MD Endocrine and Metabolic Disorders 2

Question 1

A 45-year-old woman presents with weight gain, fatigue, and constipation. Labs show TSH 12 mIU/L and free T4 0.6 ng/dL. Which finding would most likely also be present?

Accepted Answer

Elevated LDL cholesterol

Answer

Hypothyroidism impairs LDL receptor expression, leading to elevated LDL cholesterol and dyslipidemia.

Question 2

A patient with type 2 diabetes is started on metformin. Which mechanism best explains its glucose-lowering effect?

Accepted Answer

Inhibits hepatic gluconeogenesis via AMPK activation

Answer

Metformin primarily activates AMPK in the liver, suppressing gluconeogenesis and reducing hepatic glucose output.

Question 3

A 30-year-old man has episodic hypertension, headache, and diaphoresis. 24-hour urine shows elevated metanephrines. Which imaging is the BEST next step?

Accepted Answer

MRI of the adrenal glands

Answer

MRI of the adrenal glands is preferred for localizing pheochromocytoma due to its superior soft-tissue contrast and avoidance of iodinated contrast.

Question 4

A 55-year-old woman has hypercalcemia, nephrolithiasis, and a serum PTH of 95 pg/mL (normal 10–65). Which parathyroid disorder is most consistent?

Accepted Answer

Primary hyperparathyroidism

Answer

Primary hyperparathyroidism causes hypercalcemia with inappropriately elevated PTH, typically due to a parathyroid adenoma.

Question 5

Which metabolic acidosis pattern is expected in a patient with uncontrolled type 1 diabetes presenting in DKA?

Accepted Answer

High anion gap metabolic acidosis

Answer

DKA produces ketoacids (beta-hydroxybutyrate, acetoacetate) that consume bicarbonate and elevate the anion gap.

MD - Doctor of Medicine Practice Test

MD - Doctor of Medicine Practice Test

MD Endocrine and Metabolic Disorders 2