PANCE Endocrinology Practice Test

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• Thiazolidinediones increase peripheral insulin sensitivity in which tissues?
• Which autoantibodies are commonly present in new-onset type 1 diabetes?
• A solitary thyroid nodule with suppressed TSH: what is the most appropriate next diagnostic step?
• Central hypothyroidism is characterized by which of the following?
• Which antibody is most closely associated with autoimmune hyperthyroidism in Graves' disease?
• Thiazolidinediones act primarily as agonists of which receptor to improve insulin sensitivity?
• Which laboratory pattern is most typical of primary hyperparathyroidism?
• What is the primary cause of type 1 diabetes mellitus?
• Which test is diagnostic for adrenal insufficiency?
• What ultrasound finding most commonly prompts fine-needle aspiration biopsy in thyroid nodules?
• Subacute thyroiditis (de Quervain) is most typically associated with which early finding?
• What is myxedema coma and what is the typical treatment approach?
• Metabolic syndrome is defined by the presence of any three of the following five traits. Which option reflects this?
• After an elevated IGF-1 level suggests acromegaly, what is the next step to confirm?
• Which statement best describes the role of TSH suppression in differentiated thyroid cancer management?
• In hypoparathyroidism, what is the typical pattern of serum calcium and PTH?
• What is the recommended management for asymptomatic primary hyperparathyroidism?
• In primary hyperparathyroidism, what is the typical laboratory pattern?
• What is the most common cause of hypothyroidism worldwide?
• How do Hashimoto thyroiditis and Graves disease typically differ clinically?
• Which statement is NOT typical of acromegaly?
• A 45-year-old with coarse facial features and enlargement of hands; which test is best for diagnosing acromegaly?
• What is the definitive treatment for primary hyperparathyroidism?
• Which symptom is a classic presentation of new-onset type 1 diabetes?
• What combination defines diabetic ketoacidosis?
• In Hyperosmolar Hyperglycemic State (HHS) management, the initial focus is on what?
• Syndrome of inappropriate antidiuretic hormone (SIADH) management: which statement is true?
• Radionuclide thyroid scanning is most helpful when TSH is low because it assesses what?
• Which combination of tests helps localize ACTH production in Cushing's syndrome?
• How is SIADH-induced hyponatremia typically managed?
• Which pharmacologic agent is commonly used to stimulate growth hormone release during diagnostic testing?
• Which electrolyte abnormalities commonly accompany primary adrenal insufficiency?
• In Graves' disease, which medication is commonly used to control adrenergic symptoms such as tachycardia and tremor?
• Prolactinoma is likely when prolactin levels exceed which threshold, after excluding physiologic and medication causes?
• Which mechanism best describes how sulfonylureas work?
• How do potassium levels typically differ between primary and secondary adrenal insufficiency?
• In diabetic ketoacidosis, which statement best describes the metabolic process contributing to acidosis?
• How should potassium be managed when K+ is between 3.3 and 5.2 mEq/L during DKA treatment?
• In primary hypogonadism, what is the typical pattern of testosterone with LH and FSH?
• In the management of hypoparathyroidism, which therapy combination is standard?
• In pregnancy, management of Graves' disease prioritizes the first trimester with a preferred antithyroid agent due to teratogenic risk associated with methimazole; which drug is preferred in the first trimester?
• What is the first-line treatment for hypothyroidism?
• The ASCVD Risk Estimator Plus tool is used to estimate which of the following?
• What is a key component of initial management for type 1 diabetes?
• Propylthiouracil is sometimes used in Graves' disease during which scenario?
• Which laboratory pattern is most characteristic of primary hypothyroidism?
• Which thyroid cancer has the highest association with lymph node metastasis but generally has a good prognosis?
• When should insulin therapy be started in DKA?
• Which mineralocorticoid is used in replacement therapy for primary adrenal insufficiency?
• During hypoglycemia, which pattern indicates endogenous insulin production?
• What is the immediate management for suspected adrenal crisis?
• Rising thyroglobulin levels with suppressed TSH after thyroid cancer surgery indicate what?
• What perioperative glucocorticoid coverage is recommended for a patient with known adrenal insufficiency undergoing surgery?
• Which statement best describes the mechanism and a common adverse effect of GLP-1 receptor agonists used for type 2 diabetes?
• What is considered the primary treatment for acromegaly due to a pituitary adenoma?
• Metabolic bariatric surgery is recommended for type 2 diabetes in adults who meet which BMI criteria?
