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,
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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
- monitor urinary calcium excretion since hypercalciuria often limits therapy
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