PANCE Endocrine System 5

Question 1

A 55-year-old man with type 2 diabetes and a history of heart failure with reduced ejection fraction (HFrEF) needs better glycemic control. Which agent provides the most cardiovascular benefit?

Accepted Answer

Empagliflozin (SGLT-2 inhibitor)

Answer

SGLT-2 inhibitors like empagliflozin have demonstrated significant reduction in HF hospitalizations and cardiovascular mortality in patients with HFrEF.

Question 2

A 22-year-old woman presents with salt craving, hyperpigmentation, hypotension, and hyponatremia with hyperkalemia. Morning cortisol is 3 mcg/dL. What is the diagnosis?

Accepted Answer

Primary adrenal insufficiency (Addison disease)

Answer

Primary adrenal insufficiency causes hyperpigmentation (elevated ACTH) and both glucocorticoid and mineralocorticoid deficiency, causing hyperkalemia and hyponatremia.

Question 3

A 30-year-old woman with Hashimoto thyroiditis is euthyroid. She asks about her risk for other autoimmune conditions. Which condition is she at increased risk for?

Accepted Answer

Vitiligo and type 1 diabetes

Answer

Hashimoto thyroiditis is associated with other organ-specific autoimmune diseases including type 1 DM, vitiligo, and Addison disease.

Question 4

A newborn has ambiguous genitalia, hyponatremia, hyperkalemia, and low cortisol. 17-hydroxyprogesterone is markedly elevated. What is the most likely diagnosis?

Accepted Answer

Congenital adrenal hyperplasia due to 21-hydroxylase deficiency

Answer

21-hydroxylase deficiency is the most common form of CAH, causing cortisol and aldosterone deficiency with androgen excess and markedly elevated 17-OHP.

Question 5

A 65-year-old woman on alendronate for 5 years asks about continuing therapy. What is the most serious rare adverse effect associated with long-term bisphosphonate use?

Accepted Answer

Atypical femur fracture

Answer

Long-term bisphosphonate use is associated with atypical subtrochanteric or diaphyseal femur fractures.

PANCE Test Practice Test

PANCE Test Practice Test

PANCE Endocrine System 5