Endocrine Weight Loss Endocrine Disorders 2 — Questions and Answers
Question 1: Which adrenal disorder causes central obesity, purple striae, and hypertension due to excess cortisol?
- Addison's disease
- Cushing's syndrome (Correct answer)
- Conn's syndrome
- Pheochromocytoma
Correct answer: Cushing's syndrome
Cushing's syndrome results from excess cortisol, causing central (truncal) obesity, purple striae, hypertension, and buffalo hump.
Question 2: A patient with type 2 diabetes and obesity has an HbA1c of 8.5%. Which GLP-1 receptor agonist is FDA-approved for both glycemic control and weight loss?
- Metformin
- Glipizide
- Semaglutide (Correct answer)
- Pioglitazone
Correct answer: Semaglutide
Semaglutide (Ozempic/Wegovy) is a GLP-1 receptor agonist FDA-approved for both type 2 diabetes management and chronic weight management.
Question 3: Which hormone produced by adipose tissue signals the hypothalamus to suppress appetite and increase energy expenditure?
- Ghrelin
- Adiponectin
- Leptin (Correct answer)
- Resistin
Correct answer: Leptin
Leptin is produced by adipocytes and acts on hypothalamic receptors to suppress hunger and promote energy expenditure.
Question 4: Polycystic ovary syndrome (PCOS) contributes to weight gain primarily through which mechanism?
- Excess thyroid hormone
- Insulin resistance and hyperinsulinemia (Correct answer)
- Cortisol deficiency
- Low estrogen levels
Correct answer: Insulin resistance and hyperinsulinemia
PCOS is strongly associated with insulin resistance and hyperinsulinemia, which drives androgen excess and promotes fat storage.
Question 5: Which finding on labs would most strongly suggest primary hypothyroidism as a cause of weight gain?
- Low TSH with high free T4
- High TSH with low free T4 (Correct answer)
- Normal TSH with low free T3
- High TSH with high free T4
Correct answer: High TSH with low free T4
Primary hypothyroidism is characterized by elevated TSH (pituitary compensation) and low free T4 due to underactive thyroid gland output.
Question 6: A 45-year-old woman presents with weight gain, fatigue, and a 24-hour urine free cortisol of 450 mcg (normal <50). What is the most likely diagnosis?
- Primary adrenal insufficiency
- Cushing's syndrome (Correct answer)
- Hypothyroidism
- Metabolic syndrome
Correct answer: Cushing's syndrome
Markedly elevated 24-hour urine free cortisol is diagnostic of Cushing's syndrome, indicating pathologic hypercortisolism.
Question 7: Growth hormone deficiency in adults is associated with which body composition change?
- Increased lean muscle mass
- Decreased visceral fat
- Increased visceral adiposity and reduced muscle mass (Correct answer)
- Increased bone density
Correct answer: Increased visceral adiposity and reduced muscle mass
Adult growth hormone deficiency leads to increased visceral fat accumulation, reduced lean muscle mass, and dyslipidemia.
Endocrine Weight Loss Endocrine Disorders 2
Which adrenal disorder causes central obesity, purple striae, and hypertension due to excess cortisol?