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Endocrine - 3rd year > 2016 exam > Flashcards

2016 exam Flashcards

1
Q

What field of vision is lost when a pituitary tumor grows anteriorly?
A-central field
B-lateral field in one eye
C-lateral field in both eyes

A

C-lateral field in both eyes

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2
Q 
Where does the axons of hypothalamic neurons which release oxytocin terminate?
A. Pars intermedia 
B. Pars distalis
C. Median eminence 
D. Pars nervosa
E. Infundibulum
A

D. Pars nervosa

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3
Q 
Injury to which structure should be avoided during a surgery to the posterior aspect of the suprarenal gland?
A- Aorta
B- Diaphragm 
C-Pancreas
D-Stomach
A

B- Diaphragm

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4
Q 
Which of the following is a feature of oxyphil cells? 
A- They’re smaller than chief cells
B- they have basophilic cytoplasm 
C- they secrete calcitonin
D- they have lots of mitochondria
A

D- they have lots of mitochondria

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5
Q 
What is the clinical disorder that results from increased levels of growth hormone in adults?
A- Acromegaly 
B- gigantism
C- growth suppression 
D- cretinism
A

A- Acromegaly

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6
Q 
Feature of osteoclast:
A- there are no receptors for parathormone 
B- basophilic cytoplasm
C- lifespan 20 days
D- located between lamellae
A

A- there are no receptors for parathormone

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7
Q 
What’s the main feature of Leydig cells? 
A- Basophilic cytoplasm
B- Foamy high lipid content
C- Rough endoplasmic reticulum 
D- Controlled by FSH
A

B- Foamy high lipid content

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8
Q

Oral drug that inhibits ATP-dependent K+ channels?

A

Glipizide

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9
Q

In radioimmunoassay, there was low displacement of the radioactivity from the antibodies. What does that indicate?
A- low hormone levels in serum
B- high levels of hormone
C- high specificity of antibody to the tube
D-low specificity of Ab
E- high radioactivity

A

A- low hormone levels in serum

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10
Q

What is the major effect of vit D?

A

Increase absorption of Ca2+ in the gut

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11
Q

What does excess thyroid hormone cause?

A

increase BMR

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12
Q

Which hormone decreases feeding?

A

Leptin

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13
Q 
A 29 year-old female with SLE on glucocorticoid treatment. Whats the most likely diagnosis?
A- cortical atrophy
B- cortical hyperplasia 
C- cortical nodule
D- medullary atrophy 
E- medullary nodule
A

A- cortical atrophy

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14
Q 
A 39 year old female with hyperpigmentation hypotension and high Ach levels. 
A- cortical atrophy
B- cortical hyperplasia 
C- cortical nodule
D- medullary atrophy 
E- medullary nodule
A

A- cortical atrophy

Addison disease

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15
Q 
What causes somatostatin to inhibit growth hormone?
A- Increased cAMP
B- Decreased cAMP
C- Increased intracellular Ca+2 
D- Decreased intracellular Ca+2
A

B- Decreased cAMP

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16
Q 
These cells secrete a hormone identical to the hormone secreted from the hypothalamus
A- D1 cells 
B- EC cells
C- Epsilon cells 
D- Alpha cells 
E- Delta cells
A

E- Delta cells

they release somatosstatin and it is structurally the same as GHRH

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17
Q 
These cells produce a hormone that stimulates appetite
A- D1 cells 
B- EC cells
C- Epsilon cells 
D- Alpha cells 
E- Delta cells
A

C- Epsilon cells

ghrelin secreting

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18
Q

A 22 y/o old female who failed to have pregnancy after 2 years of unprotected intercourse. What would give her an anovulatory menstrual cycle?

A

PCOS

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19
Q

male phenotype with 46/XY, 47/XXY mosaic karyotype

A

Klinefelter syndrome

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20
Q

131-MIBG is treatment of what?

A

neuroblastomas

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21
Q

What is the cause of failure to complete sexual maturation in Klinefelter syndrome?

A

Testosterone release by Leydig cell

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22
Q

Organ specific autoimmune disease

A

Hashimoto’s hypothyroidism

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23
Q

Which of the following is consistent with HONK?
A- Severe hyperglycemia and dehydration
B- Severe hyperglycemia due to insulin omission
C- Good prognosis less than 1% mortality
D- Associated with metabolic alkalosis

A

A- Severe hyperglycemia and dehydration

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24
Q

Patient with DM type 2 and heart failure. What is the least likely treatment that you will give him?

