Internal-Medicine

58 3: Endocrinology
34. A 33-year-old man is complaining of feeling
thirsty all the time and passing more urine than
usual. His physical examination is normal,
except for a JVP at the sternal angle. His serum
sodium is 150 mEq/L, glucose 120 mg/dL, and
osmolality 315 mOsm/kg. The urine sodium is
20 mE/L and osmolality 260 mOsm/kg. Which
of the following drugs is most likely to cause
this disorder?
(A)
(B)
(C)
(D)
(E)
lithium
cyclophosphamide
barbiturates
nicotine
morphine
DIRECTIONS (Questions 35 through 39): The
group of matching questions in this section consists
of a list of lettered options followed by several
numbered items. For each numbered item,
select the appropriate lettered option(s). Each lettered
option may be selected once, more than
once, or not at all. EACH ITEM WILL STATE THE
NUMBER OF OPTIONS TO SELECT. CHOOSE
EXACTLY THIS NUMBER.
Questions 35 through 39
(A) palmar plane xanthomas
(B) triglycerides >1000
(C) subcutaneous extensor tendon xanthomas
(D) low serum cholesterol
(E) normal cholesterol levels
(F) xanthelasma after age 50 only
For each of the following dyslipidemias, select the
most characteristic finding.
35. Hyperchylomicronemia (SELECT ONE)
36. Hyperbetalipoproteinemia (SELECT ONE)
37. Type III hyperlipoproteinemia (SELECT ONE)
38. Hyperprebetalipoproteinemia (SELECT ONE)
39. Hypertriglyceridemia (SELECT ONE)
DIRECTIONS (Questions 40 through 73): Each of
the numbered items in this section is followed by
answers. Select the ONE lettered answer that is
BEST in each case.
40. A 20-year-old woman is complaining of passing
large amounts of urine. She is otherwise
well and her physical examination is normal.
The serum sodium is 140 mEq/L and the urinalysis
is negative for protein and glucose. The
urine sodium is 33 mEq/L, and urine osmolality
is 268 mOsm/kg. She weighs 60 kg, and
her 24-hour urine output is over 4 l. Which of
the following is the most likely diagnosis?
(A)
(B)
(C)
(D)
(E)
diabetes mellitus (DM)
psychogenic polydipsia
diabetes insipidus (DI)
contracted bladder
solute diureses
41. A 62-year-old man is seen in the office. Routine
blood testing reveals elevated LDL cholesterol.
Which of the following is the most likely cause
for the elevated LDL?
(A)
(B)
(C)
(D)
(E)
an autosomal dominant disease
an X-linked recessive disease
a polygenic disease
a poor diet
DM
42. Which of the following dietary abnormalities is
most commonly associated with elevated cholesterol
levels?
(A)
(B)
(C)
(D)
(E)
inadequate fiber
excess calories resulting in obesity
excess dietary cholesterol
excess total fat intake
excess trans-fatty acid intake
43. A 63-year-old asymptomatic woman is investigated
for a high alkaline phosphatase (ALP)
level. X-rays of the pelvis show multiple
porotic and sclerotic lesions with characteristic
whorls of trabeculation. Her excretion of urinary
hydroxyproline is also elevated. Which
of the following is the most likely diagnosis?