DUNPHY - ENDOCRINE AND METABOLIC PROBLEMS QUESTIONS AND ANSWERS 2022

A patient is 66 inches in height, weighing 200 lbs, and newly diagnosed with type 2 diabetes mellitus (DM). The A1c is 7.1%. What is the best initial treatment? A. No treatment at this time B. Diet and exercise C. Diet, exercise, and metformin D. Diet, exercise, and exogenous insulin - ANS-C. Diet, exercise, and metformin The clinician suspects that a patient seen in the office has hyperthyroidism. Which test should the clinician order on the initial visit? A. Sensitive thyroid-stimulating hormone (TSH) assay and T4 B. Free T4 and serum calcium C. Nuclear scintigraphy with radiolabeled iodine (123I) D. Magnetic resonance imaging - ANS-A. Sensitive thyroid-stimulating hormone (TSH) assay and T4 Which statement made by a patient with type 1 diabetes indicates successful teaching regarding general guidelines for exercise? A. "I will not exercise if my blood sugar is 315." B. "I should just check my blood glucose after exercise." C. "I should eat more carbohydrates if my blood glucose is less than 200." D. "I will exercise when my urine ketones are positive but blood sugar is 260." - ANSA. "I will not exercise if my blood sugar is 315." A male patient with type 1 diabetes comes to the clinic complaining of feeling nervous and clammy. He states that he took his insulin this morning but was late for work and did not eat breakfast. Which action should the clinician take first? A. Administer glucagon subcutaneously. B. Have him drink 4 ounces of juice. C. Call 911. D. Ask him about his usual eating habits. - ANS-B. Have him drink 4 ounces of juice. A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which condition that the patient also has would be a contraindication to taking metformin? A. Ulcerative colitis B. Inflammatory bowel disease C. Chronic obstructive pulmonary disease D. Renal disease - ANS-D. Renal disease A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which test should be ordered next? A. Serum calcium B. Thyroid-stimulating hormone C. Electrolytes D. Urine specific gravity - ANS-B. Thyroid-stimulating hormone The clinician has been doing diabetic teaching for a patient with type 1 diabetes with no retinopathy. Which statement by the patient would indicate that teaching has been effective? A. "As long as I don't need glasses, I don't have to worry about going blind." B. "I know I need to have my eyes checked every 2 years." C. "My primary doctor will check my eyes." D. "I will see my eye doctor when my vision gets blurry." - ANS-B. "I know I need to have my eyes checked every 2 years." A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of "my feet feel like they are on fire." He has a loss of vibratory sense and +1 Achilles reflex. Which of the following would be an appropriate treatment?