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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 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?

    Answer: Levothyroxine (T4)

    Levothyroxine is the standard treatment for primary hypothyroidism and is titrated to normalize TSH levels.

  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?

    Answer: ACTH stimulation test

    The ACTH (cosyntropin) stimulation test is the gold standard for diagnosing primary adrenal insufficiency (Addison disease) by assessing adrenal cortisol response.

  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?

    Answer: GLP-1 receptor agonist

    GLP-1 receptor agonists have cardiovascular and renal benefits, are effective at all GFR levels (most agents), and reduce HbA1c significantly, making them preferred add-on therapy.

  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?

    Answer: Surgery is indicated if age 1 mg/dL above upper limit

    According to guidelines, parathyroidectomy is indicated in asymptomatic primary hyperparathyroidism if age 1 mg/dL above normal, T-score <−2.5, or GFR <60 mL/min.

  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?

    Answer: MRI of the foot

    MRI is the gold standard for diagnosing diabetic osteomyelitis, offering high sensitivity and specificity for bone marrow involvement when plain X-rays are inconclusive.

  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?

    Answer: Graves disease

    Graves disease is the most common cause of hyperthyroidism in young women and is characterized by diffuse goiter, thyroid bruit, and often extrathyroidal manifestations like ophthalmopathy.