AMEDEX MIX

Question 1

pituitary adenomas (micro or macro) -
disruption of stalk

Answer 1

causes of hyperprolactinaemia

Question 2

hypothalams tumors (craniopharyngioma, glioma),
infiltration (sarcoidosis), irradiation

Answer 2

causes of hyperprolactinaemia

Question 3

drug-induced
cimetidine, methyldopa,
metodopramide, phenothizine,
risperidone, other neuroleptics, SSRIs,
TCAs, opiates and marijuana

Answer 3

causes of hyperprolactinaemia

Question 4

systemic pregnancy, hypothyroidism, renal
failure, liver disease, polycystic ovarian
syndrome, epileptic seizures

Answer 4

causes of hyperprolactinaemia

Question 5

neurogenic breast stimulation, chest wall trauma

or lesion, stress

Answer 5

causes of hyperprolactinaemia

Question 6

prolactin level as high as 7845 mU/L, the most likely cause would be a

Answer 6

prolactin secreting pituitary adenoma (prolactinoma).

Question 7

A prolactin level of above 5000 mU/L is more

likely to have been caused by a

Answer 7

prolactinoma

Question 8

Although drugs such as risperidone are a potential cause of hyperprolactinemia, the
prolactin levels are expected to be below

Answer 8

5000 mU/L.

Question 9

In children with type I diabetes mellitus, _____________is the most common encountered
complication

Answer 9

hypoglycemia

Question 10

hypoglycemia may lead to _________and loss of consciousness

Answer 10

seizures

Question 11

In childhood (other than neonatal period), \_\_\_\_\_\_\_\_\_is defined as a blood glucose
level of <2.6 mmol/L.

Answer 11

hypoglycaemia

Question 12

The most appropriate treatment of severe hypoglycemia when the
patient is unconscious and unable to take oral glucose is with a bolus of __________________10%, 2.5 to 5 mL/Kg followed by 0.03 to 0.05 mL/Kg/minute until the patient is
stable

Answer 12

intravenous

dextrose

Question 13

In adults with hypoglycemia, _____% glucose solution is used for treatment of severe
hypoglycemia

Answer 13

50

Question 14

This solution is not recommended for children because it can result in serum
hyperosmolarity and death.

Answer 14

50% glucose solution is used for treatment of severe

hypoglycemia

Question 15

In a conscious and cooperative child, oral route is preferred.

Answer 15

In childhood (other than neonatal period), hypoglycaemia

Question 16

________neuropathy is one of the complications of diabetes mellitus. Diabetic autonomic
neuropathy is common and often a debilitating condition

Answer 16

Autonomic

Question 17

Skin - dry skin (due to lack of sweating), or excessive sweating in defined areas
• Eye - poor dark adaptation, sensitivity to bright lights
• Cardiovascular - postural lightheadedness, fainting, orthostatic tachycardia,
orthostatic bradycardia and orthostatic hypotension
• Urinary - urgency, incontinence, dribbling, and bladder emptying abnormalities
• Gastrointestinal - diarrhea, constipation, nausea and vomiting
• Sexual - erectile dysfunction and ejaculatory failure in men, loss of ability to reach
sexual climax in women

Answer 17

Clinical manifestations of

diabetic autonomic neuropathy

Question 18

Diabetic foot ulcers have a
different pathophysiology, mostly including peripheral neuropathy and ischemia from
________________

Answer 18

peripheral vascular disease

Question 19

Poor resistance against infections is also a contributing factor.

Answer 19

Diabetic foot ulcers

Question 20

First is the feeling of ‘always
afraid that something bad is going to happen soon’. This subjective feeling also described as
‘impending doom’ often indicates the presence of anxiety and can be seen during a panic attack
in patients with pheochromocytoma, and in those with hyperthyroidism and __________

Answer 20

thyrotoxicosis

Question 21

Increased perspiration and palpitation are features seen almost in every hypermetabolic and
________________state

Answer 21

hypersympathetic

Question 22

___________ blood pressure on examination goes against generalized anxiety
disorder (option D) and panic disorder (option B), making these two less likely, but still
possible

Answer 22

Elevated

Question 23

The
most common presentation of ______________is with episodic headache, tachycardia,
hypertension, anxiety and sweating

Answer 23

pheochromocytoma

Question 24

Although some patients with pheochromocytoma appears
to have sustained increased blood pressure, the absence of _____________, which is one of the
components of the classic triad of the disease (headache, palpitation, and diaphoresis), makes
pheochromocytoma (option C) less likely

Answer 24

headache

Question 25

The most frequent symptoms of hyperthyroidism are nervousness (anxiety), ________________,
palpitations, and fatigue and weight loss.

Answer 25

heat intolerance

Question 26

Common signs on examination include agitation, sinus

tachycardia, elevated systolic blood pressure, fine tremors and hyper-reflexia

Answer 26

hyperthyroidism

Question 27

The low BMI of this woman, as well as being a professional athlete makes _________________ a very likely diagnosis

Answer 27

anorexia nervosa

AN

Question 28

If the diagnosis is AN, it is most likely to be of restricting type,
where the patients reduces weight through restricted calorie intake or _________________.

Answer 28

excessive exercise

Question 29

one thing is certain: this woman is at increased risk of
osteopenia/osteoporosis due to ________________ and prolonged menopause and the DEXA
scan proves that osteoporosis of the vertebral column ans osteopenia of the hip have
already occured.

Answer 29

low body weight

Question 30

. All patients with AN should be started on calcium (1200-1600mg,
daily) and vitamin D. Calcium and vitamin D, will not restore the bone density, but they
prevent further ___________.

Answer 30

bone loss

Question 31

Alendronate and other bisphosphonates are first-line treatment for
postmenopausal women with established ______________.

Answer 31

osteoporosis

Question 32

In women of reproductive age,
bisphosphonates should not be used routinely as they are ____________and may remain in
the body for long periods

Answer 32

teratogenic

Question 33

Weight-bearing exercises have been shown equivocal results in bone ______________ to date.

Answer 33

mass

restoration

Question 34

Furthermore, excessive exercise can be associated with more

probability of ___________fractures in a osteopenic/osteoporotic woman

Answer 34

traumatic

Question 35

Androgens, in any form, have shown no benefit in treatment of AN-related
__________________.

Answer 35

osteoporosis

Question 36

Osteoporosis is one of the significant complications of anorexia nervosa (AN) seen in at
least _________% of female patients.

Answer 36

30

Question 37

Osteoporosis is associated with risk of ________.

Answer 37

fractures

Question 38

Osteoporosis in AN is characterized by increased bone resorption without concomitant
increased _________formation

Answer 38

bone

Question 39

Trabecular bone, found in the spine and hips, is affected more
than cortical bone.

Answer 39

Osteoporosis

Question 40

. The most severely affected site is the lumbar spine. Bone loss occurs at
a rate of 4% to 10% per year.

Answer 40

Osteoporosis

Question 41

Peak bone mass is generally acquired
during adolescence and young adulthood, which frequently coincides with the onset of AN.
The peak bone mass acquired by a patient with AN depends on the time of onset and
duration of the eating disorder, the degree of nutritional depletion, and changes in body
composition.

Answer 41

factors contribute to osteoporosis in AN