PANCE Endocrine System 3

Question 1

A 35-year-old woman has episodic hypertension, headache, diaphoresis, and palpitations. 24-hour urine shows elevated metanephrines. Which imaging is most appropriate next?

Accepted Answer

CT or MRI of the abdomen/pelvis

Answer

CT or MRI of the abdomen/pelvis is used to localize pheochromocytoma after biochemical confirmation.

Question 2

Which electrolyte abnormality is most characteristic of primary hyperaldosteronism (Conn syndrome)?

Accepted Answer

Hypokalemia and hypertension

Answer

Excess aldosterone causes sodium retention and potassium wasting, producing hypokalemia with hypertension.

Question 3

A 70-year-old woman with osteoporosis is found to have a serum calcium of 10.9 mg/dL and PTH-related peptide (PTHrP) elevated. PTH is suppressed. What is the most likely etiology?

Accepted Answer

Humoral hypercalcemia of malignancy

Answer

Elevated PTHrP with suppressed PTH in an elderly patient suggests humoral hypercalcemia of malignancy.

Question 4

A patient with type 2 diabetes has an HbA1c of 9.2% and CKD stage 3 (eGFR 38 mL/min). Which medication should be avoided or used with caution?

Accepted Answer

Metformin

Answer

Metformin is contraindicated when eGFR <30 and requires dose reduction/caution at eGFR 30-45 due to lactic acidosis risk.

Question 5

Graves disease is caused by which mechanism?

Accepted Answer

Stimulating antibodies against the TSH receptor

Answer

Thyroid-stimulating immunoglobulins (TSI) bind and activate the TSH receptor, causing hyperthyroidism in Graves disease.

PANCE Test Practice Test

PANCE Test Practice Test

PANCE Endocrine System 3