A

Rosiglitazone

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25
Q

Female phenotype, 46 XY karyotype with undescended testes and normal testosterone secretion

A

Androgen insensitivity

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26
Q 
A 20 y/o lady presents with a 9 month history of neck swelling and thyrotoxicosis symptoms. Investigations revealed increased T4 and decreased TSH with a palpable nodule. What will be the next investigation? 
A- ultrasound scan of the thyroid
B- thyroid scan
C- radioactive iodine uptake 
D- CT scan of the pituitary 
E- MRI of the pituitary
A

B- thyroid scan

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27
Q 
28 y/o female patient with thyroid nodule she denies pain, hoarseness of voice, obstructive symptoms, the laboratory test reviled normal TSH? What is the next step of investigation?
A- thyroid scan 
B- measuring T4
C- ultrasonography
D- no further evaluation
A

C- ultrasonography

thyroid investigations

  1. Always start w/ TSH
  2. T4 ( you don’t do it if TSH is normal)
  3. Thyroid scan (you do it if the patient is symptomatic and TSH is abnormal)
  4. Ultrasound (you always do it if you have nodule/goiter to check for nodularity, cystic changes, and vascularity), ( if microcalcifications and solid component = high risk of malignancy)
  5. FNAC (you do it if you have a high risk of malignancy = cold nodule, microcalcifications, or solid component)
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28
Q 
What pancreatic tumor is associated with amyloid deposition? 
A- VIPoma
B- Glucagonoma 
C- insulinoma 
D- SSToma
A

C- insulinoma

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29
Q

XX female presented with ambiguous genitalia, hyperplasia of both adrenals, What is the mechanism of the condition?

A

Enzymatic defect

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30
Q

Choose the appropriate biochemical laboratory test for a mass in the sella turcica composed of acidophilic cells that stained positive for growth hormone?

A

Pit1

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31
Q

25 years old female presented with fever, myalgia and enlarged thyroid , fine needle aspiration shows granuloma giant cells and destroyed thyroid follicles?

A

De Quervain thyroiditis

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32
Q

35 year old female presented w/ weight gain and abdominal striae on examination and she was on rheumatoid arthritis medications more than 6 month, what is the most likely cause of her symptoms?

A

iatrogenic Cushing

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33
Q 
53 y/o old female she complains of nausea and constipation, she had recently been diagnosed with hypertension, she had a past history of renal stones?
A- Hyperparathyroidism 
B- vit D deficiency
C- Cushing’s syndrome 
D- celiac disease
A

A- Hyperparathyroidism

(hypertension is one of the earliest manifestations of Cushing BUT
Nausea, constipation, and renal stones are typical the presentations of hyperparathyroidism)

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34
Q

What is the main source of estrogen in the fetus?

A

Placenta (main estrogen in pregnancy = estriol)

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35
Q 
What is the function of sTAR? 
A- cholesterol ester
B- regulation of steroid synthesis 
C- degradation of steroids
D- cholesterol to pregnanolone
A

B- regulation of steroid synthesis

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36
Q

Ophthalmopathy may be associated in 50% in these patients?

A

Grave’s disease

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37
Q

A 40 year old male presented with a solitary thyroid nodule. Physician suspected it to be a neoplasm. What investigation is appropriate for preoperative diagnosis?
A- Ultrasonography
B- T3, T4 & TSH levels in blood
C- FNAC

38
Q

What prevents osteoporosis in a female by inhibiting the activation of osteoclasts?

39
Q 
20 y/o overweight female went to diabetic clinic to check her risk of developing DMT2, despite her positive family history, which of the following will put her at high risk of DMT2?
A- Waist circumference 75 cm 
B- Acanthosis nigricans
C- BMI = 25kg/m2 
D- BP = 130/85
E- HR = 100beat/min
A

B- Acanthosis nigricans

40
Q

A woman post-delivery she couldn’t breast feed her baby, and had a blood transfusion due to excessive hemorrhage. Whats the diagnosis?

A

Sheehan syndrome

41
Q

What stimulates the production of testosterone from testes?

42
Q

in postmenopausal women, which sex hormone and gonadotropin will be elevated?
A- Estriol and FSH
B- Estrone and LH
C- Estrone and FSH

A

C- Estrone and FSH

43
Q

Why is male sperm auto-immunogenic/ why is there anti-sperm autoimmunity in males?

A

Because the sperms develop after the immune system learns to distinguish between self and non-self

44
Q

What indicates energy depletion in cells?

a. AMP
b. ATP
c. Phosphate
d. Lactate

45
Q

A 32 y/o female presented w/ palpitations, increased respiratory rate, warm hand, and proptosis, what do you expect to find in lab results?

