Endocrinology Flashcards
Which of the following connections are consistent with the principle of positive feedback:
a. T3 – TSH
b. Estradiol – LH
c. Ca – PTH
d. Plasma osmolality – AVP
e. cortisol – ACTH
b. Estradiol – LH
If the hormone travels from the place of creation to the place of action through the lumen of a
hollow organ, this action is called
a. autocrine
b. paracrine
c.lumocrina
d. neuroendocrine
e. classic
c.lumocrina
The following applies to the plasma transfer of hormones:
a. steroid hormones are water soluble and do not require binding to plasma
proteins
b.steroid hormones are not water soluble and require binding to plasma
proteins
c.protein-bound hormone cannot enter the cell and is biologically inactive
d.most peptide hormones are water soluble
e.binding proteins can be specific or nonspecific
b.steroid hormones are not water soluble and require binding to plasma
proteins
c.protein-bound hormone cannot enter the cell and is biologically inactive
d.most peptide hormones are water soluble
e.binding proteins can be specific or nonspecific
Among eicosanoids which doesn’t belongs to them:
a. prostaglandins
b. prostacyclin
c.interleukin
d. leukotriene
e. thromboxane
c.interleukin
Scintigraphy with marked octreotide (octreoscan) is mainly used in diagnostics:
a. Hyperparathyroidism
b. Hypoglycemia
c.Neuroendocrine tumors
d. Osteoporosis
e. Goiters
c.Neuroendocrine tumors
The following statements apply to the synthesis of hormones,except:
a. Peptide hormones are synthesized on ribosomes by translation from specific mRNAs in the
form of preprohormones, which become active after appropriate cleavage of parts of the
molecule
b. Steroid hormones are made from cholesterol, which is first converted into pregnenolone
c. Steroid hormones accumulate in the cells where they are produced and are released only upon a
certain stimulus
d. Most of the steps in steroid synthesis are catalyzed by cytochrome 450 and
dehydrogenase enzymes
e. Nitric oxide (NO) is produced from L-arginine in endothelium, nerve fibers and
macrophages
c. Steroid hormones accumulate in the cells where they are produced and are released only upon a certain stimulus
The hormone travels through the intercellular space - this type of secretion is called:
a.paracrine
b.autocrine
c. classic
d. neurocrine
e. lumocrina
a.paracrine
Prostaglandins are eicosanoids. Choose one answer:
a. True
b. It’s not true
a. True
ACTH and cortisol are examples of hormones that work according to the principle of positive
feedback
a. True
b. It’s not true
b. It’s not true
Which of the complications of long-term glucocorticoid treatment can be prevented
or mitigated by preventive measures?
a. stunted growth in children
b.peptic ulcer
c.osteoporosis
d. inhibition of the pituitary-adrenal axis
e. diabetes
b.peptic ulcer
c.osteoporosis
Side effects of dopamine agonists:
a.Swelling of the nasal mucosa
b.Psychosis
c.Nausea and vomiting
d.Constipation
e.Orthostatic hypotension
All of them
For the hypothalamus the following statement is NOT true:
a. It forms a connection between the CNS and the endocrine regulatory system
b. It consists of the nuclei of neuroendocrine cells
c.The median eminence lies in the uppermost part of the hypothalamus
d. In the hypothalamus there are centers for thirst, satiety, hunger and heat regulation
e. There is a biological clock in the hypothalamus
c.The median eminence lies in the uppermost part of the hypothalamus
Which of the following hormones mainly is not produced in the hypothalamus?
a. Gonadoliberin (GnRH)
b. Oxytocin
c. Somatostatin (STH)
d.Adrenocorticotropin
e. Adiuretin (ADH = vasopressin)
d.Adrenocorticotropin (ACTH)
The diagnosis of syndrome of inadequate secretion of ADH is made with the following…
a.Excessive urinary sodium excretion (>20, often >40 mmol/l)
b.Hyponatremia with correspondingly reduced plasma osmolality
c. The patient is clinically hypovolaemic: orthostasis, tachycardia, decreased skin turgor, dried
mucous membranes
d.Normal functioning of the kidneys, thyroid and adrenal cortex, the patient
has not recently received diuretics
e.Urine osmolality is inappropriately high
a.Excessive urinary sodium excretion (>20, often >40 mmol/l)
b.Hyponatremia with correspondingly reduced plasma osmolality
d.Normal functioning of the kidneys, thyroid and adrenal cortex, the patient
has not recently received diuretics
e.Urine osmolality is inappropriately high
–> The patient is euvolemic
Which statement about the regulation of hypothalamic and pituitary hormones is NOT correct:
a. Thyroliberin (TRH) stimulates prolactin secretion
b. Thyroliberin (TRH) stimulates the secretion of thyrotropin-releasing hormone (TSH)
c.Dopamine stimulates prolactin secretion
d. Somatostatin inhibits the secretion of growth hormone
e. Arginine-vasopressin stimulates the secretion of adrenocorticotropic hormone
(ACTH)
c.Dopamine stimulates prolactin secretion
Which statement about the pituitary gland is NOTcorrect?
a. The pituitary gland, or brain appendage, lies in the sella turcica
b. The pituitary gland weighs up to 1 gram
c. Five types of pituitary cells secrete 6 types of hormones
d.The neurohypophysis arises from Rathke’s sac
e. After disruption of the pituitary stalk, prolactin secretion increases
d.The neurohypophysis arises from Rathke’s sack
Which statement is correct?
a. After a brain injury, the functioning of the pituitary gland is very rarely affected
b.After irradiation of the pituitary gland (due to a tumor), the secretion of prolactin increases
temporarily
c. After disruption of the pituitary stalk, prolactin secretion decreases
d. Dopamine antagonists inhibit prolactin secretion
e. Macroprolactin is an extremely active form of prolactin
b.After irradiation of the pituitary gland (due to a tumor), the secretion of prolactin increases
temporarily
Local symptoms caused by pituitary tumors can include all of the following,except:
a. Temporal epilepsy
b. Liquor
c. Hydrocephalus
d.Affection of the 5th and 9th cranial nerves
e. Drops in the field of view
d.Affection of the 5th and 9th cranial nerves
Which of the following syndromes doesn’t belong to the hypothalamus?
a. Kallman syndrome
b.Marfan syndrome
c. Laurence-Moon syndrome
d. Prader-Willi syndrome
e. Bardet-Biedl syndrome
b.Marfan syndrome
Which pituitary adenomas are the most common?
a.Prolactinomas (lactotropic adenomas)
b. Somatotropic adenomas
c. TSH adenomas
d. Corticotropic (ACTH) adenoma
e. Gonadotropic adenomas
a.Prolactinomas (lactotropic adenomas)
Which of the following statements are consistent with the diagnosis of a pituitary tumor (or do not
exclude it)?
a.diplopia due to damage to the oculomotor nerve
b.loss of vision in one eye
c.discharge of cerebrospinal fluid from the nose
d. normal pituitary test results
e.normal size of the sella turcica on a normal radiograph
d. normal pituitary test results
The morphological cause of hypopituitarism is best determined by:
a. X-ray imaging of the Turkish saddle in two projections
b. CT scan of the hypothalamic-pituitary region
c.MRI of the hypothalamic-pituitary region
d. Scintigraphy with isotopically labeled octreotide
e. Scintigraphy with MIBG
c.MRI of the hypothalamic-pituitary region
What are the most common tumors in the region of the sella turcica?
a. Craniopharyngiomas
b. meningiomas
c. germinomas
d.adenomas
e. breast and lung carcinoma cells
d.adenomas
Pituitary tumors can cause symptoms and signs in a variety of ways. Excluding extremely
rare cases, it is all of the listed conditions except for:
a. increased production of prolactin
b. impaired production of TSH
c. pressure on the optic chiasm
d.liver metastases
e. increased production of growth hormone
d.liver metastases
Pituitary tumors are generally treated surgically first, except:
a. TSH of adenomas
b.Craniopharyngiomas
c.Prolactinomas
d. Somatotropic adenomas
e. Meningiomas
c.Prolactinomas
The listed complications of operative treatment of pituitary tumors via the transsphenoidal route
are very rare,except:
a.Transient diabetes insipidus
b. Hypopituitarism
c. Liquorice
d. Meningitis
e. Newly formed outages in the field of vision
a.Transient diabetes insipidus
Which of the following diseases is characterized by excessive hormone secretion from an
endocrine tumor
a. Graves’ disease
b. Kallman syndrome
c. Addison’s disease
d. hypopituitarism
e.acromegaly
e.acromegaly
Acromegaly is characterized by the following statements:
a. the prevalence of acromegaly is 3-4 patients per million inhabitants
b.mortality in untreated acromegaly is 2-3 times higher than in the general
population
c. the incidence of acromegaly is 50-70 patients per million inhabitants per year
d. acromegaly is diagnosed an average of 9 years after the first symptoms appear
e. men suffer from acromegaly more often than women
b.mortality in untreated acromegaly is 2-3 times higher than in the general
population
Growth hormone (STH) plays an important role in metabolism. What statement is NOT right?
