2012 exam Flashcards
Intrasellar mass lined by cuboidal and columnar cells?
a. Craniopharyngioma
b. Rathke’s cleft cyst
b. Rathke’s cleft cyst (columnar or cuboidal)
Craniopharyngioma = squamous
EBM a question with a table of risk factors & obesity
Comparison between Kuwaitis & non-kuwaitis and Old & young
What is the consequence of conn’s disease?
Metabolic alkalosis
What is most likely associated with vascular invasion?
Follicular carcinoma
Low bone densitometry in distal forearm associated with hypercalcemia?
Primary hyperparathyroidism
*Hypercalcemia occurs in primary hyperparathyroidism, but calcium may be low or normal in secondary hyperparathyroidism
What is the first line drug for pregnant women with hyperthyroidism on her first trimester?
Propylthiouracil
Paroxysmal hypertension indicates which condition?
Pheochromocytoma
What measures the magnitude of association between the incidence of diabetes and obesity?
a. Linear regression slope
b. Relative risk
c. Difference in means
d. Spearman correlation coefficient
b. Relative risk
Nature of variables: (cumulative) incidence + qualitative binary -> relative risk used
A lawyer and an engineer both were diagnosed with breast cancer. What can be the cause of difference in pain perception?
?
Required for aldosterone synthesis?
Cyp11b2
aldosterone synthase
Specifically expressed on the adrenal gland?
Cyp21a1
CYP21A2 gene encodes 21-hydroxylase
Needs high levels of cortisol?
PNMT
Is inhibited when norepinephrine is converted to epinephrine?
MOA
Which estrogen receptor modulator stimulates ovulation?
Clomiphene
*Clomiphene antagonizes action of estrogen in pituitary and hypothalamus -> decreased estrogen negative feedback -> increased LH and FSH -> ovulation
A 60 year old man diagnosed with hyponatremia due to water retention not because of sodium deficiency, what aquaretic drug that blocks ADH V2 receptors would you give?
a. Desmopressin
b. Demecyclin
c. Conviptan
d. Tolvaptin
e. Leuprolide
c. Conviptan
A patient with type 1 DM put a plan to strictly control HBA1c and glucose for better prognosis, which regimen would you use?
a. Lente with Regular mix taken in the morning and evening
b. Once daily Ultra Lente with Lisopro before each meal
c. Morning Regular and Lente before each meal
d. Three Regular in the morning and Ultra Lente before bed time
e. One Glargine in morning and three lisporo with every meal
b. Once daily Ultra Lente (morning) with Lisopro before each meal
Diagnostic test of primary adrenal insufficiency?
Cosytropin
Which radionuclide is used for imaging the adrenal gland?
Metaiodobenzylguanidine (MIBG)
A 36 year old female presented with paroxysmal HTN, headache, sweating, and palpitations. What is the best method to diagnose this condition?
24 hour urinary metanephrines
Cell secrete ADH?
Supraoptic
Cells in posterior pituitary?
Pituicyte
Dopamine and TRH control them?
a. Somatotrophs
b. Lactotrophs
c. Corticotrophs
d. Chromophobes
e. Thryroid hormones
b. Lactotrophs / Lactocytes
Secrete the same hormone as the hypothalamus?
a. alpha cells
b. beta cells
c. EC cells
d. Delta cells
d. Delta cells
Stimulated by sympathetic?
a. Alpha cells
b. Delta cells
c. EC cells
a. Alpha cells
Patient on long term glucocorticoid in 59 year old male?
Hyperglycemia
Female with menstrual cycle of 30-32 days, when does she ovulate?
16-18 days
What hormone is used with RXR receptor and thyroid hormone receptor?
T3
46 year old male XY without sry gene, fastest way to diagnose?
PCR
In what case testosterone used to treat erectile dysfunction?
a. Alcoholism
b. Depression
c. Hypogonadism
d. Diabetes
c. Hypogonadism
Which hormone causes gynecomastia in males and causes amenorrhea and galactorrhea in females?
Prolactin
Cells that secrete parathyroid hormone?
Principal cells
What is stimulated by splanchnic nerve?
Chromaffin cells
Has SH domain and is activated by IGF-1?
Phospholipase gamma c
Question about something that delivers calcium for bone formation
?? (vitamin D helps Ca absorption, which is then used to build bone. Calcitonin also for bone formation)
A drug that has a rapid action in treating severe ketoacidosis in type 1 DM?
Crystalline zinc insulin
GH receptor antagonist?
Pegvisomant
Its action potentiated with hypoproteinemia?
Somatotropin
Decreases glycan stores?
Prednisolone
Given to patients with hypoprotenemia?
Norethindrone
A patient with hyponatremia due to ADH excess is given?
Conivaptan
Testis with coagulative necrosis is?
Testicular torsion
A young patient with DM type 2 has hyperpigmentation on his neck?
Insulinemia
Which blood vessel is used to locate parathyroid gland?
Inferior thyroid artery
What is the function of SRY gene?
Male development
Drug used in treatment of acromegaly that inhibits the growth hormone release?
Octreotide
Which cell is responsible for apoptosis in DM2?
Cytotoxic T cell
How does inflammatory cytokines hamper growth of children?
Block IGF-1 production from the liver
What is the biochemical marker of vitamin D3?
25 hydroxyvitamin D
When is the prepubertal spurt period in males?
12.5-13 years old
High T4 (22/jan) -> Low T4 (3/march) -> Normal T4 (4/june) -> Low TSH (22/jan) -> high TSH (3/march) -> normal TSH (4/june) What do these changes indicate?
Subacute thyroiditis
What is the side effect of metformin with alcoholism?
Lactic acidosis
How do we differentiate between cushing’s disease and syndrome?
The presence of pituitary adenoma
Presence of what helps diagnose grave’s disease?
Exophthalmos
What mediates the action of teriparatide?
a. cGMP
b. Adenyle cyclase
c. IP3
b. Adenyle cyclase
After thyroidectomy, the patient presented with multiple nodules with distended colloid and fibrosis?
Multinodular goiter
Section of an enlarged testis in a 30 year old male showed multiple granulomas some with central necrosis. Whats the diagnosis?
Tuberculous orchitis
A 20 year old presented with polyuria, weight loss, and was diagnosed with type 1 diabetes. On examination, she was hypotensive, dehydrated, and had acidic breath. Lab investigations show ketone in the urine, with pH 7.12 and glucose level 22. The first way to manage the patient?
IV saline 500 ml over 2 hours
*Fluid replacement: 6 L in 12 hours (=0.5 L per hour). LOW DOSE short-acting (regular) insulin replacement by IV is also initiated because DKA is a state of marked insulin resistance.
What’s the mechanism of action of rosiglitazone?
Regulates transcription of genes involved in glucose utilization
(how? by activating Peroxisome proliferator-activated receptor-gamma, which enhances the promotor genes for glucose utilization and thus increases insulin sensitivity)
How can CYP17 catalyze P5 to 17-OH P5 to DHEA in zona reticularis, but only P5 to 17-OH P5 in zona fasiculata?
CYP17 shows post-translational regulation in zona reticularis
Patient lost his voice pitch after thyroid surgery when his superior thyroid artery was mistakingly ligated. Damage to which structure caused this condition?
External laryngeal nerve
