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PEDIA > ENDOCRINE > Flashcards

ENDOCRINE Flashcards

1
Q

The following factors are implicated in the pathogenesis of type 1 DM EXCEPT *
a. prenatal influences
b. diet in infancy
c. viral infections
d. psychologic stress
e. excessive exposure to certain
infections

A

excessive exposure to certain
infections

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2
Q

In cerebral salt wasting, vasopressin level is characterized as:
a. Low
b. Normal
c. High
d. Very high

A

LOW

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3
Q

Clinical manifestations of pheochromocytomas include the following EXCEPT *
a. hypertension
b. good appetite
c. convulsions
d. pulmonary
edema
e. Obesity

A

Obesity

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4
Q

The MOST common cause of acquired hypopituitarism is : *
A. tuberculosis
B. craniopharyngioma
C. eosinophilic granuloma
(histiocytosis)
D. toxoplasmosis meningitis

A

craniopharyngioma

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5
Q

The MOST accurate test of thyroid function is *
A. T4
B. free T4
C. T3
D. thyroglobulin
E. TSH

A

TSH

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6
Q

The MOST common brain lesion causing central precocious puberty is *
A. postencephalitic scar
B. tuberculous meningitis
C. hypothalamic hamartoma
D. tuberous sclerosis
E. hydrocephalus

A

hypothalamic hamartoma

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7
Q

The following are true about Hashimoto’s Thyroiditis EXCEPT: *
A. presence of thyrothropin
receptor-blocking Ab (TRB Ab)
B. patients don’t present with normal
serum T4 and TSH
C. in marked hypothyroidism, there is an
elevated TSH, low FT4
D. in subclinical hypothyroidism, there is an
elevated TSH and normal FT4

A

presence of thyrothropin
receptor-blocking Ab (TRB Ab)

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8
Q

Patients with autoimmune Addison disease must be closely observed for the development of
other autoimmune disorders. Of the following, the MOST commonly associated disorder in
children is *
A. alopecia
B. vitiligo
C. chronic active hepatitis
D. type 1 diabetes mellitus
E. hypoparathyroidism

A

hypoparathyroidism

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9
Q

The current criteria for the diagnosis of type 1 and type 2 DM is a fasting blood glucose that
exceeds *
A. 110 mg/dL
B. 115 mg/dL
C. 120 mg/dL
D. 125 mg/dL
E. 130 mg/dL

A

D. 125 mg/dL

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10
Q

The following features suggest constitutional delay as a cause of short stature no signs or
symptoms of systemic disease: *
A. bone age delayed beyond the height age
B. period of poorest growth often occurring
between the ages of 18 and 30 months
C. parental or sibling history of delayed
development
D. height predictions consistent with family
characteristic

A

parental or sibling history of delayed
development

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11
Q

The most common cause of patients presenting with rounded face, prominent cheeks, moon
facies, “Buffalo hump”, generalized obesity, abnormal masculinization and Impaired growth
with hypertension is: *
A. dyshormonogenesis
B. acquired primary adrenal insufficiency
C. autoimmune destruction of
pancreatic islets
D. prolonged exogenous administration
of glucocorticoid hormones

A

prolonged exogenous administration
of glucocorticoid hormones

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12
Q

A 1-month old presents with vomiting and severe dehydration. PE shows ambiguous
genitalia.Lab tests show hyponatremia. There is a deficiency in what enzyme/hormone?
A. 11 B-Hydroxylase
B. 17B-Hydroxylase
C. 21A-Hydroxylase
D. 17A-hydroxyprogesterone

A

21A-Hydroxylase

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13
Q

In young persons with open epiphysis, overproduction of growth hormone results in: *
A. Acromegaly
B. Gigantism
C. Klinefelter syndrome
D. Sotos syndrome

A

Gigantism

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14
Q

A water deprivation test is indicated when pathologic polyuria and polydipsia are present and
serum osmolality is: *
A. >250 mOsm/kg, < 300 mOsm/kg
B. > 260 mOsm/kg, < 300 mOsm/kg
C. > 270 mOsm/kg, < 300 mOsm/kg
D. > 270 mOsm/kg, > 300 mOsm/kg

