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Endocrine System Flashcards

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  1. A 40-year-old woman presents with heat intolerance, weight loss, tremor, and TSH <0.01 mIU/L with elevated free T4. Radioiodine uptake is diffusely increased. What is the preferred long-term treatment option in a non-pregnant patient?

    Answer: Radioactive iodine (RAI) ablation

    RAI ablation is the preferred definitive treatment for Graves disease in non-pregnant adults in the US.

  2. Which laboratory finding is most consistent with syndrome of inappropriate antidiuretic hormone (SIADH)?

    Answer: Serum sodium 128 mEq/L, urine osmolality 550 mOsm/kg, urine sodium 45 mEq/L

    SIADH features hyponatremia with inappropriately concentrated urine (>100 mOsm/kg) and high urine sodium (>20 mEq/L).

  3. A 48-year-old man with poorly controlled type 2 diabetes develops painless loss of vision in one eye. Fundoscopy shows neovascularization. What is the most appropriate next step?

    Answer: Urgent ophthalmology referral for laser photocoagulation

    Proliferative diabetic retinopathy with neovascularization requires urgent ophthalmology referral for pan-retinal photocoagulation.

  4. A patient with MEN1 syndrome would most likely have which combination of tumors?

    Answer: Pituitary adenoma, pancreatic islet tumor, parathyroid hyperplasia

    MEN1 (Wermer syndrome) involves the 3 Ps: pituitary adenoma, pancreatic islet tumors, and parathyroid hyperplasia.

  5. An 8-year-old boy presents with pubic hair and testicular enlargement. Bone age is advanced. LH and FSH are elevated. What is the most likely diagnosis?

    Answer: Central (gonadotropin-dependent) precocious puberty

    Elevated LH and FSH confirm central (GnRH-dependent) precocious puberty, which is driven by the hypothalamic-pituitary axis.

  6. A 32-year-old woman develops gestational diabetes at 28 weeks. Her fasting glucose is 105 mg/dL. After failing medical nutrition therapy, what is the preferred pharmacologic treatment during pregnancy?

    Answer: Insulin

    Insulin is the preferred medication for gestational diabetes when dietary modification fails, as it does not cross the placenta in significant amounts.

  7. Which finding on DEXA scan defines osteoporosis (not osteopenia)?

    Answer: T-score of -2.5 or below

    Osteoporosis is defined by a T-score of -2.5 or lower on DEXA scan.