ENT & Endocrinlogy-MCQQ- (1-174) part 2 NR
A 50-year-old male comes to the office due to an ulcer in his right foot. He has type 2 diabetes, for which he takes glyburide. Laboratory investigations reveal an HbA1c of 9%, and random blood sugar of 180 mg/dl. X-ray of the leg/foot is normal. A picture of the foot ulcer is shown below. Which of the following is the most appropriate management of this patient's foot ulcer?
Perform thorough debridement of the wound
Start aspirin and atorvastatin
Prescribe tight-fitting shoes
Prescribe oral antibiotics and follow-up as an outpatient
Amputation
A 46-year-old female complains of a "sandy" sensation in her eyes. Review of systems is notable for a 6-pound weight loss over the last month. A picture of her eyes is shown on the slide below. Which of the following most likely underlies this finding?
Periorbital lymphocytic infiltration
High circulating thyroxine level
Bilateral facial nerve compression
Increased intraocular pressure
Increased intracranial pressure
A 25-year-old female comes to the office for a follow-up visit. She was just diagnosed with type 1 diabetes mellitus a few days ago, when she presented at the emergency department with ketoacidosis. After successful management of her diabetic ketoacidosis (DKA), she was sent home on an insulin regimen with the following dosage: Before breakfast 10 units of NPH and 10 units of regular insulin Before supper 10 units of NPH and 4 units of regular insulin During this office visit, she shows the record of her fingerstick readings at home. Blood glucose levels were: What is the most likely explanation for her 7:00 am blood glucose level?
Epinephrine, norepinephrine, & glucagon release
Spikes of growth hormone release
Waning of insulin levels
Destruction of glucagon-secreting cells
Decrease Insulin-secretor
A 19-year-old G1P0 woman at 32 weeks’ gestation presents for scheduled prenatal appointment. The pregnancy has been uncomplicated to date. However, she mentions that she recently noticed a hard lump on her neck. She denies pain or difficulty swallowing, speaking, or breathing. Physical examination reveals a firm, nontender, immobile, solitary nodule on the left hemithyroid. Ultrasound reveals a solid 2-cm mass. There is no cervical lymphadenopathy. Thyroid function tests reveal a thyroid-stimulating hormone level of 1.2 μU/mL and free thyroxine level of 0.9 ng/dL. Results of fine-needle aspiration biopsy are shown in the image. Which of the following is the best next step in management?
Monitor until after delivery
Left hemithyroidectomy
Radioablation therapy
Start methimazole
Start propylthiouracil
A 30-year-old female complains of palpitations, fatigue, and insomnia. On physical examination, her extremities are warm and she is tachycardia. There is diffuse thyroid gland enlargement and proptosis. There is thickening of the skin in the pretibial area. Mild clubbing of digits is present. Which of the following laboratory values would you expect in this patient?
Increased free thyroxine, decreased TSH
Increased free thyroxine (free T4), increased TSH
Increased free thyroxine, normal TSH
Normal free thyroxine, elevated triiodothyronine (T3), normal TSH
Normal free thyroxine, decreased TSH
A 17-year-old girl has never had a menstrual period. On physical examination, she has minimal breast development and no axillary or pubic hair. She is color blind and has had a diminished sense of smell since birth. Laboratory evaluation would most likely reveal which of the following?
A
B
C
D
E
A 6-year-old boy is brought to his pediatrician for a routine check-up. He has not been seen by a physician for the past 3 years. Recently, he has developed some patchy areas of hair loss on his scalp. The mother also notes he has had many colds over the past year. She says he has developed normally, although he started walking later than her other two children. On physical examination his wrists appear enlarged, and he has bowing of the forearms and legs. X-ray of the boy’s legs is shown in the image. Laboratory tests show a calcium level of 7.1 mg/dL, phosphate of 1.8 mg/dL, and intact parathyroid hormone of 130 pg/mL (normal: 10–65 pg/mL). Vitamin D level is normal. Treatment with vitamin D does not correct the patient’s hypocalcemia. Which of the following disorders best explains this patient’s findings?
Vitamin D-resistant rickets
Dietary vitamin D deficiency
Hypoalbuminemia
Primary hyperparathyroidism
Pseudohypoparathyroidism
A 14-year-old boy presents at the pediatric clinic for a routine check-up. The patient had developed end-stage renal disease over the previous 2 years, and was successfully treated with a renal transplant 6 months prior. Since his operation, he has developed purple striae on his back and arms, central obesity, and an increasingly round face. During the subsequent blood analysis, which of the following results would be most likely?
A
B
C
D
E
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