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Multiple Choice Questions (MCQ)

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Category: Medicine--->Endocrinology and Metabolic Disease
Page: 5

Question 21#Print Question

A 60-year-old woman comes to the emergency room in a coma. The patient’s temperature is 32.2°C (90°F). She is bradycardic. Her thyroid gland is enlarged. There is diffuse hyporeflexia. BP is 100/60. Which of the following is the best next step in management? 

a. Await results of T4 and TSH
b. Obtain T4 and TSH; begin intravenous thyroid hormone and glucocorticoid
c. Begin rapid rewarming
d. Obtain CT scan of the head
e. Begin intravenous fluid resuscitation


Question 22#Print Question

A 19-year-old man with insulin-dependent diabetes mellitus is taking 30 units of NPH insulin each morning and 15 units at night. Because of persistent morning glycosuria with some ketonuria, the evening dose is increased to 20 units. This worsens the morning glycosuria, and now moderate ketones are noted in urine. The patient complains of sweats and headaches at night. Which of the following is the most appropriate next step in management?

a. Measure blood glucose levels at bedtime
b. Increase the evening dose of NPH insulin further
c. Add regular insulin to NPH at a ratio of 2/3 NPH to 1/3 regular
d. Obtain blood sugar levels between 2:00 and 5:00 AM
e. Add lispro via a calculated scale to each meal; continue NPH


Question 23#Print Question

A 25-year-old woman is admitted for hypertensive crisis. The patient’s urine drug screen is negative. In the hospital, blood pressure is labile and responds poorly to antihypertensive therapy. The patient complains of palpitations and apprehension. Her past medical history shows that she developed hypertension during an operation for appendicitis at age 23.

  • Hct: 49% (normal range 37%-48%)
  • WBC: 11,000/mm3 (4.3-10.8)
  • Plasma glucose: 160 mg/dL (75-115)
  • Plasma calcium: 11 mg/dL (9-10.5)

Which of the following is the most likely diagnosis?

a. Panic attack
b. Renal artery stenosis
c. Essential hypertension
d. Type 1 diabetes mellitus
e. Pheochromocytoma


Question 24#Print Question

A 23 year old man complains of persistent headache. He has noticed gradual increase in his ring size and his shoe size over the years. On physical examination, he has a peculiar deep, hollow-sounding voice and a prognathic jaw. Bedside visual field testing suggests bitemporal hemianopsia.

What initial studies are indicated?

a. Serum insulin-like growth factor 1(IGF-1) and prolactin levels
b. Morning growth hormone levels
c. Overnight dexamethasone-suppressed cortisol level
d. Lateral skull film to assess sella turcica size
e. GHRH-stimulated growth hormone level


Question 25#Print Question

A patient with small cell carcinoma of the lung develops increasing fatigue but is otherwise alert and oriented. Serum electrolytes show a serum sodium of 118 mg/L. There is no evidence of edema, orthostatic hypotension, or dehydration. Urine is concentrated with an osmolality of 550 mmol/L. Serum BUN, creatinine, and glucose are within normal range. Which of the following is the next appropriate step?

a. Normal saline infusion
b. Diuresis
c. Fluid restriction
d. Demeclocycline
e. Hypertonic saline infusion




Category: Medicine--->Endocrinology and Metabolic Disease
Page: 5 of 7