Module 6 Rosh Review Prep
1. Which of the following patient presentations is concerning for delayed puberty and warrants
further evaluation?
a. A 10-year-old girl with breast budding and absence of menarche
b. A 13-year-old girl who just experienced menarche
c. A 13-year-old girl without signs of breast development
d. A 14-year-old girl who has not experienced menarche
2. Which of the following patients is at greatest risk for renal artery stenosis?
a. A 30-year-old patient with hypertension
b. A 48-year-old patient with kidney disease
c. A 60-year-old patient with hepatitis
d. A 68-year-old patient who smokes
3. A 41-year-old man presents to the clinic for an annual check-up. He has no previous medical
history. Which of the following results in this patient’s fasting lipid panel indicates an increased
risk of atherosclerotic cardiovascular disease?
a. HDL-C of 62 mg/dL
b. LDL-C of 100 mg/dL
c. Total cholesterol of 182 mg/dL
d. Triglycerides of 192 mg/dL
4. Which of the following laboratory findings would you expect to find in primary
hyperaldosteronism?
a. Hypokalemia
b. Hyponatremia
c. Low serum aldosterone
d. Metabolic acidosis
5. A 15-year-old boy with severe asthma is seen in the clinic for a follow-up. He has been
hospitalized three times during the past 3 months due to asthma exacerbations. He required
prolonged steroid use to control his asthma. You note abnormal findings on examination that
make you suspect Cushing’s syndrome. Which exam finding is associated with Cushing’s
syndrome?
a. Distal atrophy and weakness
b. Dry skin
c. Hypotension
d. Supraclavicular fat pads
, 6. When suspecting adrenal insufficiency in a pediatric patient, which of the following test results
would indicate central rather than primary adrenal insufficiency?
a. Elevated plasma renin activity
b. High adrenocorticotropic hormone levels
c. Hyponatremia and hyperkalemia
d. Low adrenocorticotropic hormone levels
7. A 40-year-old woman with no cardiovascular risk factors is screened for hyperlipidemia at a
routine physical examination. She has a total cholesterol of 175 mg/dL, low-density lipoprotein of
100 mg/dL, and high-density lipoprotein of 40 mg/dL. When is it recommended that she have her
next lipid panel?
a. 1 year
b. 10 years
c. 2 years
d. 5 years
8. A 16-year-old girl presents to your clinic with decreased energy, poor performance in school, and
constipation for the past 8 months. Vital signs include a blood pressure of 110/72 mm Hg, heart
rate of 62 bpm, respiratory rate of 16/min, oxygen saturation of 99% on room air, and
temperature of 36.7°C (98.1°F). Her physical exam is unremarkable, but you are concerned she
may have thyroid disease. Which of the following is the most appropriate best next step in
management?
a. Obtain a complete blood count with differential
b. Obtain an ultrasound of the thyroid
c. Obtain free triiodothyronine level
d. Obtain thyroid peroxidase antibody level
e. Obtain thyroid-stimulating hormone and free thyroxine levels
9. A 10-year-old boy presents to the primary care clinic with complaints of blurry vision. He is also
found to have recent weight loss of 5 lbs and his parent reports increased thirst and frequent
urination. He is found to have an HgA1C of 7.0% and is diagnosed with type 1 diabetes mellitus.
Which of the following genetic markers would be helpful in assessing the risk of type 1 diabetes
mellitus for this patient’s sister?
a. APOB
b. HLA-DQA and HLA-DQB
c. NOD2
d. PCSK9
1. Which of the following patient presentations is concerning for delayed puberty and warrants
further evaluation?
a. A 10-year-old girl with breast budding and absence of menarche
b. A 13-year-old girl who just experienced menarche
c. A 13-year-old girl without signs of breast development
d. A 14-year-old girl who has not experienced menarche
2. Which of the following patients is at greatest risk for renal artery stenosis?
a. A 30-year-old patient with hypertension
b. A 48-year-old patient with kidney disease
c. A 60-year-old patient with hepatitis
d. A 68-year-old patient who smokes
3. A 41-year-old man presents to the clinic for an annual check-up. He has no previous medical
history. Which of the following results in this patient’s fasting lipid panel indicates an increased
risk of atherosclerotic cardiovascular disease?
a. HDL-C of 62 mg/dL
b. LDL-C of 100 mg/dL
c. Total cholesterol of 182 mg/dL
d. Triglycerides of 192 mg/dL
4. Which of the following laboratory findings would you expect to find in primary
hyperaldosteronism?
a. Hypokalemia
b. Hyponatremia
c. Low serum aldosterone
d. Metabolic acidosis
5. A 15-year-old boy with severe asthma is seen in the clinic for a follow-up. He has been
hospitalized three times during the past 3 months due to asthma exacerbations. He required
prolonged steroid use to control his asthma. You note abnormal findings on examination that
make you suspect Cushing’s syndrome. Which exam finding is associated with Cushing’s
syndrome?
a. Distal atrophy and weakness
b. Dry skin
c. Hypotension
d. Supraclavicular fat pads
, 6. When suspecting adrenal insufficiency in a pediatric patient, which of the following test results
would indicate central rather than primary adrenal insufficiency?
a. Elevated plasma renin activity
b. High adrenocorticotropic hormone levels
c. Hyponatremia and hyperkalemia
d. Low adrenocorticotropic hormone levels
7. A 40-year-old woman with no cardiovascular risk factors is screened for hyperlipidemia at a
routine physical examination. She has a total cholesterol of 175 mg/dL, low-density lipoprotein of
100 mg/dL, and high-density lipoprotein of 40 mg/dL. When is it recommended that she have her
next lipid panel?
a. 1 year
b. 10 years
c. 2 years
d. 5 years
8. A 16-year-old girl presents to your clinic with decreased energy, poor performance in school, and
constipation for the past 8 months. Vital signs include a blood pressure of 110/72 mm Hg, heart
rate of 62 bpm, respiratory rate of 16/min, oxygen saturation of 99% on room air, and
temperature of 36.7°C (98.1°F). Her physical exam is unremarkable, but you are concerned she
may have thyroid disease. Which of the following is the most appropriate best next step in
management?
a. Obtain a complete blood count with differential
b. Obtain an ultrasound of the thyroid
c. Obtain free triiodothyronine level
d. Obtain thyroid peroxidase antibody level
e. Obtain thyroid-stimulating hormone and free thyroxine levels
9. A 10-year-old boy presents to the primary care clinic with complaints of blurry vision. He is also
found to have recent weight loss of 5 lbs and his parent reports increased thirst and frequent
urination. He is found to have an HgA1C of 7.0% and is diagnosed with type 1 diabetes mellitus.
Which of the following genetic markers would be helpful in assessing the risk of type 1 diabetes
mellitus for this patient’s sister?
a. APOB
b. HLA-DQA and HLA-DQB
c. NOD2
d. PCSK9
