PANCE Endocrine System 4

Question 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?

Accepted Answer

Radioactive iodine (RAI) ablation

Answer

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

Question 2

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

Accepted Answer

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

Answer

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

Question 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?

Accepted Answer

Urgent ophthalmology referral for laser photocoagulation

Answer

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

Question 4

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

Accepted Answer

Pituitary adenoma, pancreatic islet tumor, parathyroid hyperplasia

Answer

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

Question 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?

Accepted Answer

Central (gonadotropin-dependent) precocious puberty

Answer

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

PANCE Test Practice Test

PANCE Test Practice Test

PANCE Endocrine System 4