2015 exam Flashcards
Which of the following are not used to diagnose an adrenal tumor?
a. Tc99
b. Np 59
c. MIBG
d. In – 111
a. Tc99
In which part of the pituitary do you find small irregular colloid cell lined by cuboidal epithelium?
a. Pars intermedia
b. Pars distalis
c. Median eminence
a. Pars intermedia
Which is a better indicator of growth
a. Growth hormone
b. IGF 1
c. Cortisone
b. IGF 1
What is the mechanism of autoimmunity in oophoritis?
a. Antibody mediated cytotoxic killing
b. Inducers of suppressive T-cells
c. Cytotoxic t cell
d. NK cells
c. Cytotoxic t cell
Which of the following acts peripherally and antagonizes the effect of growth hormone?
a. Octreotide
b. Pegvisomant
b. Pegvisomant
Graph of oral glucose and IV glucose, why does oral glucose stimulate higher insulin release than IV? (graph about the insulin release after IV glucose injection & after intake of glucose in diet. What does this graph indicate?)
a. When glucose is given iv the pancreatic b cells response is exaggerated
b. Intestinal factors play a role in the release of insulin
b. Intestinal factors play a role in the release of insulin
Which of the following is the effect of parasympathetic nervous system on Langerhans islet cells?
a. Activates beta cells
b. Activates delta cells
c. Deactivates alpha cells
a. Activates beta cells
Which cells will be destroyed if the adenohypophysis is damaged?
a. Zona fasiculata
b. Zona glomurulosa
c. Zona reticularis
a. Zona fasiculata
Which of the following treats benign prostate hyperplasia by decreasing dihydrotestosterone?
a. Finasteride
b. Ketoconazole
a. Finasteride
What if the effect of long term use of prednisolone?
a. High fibroblast and collagen synthesis
b. High bronchial smooth muscle leukotriene synthesis
c. Low hepatic glycogen store
d. High circulation of insulin
d. High circulation of insulin
What stimulates the release of glucagon?
a. Amino acids
b. Insulin
c. Glucose
a. Amino acids
Which of the following decreases collagen formation?
a. Methimazole
b. Propylthiouracil
c. Rosiglitazone
d. Prednisolone
d. Prednisolone
Which of the following blocks the conversion of T4 to T3?
a. Methimazole
b. Propylthiouracil
c. Rosiglitazone
d. Prednisolone
b. Propylthiouracil
Which drug works on gene expression of increasing insulin sensitivity in tissues?
a. Methimazole
b. Propylthiouracil
c. Rosiglitazone
d. Prednisolone
c. Rosiglitazone
What’s the difference between dexamethasone and cortisol?
a. Potency of dexamethasone is less than cortisol
b. Half-life of dexamethasone is shorter than cortisol
c. Dexamethasone causes secondary hyperparathyroidism
c. Dexamethasone causes secondary hyperparathyroidism
Picture/diagram of 2 TG’s being coupled with oxygen bond, what enzyme catalyzes this?
a. TP
b. NADPH dual oxidase
a. TP
A 35-year-old single female with secondary amenorrhea and increase weight with 2-month sudden vision problems. What is the diagnosis?
a. Pituitary adenoma
b. Cushing syndrome
c. Hyperthyroidism
a. Pituitary adenoma
25year old female, having generalized weakness and numbness in circumoral region. What other sign you might find with further investigation (Patient with “symptoms of hypocalcemia”, what do you expect to find)?
Chvostek sign
Thyroid cancer with RET Rearrangement
a. papillary carcinoma
b. medullary carcinoma
c. follicular carcinoma
d. Anaplastic carcinoma
a. papillary carcinoma
Pure gonadal dysgenesis?
a. SRY gene mutation
b. Deletion of the whole Y chromosome
a. SRY gene mutation
What is Insulin shock\ What is a characteristic of insulin shock?
a. Severe hyperglycemia caused by omitting insulin dose
b. Severe hypoglycemia caused by overdose of insulin
c. An allergic reaction to insulin
d. Hyperglycemia caused by insulin resistance
e. Hypoglycemia caused by insulin antibodies
b. Severe hypoglycemia caused by overdose of insulin
What is true about glargine?
a. Less hypoglycemia than NPH
b. less potent than NPH
c. can’t be combined with other drugs
a. Less hypoglycemia than NPH
Treating hyperglycemia in diabetics will decrease the incidence of all except?
a. Retinopathy
b. Microvascular complications
b. Microvascular complications
What is the cause of CAH if low levels of deoxy-cortisol 11 metabolite were detected?
