Endocrinology
1) A 76 year old man from a nursing home is 3) A 37 year old female is referred to you, an
brought into the emergency department endocrinologist, because she is concerned
after staff notice a decreased level of about her weight. She is obese with a BMI
consciousness. He has Type II diabetes of 35.2. On her last physical, her family
mellitus and is diagnosed with doctor found her LDL level to be extremely
hyperosmolar state. All of the following elevated. Her only medications are
may be features of hyperosmolar state acetaminophen PRN for headache and
EXCEPT: quetiapine, which she has been taking for
a) Hyponatremia the past several years for anxiety and to
b) Positive ketones on urine dipstick help her sleep at night. As you chat with
c) Positive glucose on urine dipstick her, you learn she has never married and
d) Elevated blood glucose level never had any children. In fact, she admits
e) History of decreased fluid intake to having few social supports. Apparently,
she has had poor self esteem since she
was young because of unwanted hair
2) All of the following are complications of growth and obesity. She agrees that she
diabetes mellitus EXCEPT: uses food for comfort. Which of the
a) Retinal detachment following statements apply to this case?
b) Gangrene in the feet a) She is at risk for osteoarthritis in the
c) Calcification of cartilage future
d) Abdominal bloating b) You should order gonadotropin levels in
e) Urinary retention her
c) She should be referred to a dietician
d) She should be started on cholesterol
lowering medications immediately
e) With such a high BMI, she should be
initiated on orlistat (pancreatic lipase
inhibitor) immediately
4) A patient complains of a non-tender mass
over the thyroid region on the left side of
her neck. Concerned about a thyroid
disorder, you order the appropriate
investigations. The results are as follows:
TSH: 6.0
Free T4: 20.2
Thyroid antibodies: none
RAIU: No “hot” spots seen
The next investigation(s) you choose to
do are:
a) Watch and wait for 3-6 months
b) FNA
c) Surgical biopsy
d) Trial of L-thyroxine therapy for 6 months
e) None of the above
1) A 76 year old man from a nursing home is 3) A 37 year old female is referred to you, an
brought into the emergency department endocrinologist, because she is concerned
after staff notice a decreased level of about her weight. She is obese with a BMI
consciousness. He has Type II diabetes of 35.2. On her last physical, her family
mellitus and is diagnosed with doctor found her LDL level to be extremely
hyperosmolar state. All of the following elevated. Her only medications are
may be features of hyperosmolar state acetaminophen PRN for headache and
EXCEPT: quetiapine, which she has been taking for
a) Hyponatremia the past several years for anxiety and to
b) Positive ketones on urine dipstick help her sleep at night. As you chat with
c) Positive glucose on urine dipstick her, you learn she has never married and
d) Elevated blood glucose level never had any children. In fact, she admits
e) History of decreased fluid intake to having few social supports. Apparently,
she has had poor self esteem since she
was young because of unwanted hair
2) All of the following are complications of growth and obesity. She agrees that she
diabetes mellitus EXCEPT: uses food for comfort. Which of the
a) Retinal detachment following statements apply to this case?
b) Gangrene in the feet a) She is at risk for osteoarthritis in the
c) Calcification of cartilage future
d) Abdominal bloating b) You should order gonadotropin levels in
e) Urinary retention her
c) She should be referred to a dietician
d) She should be started on cholesterol
lowering medications immediately
e) With such a high BMI, she should be
initiated on orlistat (pancreatic lipase
inhibitor) immediately
4) A patient complains of a non-tender mass
over the thyroid region on the left side of
her neck. Concerned about a thyroid
disorder, you order the appropriate
investigations. The results are as follows:
TSH: 6.0
Free T4: 20.2
Thyroid antibodies: none
RAIU: No “hot” spots seen
The next investigation(s) you choose to
do are:
a) Watch and wait for 3-6 months
b) FNA
c) Surgical biopsy
d) Trial of L-thyroxine therapy for 6 months
e) None of the above
