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1) A 76 year old man from a nursing home is
brought into the emergency department
after staff notice a decreased level of
consciousness. He has Type II diabetes
mellitus and is diagnosed with
hyperosmolar state. All of the following
may be features of hyperosmolar state
EXCEPT:
a) Hyponatremia
b) Positive ketones on urine dipstick
c) Positive glucose on urine dipstick
d) Elevated blood glucose level
e) History of decreased fluid intake
2) All of the following are complications of
diabetes mellitus EXCEPT:
a) Retinal detachment
b) Gangrene in the feet
c) Calcification of cartilage
d) Abdominal bloating
e) Urinary retention
3) A 37 year old female is referred to you, an
endocrinologist, because she is concerned
about her weight. She is obese with a BMI
of 35.2. On her last physical, her family
doctor found her LDL level to be extremely
elevated. Her only medications are
acetaminophen PRN for headache and
quetiapine, which she has been taking for
the past several years for anxiety and to
help her sleep at night. As you chat with
her, you learn she has never married and
never had any children. In fact, she admits
to having few social supports. Apparently,
she has had poor self esteem since she
was young because of unwanted hair
growth and obesity. She agrees that she
uses food for comfort. Which of the
following statements apply to this case?
a) She is at risk for osteoarthritis in the
future
b) You should order gonadotropin levels in
her
c) She should be referred to a dietician
d) She should be started on cholesterol
lowering medications immediately
e) With such a high BMI, she should be
initiated on orlistat (pancreatic lipase
inhibitor) immediately
4) A patient complains of a non-tender mass
over the thyroid region on the left side of
her neck. Concerned about a thyroid
disorder, you order the appropriate
investigations. The results are as follows:
TSH: 6.0
Free T4: 20.2
Thyroid antibodies: none
RAIU: No “hot” spots seen
The next investigation(s) you choose to
do are:
a) Watch and wait for 3-6 months
b) FNA
c) Surgical biopsy
d) Trial of L-thyroxine therapy for 6 months
e) None of the above
Endocrinology