a. 21 alpha hydroxylase deficiency
b. 11 b hsd deficiency
c. 3 b hsd deficiency
d. 17 b hsd deficiency
a. 21 alpha hydroxylase deficiency
What is the relative risk of CVD death in diabetics?
a. 2-3
b. 3-5
a. 2-3
Study of Diabetes and mean cholesterol (i.e. categorical x continuous)?
a. Anova
b. chi2
c. paired T test
c. paired T test
S100 cells are found in? (Contains sustentacular cell)?
a. aldosterone producing adenoma
b. incidentaloma
c. pheochromocytoma
d. tuberculoma
e. cortisol producing adenoma
f. adrenocortical carcinoma
g. metastatic carcinoma
h. lymphoma
c. pheochromocytoma
Origin of thyroglossal duct/cysts?
a. roof of mouth
b. floor of pharynx
c. roof of pharynx
b. floor of pharynx
What’s the effect of leptin on food intake?
a. Increases ghrelin secretion
b. increases a-msh secretion
c. Decreases NPY secretion
b. increases a-msh secretion
Which drug taken orally treats hyper ADH state?
a. Tolvaptan
b. Conivaptan
a. Tolvaptan
What hormone is needed for the formation of catecholamines?
Dopamine
Which of the following hormones comes from the supraoptic region of the hypothalamus?
a. ADH
b. Oxytocin
a. ADH
Retrograde neurotransmitters?
Endocannabinoid
A 40-year old man with BMI of 34, and family history of cardiovascular disease, complaining of low energy level. His random glucose level is 11.1 mmol/l ((man has 11.1 random glucose level, what is the appropriate management))?
a. Diet and exercise
b. Metformin
c. Insulin
d. Oral glucose
e. Stop treatment
f. No treatment
a. Diet and exercise
Mechanism of action of Cosyntropin?
a. decrease glucose
b. increased aldosterone
b. increased aldosterone
What is the function of dual oxidase?
a. oxidizes nadh
b. produces hydrogen peroxide
b. produces hydrogen peroxide
What causes more ossification and stops cartilage synthesis?
a. Excess vitamin A
b. Excess vitamin K
c. Decreased vitamin A
a. Excess vitamin A
Patient presented to the ER with tachycardia and hypotension.
a. Waterhouse-friderichsen
b. Pheochromocytoma
c. Addisonian crisis
c. Addisonian crisis (aka adrenal crisis)
Patient (child) w/CSF and/or blood positive w/ Neisseria meningitides & symptoms of adrenal insufficiency?
a. Waterhouse-friderichsen
b. Pheochromocytoma
c. Adrenal crisis
d. Conn’s syndrome
e. Cushing’s disease
f. Cushing’s syndrome
g. congenital adrenal hyperplasia
h. constitutional delay of growth and development
a. Waterhouse-friderichsen
A 30-year-old woman arrives to ER in a very distressed state. She complains from lethargy and confusion following her recent knee surgery. She had tachycardia and postural hypotension. Investigations revealed hyponatremia and hyperkalemia?
a. Waterhouse-friderichsen
b. Pheochromocytoma
c. Adrenal crisis
d. Conn’s syndrome
e. Cushing’s disease
f. Cushing’s syndrome
g. congenital adrenal hyperplasia
h. constitutional delay of growth and development
c. Adrenal crisis
18 year old male with no secondary sexual characteristics and dad remembered not shaving until university?
a. Constitutional growth delay
b. Klinefelters syndrome
a. Constitutional growth delay
Patient removed left part of thyroid gland and later presented with symptoms of low calcium, what should we do first?
Give oral calcium and Vit. D
What is the mechanism of tc99 use in radioactive scanning?
a. Trapping/uptake in follicular cells
b. Increases blood flow to thyroid
a. Trapping/uptake in follicular cells
A tumor from the thyroid was excised, it was encapsulated, follicular epithelial cells arranged in nests and scanty colloid
a. Follicular adenoma
b. Hashimoto’s thyroiditis
c. Papillary carcinoma
a. Follicular adenoma
What is the mechanism of GH cellular signaling?