A

C. > 270 mOsm/kg, < 300 mOsm/kg

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15
Q

Rapid correction of a person with serum sodium of 115meq/L will cause: *
A. Lateral pontine myelinolysis
B. Cerebral salt wasting
C. Central cerebellar myelinolysis
D. Central pontine myelinolysis

A

Central pontine myelinolysis

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16
Q

Acquired nephrogenic diabetes insipidus (NDI) is associated with the following EXCEPT *
A. lithium
B. amphotericin
C. Methicillin
D. Rifampicin
E. vancomycin

A

vancomycin

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17
Q

To diagnose a 2-day old neonate with ambiguous genitalia, vomiting, poor suck, the following
laboratory parameters are needed EXCEPT: *
A. androstenedione
B. dihydrotestosterone
C. 11-deoxycortisol
D. 17-hydroxyprogesterone
E. 17-hydroxypregnenolone

A

11-deoxycortisol
???

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18
Q

The gold standard for diagnosis of tall stature is: *
A. MRI
B. IV glucose challenge test
C. IGF-1 challenge test
D. Oral Glucose challenge test

A

IGF-1 challenge test

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19
Q

The following criteria are needed for the diagnosis of syndrome of inappropriate secretion of
antidiuretic hormone (SIADH) EXCEPT *
A. absence of volume
depletion
B. excessive urinary
sodium
concentration
C. hyponatremia with
normal serum
osmolality
D. elevated urine
osmolality D. normal
renal, adrenal, and
thyroid function

A

hyponatremia with
normal serum
osmolality

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20
Q

All the following tests are of diagnostic utility in the diagnosis of Cushing syndrome EXCEPT *
A. midnight cortisol levels
B. nighttime salivary cortisol levels
C. glucose tolerance test
D. urinary excretion of free cortisol
E. dexamethasone suppression test

A

glucose tolerance test

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21
Q

The cardinal clinical feature of gigantism includes: *
A. Longitudinal growth acceleration
B. Coarse facial features
C. Enlarging hands and feet
D. Visual problems

A

Longitudinal growth acceleration

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22
Q

The following stimulate vasopressin (VP) secretion EXCEPT *
A. nausea
B. hyperosmolality
C. hyperglycemia
D. hypovolemia
E. hypotension

A

hyperglycemia

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23
Q

Fluid resuscitation in patients with Congenital Adrenal Hyperplasia are needed to correct the
following EXCEPT: *
A. hypoglycemia
B. hyponatremia
C. hypokalemia
D. hyperkalemia
E. dehydration

A

hypokalemia

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24
Q

Physiologic factors play a role in stimulating and inhibiting growth hormone (GH). One of the
following inhibit GH release : *
A. sleep
B. exercise
C. Fasting
D. hyperglycemia
E. Acute illness

A

hyperglycemia

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25
Q

A 1-month old presents with vomiting and severe dehydration. PE shows ambiguous genitalia.
Lab tests show hyponatremia. One of the following is the most reliable laboratory parameter
to diagnose this patient: An increase in serum _________________? *
A. 17-hydroxylase
B. 21A-Hydroxylase
C. 17A- OH progesterone
D. 17A-OH pregnenolone

A

17A- OH progesterone

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26
Q

Diabetic ketoacidosis (DKA) is the end result of the metabolic abnormalities resulting from a
severe deficiency of insulin or insulin effectiveness. DKA is characterized by the following
EXCEPT *
A. ketonuria
B. decreased pH
There is a large amount of ketonuria, an increased
ion gap, a decreased serum bicarbonate (or total
C. normal ion gap
D. elevated effective serum osmolality
E. decreased serum bicarbonate decreased
pH elevated effective serum osmolality

A

normal ion gap

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27
Q

In older children with Cushing syndrome, in addition to obesity, a common early manifestation
is *
A. purplish striae on abdomen
B. short stature
C. hypertension
D. hyperglycemia
E. osteoporosis

