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Pseudopseudohypoparathyroidism For Dummies

Total questions: 20

Worksheet time: 10mins

Name
Class
Date
1.

Which gene is most commonly mutated in pseudopseudohypoparathyroidism?

a)

GNAS

b)

PTH

c)

CALCA

d)

FGFR3

2.

What is the inheritance pattern of pseudopseudohypoparathyroidism?

a)

Autosomal dominant

b)

Autosomal recessive

c)

X-linked dominant

d)

Mitochondrial

3.

Which of the following is a classic physical feature of pseudopseudohypoparathyroidism?

a)

Shortened fourth and fifth metacarpals

b)

Tall stature

c)

Macroglossia

d)

Webbed neck

4.

Which laboratory finding is typically normal in pseudopseudohypoparathyroidism?

a)

Serum calcium

b)

Serum phosphate

c)

Parathyroid hormone (PTH) levels

d)

Serum magnesium

5.

What is the main difference between pseudopseudohypoparathyroidism and pseudohypoparathyroidism?

a)

Presence of hormone resistance in pseudohypoparathyroidism

b)

Different gene mutations

c)

Different inheritance patterns

d)

Only pseudopseudohypoparathyroidism affects children

6.

A patient with pseudopseudohypoparathyroidism is most likely to have which of the following?

a)

Normal serum calcium and phosphate levels

b)

Hypocalcemia and hyperphosphatemia

c)

Hypercalcemia and hypophosphatemia

d)

Low PTH levels

7.

Which of the following best describes the genetic mechanism underlying pseudopseudohypoparathyroidism?

a)

Imprinting defect of the GNAS gene

b)

Deletion of the PTH gene

c)

Duplication of chromosome 21

d)

Mutation in the vitamin D receptor gene

8.

A 20-year-old patient presents with short stature, round face, and shortened metacarpals but normal calcium and phosphate levels. Which diagnosis is most likely?

a)

Pseudopseudohypoparathyroidism

b)

Pseudohypoparathyroidism

c)

Hypoparathyroidism

d)

Hyperparathyroidism

9.

Which clinical feature would help distinguish pseudopseudohypoparathyroidism from pseudohypoparathyroidism?

a)

Absence of biochemical evidence of PTH resistance

b)

Presence of Albright hereditary osteodystrophy

c)

Short stature

d)

Obesity

10.

A family has several members with Albright hereditary osteodystrophy features but normal calcium metabolism. What is the most likely explanation?

a)

Pseudopseudohypoparathyroidism due to paternal inheritance of GNAS mutation

b)

Pseudohypoparathyroidism due to maternal inheritance of GNAS mutation

c)

Vitamin D deficiency

d)

X-linked hypophosphatemia

11.

Which of the following is NOT a typical feature of Albright hereditary osteodystrophy?

a)

Brachydactyly

b)

Round face

c)

Tall stature

d)

Subcutaneous ossifications

12.

Which of the following is the most appropriate long-term management strategy for a patient with pseudopseudohypoparathyroidism?

a)

Regular monitoring for complications and supportive care

b)

Lifelong calcium and vitamin D supplementation

c)

Parathyroidectomy

d)

High-dose corticosteroids

13.

A patient with pseudopseudohypoparathyroidism is concerned about the risk of developing hypocalcemia. What should you advise?

a)

Hypocalcemia is not expected; routine monitoring is sufficient

b)

Immediate calcium supplementation is necessary

c)

Hospitalization for intravenous calcium is required

d)

Avoid all dairy products

14.

Which of the following best explains why patients with pseudopseudohypoparathyroidism do not develop hypocalcemia?

a)

They do not have end-organ resistance to PTH

b)

They have increased PTH secretion

c)

They have increased vitamin D absorption

d)

They have decreased renal excretion of calcium

15.

A 22-year-old woman with a family history of Albright hereditary osteodystrophy presents for genetic counseling. What is the most important factor in predicting whether her children will have pseudopseudohypoparathyroidism or pseudohypoparathyroidism?

a)

Whether the GNAS mutation is inherited from the mother or father

b)

The age of onset of symptoms

c)

The presence of subcutaneous ossifications

d)

The serum calcium level

16.

A patient with pseudopseudohypoparathyroidism is planning to start a family. What genetic counseling advice should be provided regarding the risk to offspring?

a)

The risk depends on the parent of origin of the GNAS mutation due to imprinting effects

b)

All children will be affected

c)

There is no risk to offspring

d)

Only male children are at risk

17.

A 19-year-old male with pseudopseudohypoparathyroidism is found to have subcutaneous ossifications and brachydactyly. His laboratory values are normal. What is the most appropriate next step in management?

a)

Reassure and provide supportive care, with periodic monitoring

b)

Start calcium and vitamin D supplementation

c)

Refer for parathyroidectomy

d)

Begin bisphosphonate therapy

18.

A family pedigree shows several individuals with Albright hereditary osteodystrophy features but only those who inherited the mutation from their mother have hypocalcemia. What does this suggest about the underlying genetic mechanism?

a)

Genomic imprinting of the GNAS gene

b)

X-linked inheritance

c)

Mitochondrial inheritance

d)

Autosomal recessive inheritance

19.

A patient with pseudopseudohypoparathyroidism is being followed for potential complications. Which of the following complications should be monitored for, despite normal calcium and phosphate levels?

a)

Subcutaneous ossifications and skeletal abnormalities

b)

Renal failure

c)

Hyperthyroidism

d)

Diabetes insipidus

20.

A 25-year-old woman with pseudopseudohypoparathyroidism is concerned about her risk of developing hormone resistance in the future. What is the best explanation you can provide?

a)

She is unlikely to develop hormone resistance because the mutation was inherited from her father, resulting in pseudopseudohypoparathyroidism

b)

She will definitely develop hormone resistance as she ages

c)

Hormone resistance is unrelated to the parent of origin

d)

Hormone resistance only occurs in males