a. STH is an insulin antagonist in glucose metabolism
b.STH inhibits the secretion of insulin from the beta-cells of the pancreas
c. STH inhibits the action of insulin on cells and increases insulin resistance
d. STH is an insulin agonist in protein metabolism, both have an anabolic effect
e. STH is an insulin antagonist in fat metabolism and causes lipolysis
b.STH inhibits the secretion of insulin from the beta-cells of the pancreas
Patients with acromegaly more often have the following complications,except:
a. increased arterial pressure
b. diabetes
c.skeletal muscle atrophy
d. affected heart muscle (cardiomyopathy)
e. sleep apnea syndrome
c.skeletal muscle atrophy
Compared to the general population, patients with acromegaly have more often all of the above, except:
a. carpal tunnel syndrome
b. kidney stones
c. polyposis of the large intestine
d. breathing interruptions during sleep
e.lung carcinoma
e.lung carcinoma
Adrenocorticotropin is produced in the hypothalamus.
a. True
b. It’s not true
b. It’s not true
When do we find decreased gonadotropins?
a. Primary ovarian carcinoma
b. Klinefelter
c. Kallman
c. Kallman
The following biochemical features are often observed in patients with acromegaly,
except:
a. Increased concentration of IGF-1
b. Decrease in growth hormone (STH) concentration during OGTT below 0.4
mcg/L
c. Increased serum phosphate concentration
d. Increased calciuria
e. Impaired glucose tolerance
b. Decrease in growth hormone (STH) concentration during OGTT below 0.4
mcg/L
Which of the following statements is NOTcorrect?
a. Acromegaly is primarily treated by surgical removal of the STH pituitary
adenoma
b.Dopamine agonists normalize growth hormone secretion from STH
pituitary adenoma in 50% of acromegalics.
c. Somatostatin analogues restore normal secretion of growth hormone and IGF-1 in
60-70% of acromegalic patients.
d. Octreotide can cause STH adenoma shrinkage in more than half of patients
with acromegaly.
e. The growth hormone receptor antagonist pegvisomant normalizes the concentration of
IGF-1 and improves the clinical signs of acromegaly in more than 90% of patients, but it
does not reduce the secretion of growth hormone, it can even increase it.
b.Dopamine agonists normalize growth hormone secretion from STH
pituitary adenoma in 50% of acromegalics.
Which of the following statements is characteristic of successfully treated acromegaly:
a.the mortality of patients is reduced and equates to that typical of the general
population
b.after successful pituitary adenoma STH surgery, STH during OGTT decreases
below 0.4 mcg/l
c.conc. IGF-1 is lowered into the normal range for the patient’s age and gender
d.the safe average concentration of STH in the daily profile is less than 1 µg/l
e. if no remnant of the STH adenoma can be seen with magnetic resonance, it means
that acromegaly is definitely cured
a,b,c,d
As part of acromegaly, the patient may have:
a. anosmia
b. arthralgias
c. arterial hypertension
d. increased sweating
e. carpal tunnel syndrome
b. arthralgias
c. arterial hypertension
d. increased sweating
e. carpal tunnel syndrome
Increased prolactin concentration can cause:
a.impotence
b.galactorrhea
c.osteopenia
d.amenorrhea
e. acanthosis nigricans
a.impotence
b.galactorrhea
c.osteopenia
d.amenorrhea
Which of the following could be the cause of increased serum prolactin concentration in a 36-yearold woman?
a.treatment with phenothiazines(dopamine receptor blocker)
b.opioid addiction
c.renal failure
d. ovarian failure
e. hyperthyroidism
a.treatment with phenothiazines(dopamine receptor blocker)
b.opioid addiction
c.renal failure
Known causes of hyperprolactinemia include:
a.estrogen therapy
b.chlorpromazine and haloperidol
c.primary hypothyroidism
d. adrenal insufficiency
e. Cushing’s syndrome
a.estrogen therapy
b.chlorpromazine and haloperidol
c.primary hypothyroidism
d. adrenal insufficiency
There is a biological clock in the hypothalamus. Choose one answer:
a. True
b. It’s not true
a. True
The following statements apply to prolactinomas, except:
a. Prolactinomas are the most common hormonally active pituitary adenomas
b. In unselected autopsies, microprolactinomas have been found in 5-10% of adults
c. Twice as many prolactinomas are found in women than in men
d. As a rule, prolactinomas always cause hyperprolactinemia
e.Prolactin is always secreted only from prolactinomas
e.Prolactin is always secreted only from prolactinomas
The following does NOT apply to prolactin:
a.The normal concentration of PRL is higher in men than in women
b. PRL is secreted in a characteristic day-night rhythm, concentrations are highest at
night. (or during sleep)
c. Estrogens directly influence the secretion of PRL from the pituitary PRL-cells
d. PRL initiates lactation from previously estrogen-treated breasts.
e. PRL accelerates the activation of vitamin D during pregnancy and breastfeeding, thus increasing
the absorption of calcium from food
a.The normal concentration of PRL is higher in men than in women
Prolactin secretion increases in the following conditions:
a.during sleep
b.stress
c.physical exertion
d.during orgasm
e.after disruption of the pituitary stalk
All of them
Which statements are correct?
a.microprolactinomas measure less than 1 cm in diameter
b. prolactinomas can occur as part of multiple endocrine neoplasia type 2
c.microprolactinomas are treated with dopamine agonists
d. prolactinomas are first treated surgically, transsphenoidal surgery is the most
successful method of treatment
e.macroprolactinomas several centimeters in diameter can be reduced to a
few millimeters with bromergocriptine
a.microprolactinomas measure less than 1 cm in diameter
c.microprolactinomas are treated with dopamine agonists
e.macroprolactinomas several centimeters in diameter can be reduced to a
few millimeters with bromergocriptine
Hypopituitarism can be caused by:
a. excessive hormone secretion from an endocrine tumor
b.destruction of the endocrine gland by tumor, trauma or infarction
c. stimulation of the endocrine gland by autoimmune mechanisms
d.destruction of the endocrine gland by autoimmune mechanisms
e. anomalies in the development of the olfactory lobe and surrounding structures
b.destruction of the endocrine gland by tumor, trauma or infarction
d.destruction of the endocrine gland by autoimmune mechanisms
Clinical signs of hyperprolactinemia are all listed except:
a. anovulatory menstrual cycles
b.increased sexual desire in men
c. secondary amenorrhea
d. infertility
e. hypogonadism in men
b.increased sexual desire in men
Prolactin can cause the following signs and symptoms in a woman:
a.headache, loss of vision
b.galactorrhea and amenorrhea
c.hirsutism
d.depression
e.acne
a.headache, loss of vision
b.galactorrhea and amenorrhea
c.hirsutism
d.depression
e.acne
Common manifestations of hypopituitarism are:
a. erythema
b. greasy hair
c. skin hyperpigmentation
d.reduced secondary hair growth
e.fine lines around the eyes and mouth that give the appearance of a prematurely aged face
d.reduced secondary hair growth
e.fine lines around the eyes and mouth that give the appearance of a prematurely aged face
Hypopituitarism is a common consequence of the following diseases and events, except:
a. head injury
b. subarachnoid hemorrhage
c. pituitary and hypothalamic tumors
d.sarcoidosis
e. postpartum pituitary necrosis
d.sarcoidosis
Which of the following signs and symptoms are characteristic of hypopituitarism?
a.sensitivity to cold
b.fatigue that increases throughout the day
c. fatigue that is worst in the morning
d. pronounced excessive hair growth in women
e.numbness and indifference
a.sensitivity to cold
b.fatigue that increases throughout the day
e.numbness and indifference
Patients with hypopituitarism usually do not have:
a. fair thin skin
b. reduced secondary hair growth
c. hyponatremia
d.hyperkalemia
e. low blood pressure
d.hyperkalemia
Panhypopituitarism in a 55-year-old woman will be treated by replacing the following
hormones:
a.hydrocortisone
b.thyroxine
c. triiodothyronine
d.growth hormone
e. gonadotropins
a.hydrocortisone
b.thyroxine
d.growth hormone
A 24-year-old patient, who suffered a head injury three years ago and was in a coma for three days,
was brought to the emergency department this time affected, hypotensive, bradycardic,
dehydrated, fair-skinned, with almost no secondary hair growth. Serum concentration of sodium is
125 mmol/l, potassium 4.1 mmol/l, glucose 3.6 mmol/l. What is the likely diagnosis?
a. post-traumatic syndrome
b.hypopituitary crisis
c. Addison’s disease
d. Hypothyroidism
e. Syndrome of inadequate secretion of adiuretin (arginine-vasopressin)
b.hypopituitary crisis
How would you treat a patient with newly diagnosed hypopituitarism who is in a hypopituitary crisis?
a.hydrocortisone 100 mg iv, then 200-300 mg hydrocortisone in continuous infusion
over 24 hours
b.Thyroxine 50 mcg
c. Hydrocortisone 20 mg in the morning, 10 mg at noon and 5 mg in the late afternoon
d. With testosterone im
e. With growth hormone in high doses sc
a.hydrocortisone 100 mg iv, then 200-300 mg hydrocortisone in continuous infusion
over 24 hours
b.Thyroxine 50 mcg
Which of the following investigations would you choose to demonstrate a pituitary microadenoma?
a. measurement of serum prolactin concentration
b. visual field inspection
c. computed tomography with simultaneous injection of a contrast medium
d.magnetic resonance imaging with simultaneous injection of gadolinium
e. insulin tolerance test
d.magnetic resonance imaging with simultaneous injection of gadolinium
Which of the following statements is NOT true?