A

short stature

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28
Q

Congenital X-linked Nephrogenic Diabetes Insipidus (NDI) results from mutations in the
gene/receptor: *
A. Aquaporin-1 gene
B. Aquaporin-2 gene
C. Vasopressin V1 receptor
D. Vasopressin V2 receptor

A

Vasopressin V2 receptor

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29
Q

This is the major cause of morbidity and mortality in children with Type 1 Diabetes milletus. *
A. Ketoacidosis
B. Cerebral edema
C. Hyperglycemia
D. Nonketotic Hyperosmolar coma

A

Cerebral edema

30
Q

A well-educated 11-year old female sought consult due to short stature. Family history
showed a few short maternal aunts. Which is the most likely test that will help you with your
diagnosis? *
A. Bone aging
B. Thyroid hormone tests
C. Serum cortisol levels
D. Serum insulin levels

A

Bone aging
???

31
Q

The maximum days of estrogen priming needed prior to GH testing to achieve greater
diagnostic specificity is: *
A. 2 days
B. 3 days
C. 4 days
D. 5 days

A

3 days

32
Q

Treatment options of patients with Congenital Adrenal Hyperplasia include the ff. EXCEPT: *
A. prednisone
B. hydrocortisone
C. dexamethasone
D. Fluodrocortisone
E. potassium chloride supplements
F. sodium chloride supplements

A

potassium chloride supplements

33
Q

Chronic SIADH is BEST treated with one of the following : *
A. Diuretics
B. Oral fluid restriction
C. Demeclocycline
D. Sodium supplementation

A

Oral fluid restriction

34
Q

A 2-month old appears to be having inadequate weight gain. His mother claims that he is
constipated.On PE, he has decreased muscle tone, a large fontanel, a large tongue, an
umbilical hernia. The most common cause for this case is: *
A. Iodine deficiency
B. Thyroid malformation
C. TSH unresponsiveness
D. Defect in thyroid
hormone synthesis
E. Maternal Abs:
Thyrotropin
receptor-blocking Ab
(TRB Ab)

A

Thyroid malformation
???

35
Q

The classic manifestations of polyuria, polydipsia, optic atrophy, and brain abnormalities
characterize this disorder: *
A. Hyponatremia
B. Diabetes insipidus
C. Cerebral salt wasting
D. Syndrome of Inappropriate
Anti-Diuretic hormone

A

Diabetes insipidus

36
Q

Syndrome of inappropriate antidiuretic hormone secretion is characterized by hyponatremia
and an inappropriately concentrated urine mOsm/kg value of: *
A. > 100
B. > 200
C. > 300
D. > 400

A

> 100

37
Q

When a person consumes more than 2L per day, he would have increased urine output and
the serum sodium would be: *
A. Normal
B. Decreased
C. Increased
D. Absent

A

Normal
???

38
Q

The first clinical manifestation of acquired hypothyroidism is *
A. goiter
B. weight gain
C. constipation
D. poor schoolwork
E. deceleration of growth

A

deceleration of growth

39
Q

This is the end result of metabolic abnormalities from a severe insulin deficiency or insulin
effectiveness. *
A. Hyperglycemia
B. Ketoacidosis
C. Metabolic alkalosis
D. Pheochromocytoma

A

Ketoacidosis

40
Q

The MOST common cause of permanent congenital hypothyroidism is *
A. dyshormonogenesis
B. defect of iodide transport
C. thyroid dysgenesis
D. Iodine deficiency

A

thyroid dysgenesis

41
Q

One of the following conditions are associated with Graves’ disease EXCEPT *
A. Type 1 diabetes mellitus
B. alopecia areata
C. celiac disease
D. vitiligo
E. Anemia

A

Anemia

42
Q

Approximately 10% of infants with congenital hypothyroidism have associated congenital
anomalies. Of the following, the MOST common are *
A. nervous system anomalies
B. cardiac anomalies
C. genitourinary anomalies
D. lungs anomalies
E. eye anomalies

A

cardiac anomalies

43
Q

The following statements are TRUE about Type 2 Diabetes Mellitus EXCEPT: *
A. Non-insulin dependent diabetes
B. Noted peripheral insulin resistance
C. With absolute insulin deficiency
D. non-autoimmune destruction of B
cells