Jak–stat
51 yr male came to hospital confused, days before his confusion he stopped eating and stopped his insulin which was prescribed after his pancreatectomy 20 years ago in ER his glucose was 29 and pH 7.25. What’s the diagnosis?
a. Diabetic ketoacidosis
b. Hyperosmolar non-ketoacidosis
c. diabetic neuropathy
d. diabetic hypoglycemic coma
e. lactic acidosis
f. metabolic syndrome
g. metabolic alkalosis
a. Diabetic ketoacidosis
55 yr male history of asthma on examination his weight 100kg BMI 31.6 his fasting glucose was 6 point something (impaired fasting glucose) he stopped smoking when he was 50 and he takes his high blood pressure medication (Male, obese, hypertension, ex-smoker, had impaired fasting glucose). What's the diagnosis? a. Diabetic ketoacidosis b. Hyperosmolar non-ketoacidosis c. diabetic neuropathy d. diabetic hypoglycemic coma e. lactic acidosis f. metabolic syndrome g. metabolic alkalosis
f. metabolic syndrome
What is used to antagonize GnRH in ovarian hyperstimulation?
a. ganirelix
b. leuprolide
a. ganirelix
Why is it beneficial to maintain low levels of glucose in diabetics?
Because it doesn’t react and generate AGEs
Symptoms of acromegaly (increased hand size, growth). What is the cause of hyperglycemia?
a. T2DM
b. Acromegaly
a. T2DM
Type 2 diabetes mellitus
What is low in osteomalacia and normal in osteoporosis?
Calcium levels
What is the difference between Paget’s disease and osteoporosis?
a. ALP levels in serum
b. ALP levels in urine
a. ALP levels in serum
A 27-year-old hypertensive male and a pituitary tumor associated with hypokalemia and metabolic alkalosis. Whats the diagnosis?
a. Diabetes insipidus
b. Conns Syndrome
c. Addison’s
d. Cushing disease
e. Achondroplasia
f. Acromegaly
d. Cushing disease
Drug that is similar to growth hormone that is used to treat GH deficiency, but has an additional amino acid?
a. Somatrem
b. Octereotide
c. Pegvisomant
a. Somatrem
What induces GH secretion by activating phospholipase C (treat GH deficiency by increasing PLC)?
Hexarelin
Defect in this causes polyendocrine autoimmune syndrome (PAS-1)?
a. AIRE
b. CD4
c. BTK
d. IL2
a. AIRE
Which of these is a characteristic of the glucocorticoid analogue dexamethsone?
a. Replacement therapy for Addison’s
b. Causes 2ndry hyperparathyroidism in pharmacological doses
c. Its half life is like cortisol half life
d. Promotes salt retention
e. Anti-inflammatory action is like cortisol
b. Causes 2ndry hyperparathyroidism in pharmacological doses
What is evidence of autoimmune adrenalitis (or Addison’s)?
a. Antibodies to adrenal cortex antigens
b. Nk cells
c. Antigens to cortisol
a. Antibodies to adrenal cortex antigens
Which hormone is likely to increase if pituitary stalk is damaged?
Prolactin
What guides the surgeon to parathyroid gland lll?
a. Inferior thyroid artery
b. Inferior thyroid vein
c. Internal laryngeal nerve
d. External laryngeal nerve
e. Cricoid cartilage or bone
a. Inferior thyroid artery
Amina, a hyperglycemic and weights 95kg. Said to the doctor her husband’s sleeps in another room because her snoring keeps him awake. The doctor noticed her large hand and hoarseness in her voice. What causes the hyperglycemia?
a. type 1 diabetes
b. hyperthyroidism
c. acromegaly
c. acromegaly
What would microscopic examination of the gonads in a patient with Klinefelter syndrome most likely show?
a. atrophic ovarian tissue
b. atrophic seminiferous tubules
c. atrophic testicular and ovarian tissue
d. normal ovaries in the first year
e. normal testes
b. atrophic seminiferous tubules
What is the mechanism of beta cells destruction in type 1 diabetes mellitus?
a. apoptosis mediated by inflammatory cytokines
b. compliment mediated cytotoxicity
c. ab mediated activation of macrophages
d. granulocytes activation
a. apoptosis mediated by inflammatory cytokines
A 42-year old presented w/ headache & blurred vision, high GH and high IGF-1. Which of these metabolic abnormalities would you see?
a. insulin resistance
b. reduce gluconeogenesis
c. reduce cholesterol synthesis
a. insulin resistance
A 32 year old woman presented with BP 165/100. Laboratory tests reveal K+ 3.0 (normal 3.5-5.3), renin activity suppressed and aldosterone levels high. What is the most likely cause of her hypertension?
a. essential hypertension
b. Conn’s syndrome
c. licorice ingestion
b. Conn’s syndrome
17 y/o with polyuria, polydipsia, glucosuria, BMI 19. What’s the first line of management?
a. Insulin
b. Oral glucose
c. Notreatment
d. Metformin
a. Insulin
because its type 1 DM
A 14-year-old lady come to the clinic with her parents with irregular menses and growth of facial hair and hirsutism, she was short compaird to her tall parents. Whats the diagnosis?
a. Cushing syndrome
b. Cushing disease
c. CAH
d. pheochromocytoma
e. Conn’s syndrome
?
