Physician Assistant Endocrine System Disorders 2

Question 1

A 40-year-old woman presents with moon facies, central obesity, purple striae, and easy bruising. 24-hour urinary free cortisol is markedly elevated. What is the most likely diagnosis?

Accepted Answer

Cushing's syndrome

Answer

Cushing's syndrome results from chronic excess cortisol and presents with moon facies, buffalo hump, purple striae, and central obesity.

Question 2

Which of the following is the most common overall cause of Cushing's syndrome?

Accepted Answer

Exogenous corticosteroid use

Answer

Exogenous corticosteroid use is the most common cause of Cushing's syndrome overall, making it iatrogenic in most cases.

Question 3

A 35-year-old woman presents with weakness, fatigue, hyperpigmentation, hyponatremia, and hyperkalemia. Cortisol is low and ACTH is markedly elevated. What is the most likely diagnosis?

Accepted Answer

Addison's disease

Answer

Addison's disease (primary adrenal insufficiency) features elevated ACTH causing hyperpigmentation, with low cortisol, hyponatremia, and hyperkalemia.

Question 4

A 45-year-old man has resistant hypertension despite three antihypertensives and persistent hypokalemia. The aldosterone-to-renin ratio is markedly elevated. What is the most likely diagnosis?

Accepted Answer

Primary hyperaldosteronism (Conn's syndrome)

Answer

Primary hyperaldosteronism causes autonomous aldosterone excess, resulting in resistant hypertension, hypokalemia, and an elevated aldosterone-to-renin ratio.

Question 5

A 30-year-old woman presents with galactorrhea, amenorrhea, and bitemporal headaches. MRI shows a pituitary mass and prolactin is 160 ng/mL. What is the first-line treatment?

Accepted Answer

Dopamine agonist (cabergoline or bromocriptine)

Answer

Dopamine agonists are the first-line treatment for prolactinomas, as they suppress prolactin secretion and reduce tumor size.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Endocrine System Disorders 2