A

With absolute insulin deficiency

44
Q

Congenital autosomal recessive NDI results from mutations in: *
A. Aquaporin-1 gene
B. Aquaporin-2 gene
C. Vasopressin V1 receptor
D. vasopressin V2 receptor

A

Aquaporin-2 gene

45
Q

One of the following is NOT part of the management of diabetic ketoacidosis. *
A. Sodium HC03
only if pH is
<7.2
B. Initial
hydration fluid
of hypertonic
3% NaCl
C. Administration
of glucose (5%
soln in 0.2 N
saline)
D. Give K+ added
after the initial
20ml/kg if UO
is adequate

A

Initial
hydration fluid
of hypertonic
3% NaCl

46
Q

The following are main features of Diabetic Ketoacidosis (DKA) EXCEPT: *
A. ketonuria
B. venous pH <7.20
C. serum HCO3<15 mEq/L
D. ketonemia (serum ketones >3 mmol/L)
E. hyperglycemia (glucose usually >300
mg/dL)

A

venous pH <7.20
???

47
Q

It is the most common recessive form of Multiple Pituitary Hormone Deficiency (MPHD). *
A. Mutations in PTX2
B. Mutations in PROP1
C. Mutations in POU1F1
D. Mutations in POU1F2

A

Mutations in PROP1

48
Q

The definitive diagnosis of growth hormone deficiency is the demonstration of:
A. high levels of IGF1
B. High levels of GH
C. Low levels of GH
D. Low levels of IGF1

A

Low levels of GH

49
Q

The thyroid hormones are transported in plasma bound to thyroxine-binding globulin (TBG), a
glycoprotein synthesized in the liver. TBG binds approximately 70% of T4 and 50% of T3. TBG
level increase with administration of : *
A. estrogens
B. androgens
C. glucocorticoids
D. nicotinic acid
E. l-asparaginase

A

estrogens

50
Q

Extracellular fluid volume is
regulated by this mechanism. *
a. Potassium intake and secretion
b. Potassium intake and excretion
C. Sodium intake and secretion
d. Sodium intake and excretion

A

Sodium intake and excretion

51
Q

The following are true in the
management of severe
Hyponatremia: *
a. Fluid restriction
b. Raise serum Na+ @ 0.5mEq/L/Hr using
isotonic 3% NaCl
C. Do emergency fluid challenge when
serum sodium is <130 meq/L
d. Raise serum Na+ no higher than 12
mEq/L/24hrs with hypertonic 3% NaCl

A

Raise serum Na+ no higher than 12
mEq/L/24hrs with hypertonic 3% NaCl

52
Q

A consequence of Radioactive iodine
Ablation in patients with Grave’s
disease would be: *
a. Hashimoto’s thyroiditis
b. Permanent hypothyroidism
C. Transient diabetes insipidus
d. Transient hypoparathyroidism

A

Permanent hypothyroidism

53
Q

In systemic dehydration, the
intravascular volume characterized
as: *
a. Low
b. High
C. Normal
d. Very high

A

LOW

54
Q

The following are TRUE of Type 1
Diabetes Milletus EXCEPT: *
a. utilization of glucose by muscle and fat
decreases
b. dependent on insulin to prevent
metabolic alkalosis
C. Due to autoimmmune destruction of
pancreatic B cells
d. if uncontrolled, would lead to a nonlabored,
rapid breathing

A

dependent on insulin to prevent
metabolic alkalosis

55
Q

The diagnosis of diabetes insipidus
is established when: *
3. Serum osmolality is >200; urine
osmolality is <200
b. Serum osmolality is >300; urine
osmolality is >300
C. Serum osmolality is <200; urine
osmolality is >200
d. Serum osmolality is >300; urine
osmolality is <300

A

Serum osmolality is >300; urine
osmolality is <300

56
Q

Diagnostic criteria for Diabetic
Milletus includes the following
EXCEPT: *
a. FBS>126mg/dL
b. RBS > lOOmg/dL
C. HbAlcof>6.5%
d. 2-hour plasma glucose of 200mg/dL

