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WorksheetsCh 10 Questions
Total questions: 10
Worksheet time: 5mins
A 47-year-old man presents with severe hypertension, episodic headaches, palpitations, and diaphoresis. Labs show elevated plasma metanephrines. Which process best explains his presentation?
Autoimmune adrenal cortex destruction leading to loss of aldosterone and cortisol
Catecholamine-secreting tumor of the adrenal medulla causing episodic sympathetic overdrive
Pituitary ACTH overproduction leading to excess cortisol and androgen secretion
Hyperaldosteronism from adrenal cortical adenoma causing sodium retention
A 68-year-old woman presents with fatigue, constipation, weight gain, and dry skin. Labs: TSH 18 mIU/L, free T4 low. Which mechanism best explains her labs?
Pituitary tumor suppressing TSH release
Autoimmune destruction of the thyroid gland reducing T3/T4 production, triggering compensatory pituitary TSH secretion
Excess dietary iodine causing thyroid hormone suppression
Excess cortisol inhibiting TSH release from the pituitary
A 25-year-old woman presents with exophthalmos, heat intolerance, weight loss, and tremor. Labs: TSH suppressed, T3/T4 elevated. Which pathophysiologic process is most likely?
Pituitary adenoma producing excess TSH
Thyroid nodules secreting T3/T4 independently of TSH
Autoantibody activation of TSH receptors on the thyroid, stimulating excess hormone release
Inflammatory destruction of thyroid follicles releasing stored hormones
A 55-year-old man with uncontrolled type 2 diabetes presents with polyuria, thirst, and confusion. Labs: glucose 780 mg/dL, osmolality 330 mOsm/kg, negative ketones. Which condition is most likely?
Diabetic ketoacidosis from absolute insulin deficiency
Hyperosmolar hyperglycemic state from relative insulin deficiency and severe dehydration
Addisonian crisis from adrenal insufficiency
SIADH from excessive ADH release
A 39-year-old woman presents with hypertension, hypokalemia, and metabolic alkalosis. Labs: plasma aldosterone elevated, renin suppressed. Which diagnosis fits best?
Secondary hyperaldosteronism from renal artery stenosis
Primary hyperaldosteronism from adrenal cortical adenoma
Cushing syndrome from pituitary ACTH overproduction
Pheochromocytoma causing renin release
A 62-year-old woman presents with central obesity, purple abdominal striae, hypertension, and proximal muscle weakness. Low-dose dexamethasone suppression test shows elevated cortisol. Which is the most likely cause?
Addison’s disease from autoimmune adrenal cortex destruction
Pituitary adenoma producing ACTH, leading to adrenal hyperplasia and excess cortisol
Adrenal medullary tumor producing cortisol directly
Ectopic ADH production by lung tumor
A 50-year-old man with chronic kidney disease presents with bone pain and fractures. Labs: calcium low, phosphate high, PTH elevated. Which mechanism explains this?
Parathyroid tumor producing PTH independent of calcium levels
Phosphate retention and low vitamin D activation from CKD leading to hypocalcemia and secondary hyperparathyroidism
Excess dietary phosphorus reducing bone mineralization directly
Malignancy secreting PTH-related peptide
A 28-year-old man presents with polydipsia, polyuria, and dilute urine despite high serum sodium and osmolality. Water deprivation test shows no change in urine osmolality; desmopressin raises it significantly. Which diagnosis fits?
Nephrogenic diabetes insipidus from renal tubule resistance to ADH
Central diabetes insipidus from deficient ADH production
Psychogenic polydipsia causing water overload
SIADH from ectopic ADH secretion
A 46-year-old woman presents with hypotension, hyperpigmentation, and fatigue. Labs: sodium low, potassium high, cortisol low, ACTH elevated. Which pathophysiologic process is most likely?
Pituitary failure reducing ACTH and cortisol production
Exogenous glucocorticoid use suppressing ACTH and adrenal function
Autoimmune destruction of adrenal cortex reducing cortisol and aldosterone, triggering compensatory ACTH elevation
Adrenal medulla tumor producing excess catecholamines
A 33-year-old woman presents with galactorrhea, amenorrhea, and infertility. MRI shows pituitary adenoma. Which hormonal change is expected?
Low prolactin with high dopamine
High prolactin with low GnRH, leading to reduced LH/FSH and estrogen
High TSH with low T3/T4
High ACTH with high cortisol
