MD Endocrine and Metabolic Disorders 4

Question 1

A 25-year-old woman has muscle cramps, perioral tingling, and a positive Chvostek sign after thyroid surgery. Labs show calcium 7.0 mg/dL and PTH 5 pg/mL. What is the diagnosis?

Accepted Answer

Hypoparathyroidism

Answer

Surgical removal or damage to parathyroid glands causes hypoparathyroidism with low calcium and very low PTH.

Question 2

A patient with type 2 diabetes on metformin has an HbA1c of 8.5%. The provider adds an SGLT2 inhibitor. Which additional benefit beyond glucose control supports this choice in a patient with established cardiovascular disease?

Accepted Answer

Decreased risk of major adverse cardiovascular events

Answer

SGLT2 inhibitors (e.g., empagliflozin, canagliflozin) have demonstrated significant reduction in MACE and heart failure hospitalization in patients with established CVD.

Question 3

A 45-year-old man has hypertension, hypokalemia, and a plasma aldosterone-to-renin ratio of 35 (elevated). What is the most likely diagnosis?

Accepted Answer

Primary hyperaldosteronism (Conn's syndrome)

Answer

An elevated aldosterone-to-renin ratio with hypokalemia and hypertension is the hallmark of primary hyperaldosteronism due to autonomous aldosterone secretion.

Question 4

A newborn presents with ambiguous genitalia, vomiting, and hyponatremia with hyperkalemia. 17-hydroxyprogesterone is markedly elevated. What enzyme is deficient?

Accepted Answer

21-hydroxylase

Answer

21-hydroxylase deficiency is the most common cause of congenital adrenal hyperplasia, blocking cortisol and aldosterone synthesis with excess 17-OHP accumulation.

Question 5

A 60-year-old woman with osteoporosis has a serum calcium of 11.8 mg/dL, low phosphorus, and PTH of 120 pg/mL. Neck ultrasound shows a right inferior parathyroid adenoma. What is the definitive treatment?

Accepted Answer

Parathyroidectomy

Answer

Parathyroidectomy is the definitive curative treatment for symptomatic primary hyperparathyroidism, including cases with osteoporosis or nephrolithiasis.

MD - Doctor of Medicine Practice Test

MD - Doctor of Medicine Practice Test

MD Endocrine and Metabolic Disorders 4