A phosphate derivative that used to prevent bone loss in osteoporosis?
Alendronate
A tissue section of a thyroidal nodule shows lymphocytic infiltration, lymphoid follicles, and hurthle cell metaplasia.
a. Hashimoto Thyroiditis
b. Follicular adenoma
c. Follicular carcinoma
d. Medullary carcinoma
e. Papillary carcinoma
f. De Quevien Thyroiditis
a. Hashimoto Thyroiditis
Which one of these is an indicator of hypothalamus dysfunction?
a. diabetes insipidus
b. pituitary apoplexy
c. pituitary adenoma
d. hashimoto’s disease
a. diabetes insipidus
After removal of adenohypophysis which of these will be atrophied?
a. Parafollicular cells of thyroid
b. Medulla of adrenal gland
c. Zona glomerulosa
d. Zona fasiculata
d. Zona fasiculata
What characterizes Cosyntropin?
a. Stimulates aldosterone release
b. Elevates glucose levels
c. Enhances CRH secretion
d. Increases phospholipase C activity
e. Decreases cellular Camp
b. Elevates glucose levels
Test to differentiate between Paget’s disease and osteoporosis?
a. Serum alkaline phosphatase
b. Bone alkaline phosphatase
c. Serum PTH
a. Serum alkaline phosphatase
A baby was born with superior parathyroids, but without inferior parathyroids or thymus. Which structure is affected?
a. 1st pharyngeal pouch
b. 2nd pharyngeal pouch
c. 3rd pharyngeal pouch
d. 2nd pharyngeal arch
e. 3rd pharyngeal arch
c. 3rd pharyngeal pouch
A patient that is hypertensive came to the ER with Glucose: 29, pH: 7.25
a. Osmolar non ketotic
b. Ketoacidosis
b. Ketoacidosis
Cabergoline’s mode of action is (what is Cabergoline?)
dopamine agonist
What increases the expression of water channel in the collecting duct of the nephron?
Desmopressin
What oral agent that will most likely cause hypoglycemia?
Sulfonolyurea
Which defect is involved in nezlof’s syndrome?
a. 1st pharyngeal pouch
b. 2nd pharyngeal pouch
c. 3rd pharyngeal pouch
d. 2nd pharyngeal arch
e. 3rd pharyngeal arch
c. 3rd pharyngeal pouch
Which drug alleviates signs and symptoms of acromegaly by antagonizing the peripheral action of growth hormone?
Ganirelix
i think they meant pegvisomant= GH blocker
What is the most common cause of hypothyroidism in developed countries?
a. Hashimotos thyroiditis
b. Iodine deficiency
a. Hashimotos thyroiditis
What cella type are responsible for immune damage to pancreatic B-cells in insulin-dependent Diabetes Mellitus?
a. infiltrative neutrophils
b. cytotoxic T cells
c. activated NK cells
d. regulatory T cell
b. cytotoxic T cells
What causes osteoporosis by reducing calcium absorption and increasing crystallization?
Glucocorticoid (?)
What stimulates granulosa cells?
a. LH
b. Testosterone
c. FSH
c. FSH
What period of control of hyperglycemia can the presence of HbA1c indicate?
a. 6-7 days
b. 2-3 weeks
c. 2-3 months
d. 4-5 months
c. 2-3 months
A 63 yrs old lady presents with generalized bone pain. Laboratory investigations show increased serum Ca & low serum phosphate. What is the most likely diagnosis?
a. Paget’s disease
b. Multiple myeloma
c. Vit. D deficiency
d. Primary hyper PTH
e. Secondary hyper PTH
d. Primary hyper PTH
What is the pharmacological basis for the adjunct of atenolol along with the treatment of hyperthyroidism, especially before surgery?
a. Inhibits the intake of iodine into the thyroid gland
b. Lowers the circulating concentration of thyroid hormones
c. Protects the heart from the sensitizing effects of thyroid hormone
d. Is selectively concentrated in the thyroid
e. Decreases gland vascularity
c. Protects the heart from the sensitizing effects of thyroid hormone
A young woman has puffy skin, hoarse voice, and cold dry skin. Her plasma thyrotropin concentration is low but increases markedly in response to exogenous thyroid releasing hormone administration. Which of the following is the woman suffering from?
a. Hyperthyroidism due to a thyroid tumor
b. Hyperthyroidism due to an abnormality in the hypothalamus
c. Hypothyroidism due to thyroid gland abnormality
d. Hypothyroidism due pituitary gland abnormality
e. Hypothyroidism due to hypothalamic abnormality
e. Hypothyroidism due to hypothalamic abnormality
A 55 year old man with miliary TB has suffered from a severe acute adrenal insufficiency. What is the best rational that should be administered?
