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

A 32-year-old woman comes to the physician for a 3-day history of feeling very hot and the sensation of palpitations. There is moderate tenderness beneath the hyoid bone on palpation. Temperature is 99 F. HR is 95. Which of the following is most likely to be seen in this patient?

A) Anti-microsomal antibodies
B) Anti-thyrotropin receptor antibodies
C) Decreased iodine uptake
D) Jod-Basedow phenomenon
E) Wolff-Chaikoff effect

A 66-year-old woman comes to the physician for a follow-up dialysis appointment. She has long-standing diabetes mellitus and dyslipidemia. Vitals are: temperature 98.6 F, HR 72, RR 16, BP 130/80. Medications are insulin, enalapril, and atorvastatin. Laboratory studies show:

Creatinine                    4.4 mg/dL
BUN                                 70 mg/dL
Na⁺                                   140 mEq/L
K⁺                                      6.1 mEq/L
Ca²⁺                                 7.5 mg/dL

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

A) Decreased 24,25-vitamin D3
B) Diminution of renin-angiotensin-aldosterone system function
C) Increased fecal cation
D) Increased kaliuresis
E) Increased late-distal convoluted tubule cation channel insertion

A 46-year-old man comes to the physician for a follow-up appointment. Two weeks ago, his blood pressure was recorded at 150/95. Today, repeat blood pressure measurement is 151/95. BMI is 24. The patient is commenced on enalapril. Which of the following is most likely to be seen in this patient as a result of this pharmacotherapy?

A) Decreased efferent arteriolar diameter
B) Increased ejection fraction
C) Increased proximal convoluted tubule sodium reabsorption
D) Increased serum bicarbonate
E) Kaliuresis

A 49-year-old man comes to the physician because of a 4-month history of gradually worsening fatigue. He has lost 5 pounds during this time. He has no past medical history and works as a carpenter. Vitals are: temperature 98.5 F, RR 12, HR 70, BP 100/60. BMI is 24. Fasting glucose is 80 mg/dL. Physical examination shows slight darkening of the skin of the forearms. Serum ACTH is elevated. Which of the following is most likely to be seen in this patient?

A) Decreased corticotropin releasing hormone
B) Eosinophils of 15%
C) Failure of suppression with high-dose Dex
D) Hilar coin lesion
E) Serum sodium of 147 mEq/L

A 75-year-old woman comes to the physician for a follow-up appointment. Her serum PTH and calcium are plotted on the nomogram, with the magenta circle denoting the patient’s levels.

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

A) Chronic kidney disease
B) Metastatic malignancy
C) Osteomalacia
D) Osteoporosis
E)  Primary hypoparathyroidism