A

High T4 and T3, low TSH

46
Q

We do screening for which thyroid disease?

a. Thyroid cancer
b. Adult hyperthyroidism
c. Adult hypothyroidism
d. Infant cretinisim

A

d. Infant cretinisim

47
Q 
What inhibits feeding center? 
A- NPY
B- AGRP
C- PPY
D- cortisol
48
Q

Compared to leuprolide, what describes ganirelix?
A- it antagonizes GnRH directly
B- initially it increases LH and FSH then it suppresses them

A

A- it antagonizes GnRH directly

49
Q

A female with a normal 28-days menstrual cycle. 12-hours earlier she had her peak estradiol levels without any significant progesterone. What do you expect after 3 days?

a. Ovulation
b. Menses
c. Corpus luteum will degenerate

A

a. Ovulation

50
Q

What is involved in tissue destruction in autoimmune oophoritis?

a. Antibody mediated cytotoxic killing
b. Inducers of suppressive T-cells
c. Cytotoxic t cell
d. NK cells

A

c. Cytotoxic t cell

51
Q 
Which is responsible in bone formation in osteoporosis? 
A- calcitonin
B- calcitriol 
C- Estrogen
D- Fluoride
A

D- Fluoride

the only osteoblastic drug

52
Q

What is the function of dual oxidase?

A

production of H2O2

53
Q

What hormone synthesis requires vitamin C?

A

Both oxytocin and vasopressin

54
Q 
27 year old male presented with hypertension and a pituitary tumor associated with hypokalemia and metabolic alkalosis. What condition is most likely present?
A- Acromegaly
B- Cushing disease 
C- Pheochromocytoma 
D- Addison’s
E- Ectopic ACTH
A

B- Cushing disease

55
Q 
Least likely risk factor to develop osteoporosis 
A- smoking
B- alcohol
C- parental history (genetic) 
D- past history of hip fracture 
E- low bone mass density
F- hypothyroidism
A

F- hypothyroidism

56
Q

Mass in sella turcica with cells expressing pit1. Whats the diagnosis?

A

Acromegaly

57
Q 
36 year old female with numbness around her mouth for a few weeks came to the emergency room because of carpopedal spasm. Serum calcium is 2.0. Which is the most likely:
A- Low magnesium
B- Low sodium 
C- High glucose
D- High anion gap acidosis
A

A- Low magnesium

Mg is needed for normal parathyroid function; low Mg →low PTH →low Ca

58
Q

A female had a surgery to remove pituitary gland and she didn’t take any replacement therapy, what symptom will she experience?
A- Amenorrhea
B- high blood sugar
C- hypoparathyroidism

A

A- Amenorrhea

59
Q

Patient with increased thyroxine and decreased TSH with smaller than normal thyroid gland, What is the possible cause?
A- Gravis disease
B- Increased iodine intake
C- Patient taking Antithyroid drug
D- Anterior pituitary lesion causing low TSH
E- Patient taking propylthiouracil

A

B- Increased iodine intake

60
Q 
What is the most common form of adult thyroid cancer? 
A- anaplastic
B- medullary carcinoma 
C- Hurthle cell cancer 
D- papillary cancer
E- follicular cancer
A

D- papillary cancer

61
Q

What is involved in tissue destruction of DM type 1?

A

cytotoxic t cell & MPs

62
Q

What inhibits carbohydrate absorption?
A- Glipizide
B- Acarbose

A

B- Acarbose

63
Q

What is the substrate of 5 alpha reductase?

A

Testosterone

64
Q

A question about calculating the ovulation day in a female with 30-32 days regular menstrual cycle. When is her ovulation day?

A

day (16-18)

65
Q

which of the following statements best describes teriparatide?
A- it increases osteoblasts apoptosis
B- it increases the number of osteoblasts
C- is the 1-84 peptide fragment of PTH
D- is given orally, in high doses

A

B- it increases the number of osteoblasts

66
Q

A diabetic lady who can’t control her glucose levels by diet or exercise despite trying, what would you give her?
A- sulphanureas
B- Rosiglitazone
C- Metformin

A

C- Metformin

67
Q

What cause long loop inhibition?
A- Parathyroid hormones
B- LH and FSH
C- Prolactin

A

B- LH and FSH

68
Q 
How does 2,5 T2 stimulate heat generation in brown adipose tissue? 
A- Decrease oxygen consumption
B- Increase ATP synthesis efficiency
C- Decrease the activity of TCA enzymes 
D- Uncoupling
A

D- Uncoupling

69
Q

Endocannabinoid is derived from?