a. Hypophysitis is usually of an autoimmune etiology
b. During the acute phase of hypophysitis, prolactin secretion increases
c.Autoimmune inflammation always simultaneously affects the adeno- and neurohypophysis
d. Autoimmune antibodies can be directed against only one type of
adenohypophysis cell, most often against ACTH cells
e. Autoimmune hypophysitis, similar to autoimmune thyroid diseases, occurs
more often after childbirth
c.Autoimmune inflammation always simultaneously affects the adeno- and neurohypophysis
Which of the following statements is NOT true in principle?
a. With human recombinant growth hormone (hrSTH) we treat children who are
behind in growth due to a lack of STH
b. hrSTH is used to treat adult patients with panhypopituitarism who have
pronounced clinical signs of STH deficiency and have been shown severe STH
deficiency with an insulin tolerance test
c. With hrSTH, we treat all critically ill patients in intensive care units who are
in a catabolic state
d. Treatment with hrSTH is contraindicated in patients with malignant disease
e. Treatment with hrSTH increases muscle mass through its anabolic effect, and
by stimulating lipolysis it reduces the amount of fat tissue, especially visceral
fat
c. With hrSTH, we treat all critically ill patients in intensive care units who are
in a catabolic state
A 40-year-old patient, who underwent surgical removal of a large hormonally inactive
pituitary adenoma, has postoperative panhypopituitarism with pronounced clinical signs of
deficiency of all adenohypophyseal hormones. How will we treat the patient in the long term?
a.with maintenance doses of hydrocortisone 10 mg in the morning, 5 mg after 5 hours and 5 mg
after 4 hours
b.with thyroxine 50 to 200 mcg in the morning on an empty stomach
c.with a testosterone preparation
d.with gonadotropin injections if we intend to stimulate spermatogenesis.
During this period, testosterone will be discontinued
e. with 3 tablets of growth hormone in the evening before going to bed
a.with maintenance doses of hydrocortisone 10 mg in the morning, 5 mg after 5 hours and 5 mg
after 4 hours
b.with thyroxine 50 to 200 mcg in the morning on an empty stomach
c.with a testosterone preparation
d.with gonadotropin injections if we intend to stimulate spermatogenesis.
During this period, testosterone will be discontinued
The syndrome of inappropriate AVP (adiuretin) secretion (SNIAVP) is true of the following
except:
a. SNIAVP is a common cause of hyponatremia
b. Patients with SNIAVP are normovolemic
c. SNIAVP is characterized by a disproportionately high concentration of AVP with
reduced plasma osmolality
d. SNIAVP is often caused by drugs, especially psychiatric drugs
e.Urinary sodium excretion is reduced below 20 mmol/l in hyponatremia
e.Urinary sodium excretion is reduced below 20 mmol/l in hyponatremia
The syndrome of inadequate secretion of AVP (SNIAVP) is demonstrated by the following
findings:
a.normal hydration status, hyponatremia with reduced plasma osmolality
b.urine osmolality is inappropriately high relative to plasma osmolality
c. let’s confirm hypothyroidism and hypocorticism
d.excessive urinary sodium excretion despite hyponatremia
e.normal thyroid, kidney and adrenal function
a.normal hydration status, hyponatremia with reduced plasma osmolality
b.urine osmolality is inappropriately high relative to plasma osmolality
d.excessive urinary sodium excretion despite hyponatremia
e.normal thyroid, kidney and adrenal function
A patient with bronchial carcinoma has syndrome of inadequate secretion of adiuretin –
AVP (SNIAVP). How do we act?
a. we prescribe him ethanol
b. we prescribe him phenytoin
c. he is prescribed desmopressin
d. We prescribe him a thiazide
e.limit his daily fluid intake to 500-750 ml
e.limit his daily fluid intake to 500-750 ml
Which approaches are incorrect in the treatment of chronic syndrome of inadequate
secretion of AVP (adiuretin) - SNIAVP caused by an inoperable arachnoid cyst?
a.limit fluid intake to 500-750 ml/day
b.maintain a serum sodium concentration of around 130 mmol/l
c.infusion of 1 molar NaCl solution is given to the patient only if he has pronounced
threatening clinical signs of hyponatremia
d. we advise him to regularly drink alcoholic beverages
e.if conventional measures fail, nephrogenic diabetes insipidus is induced by
administration of demeclocycline
d. we advise him to regularly drink alcoholic beverages
Syndrome of inadequate secretion of AVP (adiuretin) does NOT occur in:
a. Lung cancer
b. Brain abscess
c. Meningitis
d. Delirium tremens
e.Hyperthyroidism
e.Hyperthyroidism
An ACTH-secreting pituitary microadenoma was successfully removed from a patient with
Cushing’s disease using a transsphenoidal approach. At home he will need:
a.hydrocortisone 20-30 mg daily
b. hydrocortisone 100 mg daily
c. hydrocortisone 100 mg daily and levothyroxine 0.1 mg daily
d. hydrocortisone 100 mg daily and adiuretin 2 x 1 drop
e. none of the above
a.hydrocortisone 20-30 mg daily
Man with headache, increased PRL and impotence. We also measured PEG-PRL (PRL treated
with polyethylene glycol = pegylated PRL), which is normal. What do we do?
a.MRI of the pituitary gland and treatment with dopaminergic agonists
b. It is indirect hyperprolactinemia, so we conclude that it is a hormonally inactive tumor
c. We repeat the MRI every 1 year
d. It is indirect hyperprolactinemia, so we conclude that it is a hormonally active
tumor
a.MRI of the pituitary gland and treatment with dopaminergic agonists
What is NOT a sign of hypopituitarism?
a. sensitivity to cold
b. fatigue that increases throughout the day
c.fatigue that is worst in the morning
d.pronounced excessive hair growth in women
e. numbness and indifference
c.fatigue that is worst in the morning
d.pronounced excessive hair growth in women
Which pituitary tumors are usually treated surgically first?
a. TSH adenomas
b. Craniopharyngioma
c. Somatotropic adenomas
d. Meningiomas
a. TSH adenomas
b. Craniopharyngioma
c. Somatotropic adenomas
d. Meningiomas
Congenital hypogonadotropic hypogonadism is often associated with:
a. Excessive hormone secretion from an endocrine tumor
b. Destruction of the endocrine gland by autoimmune mechanisms
c. Destruction of the endocrine gland by tumor, trauma or infarction
d. Stimulation of the endocrine gland by autoimmune mechanisms
e.Anomaly of the olfactory lobe and surrounding structures of the CNS
e.Anomaly of the olfactory lobe and surrounding structures of the CNS
Which of the statements below is NOT correct? Hyperprolactinemia causes in women:
a. Menstrual cycle disorders and infertility
b. Mental changes
c. hirsutism
d. Acne
e.Primary osteoporosis
e.Primary osteoporosis
We define the cause of hypogonadism in a 23-year-old man. Which of the following findings
most convincingly speaks in favor of primary testicular disease?
a. Decreased number of sperm and their motility
b. Eunuchoid habitus
c. Loss of libido and sexual potency
d. Anosmia
e.Increased concentrations of LH and FSH
e.Increased concentrations of LH and FSH
Which pituitary gland tumor is the most common cause of hormonal imbalance?
a. Adenoma
b. Glioma
c. Germinoma
d. Craniopharyngioma
e. Rathke’s pouch cyst
a. Adenoma
Congenital hypogonadotropic hypogonadism is often associated with excessive
hormone secretion from an endocrine tumor. Choose one answer:
a. True
b. It’s not true
b. It’s not true
Hypoparathyroidism most often occurs as a result of chronic kidney disease. Choose
one answer:
a. True
b. It’s not true
b. It’s not true
Obese people have a higher risk of developing the following complications except:
a.hypothyroidism
b. hiatal hernias
c. diabetes
d. arterial hypertension
e. restrictive ventilation disorders
a.hypothyroidism
An adult person should consume approximately daily (we excrete 100 micrograms/day)
a. 150 milligrams of iodine
b.150 micrograms of iodine
c. 500 milligrams of iodine
d. 500 micrograms of iodine
e. 150 grams of iodine
b.150 micrograms of iodine
It plays the most important role in regulating the functioning of the thyroid gland
a. ACTH
b. PRL
c.TSH
d. FSH
e. STH
c.TSH
Which statement is NOT true about hyperthyroidism?
a. cardiac output increases
b. peripheral vascular resistance decreases, therefore diastolic blood pressure decreases
c. Supraventricular arrhythmias are common
d.ventricular arrhythmias are common
e. heart work increases
d.ventricular arrhythmias are common
Which statement is NOT true of hypothyroidism?
a. the skin is cold and dry
b. patients are lethargic, sleepy
c. heart sounds may be quieter
d. movements and speech are slowed down
e.heart failure is common
e.heart failure is common
Hyperthyroidism due to thyroid disease is characterized by the following laboratory findings:
a.decreased TSH, increased free T4, increased free T3
b. elevated TSH, normal free T4, normal free T3
c. decreased TSH, decreased free T4, decreased free T3
d. increased TSH, decreased free T4, decreased free T3
e. increased TSH, increased free T4, increased free T3
a.decreased TSH, increased free T4, increased free T3
Basedow disease is characterized by:
a. absence of antibodies against thyroglobulin (antiTg) and thyroid peroxidase
(antiTPO)
b.the presence of TSI antibodies that stimulate the TSH receptor
c. it is more common in men
d. there is never any sign of eye involvement
e. it most often appears for the first time at a late age
b.the presence of TSI antibodies that stimulate the TSH receptor
Which statement is NOT true of Basedow?
