A 25-year-old female presents to your office with a several month history of anxiety, palpitations, heat intolerance, diarrhea, and weight loss despite increased appetite.  On exam her thyroid is diffusely enlarged.  You also note bilateral exophthalmos.  Based on this information, which of the following conditions is the most likely diagnosis for this patient?

A 44-year-old man presents for follow-up of poorly controlled type I diabetes mellitus, which was diagnosed 32 years ago. What change on his funduscopic examination would indicate a need for urgent referral to an ophthalmologist?

A 52-year-old woman with no significant past medical history presents to your office complaining of fatigue, constipation, cold intolerance, and weight gain. She is presently on no medications. Her physical examination is notable for a dull facial expression, periorbital swelling, and coarse, dry skin. There is no thyromegaly. The most likely cause of this woman’s symptoms is:

A 56-year-old male presents for a follow up visit in your office. He is a known diabetic and hypertensive for 6 years. He has no complaints today and is up-to-date in the management of his conditions. He is not allergic to any medications. His medications include metformin, hydrochlorothiazide, aspirin, and acetaminophen for occasional headaches. He had just read about renal complications of diabetes mellitus and he would like to know what test could be done to evaluate him for diabetic nephropathy. His laboratory values are shown in the table. Serum glucose 129 mg/dl Sodium 144mmol/L Potassium 5.0mmol/L Chloride 110mmol/L Bicarbonate 22mmol/L BUN 15mg/dL Creatinine 1.1mg/dL Hemoglobin A1C 8.9%   Which of the following tests is the most appropriate intervention for this patient?

Multiple endocrine neoplasia type I (MEN1) is characterized by the combination of parathyroid tumors, pancreatic islet cell tumors, and anterior pituitary tumors.

The differential diagnosis of Cushing’s syndrome includes which of the following conditions?      

Upon examination of the thyroid gland of an asymptomatic 52-year-old female patient during a routine physical examination, you discover that a small diffuse goiter is present.  Which of the following interventions is the most appropriate next step in your diagnostic evaluation of this patient?

Which of the following laboratory results indicate that your diabetic patient has achieved acceptable glycemic control on her current medication regimen?

Which of the following clinical findings is a risk factor for thyroid cancer?

Parathyroid hormone-related peptide (PTHRP) is an example of an ectopically produced hormone that causes an endocrine paraneoplastic syndrome in the setting of squamous cell lung cancer, head and neck cancer, and bladder cancer.  Which of the following clinical findings are associated with PTHRP?