Review Questions

1. A 39-year-old man comes to the physician because of "facial changes" that relatives at a family reunion recognized. He says that he does not think that there is anything different about him, but his cousins that he had not seen in 10 years made him promise that he would get a "complete physical." On further questioning, he recalls that he has had to buy bigger shoes and gloves in the past few months. Physical examination shows a prominent jaw and a flat, broad forehead. Laboratory studies are most likely to show which of the following?

A. Decreased thyroid stimulating hormone

B. Decreased thyroxine

C. Elevated ACTH

Elevated parathyroid hormone Elevated somatomedin C

2. A 32-year-old woman undergoes a thyroidectomy because of papillary carcinoma. She is given thyroid replacement therapy to avoid the development of hypothyroidism. She returns to the physician a month after the surgery complaining of "sadness," generalized weakness, and muscle spasms. Gende tapping over the fecial nerve shows a fecial twitch. Inflation of a blood pressure cuff above her systolic pressure for 3 minutes shows a car-popedal spasm. An electrocardiogram shows an increased QT interval. None of these findings were present before the surgery. Laboratory studies will most likely show which of the following?

A. Hypercalcemia

B. Hyperkalemia

C. Hypermagnesemia

D. Hypocalcemia

E. Hypokalemia

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