A

RBS > lOOmg/dL

57
Q

This is the mainstay for the
management of Central Diabetes
Insipidus. *
3. Pitressin
b. Fluid therapy
C. Desmopressin
d. Caloric load for osmotic load

A

Fluid therapy

58
Q

The following are true of
Pheochromocytoma EXCEPT: *
a. the lesion involve the right kidney
b. Sx-free in between attacks of HPN
C. Most common site is the adrenal cortex
d. Surgical removal is the mainstay of
management

A

Most common site is the adrenal cortex

59
Q

Vasopressin insufficiency is found in
what condition? *
a. Central Diabetes insipidus
b. Genetic Nephrogenic Diabetes Insipidus
C. Acquired Nephrogenic Diabetes Insipidus
d. Both Genetic, Acquired Nephrogenic
Diabetes Insipidus

A

Central Diabetes insipidus

60
Q

The triphasic response mechanism
involved after a surgery or trauma is as follows : *
a. Transient Diabetes insipidus —
Permanent Diabetes insipidus—
Syndrome of Inappropriate ADH
secretion
b. Syndrome of Inappropriate ADH
secretion — Transient DI — Permanent
DI
C. Transient DI— SIADH — Permanent DI
d. Permanent DI— SIADH — Transient DI

A

Transient DI— SIADH — Permanent DI

61
Q

This is the main goal for the
treatment of Nephrogenic Diabetes
insipidus. *
3. Diuretics
b. Treat underlying problem
C. Provide enough calories
d. High dose Desmopressin

A

Treat underlying problem

62
Q

Excessive urine excretion and
excessive thirst are common clinical
manifestations in the following
EXCEPT: *
3. Primary polydipsia
b. Cushing syndrome
C. Pheochromocytoma
d. Maturity onset Diabetes of the Young

A

Cushing syndrome

63
Q

A patient had recently a
meningococcal infection and manifested the following : muscular
weakness, malaise, anorexia,
nausea, vomiting, wt loss, with saltcraving.
On PE, there are highly
pigmented- skin creases, mucosa, scars. The definitive test to confirm
diagnosis is: *
3. Catecholamine levels
b. Water deprivation test
C. Single-dose Dexamethasone Suppression
Test
d. Cortisol levels before and after ACTH
administration

A

Cortisol levels before and after ACTH
administration

64
Q

A 2-month old appears to be having inadequate weight gain. His mother claims that he is constipated. On PE, he has decreased muscle tone, a
large fontanel, a large tongue, an
umbilical hernia. The drug of choice
for this patient is: *
a. PTU
b. Levothyroxine
C. Desmopressin
d. Hydrocortisone

A

Levothyroxine

65
Q

A 12- year old female has a 6-month
history of hyperactivity with declining
school performance. Although her
appetite is increased , she doesn’t
gain weight. PE showed mild
exopthalmos, slight tremors of the
fingers and a neck mass. The following are true for this case EXCEPT:
a. LowTSH
b. Thyroxine is increased
C. Thyroid Receptor Antibody confirms the
diagnosis
d. Aside from PTU, may give Carbimazole
Dtent) as treatment

A

Aside from PTU, may give Carbimazole
Dtent) as treatment

66
Q

A 2-month old appears to be having
inadequate weight gain. His mother
claims that he is constipated. On PE,
he has decreased muscle tone, a
large fontanel, a large tongue, an
umbilical hernia. The earliest
manifestation of this patient would
have been: *
3. Hypotonia
b. Cold, mottled skin
C. Prolonged physiologic j aundice
d. Edematous genitalia, extremities

A

Prolonged physiologic j aundice

67
Q

Vasopressin release is stimulated by
this process: *
3. Decreases in plasma tonicity
b. Increases in plasma tonicity
C. Decreases in urine volume
d. Increases in urine volume

A

Increases in plasma tonicity

68
Q

Match the following defects with the
corresponding types of Nephrogenic DI. *

Receptor mutations of Vasopressin 2

Direct on the Aquaporin-2 gene

Processing mutations of Aquaporin-2 gene

A
69
Q

MATCHING TYPES

A
70
Q
A

PEDIA (4 decks)

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