Internal-Medicine

CHAPTER 3
Endocrinology
Questions
DIRECTIONS (Questions 1 through 34): Each of
the numbered items in this section is followed by
answers. Select the ONE lettered answer that is
BEST in each case.
1. A 42-year-old woman has noticed dry skin,
fatigue, and weight gain over the past 3 months.
Her blood pressure is 110/70 mm Hg, pulse
60/min, and heart and lungs are normal. Her
skin feels rough and dry, but the rest of the
examination is normal. Her biochemistry is
normal but the thyroid-stimulating hormone
(TSH) is 39 mU/L (0.5–5 mU/L). Which of
the following is the most likely cause for her
elevated TSH?
(A)
(B)
(C)
(D)
(E)
trauma
radioactive iodine ingestion
primary hypothyroidism
parathyroid surgery
antithyroid chemicals
2. A 53-year-old man has had gout for many
years, and usually experiences 4–5 attacks a
year. He is not on any medications for gout
prophylaxis, and takes an over-the-counter
nonsteroidal anti-inflammatory drug (NSAID)
to treat his flares. On examination, there are no
active joints presently, but he does have some
tophaceous deposits on his left hand. As part of
his complete evaluation, screening for renal
complications is performed. Which of the following
findings is most likely compatible with
chronic gouty nephropathy?
(A) nephrotic syndrome
(B) decrease urinary concentrating ability
and proteinuria
(C) acute renal failure
(D) acute tubular necrosis (ATN)
(E) malignant hypertension
3. Which of the following is the most common
presentation of anterior pituitary hyposecretion
in a 26-year-old woman?
(A)
(B)
(C)
(D)
(E)
occurrence of myxedema
decreased melanin pigmentation
emaciation and cachexia
loss of axillary and pubic hairs
amenorrhea
4. A 19-year-old woman presents with primary
amenorrhea. Her physical examination is
normal, and she has female sex characteristics
and breast development. The only abnormality
is the absence of body hair. Genetic testing
reveals an XY chromosome pattern. Which of
the following mechanisms is most likely to
explain her phenotypic pattern and amenorrhea?
(A)
(B)
(C)
(D)
(E)
estrogen receptor defect
excess hormone production
androgen receptor defect
decreased hormone production
abnormal hormone production
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