• Which is an advantage of second-generation sulfonylureas?
• Which reflex is characteristically slowed in hypothyroidism?
• If a patient has Cushing syndrome with elevated cortisol, which finding would suggest an ACTH-dependent etiology?
• Calcitonin's physiological role is best described as:
• If ultrasound features of a thyroid nodule are suspicious for malignancy, what is the next best step?
• Which insulin is commonly used for the basal component of basal-bolus therapy?
• In diabetes insipidus, polyuria in central DI is due to which mechanism?
• Which of the following is a symptom of Hyperosmolar Hyperglycemic Syndrome?
• Which symptom is commonly associated with hypothyroidism?
• Which of the following is a common symptom of hypothyroidism?
• In patients receiving estrogen therapy or during pregnancy, how does estrogen affect thyroid-binding globulin and total T4?
• Which replacement is often required specifically in primary adrenal insufficiency due to aldosterone deficiency?
• What is the preferred initial test for suspected adult growth hormone deficiency?
• In the treatment of hypoparathyroidism-related hypocalcemia, which active vitamin D metabolite is most commonly used?
• What is the primary mode of therapy for thyroid cancer?
• What is the initial biochemical test to confirm pheochromocytoma?
• Which statement best describes the risks and benefits of menopausal hormone therapy?
• How should HbA1c levels be interpreted for glycemic control in adults?
• Which imaging modality is commonly used first to assess thyroid cancer risk in thyrotoxicosis?
• What is the mechanism and a key adverse effect of SGLT2 inhibitors?
• Which statement is essential when diagnosing PCOS under Rotterdam criteria?
• In MEN2A, which glands are involved along with medullary thyroid carcinoma and pheochromocytoma?
• Which statement distinguishes central diabetes insipidus from nephrogenic diabetes insipidus?
• Which test distinguishes central from nephrogenic diabetes insipidus?
• What is a major contraindication to metformin use?
• What is the recommended emergency management for suspected adrenal crisis?
• Which of the following are classic signs of an acute adrenal crisis?
• What is the IV insulin dosing rate in DKA after initial fluids and potassium criteria are met?
• Which of the following is a component of the Rotterdam criteria for diagnosing PCOS?
• During insulin therapy for diabetic ketoacidosis, which statement best describes the electrolyte shift and its management?
• What is the most common sign of pheochromocytoma?
• Classic visual field deficit due to optic chiasm compression from a pituitary adenoma is which?
• Second-generation sulfonylureas include all of the following except:
• Which condition is the most common cause of hypothyroidism in the United States?
• Which glands are involved in MEN1?
• What are the main goals of treating DKA?
• Which medication can be used to lower calcium levels in primary hyperparathyroidism when surgery is not possible?
• Which statement best describes a characteristic finding in Graves' disease?
• Which condition is classically described by the mnemonic stones, bones, groans, and psychiatric overtones?
• In suspected adrenal crisis, what is part of the initial management besides steroids?
• Initial treatment for hypoparathyroidism includes supplementation with which?
• Deficiency of which vitamin can contribute to secondary hyperparathyroidism?
• Osteopenia is defined by a T-score in which range?
• In central diabetes insipidus, which result supports the diagnosis after a desmopressin challenge?
• What distinguishes central diabetes insipidus from nephrogenic diabetes insipidus clinically?
• What is the first-line imaging modality in evaluating a thyroid nodule for malignancy risk?
• Which statement correctly describes the management of hypocalcemia after total thyroidectomy when hypoparathyroidism is the cause?
• In hyperthyroidism, which finding is exclusive to Graves' disease?
• What is the first-line pharmacologic therapy for most adults with type 2 diabetes?
• How do you differentiate central from nephrogenic DI using a diagnostic test?
• Which of the following is a common adverse effect of long-term bisphosphonate therapy, and what administration practice helps mitigate it?
• What is the most sensitive screening test for acromegaly?
• Which statement is correct regarding symptomatic treatment of hyperthyroidism?
• Which option is NOT used to screen for Cushing syndrome?
• How should hypercalcemia be initially managed?
• To distinguish ACTH-dependent from ACTH-independent endogenous Cushing's syndrome, which test is used first?
• Which calcium-containing preparation is commonly used with active vitamin D for symptomatic hypocalcemia due to hypoparathyroidism?
• Which cancer secretes calcitonin and is associated with MEN2?
