Hyperparathyroidism: ABFM practice questions

7 board-style questions on hyperparathyroidism in the PulseMD family medicine question bank — physician-reviewed, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 35-year-old man presents with recurrent nephrolithiasis and is found to have a serum calcium of 11.4 mg/dL, PTH of 112 pg/mL, and a prolactin of 68 ng/mL (normal <20). He also reports a 6-month history of epigastric pain and diarrhea, and esophagogastroduodenoscopy reveals multiple duodenal ulcers. Fasting gastrin level is 890 pg/mL (normal <100). His father had a pituitary adenoma and died of pancreatic cancer. Which genetic syndrome is most likely responsible for this presentation?

  1. MEN type 2A (RET proto-oncogene mutation)
  2. Von Hippel-Lindau syndrome (VHL gene mutation)
  3. MEN type 1 (menin gene mutation)
  4. MEN type 4 (CDKN1B mutation)

Sample question 2

A 38-year-old woman with bipolar disorder has been on lithium carbonate 900 mg daily for 5 years. She presents with fatigue, weight gain of 20 pounds, constipation, and dry skin. Laboratory results show TSH 14.2 mIU/L (normal 0.4-4.0), free T4 0.6 ng/dL (normal 0.8-1.8), serum calcium 10.9 mg/dL (normal 8.5-10.5), and PTH 72 pg/mL (normal 15-65). Which of the following statements best describes the endocrine effects observed in this patient?

  1. Lithium causes hyperthyroidism that has paradoxically converted to hypothyroidism on chronic use
  2. Lithium-induced nephropathy is causing secondary hyperparathyroidism and functional hypothyroidism
  3. Lithium causes hypothyroidism only; the elevated calcium is coincidental and requires separate workup
  4. Lithium causes both hypothyroidism and hyperparathyroidism, and both conditions are drug-related

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

PulseMD is an independent educational resource and is not affiliated with, endorsed by, sponsored by, or approved by the American Board of Family Medicine.