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PANCE ENDOCRINOLOGY CERTIFICATION
PAPER 2026 FULL SOLUTION GRADED A+
โ dexamethasone supression test. Answer: cortisol>5 after test indicates cushings โ electrolytes in cushings. Answer: high NA (high BP) low K because high cortisol acts like aldosterone โ pheochromocytoma test. Answer: 24 hr urine catecholamines with metanephrines and vanillylmandelic acid โ pheochromocytoma treatment. Answer: alpha blockers (phentolamine) NO BB ALONE โ primary addisons and ACTH levels. Answer: from adrenal destruction elevated ACTH โ ACTH stimulation test. Answer: cortisol increase less than 20 indicates primary addisons
โ electrolytes in addisons. Answer: low NA (causes low BP) high K because of low aldosterone (which tells you to absorb NA) โ Addisonian crisis. Answer: IVF glucose (low cortisol causes hypoglycemia) hydrocortisone fludricortisone โ secondary hyperparathyroid. Answer: usually from CKD which causes low calcium and vit D โ hyperparathyroid treatment for high calcium. Answer: IVF calcitonin bisphosphonates lasix โ hypoparathyroidism treatment. Answer: replete calcium and vit D โ acromegaly diagnosis. Answer: elevated IGF- 1 GH test 2 hrs after glucose pituitary MRI
(decreased urine with desmopressin stimulation test if central) โ MEN 1 and 4. Answer: parathyroid pancreatic pituitary โ MEN 2A. Answer: pheochromocytoma medullary thyroid cancer parathyroid โ MEN 2B. Answer: pheochromocytoma medullary thyroid cancer mucosal neuroma/marfanoid โ metabolic syndrome. Answer: increased risk for T2DM, CVD, and stroke โ prolactinoma symptoms. Answer: amenorrhea galactorrhea low libido infertility bitemporal hemianopsia
โ prolactinoma diagnosis. Answer: prolactin >150- 200 low FSH, LH, and GnRH โ prolactinoma treatment. Answer: bromocriptine or cabergoline (dopamine agonists) โ pituitary adenoma sizes. Answer: micro if <1cm or 10mm macro if greater than โ SIADH causes and symptoms. Answer: from head trauma, infection water retention (too much ADH) HA, N/V, brain edema, ams, seizure โ SIADH electeolytes. Answer: dilutional hyponatremia NA< low serum osmolality< high NA and osmolality in urine โ SIADH treatment. Answer: water restriction increase NA tolvaptan (ADH receptor antagonist)
โ goiter diagnosis. Answer: US RAIU if hyperthyroid FNA if nodules โ thyroid nodules diagnosis. Answer: FNA if >1cm or suspicious US โ thyroid cancer risk factors. Answer: radiation fam hx >1cm microcalcifications, irregular, or hypoechogenicity on US โ subacute/ quervains thyroiditis cause and symptoms. Answer: after virus hyperthyroid painful, dysphagia, fever โ subacute/ quervains thyroiditis treatment. Answer: NSAIDS and propranolol โ
