PANCE Endocrine System 2

Question 1

A 45-year-old woman presents with weight gain, cold intolerance, and constipation. TSH is 12 mIU/L and free T4 is low. Which medication is first-line treatment?

Accepted Answer

Levothyroxine

Answer

Levothyroxine (synthetic T4) is the first-line treatment for hypothyroidism.

Question 2

A patient with type 1 diabetes develops sudden confusion, diaphoresis, and tremors. Blood glucose is 42 mg/dL. What is the most appropriate immediate intervention?

Accepted Answer

Give 15-20g of fast-acting carbohydrates

Answer

The rule of 15 (15g fast carbs, recheck in 15 min) is first-line for a conscious hypoglycemic patient.

Question 3

A 52-year-old man has a serum calcium of 11.8 mg/dL, PTH of 95 pg/mL, and is asymptomatic. What is the most likely diagnosis?

Accepted Answer

Primary hyperparathyroidism

Answer

Elevated calcium with elevated (or inappropriately normal) PTH is the hallmark of primary hyperparathyroidism.

Question 4

Which of the following is the most common cause of Cushing syndrome in clinical practice?

Accepted Answer

Exogenous corticosteroid use

Answer

Iatrogenic Cushing syndrome from exogenous glucocorticoid use is the most common cause overall.

Question 5

A 28-year-old woman has amenorrhea, galactorrhea, and a serum prolactin of 120 ng/mL. MRI shows a 7 mm pituitary lesion. First-line treatment is:

Accepted Answer

Bromocriptine or cabergoline

Answer

Dopamine agonists (cabergoline preferred) are first-line for prolactinomas regardless of size.

PANCE Test Practice Test

PANCE Test Practice Test

PANCE Endocrine System 2