Physician Assistant Endocrine System Disorders 5

Question 1

A patient with polyuria has dilute urine after water deprivation; urine osmolality rises by 70% after desmopressin. What is the diagnosis?

Accepted Answer

Central diabetes insipidus

Answer

A marked rise in urine osmolality after desmopressin indicates ADH deficiency with intact renal response.

Question 2

After a delivery complicated by massive hemorrhage, a woman is unable to breastfeed and later develops amenorrhea and fatigue. What is the most likely cause?

Accepted Answer

Sheehan syndrome

Answer

Postpartum pituitary ischemic necrosis causes hypopituitarism, with failure of lactation often the first sign.

Question 3

At what eGFR is metformin contraindicated per FDA labeling?

Accepted Answer

Below 30 mL/min/1.73 m2

Answer

Metformin is contraindicated below eGFR 30 because of lactic acidosis risk, and initiation is not recommended at 30-45.

Question 4

A woman at 9 weeks gestation is diagnosed with Graves disease requiring antithyroid therapy. Which drug is preferred during the first trimester?

Accepted Answer

Propylthiouracil

Answer

PTU is preferred in the first trimester because methimazole is associated with embryopathy such as aplasia cutis.

Question 5

A 30-year-old has mild asymptomatic hypercalcemia, high-normal PTH, and a calcium-to-creatinine clearance ratio of 0.005; her father has similar labs. What is the best management?

Accepted Answer

Reassurance and no surgery

Answer

Familial hypocalciuric hypercalcemia is a benign CaSR mutation that does not improve with parathyroidectomy.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Endocrine System Disorders 5