a.the thyroid gland is reduced
b. the thyroid gland is diffusely enlarged
c. the thyroid gland has a harder consistency
d. a murmur may be present (auscultation)
e. humming (palpation) may be present
a.the thyroid gland is reduced
Thyrostatics are characterized by:
a. their effectiveness is independent of the intracellular amount of iodine
b.their side effect can be agranulocytosis
c. they do not pass into the thyroid cell
d.we start treating patients with Basedow with them
e. they are used to treat patients with hyperthyroidism due to autonomic tissue
b) agranulocytosis
d.we start treating patients with Basedow with them
Thyroid orbitopathy is considered to be:
a. extrathyroidal manifestation of thyroid carcinoma
b. extrathyroidal manifestation of goiter
c. extrathyroidal manifestation of subacute thyroiditis
d.extrathyroidal manifestation of Basedow
e. extrathyroidal manifestation of autonomic tissue
d.extrathyroidal manifestation of Basedow
Most thyroid hormones are bound to transport proteins in the blood. Choose one
answer:
a. True
b. It’s not true
a. True
Hashimoto’s thyroiditis applies to:
a. it is more common in men
b.it is more common in women
c.antibodies against thyroid peroxidase (antiTPO) are often elevated
d. TSH receptor (TSI) antibodies are often elevated
e.the disease is autoimmune
b.it is more common in women
c.antibodies against thyroid peroxidase (antiTPO) are often elevated
e.the disease is autoimmune
The following applies to the treatment of the hypothyroid phase of Hashimoto’s thyroiditis:
a. we use thyrostatics
b.we use L-thyroxine
c. treatment is started with very high doses
d. patients need regular check-ups with a thyrologist
e. the dose is adjusted to the concentration of antibodies against thyroid peroxidase
(antiTPO)
b.we use L-thyroxine
A 45-year-old woman reports malaise, fever, neck pain radiating to the jaw and ear.
The thyroid is very painful on palpation. Subacute thyroiditis is suspected. Which
combination of laboratory findings is characteristic of the acute phase of subacute
thyroiditis?
a.greatly increased sedimentation
b.normal or marginally increased leukocytes, normal differential blood count
c. normal sedimentation
d. strongly increased leukocytes, shift to the left in the differential blood picture
e.decreased TSH, increased thyroid hormone
a.greatly increased sedimentation
b.normal or marginally increased leukocytes, normal differential blood count
e.decreased TSH, increased thyroid hormone
Acute thyroiditis is characterized by:
a. viral inflammation of the thyroid gland
b.bacterial inflammation of the thyroid gland
c. a very common disease
d. thyroid painless
e. patient unaffected
b.bacterial inflammation of the thyroid gland
Euthyrotic nodular goiter is characterized by: ENDEMIC GOITHER
a. we must treat all patients
b. treatment with L-thyroxine is very effective and is often used
c. thyroid surgery has no complications
d. L-thyroxine treatment is not required after thyroid surgery
e.it can also be treated with radioactive iodine
e.it can also be treated with radioactive iodine
The following statements apply to the effects of amiodarone on the thyroid gland:
a.contains a large amount of iodine
b. has a short elimination half-life from the body
c.it is similar in structure to thyroid hormones
d.is a source of iodine overload even after treatment has stopped
e. causes only one type of hyperthyroidism
a.contains a large amount of iodine
c.it is similar in structure to thyroid hormones
d.is a source of iodine overload even after treatment has stopped
It is used to treat hyperthyroidism due to an excess of iodine
a. radioactive iodine
b.thyrostatics in high doses
c.perchlorate(inhibits the entry of iodine into the sweat glands)
d. L-thyroxine
e. Iodide
b.thyrostatics in high doses
c.perchlorate
A 50-year-old patient, who has been taking amiodarone for several years, became tired, sleepy,
gained weight, and his skin became dry and cold. Hypothyroidism is diagnosed clinically and
laboratory. What are the next steps?
a.we start treating him with L-thyroxine
b. we start treating him with a thyrostatic
c. discontinue amiodarone
d.we do not discontinue amiodarone
e. we start treating him with glucocorticoids
a.we start treating him with L-thyroxine
d.we do not discontinue amiodarone
Autonomic tissue in the thyroid gland is characterized by:
a.is caused by a mutation in the gene for the TSH receptor or G protein
b. it is under the influence of normal regulatory mechanisms
c. it is more common in areas with adequate iodine supply
d. the development of autonomic tissue is very rapid
e. taking more iodine does not worsen hyperthyroidism
a.is caused by a mutation in the gene for the TSH receptor or G protein
For treatment with radioactive iodine (131I) applies:
a.beta rays cause cell necrosis
b.gamma rays represent a source of radiation exposure for the patient and the surrounding area
c.the treatment is safe
d. patients do not need to be monitored after treatment
e. we can also treat pregnant women and nursing mothers
a.beta rays cause cell necrosis
b.gamma rays represent a source of radiation exposure for the patient and the surrounding area
c.the treatment is safe
In hyperthyroid crisis, mortality is:
a. between 5 and 10%
b. between 10 and 15%
c.between 20 and 50%
d. above 80%
e. negligible with modern treatment
c.between 20 and 50%
A hyperthyroid crisis is characterized by:
a. hypothermia
b.hyperthermia
c.heart rhythm disorders
d. constipation
e.vomiting, diarrhea
b.hyperthermia
c.heart rhythm disorders
e.vomiting, diarrhea
A hypothyroid crisis is characterized by:
a. we start treating it with low doses of L-thyroxine
b. we start treating it with high doses of L-thyroxine iv
c. the clinical diagnosis is immediately clear
d. we meet her often
e. mortality is low
b. we start treating it with high doses of L-thyroxine iv
The following statements apply to hypothyroidism:
a.it is rarely encountered, it depends on the level of health care
b. hypotension with tachycardia is characteristic
c. treatment is started with low doses of L-thyroxine iv
d.glucocorticoids are also added to the treatment
e.the clinical picture is similar to cerebrovascular insult or poisoning
a)
d.glucocorticoids are also added to the treatment
e.the clinical picture is similar to cerebrovascular insult or poisoning
The following groups of drugs can be used in the treatment of hyperthyroid crisis:
a.thiamazole
b.propylthiouracil
c.beta blockers
d.glucocorticoids
e.Lugol’s solution
a.thiamazole
b.propylthiouracil
c.beta blockers
d.glucocorticoids
e.Lugol’s solution
Which statements are correct?
a.most thyroid hormones are bound to transport proteins in the blood
b. Most thyroid hormones are free in the blood
c. Only bound thyroid hormones are effective in tissues
d.Only free thyroid hormones are effective in tissues
e.triiodothyronine (T3) is more effective in cells than tetraiodothyronine (T4)
f. Tetraiodothyronine (T4) is more effective in cells than triiodothyronine (T3)
g.Thyroid hormones are necessary for normal brain development
a.most thyroid hormones are bound to transport proteins in the blood
d.Only free thyroid hormones are effective in tissues
e.triiodothyronine (T3) is more effective in cells than tetraiodothyronine (T4)
g.Thyroid hormones are necessary for normal brain development
The characteristics of hyperthyroidism are
a. dry and cold skin
b.Warm and moist skin
c.Palpitations
d.Losing weight
e.Sweating
f. Poor cold tolerance
g.Restlessness
b.Warm and moist skin
c.Palpitations
d.Losing weight
e.Sweating
g.Restlessness
A 60-year-old female patient noticed a swelling on the lower side of the neck, right above the collarbone. The
swelling has been growing for the past 3 months. It doesn’t hurt. He’s breathing harder and harder. We
suspect that she has a thyroid nodule. What diagnostic procedures should a specialist perform in such a
patient?
a.Inspection and palpation of the thyroid and neck
b.Thyroid ultrasound
c. X-ray imaging of the cervical spine
d.X-ray imaging of the trachea
e.Ultrasound-guided fine-needle biopsy
f.Thyroid scintigram with 99mTc
a.Inspection and palpation of the thyroid and neck
b.Thyroid ultrasound
d.X-ray imaging of the trachea
e.Ultrasound-guided fine-needle biopsy
f.Thyroid scintigram with 99mTc
Which statement applies to malignant thyroid tumors?
a. Malignant thyroid tumors are very common malignancies
b. Papillary thyroid cancer has the most malignant course
c. Papillary thyroid cancer is the least common thyroid tumor
d.Patients with anaplastic thyroid cancer mostly die a few months after
diagnosis
e. Men have malignant thyroid tumors more often than women
d.Patients with anaplastic thyroid cancer mostly die a few months after
diagnosis
In which medical conditions are the jugular veins often excessively filled?
