Multiple Choice Questions (MCQ)

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Category: Medicine--->Endocrinology and Metabolic Disease
Page: 7

Question 31# Print Question

A 36-year-old woman presents with amenorrhea. She has two children aged 8 and 6 years. She took oral contraceptives until her husband had a vasectomy 18 months ago. Since then she has not had a menstrual period. Otherwise she feels well. She takes no medications and exercises regularly but not to excess. She denies headache or galactorrhea. Her physical examination is normal. In particular, visual fields to confrontation are normal. Initial laboratory testing reveals negative pregnancy testing and normal CBC, creatinine, and TSH. Her prolactin level is 225 ng/mL (normal < 20). MRI of the pituitary is shown.

What is the best treatment for this patient’s condition?

A. Transsphenoidal hypophysectomy
B. Resume oral contraceptives to reestablish menstrual cycles
C. Somatostatin analogue
D. Dopamine agonist such as cabergoline
E. Observation with yearly prolactin levels and MRI scanning

Question 32# Print Question

A 55-year-old woman with a history of severe depression and radical mastectomy for carcinoma of the breast 1 year previously develops polyuria, nocturia, and excessive thirst.

Laboratory values are as follows:

  • Serum electrolytes: Na + 149 mEq/L; K + 3.6 mEq/L
  • Serum calcium: 9.5 mg/dL
  • Blood glucose: 110 mg/dL
  • Blood urea nitrogen: 30 mg/dL
  • Urine osmolality: 150 mOsm/L

Which of the following is the most likely diagnosis?

A. Psychogenic polydipsia
B. Renal glycosuria
C. Hypercalciuria
D. Diabetes insipidus
E. Inappropriate antidiuretic hormone syndrome

Question 33# Print Question

A 30-year-old nursing student presents with confusion, sweating, hunger, and fatigue. Blood sugar is 40 mg/dL. The patient has no history of diabetes mellitus, although her sister is an insulin-dependent diabetic. The patient has had several similar episodes over the past year, all occurring just prior to reporting for work in the early morning. At the time of hypoglycemia, the patient is found to have a high insulin level and a low C peptide level. Which of the following is the most likely diagnosis?

A. Reactive hypoglycemia
B. Pheochromocytoma
C. Factitious hypoglycemia
D. Insulinoma
E. Sulfonylurea use

Question 34# Print Question

 A 50-year-old woman presents with complaints of more than 10 severe hot flashes per day. Her last menstrual period was 13 months ago. She denies fatigue, constipation, or weight gain. Current medical issues include osteopenia diagnosed by central DXA. Family history is positive for hypertension in her father and osteoporosis in her mother. The patient uses no medications other than calcium and vitamin D supplements.

Physical examination reveals:

  • weight 145 lb
  • height 5 ft 6 in 
  • BMI 24
  • BP 126/64
  • HR 68

Otherwise the examination is normal.

Screening laboratory studies:

  • Fasting glucose: 98 mg/dL
  • Cholesterol: 200 mg/dL
  • LDL: 100 mg/dL
  • Triglycerides: 150 mg/dL
  • HDL: 50 mg/dL
  • TSH: 1.0 mU/L

The patient requests hormone therapy to decrease hot flashes.

Which of the following statements is true regarding hormone replacement therapy?

A. Progesterone therapy alone can alleviate hot flashes
B. Hormone therapy does not affect bone density
C. Her symptoms do not warrant systemic HT
D. Oral estrogen therapy does not affect lipid levels
E. The risk of breast cancer is directly related to duration of estrogen use

Category: Medicine--->Endocrinology and Metabolic Disease
Page: 7 of 7