a. Cortisol & 9-flurocortisole
b. 9-flurocortisole & metyrapone
c. Aldosterone & metyrapone
a. Cortisol & 9-flurocortisole
Scientists wanted to measure the magnitude of association between age (in years) a& diabetes. How can they measure the association?
a. RR
b. OR
c. Difference in proportions
d. Difference in means
e. Correlation coefficient
d. Difference in means
What is a bisphosphate analogue used to treat osteoporosis?
a. Alendronate
b. Prednisolone
c. PTH
d. Calcitonin
e. Calcimer
a. Alendronate
What leads to osteoporosis by decreasing collagen formation and calcium absorption?
a. Alendronate
b. Prednisolone
c. PTH
d. Calcitonin
e. Calcimer
b. Prednisolone
A patient comes to your clinic complaining of headache, HTN, sweating, palpitations, and postural hypotension.
a. conn’s disease
b. hyperPTH
c. hypoPTH
d. cushing’s disease
e. adrenoma
f. pheochromocytoma
g. primary HTN
f. pheochromocytoma
A patient suffering from a tumor that enlarged, started growing anteriorly and superiorly. Which structure would be affected?
a. Sphenoidal air sinus
b. Cavernous sinus
c. Optic chiasma
d. Abducent nerve
c. Optic chiasma
A female with a normal 28 days menstrual cycle presented to the clinic. 12 hrs earlier she had her peak in estradiol levels without any significant progesterone. What do you expect after 3 days?
a. Ovulation
b. Menses
c. Corpus luteum will degenerate
a. Ovulation
21 years old female presented with a solitary mass in the thyroid. FNAC revealed the presence of follicular cells with nuclear grooves and intranuclear cytoplasmic inclusions. What is the diagnosis?
a. Follicular adenoma
b. Follicular carcinoma
c. Medullary carcinoma
d. Papillary carcinoma
d. Papillary carcinoma
A child suffering from low BP, fever, and gram –ve septicemia, after which he died. Upon examination of his adrenal gland in autopsy. What is the diagnosis?
Hemorrhagic necrosis
A nurse treated for breast cancer for a year, developed resistance against tamoxifel. Which drug should she take to overcome this problem?
a. Raloxifene
b. Letrozole
c. Oral contraceptives
d. Estrogens
e. Clomiphene
b. Letrozole
What is the effect of PTH on the nephron?
a. Ca reabsorption occurs in the thick part of ascending loop of henle
b. PTH interacts with the luminal surface of the proximal tubule
a. Ca reabsorption occurs in the thick part of ascending loop of henle
What can help in the treatment of growth retardation in patients with Laron dwarfism?
a. Sermorelin
b. Mecasermin
c. Hexarelin
d. Somatropin
b. Mecasermin
The autoantigen responsible for autoimmunity in lymphocytic hypophysitis is?
a. Alpha enolase
b. Pituitary gland specific factor 1A
c. Pituitary gland specific factor 2
d. Human growth factor
a. Alpha enolase
Which of the following indicates depletion of energy in body cells?
a. AMP
b. ATP
c. Phosphate
d. Lactate
a. AMP
Which of the following hormones acts on uterine smooth muscles contraction and the myoepithelial cells for the breasts?
a. LH
b. Oxytocin
c. FSH
d. ACTH
b. Oxytocin
Which of the following is lined by columnar epithelium with goblet cells?
a. Craniopharyngeoma
b. Rathke’s cleft cyst
c. Atypical adenoma
b. Rathke’s cleft cyst
A 59 years old female presented with high serum phosphate levels and low serum calcium levels. She also suffers from paresthesia. What could be the diagnosis?
Hypoparathyroidism
What is seen in the gonad histology of a patient with klinefelter’s syndrome?
Ghost seminiferous tubules
A 39 years-old female presented with elevated BP and hyperpigmentation. Her glucose levels were slightly elevated. What could be the diagnosis?
a. diabetes insipidus
b. pituitary apoplexy
c. pituitary adenoma
d. hashimoto’s disease
c. pituitary adenoma
In which of the following would secondary sexual characteristics fail to develop?
a. Those who underwent castration
b. Those with damaged seminiferous tubules but intact leydig cells
a. Those who underwent castration
castration aka orchiectomy
what is inconsistent with grave’s disease?
high TSH
what is a characteristic of estrogen hormone replacement therapy in post-menopausal females?
It is more efficient if initiated at the start of the menopause
