PATHOPHYSIOLOGY ENDOCRINE PRACTICE
QUESTIONS & ANSWERS 100% ACCURATE!!
A 43-year-old male is being evaluated for a persistent headache that responds poorly to over-the-
counter medications. He is also concerned about the fat on his face. He noted his face became more
rotund about a year ago despite eating a healthy diet and exercising several times a week. On
physical examination, vital signs are normal. The examination reveals enlarged and swollen hands
and feet, macroglossia, a wide nose, and wide-spaced teeth. Which of the following is the best initial
step to screen for the diagnosis in this patient?
A) Thyroid-stimulating hormone
B) Oral glucose tolerance test
C) Random growth hormone level
D) Insulin-like growth factor level - ANSWER-Insulin-like growth factor level
A 35-year-old female presents with bilateral breast milk discharge for the past 2 weeks. She also
notes intermittent headaches and decreased libido. A pregnancy test is negative. Her physical exam,
especially the neurological exam, is otherwise within normal limits. Her vital signs include a
temperature of 37 C, a heart rate of 70/min, and a respiratory rate of 14/min. She does not have any
significant past medical history. An MRI of the brain and serology are ordered. Which of the following
lab abnormalities would be expected in this patient?
A) Increased prolactin, decreased FSH, decreased LH
B) Decreased prolactin, increased FSH, increased LH
C) Decreased prolactin, decreased FSH, decreased LH
D) Increased prolactin, decreased FSH, increased LH - ANSWER-Increased prolactin, decreased FSH,
decreased LH
A patient presents with heart palpitations, anxiety, and increased appetite. She also says that she has
lost weight. MRI reveals a 12 mm pituitary tumor. Which of the following is the most likely thyroid
function test profile?
A) Increased TSH and increased T4
B) Low T4 and increased TSH
,C) Undetectable TSH and increased T4
D) Increased TSH and low T3 - ANSWER-Increased TSH and increased T4
An 8-year-old female patient presents to the OPD with generalized weakness and growth restriction.
History reveals developmental delay and recurrent ear and throat infections since the first year of
life. The patient's mother is worried about weight and height, which have not increased much since
age 2. The mother says that the patient is intolerant to cold and takes no interest in playing. On
examination, the patient has a short stature with a proportionate body, and height is below the 3rd
percentile for age. On examination of the head and neck, she has frontal bossing, a flattened nasal
bridge, and a prominent jawbone. Intellect level is evaluated to be below average. What is the most
likely diagnosis?
A) Turner syndrome
B) Pituitary dwarfism
C) Achondroplasia
D) Rickets - ANSWER-Pituitary dwarfism
A 32-year-old male patient presents with concerns about fertility. His wife has not conceived despite
unprotected intercourse for 2 years. He reports erectile dysfunction. The wife was worked up for
infertility and did not have any abnormalities. Serum levels of estradiol, FSH, and LH are elevated.
Serum testosterone level is low. Karyotyping shows an extra X chromosome. What's the most likely
diagnosis?
A) Testicular agenesis
B) Delayed puberty
C) Klinefelter syndrome
D) Turner syndrome - ANSWER-Klinefelter syndrome
A 48-year-old female patient presents with recent unexplained weight loss, lethargy, muscle and joint
pain, abdominal pain, nausea and vomiting, amenorrhea, and salt cravings. On physical examination,
there is hyperpigmentation of her skin and mucous membranes and generalized abdominal pain.
Blood pressure 85/60 mm Hg. Her laboratory results show hyponatremia and hyperkalemia. Serum
ACTH level is elevated. What is the most likely anatomic site of this pathology?
A) Adrenal medulla
B) Adrenal cortex
, C) Pituitary gland
D) Hypothalamus - ANSWER-Adrenal cortex
A 48-year-old female patient presents with recent unexplained weight loss, lethargy, muscle and joint
pain, abdominal pain, nausea and vomiting, amenorrhea, and salt cravings. On physical examination,
there is hyperpigmentation of her skin and mucous membranes and generalized abdominal pain.
Blood pressure 85/60 mm Hg. Her laboratory results show hyponatremia and hyperkalemia. Serum
ACTH level is elevated. What is the most likely diagnosis?
A) Secondary adrenal insufficiency
B) Cushing syndrome
C) Adrenal hyperplasia
D) Primary adrenal insufficiency - ANSWER-Primary adrenal insufficiency
A 48-year-old female patient presents with recent unexplained weight loss, lethargy, muscle and joint
pain, abdominal pain, nausea and vomiting, amenorrhea, and salt cravings. On physical examination,
there is hyperpigmentation of her skin and mucous membranes and generalized abdominal pain.
Blood pressure 85/60 mm Hg. Her laboratory results show hyponatremia and hyperkalemia. Serum
ACTH level is elevated. Which of the following best explains hyponatremia and salt cravings?
A) Aldosterone hyposecretion
B) Cortisol excess
C) Cortisol hypo-secretion
D) Aldosterone excess - ANSWER-Aldosterone hypo-secretion
An 8-year-old female patient presents to the OPD with generalized weakness and growth restriction.
History reveals developmental delay and recurrent ear and throat infections since the first year of
life. The patient's mother is worried about weight and height, which have not increased much since
age 2. The mother says that the patient is intolerant to cold and takes no interest in playing. On
examination, the patient has a short stature with a proportionate body, and height is below the 3rd
percentile for age. On examination of the head and neck, she has frontal bossing, a flattened nasal
bridge, and a prominent jawbone. Intellect level is evaluated to be below average. What is the most
likely pathogenesis of this patient's disorder?