• Which feature is more typical of hyperosmolar hyperglycemic state compared with diabetic ketoacidosis?
• Among thyroid follicular epithelial-derived cancers, which has the best prognosis?
• Which of the following is a potential risk of testosterone therapy?
• When taking oral bisphosphonates for osteoporosis, which administration instruction is important?
• In SIADH, what is the initial management approach?
• Which statement best distinguishes diabetic ketoacidosis from hyperosmolar hyperglycemic state?
• In severe hypomagnesemia causing hypocalcemia, what is the initial management priority?
• Which laboratory pattern is typical of primary hypothyroidism?
• In a newly diagnosed type 1 diabetes patient, which insulin regimen is commonly used?
• Medullary thyroid cancer originates from which cells?
• Which statement about SGLT2 inhibitors is true?
• A patient has polyuria, hypernatremia, low urine osmolality, and normal blood pressure. What is the most likely diagnosis?
• Calcitriol is used in the management of hypoparathyroidism to accomplish what primary effect?
• Central diabetes insipidus is characterized by which of the following?
• According to USPSTF, what is the age range for screening adults with overweight/obesity for prediabetes and T2DM?
• In MEN1, pancreatic neuroendocrine tumors commonly present as gastrinoma or insulinoma. Which symptom is most characteristic of gastrinoma?
• Which symptom cluster is classically associated with primary hyperparathyroidism?
• In nonpregnant adults with Graves' disease, what is a common first-line therapy?
• Which of the following is NOT a metabolic syndrome trait?
• Which statement correctly lists the tumors classically included in MEN1?
• Pioglitazone is an example of which drug class?
• What is the hallmark management for myxedema coma?
• What is the 2-hour plasma glucose threshold for diagnosing diabetes after a 75-g oral glucose tolerance test?
• If NSAIDs fail to control pain in subacute thyroiditis, which therapy is commonly used next?
• Which imaging test is most commonly used to localize a parathyroid adenoma in primary hyperparathyroidism?
• Which statements describe the main criteria and methods used for osteoporosis screening?
• Which adverse effect is most commonly associated with SGLT2 inhibitors?
• What is the most common cause of Cushing's syndrome overall?
• What is the hallmark sign of acute hypocalcemia?
• Which electrolyte pattern most strongly suggests primary hyperaldosteronism?
• Which DM drugs have the highest risk of hypoglycemia?
• In which situations should metformin be avoided or used with caution?
• In pregnancy with Graves disease, which statement is correct regarding antithyroid drug choice?
• How is thyroid storm managed?
• Which thyroid cancer is most commonly associated with lymph node metastasis yet generally has a favorable prognosis?
• Initial management of Hyperosmolar Hyperglycemic Syndrome includes multiple components. Which option correctly reflects this approach?
• Which medication is commonly used to treat hirsutism in PCOS?
• What is the role of thyroid-stimulating immunoglobulins (TSI) in Graves' disease?
• What are the components of the classic triad for pheochromocytoma?
• Which obesity pharmacotherapy agent is a GLP-1 receptor agonist?
• Which postpartum consideration is recommended in the management of thyroid disease during pregnancy?
• Which category best describes a triglyceride level of 250 mg/dL?
• In severe hypomagnesemia, what is the effect on PTH?
• What is the ADA-recommended A1C target for most adults with type 2 diabetes?
• Which therapy is used for isolated hypertriglyceridemia?
• Which is a common adverse effect associated with sulfonylureas?
• Which statement best describes the renin-angiotensin-aldosterone axis differences between primary and secondary adrenal disorders?
• A common cause of hypoparathyroidism is inadvertent damage to the parathyroid glands during which operation?
• Which laboratory pattern is typical of primary hypothyroidism?
• In primary adrenal insufficiency (Addison disease), what is the initial management?
• An advantage of thiazolidinediones?
• Which combination comprises the hallmark features of polycystic ovary syndrome (PCOS) and a typical initial management approach?
• Which test is commonly used to screen for Cushing syndrome?
• What is first-line therapy for symptomatic hypocalcemia due to hypoparathyroidism?
• First-line medical treatment for a prolactinoma that reduces tumor size and restores menses?
• Which therapy is used to treat nephrogenic diabetes insipidus?
• To distinguish ACTH-dependent from ACTH-independent Cushing syndrome, which test should be ordered next?
• Which statement best describes the mechanism of insulin in diabetes management?