A

arachidonic acid

70
Q

chronic stress effect on telomeres?
A- lengthening
B- shortening

A

B- shortening

71
Q 
T1D 12 y/o diagnosed 4 years ago. Whats most likely?
A- Anti-insulin antibodies
B- undetected levels of c-peptide 
C- hyperinsulinemia
D- Lipolysis
E- Hypoglyecemia
A

B- undetected levels of c-peptide

(in T1DM, the major pathophysiology is insulin deficiency because of autoimmune destruction of beta cells, with insulin deficiency you can not detect c-peptide levels since they are both from pro-insulin which is also deficient, this is found in ALL T1DM cases; on the other hand the anti-insulin Abs are only found in approximately 50% of the pts.)

72
Q 
45 year old male with impaired glucose tolerance. Whats most likely?
A- Anti-insulin antibodies
B- undetected levels of c-peptide 
C- hyperinsulinemia
D- Lipolysis
E- Hypoglyecemia
A

C- hyperinsulinemia

73
Q 
18 year old female T1D found comatosed. Whats most likely?
A- Anti-insulin antibodies
B- undetected levels of c-peptide 
C- hyperinsulinemia
D- Lipolysis
E- Hypoglyecemia
A

D- Lipolysis

Complication of T1DM →DKA; in DKA we have increased lipolysis

74
Q

A 15 y/o adolescent presented to the outpatient 3 weeks after being discharged having meningitis. He showed no neurological symptoms but had increased urine output of 7 liters per day & increased thirst.
What do you expect to find in his urine analysis?
A- Osmolality Of 200 mOsmol/kg
B- Positive for ketone
C- Positive for nitrites
D- Glucose Of 30 mmol/L
E- Protein more than 400 mg/day

A

A- Osmolality Of 200 mOsmol/kg

75
Q 
Which form of thyroid hormone is most potent on genome?
A- T4 
B- T3 
C- rT3
D- 3,5-T2 
E- 5,5-T2
76
Q 
Which form of thyroid hormone is a pro-hormone?
A- T4 
B- T3 
C- rT3
D- 3,5-T2 
E- 5,5-T2
77
Q 
What hormone produced by hypothalamus inhibits growth hormone? 
A- Ghrelin
B- Igf11 
C- Igf1
D- Somatostatin
A

D- Somatostatin

78
Q 
Which of the following correlates positively with BMI? 
A- Insulin
B- Resistin
C- Adiponectin 
D- Cortisol
E- Growth hormone
A

B- Resistin

79
Q

Proportional rate of growth between two body parts?

A

Isometric growth

80
Q 
Which secretes testosterone?
A- Sertoli cells 
B- Leydig cells 
C- Theca leutia
D- Granulosa cells 
E- Theca interna
A

B- Leydig cells

81
Q 
Which secretes inhibin?
A- Sertoli cells 
B- Leydig cells 
C- Theca leutia
D- Granulosa cells 
E- Theca interna
A

A- Sertoli cells

82
Q

What is true with regards children and pain?
A- as children grow their pain tolerance increases
B- children behavior reflect their pain intensity
C- children get addicted to necrotic fast
D- children get accustomed to pain

A

A- as children grow their pain tolerance increases

83
Q 
The resected tumor in a 30- year old female shows pale nucleus, nuclear groove and psammoma bodies. Whats most likely?
A- Follicular carcinoma 
B- Papillary carcinoma 
C- Medullary carcinoma
D- Non-Hodgkin lymphoma
A

B- Papillary carcinoma

84
Q 
Calcitonin positive tumor
A- Follicular carcinoma 
B- Papillary carcinoma 
C- Medullary carcinoma
D- Non-Hodgkin lymphoma
A

C- Medullary carcinoma

85
Q

A 50 year old lady with a history of hypertension, sweating and palpitations, What is the diagnosis?

A

Pheochromocytoma

86
Q

34 year man with hypertension, central obesity, striae and peripheral myopathy. What biochemical test must be carried out?

A

24h urine cortisol

87
Q 
A 12 year old girl presented to the emergency department after 2 months history of lethargy, polyuria, & weight loss. Hb1c 10.5%. 
A- subcutaneous insulin 
B- intravenous insulin
C- no treatment
D- Diet & exercise
A

A- subcutaneous insulin

88
Q 
17 y/o female presented to ER with polyuria 
A- subcutaneous insulin 
B- intravenous insulin
C- no treatment
D- Diet & exercise
A

?

if DKA give IV

89
Q 
45 y/o female with hyperglycemia and polyuria. 
A- subcutaneous insulin 
B- intravenous insulin
C- no treatment
D- Diet & exercise
A

D- Diet & exercise

the q had many RFs for DMT2 so we start off the management by diet and exercise

90
Q

How does Tolvaptan work in hyponatremia?
A- Increases sensitivity of V2 receptors
B- Competitively blocks V2 receptors

A

B- Competitively blocks V2 receptors

Endocrine - 3rd year (12 decks)

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