal. Which of the following is the most appropriate initial diagnostic test?
(A) computerized tomography (CT) scan of the abdomen
(B) fasting glucose
(C) overnight dexamethasone suppression test
(D) electromyogram (EMG) studies
(E) MR of the brain
|55. A 43-year-old woman develops increased hand and foot size. On examination, she has spadelike hands, coarsened facial features, and a gap between her incisors. Her blood pressure is 155/85 mm Hg and pulse 80/min, cardiac apical beat is sustained with normal heart sounds. Which of the following is the most likely effect of this syndrome on the muscles?
(C) increased strength
(E) rhythmic contraction
|56. A 7-year-old boy has demineralized bones with pseudofractures. Physiologic doses of vitamin D do not result in improvement. Which of the following is most likely to be associated with this syndrome?
(B) low 1,25(OH)2 vitamin D levels
(E) mental retardation
|57. An 18-year-old girl is brought to hospital because of weakness. She feels well, but is under a lot of stress at school. Most of her time is spent studying, dieting, and exercising. She is 5’8”, weighs 78 lb, and appears unwell. Her blood pressure is 85/70 mm Hg, pulse 50/min, and there is muscle wasting. Which of the following is this patient most likely at risk for?
(A) renal failure
(B) ventricular tachyarrhythmias
(E) pernicious anemia
|58. A 53-year-old man develops severe pain, redness, and swelling in his left big toe. Which of the following conditions is most likely associated with this condition?
(A) pernicious anemia
(C) Alzheimer’s disease
(E) renal disease
|59. A 27-year-old woman complains of pain in her left shin. X-rays of the leg reveal a stress fracture of the tibia, decreased cortical bone density, and increased radiolucency. She is suspected ofhaving osteomalacia (impaired mineralization of bone matrix). Which of the following is the most common biochemical manifestation of osteomalacia?
(C) decreased vitamin D
(E) low alkaline phosphatase (ALP)
|60. A 44-year-old man presents with worsening abdominal distension, edema, and jaundice. He has chronic viral hepatitis B and cirrhosis. Recently he has noticed decreased urine output despite adequate fluid intake. On examination he is icteric, the blood pressure is 110/70 mm Hg, pulse 74/min, JVP is 4 cm, heart sounds are normal, and there are tense ascites and pedal edema. Which of the following is an early manifestation of hepatorenal syndrome?
(A) intrarenal vasodilatation
(B) sodium retention
(C) potassium retention
(D) severe jaundice