a. Thyroid gland enlarged to stage I
b. Thyroid gland enlarged to stage II
c.Thyroid enlarged to stage IV
d.Tricuspid valve insufficiency
e.Right-sided heart failure
f. Subacute thyroiditis
c.Thyroid enlarged to stage IV
d.Tricuspid valve insufficiency
e.Right-sided heart failure
Basedow (Graves’ disease) is caused by:
a. excessive hormone secretion from an endocrine tumor
b. destruction of the endocrine gland by tumor, trauma or infarction
c.stimulation of the endocrine gland by autoimmune mechanisms
d. destruction of the endocrine gland by autoimmune mechanisms
e. anomalies of the olfactory lobe and surrounding structures
c.stimulation of the endocrine gland by autoimmune mechanisms
Hyperthyroidism due to thyroid disease is characterized by the following laboratory findings:
a.decreased TSH, increased free T4, increased free T3
b. elevated TSH, normal free T4, normal free T3
c. decreased TSH, decreased free T4, decreased free T3
d. increased TSH, decreased free T4, decreased free T3
e. increased TSH, increased free T4, increased free T3
a.decreased TSH, increased free T4, increased free T3
What is not true of thyroid orbitopathy?
a.Basedow and thyroid orbitopathy do not need to be treated
b.Patients with thyroid orbitopathy can smoke
c.Thyroid orbitopathy is never treated surgically
d. in the acute phase, we use immunosuppressive drugs
e.Treatment with radioactive iodine cannot stop the progression of
orbitopathy
a.Basedow and thyroid orbitopathy do not need to be treated
b.Patients with thyroid orbitopathy can smoke
c.Thyroid orbitopathy is never treated surgically
e.Treatment with radioactive iodine cannot stop the progression of
orbitopathy
Which statements about thyroid hormones are true:
a.thyroid peroxidase (TPO) is involved in the formation of thyroid hormones
b.the thyroid produces more T4 than T3
c.T4 is formed from two molecules of diiodotyrosine
d.the first step in the formation of thyroid hormones is the synthesis of monomer and
dimer
e. the enzyme p450 desmolase is involved in the formation of thyroid hormones
a.thyroid peroxidase (TPO) is involved in the formation of thyroid hormones
b.the thyroid produces more T4 than T3
c.T4 is formed from two molecules of diiodotyrosine
d.the first step in the formation of thyroid hormones is the synthesis of monomer and
dimer
What is characteristic of subacute thyroiditis:
a.increased sedimentation
b. strongly increased leukocytes
c.palpable painful thyroid gland in the acute phase
d.ultrasound enlarged thyroid gland with hypoechoic findings
e. thyroid hormones are decreased in the acute phase, TSH is normal
a.increased sedimentation
c.palpable painful thyroid gland in the acute phase
d.ultrasound enlarged thyroid gland with hypoechoic findings
Which of the following endocrine diseases does not usually cause amenorrhea?
a.Primary hyperparathyroidism
b. Hypothyroidism and hyperthyroidism
c. Addison’s disease
d. Congenital adrenal hyperplasia and Cushing’s syndrome
e. Virilizing tumors of the adrenal glands and ovary
a.Primary hyperparathyroidism
Primary hyperparathyroidism can be complicated by:
a.kidney stones
b. gallstones
c.osteoporosis
d.depression
e. diarrhea
a.kidney stones
c.osteoporosis
d.depression
What activates TSH receptors on thyroid cells?
a. Triiodothyronine
b.TSH
c. Stimulatory antibodies against the TSH receptor
d. hCG
b.TSH
c. Stimulatory antibodies against the TSH receptor
d. hCG
What can be found in thyroid orbitopathy?
a. Exophthalmos
b. Feeling of sand in the eyes
c. Retraction of the eyelids
d. A feeling of tension behind the eyeball
a. Exophthalmos
b. Feeling of sand in the eyes
c. Retraction of the eyelids
d. A feeling of tension behind the eyeball
Which tests are performed on all patients with hyperthyroidism?
a. Thyroid ultrasound
b. Scintigraphy
c. Antibodies
d. Thyroglobulin
e. Thyroid puncture
a. Thyroid ultrasound
c. Antibodies
What do we get with hypothyroidism due to thyroid disease:
a. High TSH, normal/low T3 and T4
b. Other incorrect combinations
a. High TSH, normal/low T3 and T4
What are the typical findings in imaging examinations that indicate a greater possibility of malignant
formation in the thyroid gland:
a. Scintigraphically hot
b.Not sharply limited
c.Growing
d.Scintigraphically cold
e.Ultrasound hypoechoic
b.Not sharply limited
c.Growing
d.Scintigraphically cold
e.Ultrasound hypoechoic
To treat excessive thyroid function (hyperthyroidism), we use:
a. I-124
b.I-131
c. I-125
d. Tc-99m
e. I-123
b.I-131
Hypercalcemia with elevated PTH can occur in:
a. Vitamin D poisoning
b. Treatment with thiazide diuretics
c. Ca lung
d. Tuberculosis
e.Primary hyperparathyroidism
e.Primary hyperparathyroidism
Which drug is indicated for the treatment of subacute thyroiditis?
a. Propylthiouracil
b. Methimazole
c. Radioactive iodine
d.Methylprednisolone
e. Amoxicillin
d.Methylprednisolone
A 40-year-old patient with fatigue and weight loss is suspected of having primary
adrenal insufficiency (Addison’s disease). Which of the given data would increase the
probability of this disease?
a.family history of autoimmune thyroid diseases
b.localized areas of hypopigmentation on the skin
c.orthostatic hypotension
d. basal value of ACTH 7 pmol/l
e.cortisol concentration 209 nmol/l 60 minutes after the application of synthetic
ACTH
a.family history of autoimmune thyroid diseases
b.localized areas of hypopigmentation on the skin
c.orthostatic hypotension
e.cortisol concentration 209 nmol/l 60 minutes after the application of synthetic
ACTH
A 25-year-old patient was admitted to the hospital for planned inguinal hernia surgery.
His blood pressure was measured at 170/105. He had a history of previous episodes of
sweating, palpitations, and headaches, so pheochromocytoma was suspected. Which of
the following statements are correct?
a. after the operation, it will be necessary to do tests to rule out secondary
hypertension
b.determinations of catecholamines and their metabolites in urine before surgery
are necessary
c. it is necessary to do a stimulation test with glucagon
d. information about essential hypertension in the family excludes the possibility of pheochromocytoma
e.the presence of hypokalemia does not exclude pheochromocytoma
b.determinations of catecholamines and their metabolites in urine before surgery
are necessary
e.the presence of hypokalemia does not exclude pheochromocytoma
A 38-year-old patient with android obesity, red stretch marks on the abdomen and thighs,
and hypertension was referred to an endocrinologist due to suspicion of hypercorticism. She
was given a short 1 mg dexamethasone test; at 11 p.m. she took 1 mg of dexamethasone, the
next morning the cortisol concentration was 386 nmol/l (normally below 100 nmol/l). The
most appropriate and rational next diagnostic procedure is:
a. computed tomography imaging of the sella turcica
b. adrenal hissing with computed tomography
c. determination of 17-hydroxy and 17-ketosteroids in urine
d.2 day 2 mg dexamethasone test
e. adrenal scintigraphy with labeled cholesterol
d.2 day 2 mg dexamethasone test
In the treatment of acute adrenal gland failure:
a.start with a dose of 100 mg hydrocortisone iv
b. Ringer lactate is used as the infusion solution
c. the dose of hydrocortisone in 24 hours should be 1000-1500 mg
d. we start reducing the dose of hydrocortisone only after a week of treatment
e.in the first 24 hours, the patient usually needs 4-6 liters of fluids
a.start with a dose of 100 mg hydrocortisone iv
e.in the first 24 hours, the patient usually needs 4-6 liters of fluids
The following statements apply to pheochromocytoma:
a.in malignant pheochromocytomas, alpha-methyl-tyrosine can be used for
treatment(particularly resistant forms)
b.alpha receptor blockers are used in preparation for pheochromocytoma
surgery
c.we also use beta receptor blockers in preoperative preparation
d. the diagnosis of pheochromocytoma can be established already on the basis of the clinical picture
e. determination of plasma catecholamines is more specific, but also more time-consuming,
compared to urinary catecholamines
a.in malignant pheochromocytomas, alpha-methyl-tyrosine can be used for
treatment(particularly resistant forms)
b.alpha receptor blockers are used in preparation for pheochromocytoma
surgery
c.we also use beta receptor blockers in preoperative preparation
Which of the following statements about Addison’s disease is not true?
a. The prevalence of the disease is 40-60 patients per million inhabitants
b. The peak incidence of the disease is between the ages of 30 and 40
c.The most common cause is lung cancer metastases
d. Clinical signs of the disease appear when 90% of the cortex of both adrenal glands is destroyed
e. Today, autoimmune etiology is more common than tuberculosis
a. The prevalence of the disease is 40-60 patients per million inhabitants
c.The most common cause is lung cancer metastases
For adrenalectomy with drugs, which is considered for preoperative preparation of
severely affected patients or in inoperable patients with Cushing’s syndrome
(ectopic Cushing), we most often use:
a.metyrapone
b. spironolactone
c. bromocriptine
d. cyproheptadine
e. dexamethasone
a.metyrapone
Which of the listed laboratory indicators is NOT present in a patient with severe
adrenal insufficiency?