A) Vitamin D deficiency
B) Chromosomal aneuploidy
C) Growth hormone hyposecretion
QUESTIONS & ANSWERS 100% ACCURATE!!
A 43-year-old male is being evaluated for a persistent headache that responds poorly to over-the-
counter medications. He is also concerned about the fat on his face. He noted his face became more
rotund about a year ago despite eating a healthy diet and exercising several times a week. On
physical examination, vital signs are normal. The examination reveals enlarged and swollen hands
and feet, macroglossia, a wide nose, and wide-spaced teeth. Which of the following is the best initial
step to screen for the diagnosis in this patient?
A) Thyroid-stimulating hormone
B) Oral glucose tolerance test
C) Random growth hormone level
D) Insulin-like growth factor level - ANSWER-Insulin-like growth factor level
A 35-year-old female presents with bilateral breast milk discharge for the past 2 weeks. She also
notes intermittent headaches and decreased libido. A pregnancy test is negative. Her physical exam,
especially the neurological exam, is otherwise within normal limits. Her vital signs include a
temperature of 37 C, a heart rate of 70/min, and a respiratory rate of 14/min. She does not have any
significant past medical history. An MRI of the brain and serology are ordered. Which of the following
lab abnormalities would be expected in this patient?
A) Increased prolactin, decreased FSH, decreased LH
B) Decreased prolactin, increased FSH, increased LH
C) Decreased prolactin, decreased FSH, decreased LH
D) Increased prolactin, decreased FSH, increased LH - ANSWER-Increased prolactin, decreased FSH,
decreased LH
A patient presents with heart palpitations, anxiety, and increased appetite. She also says that she has
lost weight. MRI reveals a 12 mm pituitary tumor. Which of the following is the most likely thyroid
function test profile?
A) Increased TSH and increased T4
B) Low T4 and increased TSH
,C) Undetectable TSH and increased T4
D) Increased TSH and low T3 - ANSWER-Increased TSH and increased T4
An 8-year-old female patient presents to the OPD with generalized weakness and growth restriction.
History reveals developmental delay and recurrent ear and throat infections since the first year of
life. The patient's mother is worried about weight and height, which have not increased much since
age 2. The mother says that the patient is intolerant to cold and takes no interest in playing. On
examination, the patient has a short stature with a proportionate body, and height is below the 3rd
percentile for age. On examination of the head and neck, she has frontal bossing, a flattened nasal
bridge, and a prominent jawbone. Intellect level is evaluated to be below average. What is the most
likely diagnosis?
A) Turner syndrome
B) Pituitary dwarfism
C) Achondroplasia
D) Rickets - ANSWER-Pituitary dwarfism
A 32-year-old male patient presents with concerns about fertility. His wife has not conceived despite
unprotected intercourse for 2 years. He reports erectile dysfunction. The wife was worked up for
infertility and did not have any abnormalities. Serum levels of estradiol, FSH, and LH are elevated.
Serum testosterone level is low. Karyotyping shows an extra X chromosome. What's the most likely
diagnosis?
A) Testicular agenesis
B) Delayed puberty
C) Klinefelter syndrome
D) Turner syndrome - ANSWER-Klinefelter syndrome
A 48-year-old female patient presents with recent unexplained weight loss, lethargy, muscle and joint
pain, abdominal pain, nausea and vomiting, amenorrhea, and salt cravings. On physical examination,
there is hyperpigmentation of her skin and mucous membranes and generalized abdominal pain.
Blood pressure 85/60 mm Hg. Her laboratory results show hyponatremia and hyperkalemia. Serum
ACTH level is elevated. What is the most likely anatomic site of this pathology?
A) Adrenal medulla
B) Adrenal cortex
, C) Pituitary gland
D) Hypothalamus - ANSWER-Adrenal cortex
A 48-year-old female patient presents with recent unexplained weight loss, lethargy, muscle and joint
pain, abdominal pain, nausea and vomiting, amenorrhea, and salt cravings. On physical examination,
there is hyperpigmentation of her skin and mucous membranes and generalized abdominal pain.
Blood pressure 85/60 mm Hg. Her laboratory results show hyponatremia and hyperkalemia. Serum
ACTH level is elevated. What is the most likely diagnosis?
A) Secondary adrenal insufficiency
B) Cushing syndrome
C) Adrenal hyperplasia
D) Primary adrenal insufficiency - ANSWER-Primary adrenal insufficiency
A 48-year-old female patient presents with recent unexplained weight loss, lethargy, muscle and joint
pain, abdominal pain, nausea and vomiting, amenorrhea, and salt cravings. On physical examination,
there is hyperpigmentation of her skin and mucous membranes and generalized abdominal pain.
Blood pressure 85/60 mm Hg. Her laboratory results show hyponatremia and hyperkalemia. Serum
ACTH level is elevated. Which of the following best explains hyponatremia and salt cravings?
A) Aldosterone hyposecretion
B) Cortisol excess
C) Cortisol hypo-secretion
D) Aldosterone excess - ANSWER-Aldosterone hypo-secretion
An 8-year-old female patient presents to the OPD with generalized weakness and growth restriction.
History reveals developmental delay and recurrent ear and throat infections since the first year of
life. The patient's mother is worried about weight and height, which have not increased much since
age 2. The mother says that the patient is intolerant to cold and takes no interest in playing. On
examination, the patient has a short stature with a proportionate body, and height is below the 3rd
percentile for age. On examination of the head and neck, she has frontal bossing, a flattened nasal
bridge, and a prominent jawbone. Intellect level is evaluated to be below average. What is the most
likely pathogenesis of this patient's disorder?
A) Vitamin D deficiency
B) Chromosomal aneuploidy
C) Growth hormone hyposecretion
