PANCE ENDOCRINE EXAM |ACTUAL QUESTIONS
AND VERIFIED ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
History & Physical/Endocrinology
Question 1
A 26-year-old obese female complains of a 3-4 month history of discrete erythematous
plaques on the pretibial areas of her legs. The lesions have increased in size, become
darker, and are painful. She is concerned because the centers of the lesions have become
ulcerated. This patient should be screened for which of the following?
Answers
A. Hypothyroidism
B. Diabetes mellitus
C. Melanoma
D. Scleroderma
CORRECT ANSWER
Explanations
(u) A. In hypothyroidism the skin of the pretibial area may thicken leading to edema. This is a
diffuse finding, involving the face and eyelids, without discrete lesions.
(c) B. The description of the skin lesions is characteristic of necrobiosis lipoidica
diabeticorum, one of the dermatologic manifestations of diabetes mellitus.
(u) C. The lesions of melanoma are typically not painful and do not ulcerate.
(u) D. Scleroderma is marked by thickening of the skin, with swelling of the fingers and
hands. The swelling may involve the forearms and face; the lower extremities are relatively
spared.
Question 2
History & Physical/Endocrinology
1
,A 40 year-old male presents to your clinic complaining of nontender, yellow patches on both
eyelids. He states his brother and uncle have similar growths. He denies any visual changes
or other complaints. Your primary suspicion is
Answers
A. gout.
B. lipoma.
C. hyperlipidemia.
D. seborrheic dermatitis.
CORRECT ANSWER
Explanations
(u) A. Tophaceous gout may appear as yellow skin lesions but they usually occur around the
joints and helix of the ear.
(u) B. Lipomas tend to be flesh-colored and are not usually bilateral.
(c) C. Xanthelasmas, along with xanthomas, are common findings in familial
hypercholesterolemia.
(u) D. Eyelids are a common location for seborrheic dermatitis but the lesions are not yellow
in color.
Question 3
Diagnostic Studies/Endocrinology
A patient complains of fatigue, tremors, palpitations, and heat intolerance. The thyroid is
diffusely enlarged and firm on palpation. Which of the following laboratory findings is the
most consistent with this presentation?
Answers A. Low T4
24
B. Low TSH
C. Decreased bilirubin
D. Normal radionuclide scan
CORRECT ANSWER
2
,Explanations
(u) A. See B for explanation.
(c) B. The presentation is consistent with hyperthyroidism. Laboratory findings include low
TSH, elevated free and total thyroid hormone levels, and an increased uptake on
radionuclide scan.
There may also be elevated bilirubin, liver thrombocytopenia.
(u) C. See B for explanation
(u) D. See B for explanation
Question 4
Diagnostic Studies/Endocrinology
A solitary thyroid nodule is noted on physical examination. The TSH level is normal. The next
step in the evaluation is
Answers
A. measurement of T4 and free T3 levels. B. a radionuclide thyroid scan.
C. a fine needle biopsy.
D. a surgical excision.
CORRECT ANSWER
Explanations
(u) A. Measurement of T4 and T3 levels would not be of benefit in the evaluation of a
solitary thyroid nodule with a normal TSH level.
(u) B. A thyroid scan would be the next step if there were a low TSH level.
(c) C. Fine needle aspiration (FNA) is the first step in the evaluation of a solitary nodule with
a normal TSH level. FNA has a high level of accuracy in diagnosing benign versus malignant
nodules in this setting.
(u) D. Surgical excision would be the final step after determination of malignancy or
suspicion of malignancy by FNA.
3
, Question 5
Diagnosis/Endocrinology
A 30 year-old female complains of fatigue, weakness, diminished appetite, weight loss, and
syncope. She denies fever, chest or abdominal pain, palpitations, changes in bowel patterns
or sleep patterns. Physical examination reveals a thin female, BP 90/65 mmHg, and pulse 80
beats per minute. Pulmonary, cardiovascular, abdominal, and neurologic exam are without
abnormalities. Areas of brown and bronze hyperpigmentation are noted
39
on her elbows and the creases of her hands. Which of the following is the most likely
diagnosis?
Answers
A. Addison's disease
B. Cushing's disease
C. Anorexia nervosa
D. Porphyria
CORRECT ANSWER
Explanations
(c) A. Addison's disease (adrenal insufficiency) would account for all her symptoms, the
hypotension, and the hyperpigmentation of the skin.
(u) B. Cushing's disease, the presence of an ACTH-producing adenoma, is characterized by
central obesity, hypertension, moon facies, purple striae, and glucose intolerance.
(u) C. Anorexia nervosa may explain the weakness, weight loss, hypotension, and syncope,
however, a normal pulse rate would be an unexpected finding along with the
hyperpigmentation.
(u) D. Porphyria presents acutely with anxiety, depression, disorientation, and insomnia.