a. elevated serum urea concentration
b. increased concentration of serum potassium
c.elevated serum glucose concentration
d. decreased serum sodium concentration
e. eosinophilia
c.elevated serum glucose concentration
Which of the following statements is NOT true of congenital adrenal hyperplasia
(CAH)?
a. it is the result of congenital disorders in the synthesis of cortisol
b. is primarily a disease of childhood
c. serum ACTH concentration is elevated
d.21-hydroxylase defect is the rarest form of CAH
e. the possibility of CAH is suspected in younger patients of short stature
d.21-hydroxylase defect is the rarest form of CAH
The adrenal cortex secretes:
a.glucocorticoids
b. calcitonin
c. catecholamines
d.mineralocorticoids
e.androgens
a.glucocorticoids
d.mineralocorticoids
e.androgens
In a patient with Cushing’s syndrome, we can find:
a. hypotension
b.round face
c.vertebral fractures
d. hypoglycemia
e. weight loss
b.round face
c.vertebral fractures
Acute adrenal failure is treated with:
a.infusions of 5% glucose in physiological solution
b.high doses (200-300 mg/24h) of hydrocortisone in infusion
c. growth hormone
d. with the addition of calcium and vitamin D
e. diet
a.infusions of 5% glucose in physiological solution
b.high doses (200-300 mg/24h) of hydrocortisone in infusion
The following statements are true for iatrogenic Cushing’s syndrome:
a.it is caused by the therapeutic use of synthetic glucocorticoids
b. a very rare form of Cushing’s syndrome
c.even low systemic doses of glucocorticoids can cause Cushing’s syndrome
d.the pituitary-adrenal axis is often suppressed in such patients
e. local application of synthetic glucocorticoids is more dangerous than systemic application
a.it is caused by the therapeutic use of synthetic glucocorticoids
c.even low systemic doses of glucocorticoids can cause Cushing’s syndrome
d.the pituitary-adrenal axis is often suppressed in such patients
In a patient with Addison’s disease, we can determine:
a.Hypotension
b.occasional nausea and vomiting
c.dark pigmentation of the skin and mucous membranes
d.fatigue
e.weight loss
All of them
In the case of incidentally discovered tumors of the adrenal glands (incidentalomas), we try
to answer 2 key questions:
a.whether the tumor is hormonally active
b. or is it a congenital disorder
c. or is it related to the symptom for which the patient underwent imaging
d.or there is a high probability that it is an adrenal carcinoma or a tumor from
elsewhere
e. whether the patient is interested in further processing
a.whether the tumor is hormonally active
d.or there is a high probability that it is an adrenal carcinoma or a tumor from
elsewhere
A hypertensive 27-year-old man was sent for examination to identify a nodule in the thyroid
gland. The patient’s grandmother, father and one of the brothers had thyroid carcinoma. The
sister and aunt died due to unexplained complications during minor surgical procedures.
Which of the following abnormalities is likely to be found in the patient?
a.hypocalcemia
b. hypoglycemia
c. increased concentration of serum T3
d. increased serum prolactin concentration
e.increased concentrations of catecholamines and/or their metabolites in urine
a.hypocalcemia
e.increased concentrations of catecholamines and/or their metabolites in urine
In primary aldosteronism
a. peripheral edema is usually present
b.characterized by diastolic hypertension
c.polyuria and polydipsia are possible
d. diabetes is usually present
e. hypertension is associated with hyperreninemia
b.characterized by diastolic hypertension
c.polyuria and polydipsia are possible
Which statement about primary aldosteronism is not true?
a. Aldosterone concentration is increased
b.Peripheral renin activity is increased
c. Peripheral renin activity is inhibited
d. Hypokalemia is not always present
e. Patients have arterial hypertension
b.Peripheral renin activity is increased
Which statements about primary aldosteronism (PA) are correct?
a.The cause of PA is an adenoma of the adrenal cortex
b.PA can be caused by hyperplasia of the adrenal cortex
c.PA is a potentially curable cause of arterial hypertension
d. Adrenal carcinoma cannot secrete aldosterone
e. glucocorticoids cannot treat any form of primary aldosteronism
a.The cause of PA is an adenoma of the adrenal cortex
b.PA can be caused by hyperplasia of the adrenal cortex
c.PA is a potentially curable cause of arterial hypertension
Which statement about primary aldosteronism (PA) is not true?
a. The prevalence among patients with arterial hypertension is much higher than 2%
b. The diagnosis is established by evidence of increased aldosterone concentration and
suppressed renin activity, at least on two occasions
c. Investigations for evidence of PA must be done in younger patients with difficult-tocontrol arterial hypertension
d.PA most often occurs in old age
e. The cause of hypokalemia is increased kaliuria under the influence of aldosterone, which stimulates the
reabsorption of sodium from the urine
d.PA most often occurs in old age
Aldosterone is a hormone of the adrenal cortex, which applies except:
a. in the distal renal tubules, it allows the reabsorption of sodium from the urine in exchange for
potassium and hydrogen ions
b. excessive secretion of aldosterone causes hypervolemia and arterial
hypertension
c. aldosterone causes heart muscle damage and fibrosis
d.hypokalemia directly stimulates aldosterone secretion
e. spironolactone inhibits mineralocorticoid receptors and aldosterone action
d.hypokalemia directly stimulates aldosterone secretion
The following statements apply to pheochromocytoma, except:
a. Patients with pheochromocytoma have characteristic attacks of increased arterial pressure,
tachycardia, pallor, sweating
b. A third of patients have persistently increased arterial pressure without attacks
c. Many patients with pheochromocytoma die suddenly before they are
diagnosed
d. It occurs sporadically or in familial syndromes
e.Pheochromocytoma is never a malignant tumor
e.Pheochromocytoma is never a malignant tumor
All of the above can be found in patients with pheochromocytoma, except:
a. Increased excretion of catecholamines, metanephrines and/or normetanephrines in the
urine
b. Increased concentrations of metanephrines and normetanephrines in plasma
c. Decreased blood volume due to constant vasoconstriction
d.Hypoglycemia
e. Orthostatic hypotension
d.Hypoglycemia
Pheochromocytoma is proven and localized with the following tests, except:
a. By determining catecholamines and their metabolites in 24-hour urine
b. By determining the plasma concentration of metanephrines and normetanephrines
c.With radioactive iodine-cholesterol scintigraphy
d. With a CT scan of the abdomen
e. By meta-iodo-benzyl-guanidine (MIBG) whole-body scintigraphy
c.With radioactive iodine-cholesterol scintigraphy
The following statements apply to adrenal cortex carcinoma, except:
a. Adrenocortical carcinoma has a poor prognosis
b. Patients may have signs of Cushing’s syndrome
c. Women with adrenocortical carcinoma may lose their periods and become
androgenized
d.Adrenocortical carcinoma always secretes hormones
e. Rare adrenal cortical carcinoma secretes mineralocorticoids
d.Adrenocortical carcinoma always secretes hormones
The following statements are true of Cushing’s syndrome except:
a. In more than half of the patients, the cause of the ACTH disease is a pituitary adenoma, so they
have Cushing’s disease
b. The cause of the disease can be an adenoma of the adrenal cortex
c.ACTH secretion is greatly increased in a patient with adrenocortical carcinoma
that secretes cortisol autonomously
d. Carcinoids, small cell carcinomas of the lung, and some other tumors can
secrete ACTH and cause ectopic ACTH-dependent Cushing’s syndrome.
e. In ectopic ACTH-dependent Cushing’s syndrome, the concentration of ACTH is
usually very high, and patients often have hypokalemia
c.ACTH secretion is greatly increased in a patient with adrenocortical carcinoma
that secretes cortisol autonomously
Primary adrenal cortex failure (Addison’s disease) is most often caused by:
a. excessive hormone secretion from an endocrine tumor
b. destruction of the endocrine gland by tumor, trauma or infarction
c. stimulation of the endocrine gland by autoimmune mechanisms
d.destruction of the endocrine gland by autoimmune mechanisms
e. anomalies of the olfactory lobe and surrounding structures
d.destruction of the endocrine gland by autoimmune mechanisms
Hormonally inactive, low-malignant tumor of the adrenal glands is characterized by:
a. On MRI > 20 HU
b. Aldosterone/plasma renin ratio (PRA) > 1
c. Larger than 4 cm
d. No metabolites of catecholamines are found in urine and plasma 2x
e. None of the above
e. None of the above
For a patient with sudden increases in blood pressure, palpitations, sweating attacks, pallor and
dizzinessis what is valid?
a.He may have pheochromocytoma
b. We can immediately prescribe him a beta-blocker
c. we prescribe an alpha-blocker
d. We can immediately prescribe him a calcium channel blocker
e. We will determine his catecholamines and their metabolites in the urine
f. He may have a paraganglioma
a.He may have pheochromocytoma
c. we prescribe an alpha-blocker
d. We can immediately prescribe him a calcium channel blocker
e. We will determine his catecholamines and their metabolites in the urine
f. He may have a paraganglioma
Which of the following should we expect in a patient with severe adrenal insufficiency?
a. Impaired glucose tolerance
b. Elevated CRP
c.Eosinophilia
d. Thrombocytosis
e. Increased serum sodium concentration
c.Eosinophilia
Hormonally inactive adrenal tumors with high malignant potential have the
following characteristics:
a. Cortisol suppression after 1 mg DMT below 50 nmol/l
b. Aldosterone/PRA ratio > 1
c. 2x normal catecholamines and their metabolites in a 24-hour urine sample
d. Size > 4 cm
e. Attenuation (HU) units on native CT image > 20
a. Cortisol suppression after 1 mg DMT below 50 nmol/l
c. 2x normal catecholamines and their metabolites in a 24-hour urine sample
d. Size > 4 cm
e. Attenuation (HU) units on native CT image > 20
The most common tumor of the adrenal glands is:
a. Adrenocorticotropic carcinoma
b. Myelolipoma
c. Outgrowths of other carcinomas
d. Pheochromocytoma
e. Adenoma
e. Adenoma
Even low systemic doses of glucocorticoids can cause Cushing’s syndrome.
