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1. A patient has new-onset hypertension with a systolic blood pressure of 180 mm Hg. Which
test will the provider order to diagnose this patient?
a. ACTH suppression testing
b. Adrenal antibody tests
c. Cortisol excretion studies
d. Fractionated metanephrine levels - (ANSWER)ANS: D
Patients with pheochromocytoma may present with new-onset hypertension with systolic
pressure >170 mm Hg. Fractionated metanephrine will be elevated when the diagnosis is confirmed. ACTH
suppression testing and cortisol excretion studies are performed to diagnose Cushing's syndrome. Adrenal antibody
tests are performed as part of the evaluation for Addison's disease.
2. A patient has rapid weight gain, amenorrhea without pregnancy, and mild hypertension. Once
confirmatory tests are performed, what is a possible treatment for this patient?
a. Antihypertensive therapy
b. Mineralocorticoid replacement
c. Oral hydrocortisone
,d. Pituitary tumor resection - (ANSWER)ANS: D
This patient has symptoms of Cushing's syndrome. When indicated, pituitary tumor resection
is performed as the first choice. Antihypertensive therapy is initiated in patients with
pheochromocytoma. Mineralocorticoids and glucocorticoids are given to patients with
Addison's disease.
3. A patient has unexplained weight loss and the provider notes increased skin pigmentation on
light-exposed skin folds along with darkened palmar creases. Which laboratory tests will the
provider order? (Select all that apply.)
a. Serum ACTH
b. Serum cortisol
c. Serum electrolytes
d. TB skin testing
e. Urine cortisol - (ANSWER)ANS: A, C, D
This patient has symptoms of Addison's disease. Serum ACTH will be elevated in patients with Addison's disease.
Hyponatremia and hyperkalemia may occur and are sometimes the initial finding. TB skin testing is done to exclude
tuberculosis. Serum and urine cortisol levels are evaluated with Cushing's syndrome is suspected.
4. An obese adolescent female patient reports irregular periods and excessive acne. The provider
notes an increased amount of hair on her upper back, shoulders, and upper abdomen. What
,will the provider do, based on these findings?
a. Consider treatment with oral contraceptive pills (OCPs)
b. Counsel her about diet, exercise, and weight loss
c. Recommend cosmetic laser hair removal
d. Refer to an endocrinologist for evaluation
3. A woman who has hirsutism with acne, and oligomenorrhea will most likely be treated with
which medication to control these symptoms?
a. Finasteride
b. Levonorgestrel
c. Norgestimate
d. Spironolactone
Atestbanks.com - (ANSWER)ANS: D
All patients with suspected hirsutism should be referred to a specialist to determine the cause.
OCPs, lifestyle changes, and cosmetic treatments may be part of the treatment, but the underlying causes must be
determined first to ensure that a life-threatening condition is not present.
, 5. A young adult woman is unable to conceive after trying to get pregnant for over 6 months.
The woman reports having had irregular periods since the onset of menarche. The provider
notes that the woman is overweight, has acanthosis nigricans, and an excess hair distribution. What does the provider
suspect as the most likely primary cause of these symptoms?
a. Congenital adrenal hyperplasia
b. Cushing's syndrome
c. Polycystic ovary syndrome (PCOS)
d. Type 2 diabetes - (ANSWER)ANS: C
PCOS is the most likely cause of oligo- or amenorrhea, so this is the most likely cause. The other conditions are
possible, but less likely.
6. A woman who has hirsutism with acne, and oligomenorrhea will most likely be treated with
which medication to control these symptoms?
a. Finasteride
b. Levonorgestrel
c. Norgestimate
d. Spironolactone - (ANSWER)ANS: C
Norgestimate is a progestin with low androgenic activity and is used to suppress testosterone and control symptoms.
Finasteride, which decreases the peripheral conversion of testosterone to dihydrotestosterone (DHT), is not approved
for this use. Levonorgestrel is an androgenic