Your-Doctor Multiple Choice Questions (MCQ)

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Category: Q&A Medicine--->Endocrine and Metabolic Disorders
Page: 1

Question 1#Print Question

A 37-year-old woman presents with several episodes of anxiety, sweating, and palpitations. She has a blood pressure of 170/110 mmHg and her pulse is 76 beats per minute. The patient recalls being told that she has a “persistently elevated calcium level.” Physical examination reveals a 3.5-cm nonmobile, hard, nontender thyroid nodule. Laboratory results are significant for elevated calcium and parathyroid hormone levels. A fine-needle aspiration biopsy of the thyroid nodule was performed and shows malignant cells.

Which of the following is most likely to be elevated in this patient?

a. Thyroglobulin
b. Calcitonin
c. Alkaline phosphatase
d. Erythrocyte sedimentation rate


Question 2#Print Question

A 21-year-old woman presents with fatigue that has been present for 6 months. History reveals a diagnosis of asthma and chronic rhinosinusitis that are well controlled with albuterol and fluticasone nasal spray. The patient denies drugs, alcohol, or sexual activity. She has a temperature of 37°C, blood pressure of 120/80 mmHg, heart rate of 75 beats per minute, respiratory rate of 16 breaths per minute, and oxygen saturation of 100% on room air. Physical examination reveals dental erosions and the patient refuses to take her hands out of her pockets. Laboratory studies reveal the following:

  • Sodium 137 mEq/L
  • Potassium 2.2 mEq/L
  • Chloride 87 mEq/L
  • Bicarbonate 39 mEq/L
  • Urine chloride 12 mEq/L (normal range, 80–250 mEq/L)
  • Arterial blood gas  pH 7.51

Based on these findings, what is the most likely diagnosis?

a. Diuretic abuse
b. Surreptitious vomiting
c. Diabetic ketoacidosis
d. Primary hyperaldosteronism


Question 3#Print Question

A 74-year-old man with a history of New York Heart Association class III congestive heart failure presents with vague abdominal pain that has inconsistently responded to acetaminophen. He has a temperature of 37°C, blood pressure of 172/88 mmHg, heart rate of 75 beats per minute, respiratory rate of 18 breaths per minute, and oxygen saturation of 99% on room air. Physical examination reveals abdominal pain on deep palpation in all four quadrants. Laboratory studies reveal a serum sodium of 148 mEq/L, serum potassium of 2.8 mEq/L, and an increased plasma aldosterone to plasma renin activity ratio of 51 (normal range, 0.9 to 20). CT scan shows an incidental left adrenal mass. The patient is deemed a poor surgical candidate due to his cardiovascular state.

Which of the following is the next best step in management?

a. Hydrochlorothiazide
b. Phenoxybenzamine
c. Spironolactone
d. Verapamil


Question 4#Print Question

A 36-year-old woman with a history of Graves disease presents with perioral numbness and muscle cramps for the last 2 weeks. She underwent a thyroidectomy 2 months ago for a large goiter that was beginning to compress her trachea. She has never had these symptoms before and her family history is insignificant. Physical examination is unremarkable and laboratory studies reveal the following:

  • Sodium 138 mEq/L
  • Potassium 4.2 mEq/L
  • Chloride 101 mEq/L
  • Bicarbonate 24 mEq/L
  • Blood urea nitrogen 11 mg/dL
  • Creatinine 0.9 mg/dL
  • Glucose 98 mg/dL (fasting)
  • Calcium 6.2 mg/dL
  • Phosphorus 5.3 mg/dL

Which of the following is associated with her condition?

a. Peaked T waves on ECG
b. Widening of the QRS complex on ECG
c. Prolongation of the QT interval on ECG
d. Shortened QT interval on ECG


Question 5#Print Question

An obese 32-year-old woman with a history of gastroesophageal reflux disease (GERD) presents with amenorrhea for the past year. Review of systems is unremarkable. She has 3 children and denies tobacco, alcohol, or drug use. She has a temperature of 37°C, blood pressure of 120/80 mmHg, heart rate of 75 beats per minute, respiratory rate of 16 breaths per minute, and oxygen saturation of 100% on room air. Visual field testing reveals no abnormality and her pregnancy test is negative. Laboratory studies reveal a serum prolactin level of 108 ng/mL. MRI of the pituitary gland confirms a 5.5-mm pituitary adenoma.

Which of the following is the next best step in management?

a. Treatment with bromocriptine
b. Estrogen replacement therapy
c. Surgery
d. Serial prolactin levels and close observation




Category: Q&A Medicine--->Endocrine and Metabolic Disorders
Page: 1 of 8