Endocrinology MKSAP Questions & Answers With Complete Solution

Endocrinology MKSAP Questions & Answers With Complete Solution 1. 45yo F w/PMH DM2, A1c not at target on metformin. She is motivated to lose weight, BMI 30. What med to add? - Correct Ans->liraglutide - GLP1 agonist, will help with wt loss 2. 33yo M w/fatigue, HA, loss of appetite. High K, low Na, ACTH high, cortisol low. Next test? - Correct Ans->21-hydroxylase antibody measurement - most common cause of primary AI is autoimmune adrenalitis 3. 23yo F w/schizophrenia on risperidone has 4 months of amenorrhea. Prolactin 220. Next step? - Correct Ans->pituitary MRI - when prolactin significantly elevated >100, either med withheld (only when OK with psych) or pituitary MRI to eval for prolactinoma 4. 72yo M w/PMH prostate ca managed w/surveillance, new onset upper back pain. Radiograph shows coarsening of trabeculae and expansion of body of T7 w/o cortical disruption c/w Paget dz of bone. Most appropriate management? - Correct Ans->measure alk phos level - marker of increased bone turnover and should be measured after radiographic dx - reflects metabolic activity of Paget's 5. 77yo w/gen weakness and hand spasm, hypoCa 2 days after having zolendronic acid rx. Dx? - Correct Ans->hypovitaminosis D - if someone is vit D deficient, normocalcemia maintained through increased bone resorption - antiresorptive drugs like bisphosphonates suppress osteoclasts and precipitate hypocalcemia 6. 58yo F s/p thyroidectomy for cancer, c/b sx hypoCa. Ca, Mg, phos, Cr, and PTH nl. What else to check? - Correct Ans->24 hour urine calcium - for chronic hypoparathyroidism, goal is to eliminate sx while avoiding therapy complications - mo