A 22 y/o female presents with irregular menses and breast discharge. She is fatigued with a 5 pound weight gain in 3 months. Thyroid is small without nodule. Heart is regular and lungs are clear. Prolactin= 44, TSH= 32, BHcg= negative, FSH is low. Which of the following medications should be initiated first?

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Question 1 of 5

A 22 y/o female presents with irregular menses and breast discharge. She is fatigued with a 5 pound weight gain in 3 months. Thyroid is small without nodule. Heart is regular and lungs are clear. Prolactin= 44, TSH= 32, BHcg= negative, FSH is low. Which of the following medications should be initiated first?

Correct Answer: C

Rationale: The markedly elevated TSH indicates severe hypothyroidism, which should be treated with thyroxine replacement before addressing hyperprolactinemia.

Question 2 of 5

Which of the following diets should be prescribed to a patient with Parkinson disease?

Correct Answer: A

Rationale: Low protein diets can enhance levodopa absorption in Parkinson's patients, improving motor symptom management.

Question 3 of 5

A 69 year-old woman with a 3 cm, lymph node negative, ER+ tumor

Correct Answer: C

Rationale: This patient has an estrogen receptor-positive (ER+) tumor, which is typically responsive to endocrine therapy (e.g., tamoxifen or aromatase inhibitors). Given her age and the tumor characteristics (3 cm, lymph node negative), endocrine therapy is a standard approach rather than immediate mastectomy, chemotherapy, or monitoring alone.

Question 4 of 5

Within a 2- 3 day time period, multiple patients from an ECF are seen in your ER with severe N/V and non-bloody diarrhea. Temperature elevations are minimal, if any. What is the most likely explanation?

Correct Answer: D

Rationale: Norovirus is the most likely cause of outbreaks of gastroenteritis with these symptoms.

Question 5 of 5

A 56-year-old woman is found to have normochromic-normocytic anemia, hypophosphatemia, hypouricemia, glycosuria, proteinuria(+1 by dipstick testing), and renal insufficiency(serum creatinine concentration of 2.6mg/dl). Urine protein creatinine ratio(UPC) was 3.1. urine albumin creatinine ratio(UAC) was .3. Urine albumin protein ratio(UAPR) 10% Which ONE of the following is the MOST LIKELY cause of this constellation of findings?

Correct Answer: D

Rationale: Findings such as hypercalcemia, renal insufficiency, anemia, and bone lesions suggest multiple myeloma. The low UAC and UPC ratios point towards non-albumin proteinuria, typical of Bence-Jones proteinuria seen in multiple myeloma.

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