ENDOCRINOLOGY BOARDS ABIM EXAM LATEST VERSION ACTUAL
EXAM 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+
Panretinal laser photocoagulation therapy for diabetic retinopathy typically results
in? - ANSWER: retained central vision but poorer peripheral and night vision.
An adrenal incidentaloma that is 6 cm in size or larger and has a high CT attenuation
value requires what therapy? - ANSWER: surgical removal
In a patient with secondary amenorrhea and normal findings of screening laboratory
studies, the cornerstone of further evaluation is? - ANSWER: a progesterone
withdrawal challenge.
In a patient with secondary amenorrhea and clinical evidence of hyperandrogenism,
such as hirsutism or the presence of virilization (voice deepening, clitoral
enlargement) further evaluation should consist of? - ANSWER: total testosterone and
dehydroepiandrosterone levels
In a patient with secondary amenorrhea and elevated prolactin and/or FSH levels
further evaluation should consist of? - ANSWER: MRI of the pituitary gland
In a patient with secondary amenorrhea who previously had dilation and curettage
or a uterine infection further evaluation should consist of? - ANSWER: pelvic
ultrasonography
* Asherman syndrome due to endometrial scarring should be considered
When should patients with subclinical hypothyroidism be treated with
levothyroxine? - ANSWER: if they are at high risk for progression to overt
hypothyroidism
* thyroid-stimulating hormone level greater than 10 microunits/mL [10 milliunits/L]
* positive family history
* goiter
* presence of anti-thyroid peroxidase antibodies
* or desire to become pregnant.
In a patient with disseminated tuberculosis with hypercalcemia consider? - ANSWER:
Hypercalcemia can be caused by the production of 1,25-dihydroxyvitamin D by
granulomatous disease with TB or with sarcoidosis, crohn's disease or leprosy.
elevated PTH
hypercalcemia
low serum phosphorus level - ANSWER: primary hyperparathyroidism
, In patients who have hypercalcemia with malignancy consider what cause? -
ANSWER: PTH-related protein (PTHrP)
* PTHrP has most, if not all, of the metabolic effects of PTH, including osteoclast
activation, increased renal tubular calcium reabsorption, and increased clearance of
phosphorus by the kidneys.
What are the expected findings in a patient with Sarcoidosis and hypercalcemia? -
ANSWER: High Serum Calcium
High Serum Phosphorus
Low PTH
What is a likely cause of diabetes mellitus in a patient with hypertension, central
obesity, and hypokalemia?
What is the appropriate diagnostic study? - ANSWER: * Cushing syndrome
* 24-Hour urine free cortisol excretion
* an overnight dexamethasone suppression test, or a midnight salivary cortisol
measurement can also make the diagnosis.
* Adrenal CT is appropriate after Cushing syndrome is diagnosed
The most common cause of Cushing syndrome is?
Other causes include? - ANSWER: corticosteroid therapy, followed by the secretion
of adrenocorticotropic hormone (ACTH) by a pituitary adenoma (Cushing disease)
and the hyperfunctioning of an adrenocortical adenoma.
In a woman with a modestly elevated serum prolactin level, what diagnosis must first
be excluded as a cause before a diagnosis of hyperprolactinemia is made? - ANSWER:
pregnancy
Measurement of the growth hormone (GH) level is not useful in the assessment of a
woman with amenorrhea or oligomenorrhea unless what diagnosis is being
considered? - ANSWER: acromegaly
Common symptoms of Cushing syndrome include?
What is the diagnostic test of choice? - ANSWER: muscle weakness, ecchymosis,
hypokalemia, unexplained osteoporosis, new-onset hypertension, and diabetes
mellitus
* 24-Hour urine free cortisol excretion
EXAM 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+
Panretinal laser photocoagulation therapy for diabetic retinopathy typically results
in? - ANSWER: retained central vision but poorer peripheral and night vision.
An adrenal incidentaloma that is 6 cm in size or larger and has a high CT attenuation
value requires what therapy? - ANSWER: surgical removal
In a patient with secondary amenorrhea and normal findings of screening laboratory
studies, the cornerstone of further evaluation is? - ANSWER: a progesterone
withdrawal challenge.
In a patient with secondary amenorrhea and clinical evidence of hyperandrogenism,
such as hirsutism or the presence of virilization (voice deepening, clitoral
enlargement) further evaluation should consist of? - ANSWER: total testosterone and
dehydroepiandrosterone levels
In a patient with secondary amenorrhea and elevated prolactin and/or FSH levels
further evaluation should consist of? - ANSWER: MRI of the pituitary gland
In a patient with secondary amenorrhea who previously had dilation and curettage
or a uterine infection further evaluation should consist of? - ANSWER: pelvic
ultrasonography
* Asherman syndrome due to endometrial scarring should be considered
When should patients with subclinical hypothyroidism be treated with
levothyroxine? - ANSWER: if they are at high risk for progression to overt
hypothyroidism
* thyroid-stimulating hormone level greater than 10 microunits/mL [10 milliunits/L]
* positive family history
* goiter
* presence of anti-thyroid peroxidase antibodies
* or desire to become pregnant.
In a patient with disseminated tuberculosis with hypercalcemia consider? - ANSWER:
Hypercalcemia can be caused by the production of 1,25-dihydroxyvitamin D by
granulomatous disease with TB or with sarcoidosis, crohn's disease or leprosy.
elevated PTH
hypercalcemia
low serum phosphorus level - ANSWER: primary hyperparathyroidism
, In patients who have hypercalcemia with malignancy consider what cause? -
ANSWER: PTH-related protein (PTHrP)
* PTHrP has most, if not all, of the metabolic effects of PTH, including osteoclast
activation, increased renal tubular calcium reabsorption, and increased clearance of
phosphorus by the kidneys.
What are the expected findings in a patient with Sarcoidosis and hypercalcemia? -
ANSWER: High Serum Calcium
High Serum Phosphorus
Low PTH
What is a likely cause of diabetes mellitus in a patient with hypertension, central
obesity, and hypokalemia?
What is the appropriate diagnostic study? - ANSWER: * Cushing syndrome
* 24-Hour urine free cortisol excretion
* an overnight dexamethasone suppression test, or a midnight salivary cortisol
measurement can also make the diagnosis.
* Adrenal CT is appropriate after Cushing syndrome is diagnosed
The most common cause of Cushing syndrome is?
Other causes include? - ANSWER: corticosteroid therapy, followed by the secretion
of adrenocorticotropic hormone (ACTH) by a pituitary adenoma (Cushing disease)
and the hyperfunctioning of an adrenocortical adenoma.
In a woman with a modestly elevated serum prolactin level, what diagnosis must first
be excluded as a cause before a diagnosis of hyperprolactinemia is made? - ANSWER:
pregnancy
Measurement of the growth hormone (GH) level is not useful in the assessment of a
woman with amenorrhea or oligomenorrhea unless what diagnosis is being
considered? - ANSWER: acromegaly
Common symptoms of Cushing syndrome include?
What is the diagnostic test of choice? - ANSWER: muscle weakness, ecchymosis,
hypokalemia, unexplained osteoporosis, new-onset hypertension, and diabetes
mellitus
* 24-Hour urine free cortisol excretion