• In a patient with newly diagnosed thyrotoxicosis, what is the initial imaging modality to assess the risk of thyroid cancer?
• Which statement best describes type 2 diabetes mellitus?
• When setting HbA1c targets, which factor may lead to adjustment?
• Which statement about screening for Cushing syndrome is true?
• What is the typical starting dose of levothyroxine for a healthy adult?
• Which statement best distinguishes hyperosmolar hyperglycemic state (HHS) from DKA?
• What is the recommended emergency management for suspected pituitary apoplexy?
• In the emergency department, a patient with suspected diabetic ketoacidosis requires initial management. What is the most appropriate first step?
• What proportion of diabetes cases in the United States are type 2?
• Which tumor marker is used to surveil for recurrence after thyroid cancer surgery?
• What is the initial diagnostic test of choice for pheochromocytoma?
• The most common type of dwarfism is achondroplasia. Which statement is true?
• What are the management options for primary hyperparathyroidism?
• Which statement about achondroplasia management is correct?
• On thyroid ultrasound, which feature is worrisome for thyroid cancer?
• What is the primary mechanism of action of metformin?
• Which electrolyte abnormality is characteristic of hypoparathyroidism and how is it addressed?
• How should testosterone therapy be monitored and what are potential risks?
• Calcitonin's clinical relevance in calcium homeostasis is best described as:
• What are typical signs of hypoparathyroidism and its treatment?
• In pregnancy, which antithyroid drug is preferred during the first trimester?
• In the initial management of diabetic ketoacidosis, which electrolyte parameter requires close monitoring due to shifts during insulin therapy?
• Which statement about GLP-1 receptor agonists is true?
• What is the initial fluid therapy and typical first-hour rate for adults with DKA?
• If the morning IGF-1 is abnormal, which test is used to confirm growth hormone deficiency?
• Hyperpigmentation of the skin is most characteristic of which form of adrenal insufficiency?
• Best drug choice for patient with ASCVD or high risk, kidney disease, or HF?
• Which safety concern is associated with SGLT2 inhibitors?
• In the evaluation of a solitary thyroid nodule with a suppressed TSH, if the radionuclide scan shows a hot nodule, which of the following is indicated?
• Nephrogenic diabetes insipidus management best choice?
• Which DM drug class is most associated with weight gain?
• Why is a sick-day protocol recommended for people with diabetes?
• Which is a nonpharmacologic treatment for type 2 diabetes?
• Which hormone is produced by the anterior pituitary gland?
• What is the initial management of a thyroid storm?
• Which cancer is associated with elevated calcitonin and MEN2, and what genetic test is recommended?
• Which of the following sets correctly lists the components of metabolic syndrome associated with type 2 diabetes?
• How is a thyroid nodule evaluated for potential cancer?
• Screening for gestational diabetes is performed at what gestational age and with what test?
• Which hormone is secreted by the posterior pituitary gland?
• In secondary (central) hypogonadism, what is the pattern of testosterone and LH/FSH?
• What is the role of TSH suppression in the management of differentiated thyroid cancer?
• A patient develops hypocalcemia after total thyroidectomy. What is the most likely cause and initial management?
• A nonpregnant patient with Graves disease asks about antithyroid drugs during pregnancy. Which drug is preferred during the first trimester?
• Which is an absolute contraindication to testosterone therapy?
• Hyperosmolar Hyperglycemic Syndrome (HHS) is best described by which statement?
• In suspected insulinoma, which test demonstrates endogenous insulin secretion during hypoglycemia?
• Which electrolyte abnormality is most commonly associated with primary hyperparathyroidism?
• What is the general blood pressure target for adults with diabetes?
• Which scenario requires initiating insulin therapy immediately?
• DPP-4 inhibitors have which potential adverse effect?
• A key consideration when treating SIADH is to correct hyponatremia carefully to avoid which complication?
• What is the first-line pharmacologic treatment for postmenopausal osteoporosis?
• What are the renal effects of parathyroid hormone?
• Which patient population is at higher risk for thyroid cancer?
• To differentiate Graves’ disease from toxic multinodular goiter, which test is most informative?
• In diabetic ketoacidosis, which substance primarily contributes to the metabolic acidosis?
• Typically, for patients needing additional therapy after two oral agents, which insulin is started once daily?
• Measures to slow diabetes-related complications include which of the following?
• What are common causes of male hypogonadism?
• Which of the following is a diagnostic criterion for diabetes mellitus in adults?