Choose one answer:
a. True
b. It’s not true
a. True
In the treatment of acute adrenal gland failure, we start with a dose of 100 mg of
hydrocortisone IV Choose one answer:
a. True
b. It’s not true
a. True
Most of the steps in steroid synthesis are catalyzed by cytochrome 450 and
dehydrogenase enzymes. Choose one answer:
a. True
b. It’s not true
a. True
Steroid hormones are water soluble. Therefore, they do not require binding to plasma
proteins. Choose one answer:
a. True
b. It’s not true
b. It’s not true
In primary aldosteronism, peripheral renin activity is increased. Choose one
answer:
a. True
b. It’s not true
b. It’s not true
Which feature of an adrenal adenoma is most important for its confirmation on a
CT scan?
a. Low intracellular fat content, attenuation values above 10 HE
b. Slow washout of the contrast agent
c. High intracellular fat content, attenuation values below 10 HU
d. Size under 2 cm
e. Sharp limitation in relation to the surrounding structures
c. High intracellular fat content, attenuation values below 10 HU
What is the first test of choice to identify adrenal gland lesions
a. Computed tomography (CT) without contrast
b. Ultrasound
c. Computed tomography (CT) with a contrast agent
d. Ultrasound with a contrast medium
e. Magnetic resonance examination
a. Computed tomography (CT) without contrast
The following statements apply to multiple endocrine neoplasia type II (MEN II):
a.the syndrome is inherited in an autosomal dominant manner
b.type IIa includes thyroid medullary Ca, pheochromocytoma, parathyroid
adenoma
c.marfanoid habit belongs to type IIb
d.type IIa is prognostically more favorable than type IIb
e.the syndrome is caused by a mutation of the proto-oncogene on chromosome 10
All of them
Characteristic findings in type I multiple endocrine neoplasia (MEN) include:
a. sex-linked recessive mode of inheritance
b.hypercalcemia, hypergastrinemia, and hyperprolactinemia
c. medullary thyroid carcinoma, pheochromocytoma and parathyroid adenoma
d. neurofibromas, pheochromocytoma and medullary thyroid carcinoma
e.insulinoma, pituitary adenoma and parathyroid adenoma
b.hypercalcemia, hypergastrinemia, and hyperprolactinemia
e.insulinoma, pituitary adenoma and parathyroid adenoma
The following statement applies to autoimmune polyglandular syndrome (APS):
a. Type I APS is a rare autosomal dominant disease
b.it is caused by a mutation in the AIRE (“autoimmune regulator”) gene
c. in type II there is no association with HLA alleles
d. the clinical picture differs in principle from that of individual gland involvement
e. APS is more common in men than women
b.it is caused by a mutation in the AIRE (“autoimmune regulator”) gene
As part of autoimmune polyglandular syndrome type I, the following diseases
occur, except:
a. Addison’s disease
b. Hypoparathyroidism
c. Chronic mucocutaneous candidiasis
d.Myasthenia gravis
e. Early menopause
d.Myasthenia gravis
The following statements apply to Turner syndrome:
a.typical karyotype is 45, X0
b. stunting begins only after puberty
c.among the distinguishing features is a skin fold on the neck - pterygium
d.coarctation of the aorta occurs more often
e. diabetes and thyroiditis occur less frequently than in the healthy population
a.typical karyotype is 45, X0
c.among the distinguishing features is a skin fold on the neck - pterygium
d.coarctation of the aorta occurs more often
In a patient with polycystic ovary syndrome, we will most likely also find:
a. a lower voice, increased muscle mass, clitoral hypertrophy and a greatly increased
serum testosterone concentration
b.oligomenorrhea, obesity, increased conc. LH and normal conc. FSH
c. amenorrhea, acne, low concentrations of LH and FSH
d. hirsutism, increased concentrations of ketosteroids in urine
e. hirsutism, normal menstrual cycle and normal conc. LH and FSH in serum
b.oligomenorrhea, obesity, increased conc. LH and normal conc. FSH
In a patient with an androgenizing ovarian tumor, we will most likely also find:
a. a lower voice, increased muscle mass, clitoral hypertrophy and a greatly
increased serum testosterone concentration
b. oligomenorrhea, obesity, increased conc. LH and normal conc. FSH
c.amenorrhea, hirsutism, low concentrations of LH and FSH
d. hirsutism, increased excretion of catecholamines in the urine
e. hirsutism, normal menstrual cycle and normal conc. LH and FSH in serum
a. a lower voice, increased muscle mass, clitoral hypertrophy and a greatly
increased serum testosterone concentration
c.amenorrhea, hirsutism, low concentrations of LH and FSH
Absolute or relative contraindications for hormone replacement therapy after
menopause are all conditions, except:
a. tumors dependent on estrogens or gestagens
b. active thromboembolic disease
c. severe uncontrolled arterial hypertension
d. severe liver disease
e.hypercholesterolemia
e.hypercholesterolemia
In the diagnosis of amenorrhea, it is appropriate to measure the concentration of prolactin.
a. True
b. It’s not true.
a. True
Which statement about the ovary is NOT correct?
a. the basic unit of the ovary is the egg follicle with the female germ cell the ovum
b. the follicle is surrounded by two layers of cells – theca cells and granulosa cells
c. Luteotropin (LH) acts on theca cells, they secrete the androgens testosterone and
androstenedione
d. follitropin (FSH) acts on the granulosa cells, estradiol and estrone are formed in them from
androgens that were formed in the run
e.progesterone is a hormone secreted by the egg cell
e.progesterone is a hormone secreted by the egg cell
Disorders of the menstrual cycle manifest themselves in different forms. Which of the following
statements is not true?
a.Amenorrhea means absence of menstruation for more than 3 months
b. In oligomenorrhea, the intervals between periods are 6 weeks to 6 months
c. Primary amenorrhea means that a girl 16 years of age or older has not yet had
menarche
d. Secondary amenorrhea means the absence of menstruation for more than 6 months in a
woman who previously had menstruation
e. Physiological amenorrhea occurs in girls before puberty, in pregnant and lactating
mothers and in women after menopause
a.Amenorrhea means absence of menstruation for more than 3 months
Amenorrhea is defined by the following procedures, except?
a. history of previous menstrual bleeding, onset of menarche, and lifestyle
b. clinical and gynecological examination, we calculate the body mass index
c. determine the gonadotropins LH, FSH,
d. determine the concentration of prolactin and thyrotropin and, if necessary, the androgenic
hormones testosterone, androstenedione and DHEAS
e.determine the concentration of growth hormone and IGF-1
e.determine the concentration of growth hormone and IGF-1
Which of the following endocrine diseases does not usually cause amenorrhea?
a.Primary hyperparathyroidism
b. Hypothyroidism and hyperthyroidism
c. Addison’s disease
d. Congenital adrenal hyperplasia and Cushing’s syndrome
e. Virilizing tumors of the adrenal glands and ovary
a.Primary hyperparathyroidism
The following statements apply to hypothalamic amenorrhea (HA), except:
a. It is the most common hypogonadotropic amenorrhea and is functional in
most cases
b. Functional HA is caused by long-term stress, weight loss(anorexia), excessive
physical activity
c. Organic HA occurs after damage to the hypothalamus due to tumor growth,
injury, subarachnoid hemorrhage, or infection
d.In HA, the concentrations of gonadotropins LH and FSH are increased
e. A rare congenital form of HA is Kallmann syndrome, which results from
impaired embryonic development of gonadoliberin-secreting GnRH neurons
d.In HA, the concentrations of gonadotropins LH and FSH are increased
The following statements apply to ovarian amenorrhea (OA), except:
a. Gonadotropin concentrations are increased in OA
b. Absence of one X chromosome causes gonadal agenesis in Turner syndrome
c. OA may be present in polycystic ovary syndrome
d. Autoimmune inflammation of the ovaries causes OA and premature menopause
e.Patients with OA do not require treatment
e.Patients with OA do not require treatment
A 22-year-old patient has not had a period for 4 years. She got her menarche at the age of 13,
periods were regular until the age of 17, then they started to disappear. It is at the age of 17
the patient lost 15 kg, now she maintains her weight at 50 kg, her height is 172 cm, BMI is 17. She
runs 10 km every day and eats a healthy mixed diet. What results do you expect, what is the
diagnosis?
