A 31-year-old woman comes to the physician for a health maintenance examination. She had a prior imaging modality performed, the results of which are shown below. “A” represents a healthy control individual; “B” is the patient’s imaging results.

Which of the following is most likely to be seen in this patient?

A) Anti-microsomal antibodies
B) Anti-thyrotropin receptor antibodies
C) Calcium of 7.9 mg/dL
D) Calcium of 11.0 mg/dL
E) Post-viral illness state

A 41-year-old woman comes to the physician for a 4-month history of increasing fatigue. She is an avid traveler and visited Honduras 6 months ago. Serum laboratory studies show:

Sodium                                             137 mEq/L
Potassium                                       5.6 mEq/L
Bicarbonate                                   22 mEq/L
Leukocytes                                     8,000/μL
Eosinophils                                    26%

Which of the following is the next best step in diagnosis?

A) ACTH stimulation test
B) Dexamethasone suppression test
C) Measure serum iron and ferritin
D) Stool nematode toxin test
E) Stool smear for ova and parasites

A 49-year-old man is brought to emergency after being found on a bench in a park by police. He appears disheveled. Serum potassium is 3.2 mEq/L; serum calcium is 8.0 mg/dL. Which of the following is most likely to be seen in this patient?

A) ↑ Serum magnesium; ↑ Serum parathyroid hormone (PTH); ↑ Renal Outer Medullary K+ (ROMK) activity
B) ↑ Serum magnesium; ↑ Serum PTH; ↓ ROMK activity
C) ↑ Serum magnesium; ↓ Serum PTH; ↑ ROMK activity
D) ↑ Serum magnesium; ↓ Serum PTH; ↓ ROMK activity
E) ↓ Serum magnesium; ↑ Serum PTH; ↑ ROMK activity
F) ↓ Serum magnesium; ↑ Serum PTH; ↓ ROMK activity
G) ↓ Serum magnesium; ↓ Serum PTH; ↑ ROMK activity
H) ↓ Serum magnesium; ↓ Serum PTH; ↓ ROMK activity

A 17-year-old girl is brought to the physician by her mother for a 5-month history of loss of her menses. She is an avid runner and frequently competes cross country for her school. BMI is 17. Which of the following is the most likely explanation for this patient’s presentation?

A) Decreased serum leptin
B) Increased serum FSH
C) Increased serum GnRH
D) Increased serum LH
E) Primary hypogonadism

A 26-year-old girl is evaluated in hospital 6 months after surgical resection of a brain tumor. MRI suggests there might be some moderate residual compression of the pituitary stalk. Which of the following hormones is most likely to be increased in this patient?

A) ACTH
B) FSH
C) Growth hormone
D) LH
E) Prolactin
F) TSH

A 34-year-old woman comes to the physician for a follow-up appointment. She is receiving triiodothyronine supplementation. Which of the following combinations of findings is most likely to be seen in this patient?

A) ↑ TSH; ↑ T3; ↑ T4
B) ↑ TSH; ↑ T3; ↓ T4
C) ↑ TSH; ↓ T3; ↑ T4
D) ↑ TSH; ↓ T3; ↓ T4
E) ↓ TSH; ↑ T3; ↑ T4
F) ↓ TSH; ↑ T3; ↓ T4
G) ↓ TSH; ↓ T3; ↑ T4
H) ↓ TSH; ↓ T3; ↓ T4

A 71-year-old woman comes to the physician for a dialysis appointment. She has chronic kidney disease due to diabetes mellitus type II. Serum creatinine is 3.1 mg/dL. Blood urea nitrogen is 45 mg/dL. Which of the following combinations of serum findings is most likely to be seen in this patient?

A) ↑ Bicarbonate, ↑ Potassium, ↑ Calcium
B) ↑ Bicarbonate, ↑ Potassium, ↓ Calcium
C) ↑ Bicarbonate, ↓ Potassium, ↑ Calcium
D) ↑ Bicarbonate, ↓ Potassium, ↓ Calcium
E) ↓ Bicarbonate, ↑ Potassium, ↑ Calcium
F) ↓ Bicarbonate, ↑ Potassium, ↓ Calcium
G) ↓ Bicarbonate, ↓ Potassium, ↑ Calcium
H) ↓ Bicarbonate, ↓ Potassium, ↓ Calcium

A 7-year-old boy is brought to the physician by his mother for a 2-day history of vomiting and sluggishness. He has been drinking a lot and using the bathroom frequently for the past couple of weeks. His glucose is 458 mg/dL. Which of the following is most likely to be seen in this patient?

A) Decreased β-hydroxybutyrate
B) Decreased serum sodium
C) Decreased urinary potassium
D) Increased glucokinase activity
E) Increased total body potassium

A 34-year-old woman comes to the physician for a 2-hour history of excruciating left flank pain. She had a similar episode 1 year ago. She also reports periodic pounding headaches and palpitations for the past 6 months. Which of the following is most likely contributory to this patient’s headaches?

A) Adrenal cortical hypersecretion
B) Enterochromaffin cell hypersecretion
C) Enterochromaffin-like cell hypersecretion
D) Preganglionic sympathetic acetylcholine release
E) RANK-L-RANK interaction

A 53-year-old woman comes to the physician for a follow-up appointment. She has a 25-year history of systemic lupus erythematosus. Her abdomen is shown.

Which of the following is most likely to be seen in this patient?

A) Decreased serum proopiomelanocortin
B) Increased renal potassium retention
C) Increased serum corticotropin-releasing hormone
D) Increased serum cortisol
E) Zona fasciculata lesion