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Category: Q&A Medicine--->Endocrine and Metabolic Disorders
Page: 3

Question 11# Print Question

A 28-year-old woman presenting with diarrhea, sweating, palpitations, and anxiety is found to have a diminished TSH (0.1 μU/mL) and an elevated free T4 (32 μg/dL).

What is the next best step in management?

A. Thyroglobulin
B. Radioactive iodine uptake (RAIU) scan
C. Thyroid antibodies
D. A fine-needle aspiration (FNA) biopsy


Question 12# Print Question

A 58-year-old man with a 50-pack-year smoking history presents with forgetfulness. He constantly forgets to lock the door when he leaves for work and locked his keys in his car two times last week. He presents with a temperature of 36.8°C, blood pressure of 134/ 86 mmHg, heart rate of 96 beats per minute, respiratory rate of 16 breaths per minute, and oxygen saturation of 96% on room air. Physical examination is unremarkable and laboratory results reveal the following:

  • Sodium   128 mEq/L
  • Potassium   3.8 mEq/L
  • Chloride   99 mEq/L
  • Bicarbonate   24 mEq/L
  • Blood urea nitrogen   11 mg/dL
  • Creatinine   0.9 mg/dL
  • Serum osmolality   242 mOsm/kg
  • Urine osmolality   476 mOsm/kg
  • Urine sodium   42 mEq/L
  • TSH   3.8 μU/mL

Which of the following is the best subsequent step in managing this condition?

A. Normal saline
B. Fluid restriction
C. Hypertonic saline
D. Dexamethasone


Question 13# Print Question

A 34-year-old woman with an insignificant past medical history presents with unrelenting headaches for the past 2 weeks. She has a temperature of 36.8°C, blood pressure of 168/102 mmHg, heart rate of 96 beats per minute, respiratory rate of 16 breaths per minute, and oxygen saturation of 98% on room air. One year prior to this episode, her recorded blood pressure was 134/86 mmHg. Physical examination was unremarkable except for a faint bruit on the left side just inferior to the costal margin. Laboratory studies reveal a serum sodium of 148 mEq/L and a serum potassium of 2.8 mEq/L. Magnetic resonance angiography (MRA) shows a “string of beads” appearance of the left renal artery.

Which of the following laboratory values do you expect with this condition?

A. (A)
B. (B)
C. (C)
D. (D)


Question 14# Print Question

A 29-year-old woman presents with heat intolerance, weight loss, and diarrhea. Her past medical history is significant for type 2 diabetes. She has a temperature of 36.8°C, blood pressure of 136/64 mmHg, heart rate of 102 beats per minute, respiratory rate of 20 breaths per minute, and oxygen saturation of 98% on room air. Physical examination is significant for a palpable 3-cm spherical and well-demarcated nodule on the right lobe of her thyroid gland. Her skin is moist. Laboratory studies reveal the following:

  • TSH   0.05 μU/mL
  • T3   276 ng/dL
  • T4   16 μg/dL

The patient is opposed to surgery and very hesitant to receive medical treatment for the condition. If she opts for no treatment, what is she at risk for developing?

A. Thyroid malignancy
B. Infiltrative ophthalmopathy
C. Atrial fibrillation
D. Bone growth


Question 15# Print Question

A 53-year-old man with a history of type 2 diabetes presents with swollen legs for the last month. The patient is asymptomatic otherwise. His current medications include a multivitamin and metformin. HbA1c was 7.9% at his annual visit in the previous year. He has a temperature of 36.8°C, blood pressure of 142/78 mmHg, heart rate of 68 beats per minute, respiratory rate of 16 breaths per minute, and oxygen saturation of 98% on room air. Physical examination reveals 2+ bilateral pitting edema up to his midtibia region. Laboratory results reveal the following:

  • Sodium   142 mEq/L
  • Potassium   4.0 mEq/L
  • Chloride   99 mEq/L
  • Bicarbonate   22 mEq/L
  • Blood urea nitrogen   41 mg/dL
  • Creatinine   3.1 mg/dL
  • Blood glucose   152 mg/dL
  • 24-hour urine protein   2.9 g/d

Which of the following should be administered to reduce the progression of this patient’s underlying renal condition?

A. Sulfonylurea
B. Lisinopril
C. Atorvastatin
D. Aspirin




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