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Self-Assessment Questions


Adrenal Disease: Review Questions

Catherine Anastasopoulou, MD, FACE

Dr. Anastasopoulou is a staff endocrinologist at
Albert Einstein Medical Center, Philadelphia, PA.

Choose the single best answer for each question.

1. A 55-year-old man with no prior medical history presents with right flank pain. During an evaluation for kidney stones, he has a computed tomography scan of the abdomen that reveals a 2 × 2-cm mass in the left adrenal gland. The patient’s vital signs, kidney function, and electrolyte levels are within normal limits. Which of the following tests should be ordered next to evaluate the adrenal mass?
  1. Aldosterone and renin levels
  2. Random cortisol levels
  3. Testosterone levels
  4. 24-Hour urine collection for metanephrines
  5. No further testing
Click here to compare your answer.

2. A 22-year-old woman who previously was healthy presents with dizziness and nausea. Routine blood tests show a blood glucose level of 52 mg/dL. Results of kidney and liver function tests are normal, but the patient’s potassium level is slightly elevated. Which of the following tests should be performed next?

  1. Insulin and C-peptide levels
  2. Adrenocorticotrophic hormone (ACTH) stimulation test
  3. Random cortisol levels
  4. Dexamethasone suppression test
  5. 24-Hour urine collection for free cortisol
Click here to compare your answer.

Questions 3 and 4 refer to the following case study.

A 45-year-old man with history of high blood pressure that has been difficult to control with a variety of antihypertensive medications presents with persistent headaches, excessive sweating, and palpitations. Routine blood tests are normal. Electrocardiogram shows supraventricular tachycardia.

3. What is this patient’s most likely diagnosis?
  1. Pheochromocytoma
  2. Primary hyperaldosteronism
  3. Cushing’s disease
  4. Hyperthyroidism
  5. Malignant hypertension
Click here to compare your answer.

4. Which of the following is the best initial pharmacologic therapy choice for this patient?

  1. ß-Blockers
  2. Diuretics
  3. Steroids
  4. Methimazole
  5. α-Blockers
Click here to compare your answer.

5. A patient with longstanding history of depression is admitted to the psychiatric ward. He complains of weight gain and frequency in urination. A 24-hour urine collection reveals above normal levels of free cortisol, but a dexamethasone suppression test shows normal suppression. What is the most likely diagnosis?

  1. Intermittent Cushing’s disease
  2. Pseudo-Cushing’s disease
  3. Diabetes mellitus
  4. Medication-induced hyperglycemia
  5. Hypothyroidism
Click here to compare your answer.


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