Question 6
Diagnosis/Endocrinology
4
AND VERIFIED ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
History & Physical/Endocrinology
Question 1
A 26-year-old obese female complains of a 3-4 month history of discrete erythematous
plaques on the pretibial areas of her legs. The lesions have increased in size, become
darker, and are painful. She is concerned because the centers of the lesions have become
ulcerated. This patient should be screened for which of the following?
Answers
A. Hypothyroidism
B. Diabetes mellitus
C. Melanoma
D. Scleroderma
CORRECT ANSWER
Explanations
(u) A. In hypothyroidism the skin of the pretibial area may thicken leading to edema. This is a
diffuse finding, involving the face and eyelids, without discrete lesions.
(c) B. The description of the skin lesions is characteristic of necrobiosis lipoidica
diabeticorum, one of the dermatologic manifestations of diabetes mellitus.
(u) C. The lesions of melanoma are typically not painful and do not ulcerate.
(u) D. Scleroderma is marked by thickening of the skin, with swelling of the fingers and
hands. The swelling may involve the forearms and face; the lower extremities are relatively
spared.
Question 2
History & Physical/Endocrinology
1
,A 40 year-old male presents to your clinic complaining of nontender, yellow patches on both
eyelids. He states his brother and uncle have similar growths. He denies any visual changes
or other complaints. Your primary suspicion is
Answers
A. gout.
B. lipoma.
C. hyperlipidemia.
D. seborrheic dermatitis.
CORRECT ANSWER
Explanations
(u) A. Tophaceous gout may appear as yellow skin lesions but they usually occur around the
joints and helix of the ear.
(u) B. Lipomas tend to be flesh-colored and are not usually bilateral.
(c) C. Xanthelasmas, along with xanthomas, are common findings in familial
hypercholesterolemia.
(u) D. Eyelids are a common location for seborrheic dermatitis but the lesions are not yellow
in color.
Question 3
Diagnostic Studies/Endocrinology
A patient complains of fatigue, tremors, palpitations, and heat intolerance. The thyroid is
diffusely enlarged and firm on palpation. Which of the following laboratory findings is the
most consistent with this presentation?
Answers A. Low T4
24
B. Low TSH
C. Decreased bilirubin
D. Normal radionuclide scan
CORRECT ANSWER
2
,Explanations
(u) A. See B for explanation.
(c) B. The presentation is consistent with hyperthyroidism. Laboratory findings include low
TSH, elevated free and total thyroid hormone levels, and an increased uptake on
radionuclide scan.
There may also be elevated bilirubin, liver thrombocytopenia.
(u) C. See B for explanation
(u) D. See B for explanation
Question 4
Diagnostic Studies/Endocrinology
A solitary thyroid nodule is noted on physical examination. The TSH level is normal. The next
step in the evaluation is
Answers
A. measurement of T4 and free T3 levels. B. a radionuclide thyroid scan.
C. a fine needle biopsy.
D. a surgical excision.
CORRECT ANSWER
Explanations
(u) A. Measurement of T4 and T3 levels would not be of benefit in the evaluation of a
solitary thyroid nodule with a normal TSH level.
(u) B. A thyroid scan would be the next step if there were a low TSH level.
(c) C. Fine needle aspiration (FNA) is the first step in the evaluation of a solitary nodule with
a normal TSH level. FNA has a high level of accuracy in diagnosing benign versus malignant
nodules in this setting.
(u) D. Surgical excision would be the final step after determination of malignancy or
suspicion of malignancy by FNA.
3
, Question 5
Diagnosis/Endocrinology
A 30 year-old female complains of fatigue, weakness, diminished appetite, weight loss, and
syncope. She denies fever, chest or abdominal pain, palpitations, changes in bowel patterns
or sleep patterns. Physical examination reveals a thin female, BP 90/65 mmHg, and pulse 80
beats per minute. Pulmonary, cardiovascular, abdominal, and neurologic exam are without
abnormalities. Areas of brown and bronze hyperpigmentation are noted
39
on her elbows and the creases of her hands. Which of the following is the most likely
diagnosis?
Answers
A. Addison's disease
B. Cushing's disease
C. Anorexia nervosa
D. Porphyria
CORRECT ANSWER
Explanations
(c) A. Addison's disease (adrenal insufficiency) would account for all her symptoms, the
hypotension, and the hyperpigmentation of the skin.
(u) B. Cushing's disease, the presence of an ACTH-producing adenoma, is characterized by
central obesity, hypertension, moon facies, purple striae, and glucose intolerance.
(u) C. Anorexia nervosa may explain the weakness, weight loss, hypotension, and syncope,
however, a normal pulse rate would be an unexpected finding along with the
hyperpigmentation.
(u) D. Porphyria presents acutely with anxiety, depression, disorientation, and insomnia.
Question 6
Diagnosis/Endocrinology
4
