ABIM Endocrinology

Question 1

A 45-year-old woman presents with weight gain, fatigue, constipation, and cold intolerance. TSH is 12 mIU/L and free T4 is low. What is the most appropriate treatment?

Accepted Answer

Levothyroxine (T4)

Answer

Liothyronine (T3) alone

Answer

Methimazole

Answer

Radioactive iodine

Question 2

A 32-year-old woman with type 1 diabetes presents with recurrent hypoglycemia, nausea, and weight loss. Morning cortisol is undetectable. What additional test should be performed?

Accepted Answer

ACTH stimulation test

Answer

Fasting glucose tolerance test

Answer

24-hour urinary free cortisol

Answer

Dexamethasone suppression test

Question 3

A 60-year-old man with type 2 diabetes has HbA1c of 8.9% on metformin monotherapy. He has CKD stage 3a (GFR 48 mL/min) and no cardiovascular disease. What is the best add-on therapy?

Accepted Answer

GLP-1 receptor agonist

Answer

Insulin glargine

Answer

SGLT-2 inhibitor

Answer

Sulfonylurea

Question 4

A 35-year-old woman develops hypercalcemia with a PTH of 120 pg/mL (normal 10–65). She is asymptomatic. Which statement is correct about management?

Accepted Answer

Surgery is indicated if age <50 or serum calcium >1 mg/dL above upper limit

Answer

Immediate parathyroidectomy is required

Answer

Only observation is appropriate for asymptomatic patients

Answer

Start bisphosphonate therapy

Question 5

A patient with type 2 diabetes has a foot ulcer that probes to bone. X-ray shows periosteal reaction and bone erosion. What is the most appropriate next step?

Accepted Answer

MRI of the foot

Answer

Topical antibiotic therapy only

Answer

Empiric oral antibiotics for 2 weeks

Answer

Immediate surgical debridement

Question 6

A 28-year-old woman presents with heat intolerance, tremor, weight loss, and a diffuse goiter with a bruit. TSH is undetectable. What is the most likely cause?

Accepted Answer

Graves disease

Answer

Toxic multinodular goiter

Answer

Subacute (de Quervain) thyroiditis

Answer

Toxic adenoma