QUESTIONS AND CORRECT ANSWERS WITH RATIONALES / UTA
NURS 5315 ADVANCED PATHOPHYSIOLOGY- MODULE 7 & 8
ENDOCRINE QUESTIONS REVIEW PRACTICE
Question 1: A 45-year-old female presents with fatigue, weight gain, cold intolerance, and constipation. Laboratory
findings reveal elevated TSH and decreased free T4. What is the most likely diagnosis?
A) Graves' disease
B) Hashimoto's thyroiditis
C) Toxic multinodular goiter
D) Subacute thyroiditis
Answer: B
Rationale: Elevated TSH with low free T4 indicates primary hypothyroidism, most commonly caused by Hashimoto's thyroiditis,
an autoimmune destruction of thyroid tissue.
Question 2: A patient with type 1 diabetes mellitus is experiencing hypoglycemia. Which of the following
counterregulatory hormones is most rapidly released in response to decreasing blood glucose levels?
A) Cortisol
B) Growth hormone
C) Glucagon
D) Epinephrine
Answer: C
Rationale: Glucagon is the primary and most rapidly released counterregulatory hormone, stimulating hepatic glycogenolysis
within minutes of hypoglycemia onset.
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,Question 3: A 60-year-old male presents with severe headache, visual field defects, and hypertension. MRI reveals a
pituitary macroadenoma. Which visual field defect is most commonly associated with this condition?
A) Homonymous hemianopia
B) Bitemporal hemianopia
C) Binasal hemianopia
D) Central scotoma
Answer: B
Rationale: Pituitary macroadenomas compress the optic chiasm, causing bitemporal hemianopia due to disruption of crossing
nasal retinal fibers.
Question 4: A patient with Cushing's syndrome undergoes a dexamethasone suppression test. Which result would
confirm the diagnosis of Cushing's disease?
A) Suppression of cortisol with low-dose dexamethasone
B) No suppression with low-dose but suppression with high-dose dexamethasone
C) No suppression with either low or high-dose dexamethasone
D) Increased cortisol with both low and high-dose dexamethasone
Answer: B
Rationale: Cushing's disease demonstrates suppression with high-dose dexamethasone, indicating pituitary ACTH-dependence,
while low-dose fails to suppress cortisol.
Question 5: A 35-year-old woman presents with palpitations, heat intolerance, weight loss, and fine tremor. Thyroid
examination reveals a diffuse, nontender goiter with bruit. What is the most likely diagnosis?
A) Hashimoto's thyroiditis
B) Graves' disease
C) Subacute thyroiditis
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,D) Toxic adenoma
Answer: B
Rationale: Graves' disease presents with classic hyperthyroidism symptoms, diffuse goiter, and bruit due to increased vascularity
from TSH receptor-stimulating antibodies.
Question 6: A patient with diabetes insipidus is given desmopressin. Which finding indicates central diabetes insipidus
rather than nephrogenic?
A) Increased urine specific gravity
B) Decreased urine output
C) Increased serum osmolality
D) No change in urine output
Answer: B
Rationale: Central diabetes insipidus responds to desmopressin with decreased urine output and increased urine osmolality,
while nephrogenic diabetes insipidus shows no response.
Question 7: A 50-year-old female is found to have hypercalcemia, low PTH, and elevated serum phosphate. What is the
most likely diagnosis?
A) Primary hyperparathyroidism
B) Familial hypocalciuric hypercalcemia
C) Malignancy-associated hypercalcemia
D) Vitamin D intoxication
Answer: C
Rationale: Malignancy-associated hypercalcemia causes low PTH with hypercalcemia and hyperphosphatemia due to PTHrP
production or osteolytic metastases.
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, Question 8: A patient with type 2 diabetes mellitus presents with polyuria, polydipsia, and weight loss. Laboratory
findings reveal fasting glucose of 180 mg/dL and HbA1c of 8.5%. Which pathophysiological mechanism is most
responsible?
A) Autoimmune destruction of pancreatic beta cells
B) Insulin resistance and relative insulin deficiency
C) Absence of insulin production
D) Glucagon deficiency
Answer: B
Rationale: Type 2 diabetes is characterized by insulin resistance in target tissues combined with relative insulin deficiency from
pancreatic beta cell dysfunction.
Question 9: A 25-year-old male presents with hypertension, hypokalemia, and metabolic alkalosis. Plasma aldosterone
is elevated, and renin is suppressed. What is the most likely diagnosis?
A) Cushing's syndrome
B) Primary aldosteronism
C) Renal artery stenosis
D) Liddle's syndrome
Answer: B
Rationale: Primary aldosteronism presents with hypertension, hypokalemia, metabolic alkalosis, elevated aldosterone, and
suppressed renin (low-renin hypertension).
Question 10: A patient with hypothyroidism develops myxedema coma. Which of the following is the most critical initial
management step?
A) Oral levothyroxine replacement
B) Intravenous levothyroxine
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