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Endocrinology Flashcards

6 cards from real ABIM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 30-year-old woman presents with oligomenorrhea, galactorrhea, and visual field defects. MRI shows a 1.5 cm pituitary mass. Serum prolactin is 320 ng/mL. What is the first-line treatment?

    Answer: Dopamine agonist (cabergoline or bromocriptine)

    Dopamine agonists (cabergoline preferred) are the first-line treatment for prolactinomas of all sizes, effectively reducing prolactin levels and tumor size in most patients.

  2. A patient develops hypocalcemia and low PTH after thyroid surgery. Signs of Chvostek and Trousseau are present. Which is the most appropriate immediate treatment?

    Answer: IV calcium gluconate

    Symptomatic hypocalcemia (with neuromuscular signs) after parathyroid injury requires immediate IV calcium gluconate for rapid correction.

  3. A 35-year-old woman has a TSH of 6.8 mIU/L (normal 0.5–4.5) with normal free T4. She has no symptoms. Anti-TPO antibodies are positive. What is the most appropriate management?

    Answer: Repeat TSH in 6–12 months and consider treatment if TSH >10

    Subclinical hypothyroidism with TSH 5–10 mIU/L is monitored with repeat testing; treatment is generally recommended when TSH >10 or symptoms are present.

  4. A 55-year-old woman with postmenopausal osteoporosis has a T-score of −2.8 at the lumbar spine. She cannot tolerate oral bisphosphonates. What is the most appropriate alternative?

    Answer: Zoledronic acid IV annually

    Zoledronic acid (annual IV infusion) is an effective alternative for patients who cannot tolerate oral bisphosphonates and reduces fracture risk significantly.

  5. A 58-year-old man with known MEN2A syndrome undergoes genetic testing. The RET mutation is confirmed. He has a calcitonin level of 800 pg/mL. What malignancy must be ruled out first?

    Answer: Medullary thyroid carcinoma

    Medullary thyroid carcinoma (MTC) arises from parafollicular C-cells and is the most common and life-threatening component of MEN2A, diagnosed by elevated calcitonin.

  6. A 42-year-old woman presents with episodic hypertension, diaphoresis, and palpitations. 24-hour urine shows elevated metanephrines and normetanephrines. What is the next step?

    Answer: CT or MRI of the adrenal glands

    After biochemical confirmation of pheochromocytoma, imaging (CT or MRI) of the adrenal glands is required to localize the tumor before surgical resection.