a.the concentration of gonadotropins will be low or low normal, FSH will be greater than
LH
b. the concentration of estradiol will be in the normal range for the luteal phase of the cycle
c.the progesterone test will be negative
d.the patient has functional hypothalamic amenorrhea
e. the patient has anorexia nervosa
a.the concentration of gonadotropins will be low or low normal, FSH will be greater than
LH
c.the progesterone test will be negative
d.the patient has functional hypothalamic amenorrhea
The following statements apply to premature menopause, except:
a. It means ovarian failure in the early reproductive period after a woman has
had a normal menstrual cycle
b. FSH concentration is increased
c.The cause of premature ovarian failure is always discovered
d. Among the iatrogenic causes of premature menopause, chemotherapy or irradiation of this
abdominal area predominate
e. Patients need replacement with estrogens and progestogens until the age of
50
c.The cause of premature ovarian failure is always discovered
The following statements are true about polycystic ovary syndrome (PCOS), except:
a. PCOS is the most common hormonal disorder in women during their childbearing years
b. PCOS is the most common cause of infertility in women with menstrual cycle
disorders
c. Patients have clinical (hirsutism, male pattern baldness, acne) and/or
laboratory signs of androgenization
d.Most PCOS patients are thin
e. PCOS patients may have elevated LH and normal FSH
d.Most PCOS patients are thin
Polycystic ovary syndrome (PCOS) is diverse and may present with the following signs and
symptoms, except:
a. PCOS patients are prone to obesity, more than half of them are obese
b. Weight gain worsens the clinical signs of the disease
c.Patients have increased sensitivity of peripheral tissues to insulin
d. Patients often develop impaired glucose tolerance and type 2 diabetes
e. Patients have several risk factors for cardiovascular diseases
c.Patients have increased sensitivity of peripheral tissues to insulin
Patients with polycystic ovary syndrome are treated with the following measures, except:
a. By changing your lifestyle: regular physical activity and slow weight loss
b.We establish a regular menstrual cycle with dopamine agonists
c. With drugs to improve insulin sensitivity, e.g. with metformin
d. The androgen receptor inhibitor spironolactone affects the signs of
androgenization
e. Ovulation is stimulated with clomiphene citrate or gonadotropins
b.We establish a regular menstrual cycle with dopamine agonists
A 35-year-old patient has amenorrhea, hypoestrogenemia and elevated
gonadotropin levels, most likely it is:
a. menopause
b.premature ovarian failure
c. Kallman syndrome
b.premature ovarian failure
In oligomenorrhea, the intervals between periods are 4-6 weeks. If menstruation is
delayed for longer than weeks, we are talking about secondary amenorrhea.
a. True
b. It’s not true
b. It’s not true
Autoimmune inflammation of the ovaries causes premature menopause.
a. True
b. It’s not true
a. True
Karyotype 47,XXY was found in a 23-year-old man with gynecomastia. This patient most
likely also has:
a. pathological liver tests
b. decreased concentrations of LH and FSH
c. high serum estrogen concentrations
d. azoospermia
e. enlarged testicles
c. high serum estrogen concentrations
d. azoospermia
We define the cause of hypogonadism in a 23-year-old man. Which of the following findings
speaks in favor of primary testicular disease?
a. anosmia
b. eunuchoid habitus
c. increased concentrations of LH and FSH
d. loss of libido and sexual potency
e. reduced number of sperm and their motility
c. increased concentrations of LH and FSH
A 34-year-old man was referred for an examination due to infertility. Clinical
examination reveals tall stature, obesity, bilateral gynecomastia, and small, hard
testicles. Which of the following tests would confirm infertility?
a. leukocyte karyotype
b. testicular biopsy
c. seminal fluid analysis
d. response to human chorionic gonadotropin stimulation
e. response to gonadoliberin stimulation
c. seminal fluid analysis
The following statements apply to fashion:
a. the testis is the male sex gland, consisting of the seminiferous tubules and the
interstitium
b. spermatogenesis takes place in the seminiferous tubules, which is an exocrine function of the testicles
c. the interstitium with Leydig cells is an endocrine and paracrine part of the testes
d. Sertoli cells secrete testosterone
e. Leydig cells provide support and nutrition to the germ cells in the seminiferous
tubules
a. the testis is the male sex gland, consisting of the seminiferous tubules and the
interstitium
b. spermatogenesis takes place in the seminiferous tubules, which is an exocrine function of the testicles
c. the interstitium with Leydig cells is an endocrine and paracrine part of the testes
The following statements apply to the Sertoli cells of the testes,except:
a. they provide support and nutrition to the germ cells in the seminiferous tubules
b. Sertoli cells are affected by the hormones testosterone and follitropin
c. Sertoli cells control the maturation and migration of germ cells
d. Sertoli cells secrete inhibin
e. Sertoli cell secretion of inhibin stimulates the pituitary gland to secrete FSH
e. Sertoli cell secretion of inhibin stimulates the pituitary gland to secrete FSH
The following statements apply to the Leydig cells of the testes,except:
a. Leydig cells make up 10-20% of the interstitial volume in the testes
b. They synthesize and secrete androgenic hormones, especially testosterone
c. Testosterone is secreted in a characteristic diurnal rhythm with the highest values in the
morning
d. Leydig cells stimulate the secretion of luteinizing hormone (LH) from the pituitary
gland
e. The pituitary hormone LH stimulates the Leydig cells to secrete testosterone
d. Leydig cells stimulate the secretion of luteinizing hormone (LH) from the pituitary
gland
The following statements apply to the male sex hormone testosterone,except:
a. Testosterone is secreted by Leydig cells into the blood and into the lumen of the seminiferous tubules
b. Testosterone is a polypeptide hormone
c. Most circulating testosterone is bound to sex hormone binding globulin
(SHBG) and is inactive
d. Only a small proportion of circulating testosterone is free and active
e. Testosterone is activated to dihydrotestosterone (DHT) in cells that have the
enzyme 5-alpha reductase and binds to its nuclear receptor
b. Testosterone is a polypeptide hormone
What effects does testosterone have?
a. in embryonic development it induces the development of epididymis, vas deferens
and accessory gonads
b. dihydrotestosterone stimulates the development of the external genitalia (penis,
scrotum)
c. at physiological concentrations, testosterone inhibits spermatogenesis
d. causes secondary body hair
e. reduces muscle mass and bone strength
a. in embryonic development it induces the development of epididymis, vas deferens
and accessory gonads
b. dihydrotestosterone stimulates the development of the external genitalia (penis,
scrotum)
d. causes secondary body hair
The following statements about spermatogenesis are correct,except:
a. Spermatogenesis is the process of formation and maturation of spermatozoa
b. Spermatogenesis lasts 64 days
c. Sperm - the spermatozoon matures 12 days after its release into the lumen of the
seminiferous tubule during transport through the epididymis
d. Sperm has a diploid number of chromosomes
e. Spermatocytes are transformed into haploid spermatids by meiosis
d. Sperm has a diploid number of chromosomes
Disorders in the functioning of the testicles can be manifested by the following signs,except:
a. with infertility - azoospermia
b. absence of puberty
c. eunuchoid physique
d. with osteoporosis
e. with short stature
e. with short stature
Male hypogonadism is characterized by:
a. impaired secretion of testosterone or insensitivity of target tissues to
testosterone
b. reduced secondary hair growth
c. gynecomastia
d. decreased libido and potency
e. hot flushes
All of them
The following statements apply to primary hypogonadism in men,except:
a. in primary hypogonadism, the function of the testicles is primarily impaired
b. primary hypogonadism means that hypogonadism developed before
puberty
c. in a patient with primary hypogonadism, the concentrations of FSH and LH are increased
d. A common form of primary hypogonadism is Klinefelter’s syndrome
e. A synonym for primary hypogonadism is hypergonadotropic hypogonadism
b. primary hypogonadism means that hypogonadism developed before
puberty
The causes of primary hypogonadism in men are all listed,except:
a. congenital absence of testicles or anorchy
b. testicular loss due to tumor injury or surgery
c. testicular damage from chemotherapy or radiation
d. disturbed migration of GnRH neurons and absent secretion of gonadoliberin
e. a disorder in meiotic division (non-disjunction) and as a result three sex
chromosomes – XXY
d. disturbed migration of GnRH neurons and absent secretion of gonadoliberin
A normal result of the ejaculate satisfies the following criteria,except:
a. volume > 2ml
b. pH 7.2-8.8
c. sperm concentration of 20 million/ml or more
d. motile sperm 50% or more
e. leukocytes in the effusion more than 20 million/ml
e. leukocytes in the effusion more than 20 million/ml
Which of the following statements about spermiogram is NOT correct?
a. Aspermia means that there are no sperm in the ejaculate
b. Oligozoospermia means that the sperm count is lower than normal
c. Asthenozoospermia means that sperm motility is less than normal
d. Teratozoospermia means that more than 70% of the sperm are irregularly shaped
e. Cryptozoospermia means that a single sperm is found in the sediment of the
ejaculate
a. Aspermia means that there are no sperm in the ejaculate
Which of the following statements about male infertilitynoright?
a. In hypogonadotropic hypogonadism, spermatogenesis is established with
gonadotropin injections
b. Complete cessation of spermatogenesis cannot be treated
c. In the case of germ cell aplasia (Sertoli-cell-only-syndrome), sperm are obtained
by biopsy of the testicles
d. In a patient with azoospermia and the existence of spermatogenesis in the testicles, sperm are
obtained by biopsy of the testicle
e. Male infertility can be treated by direct injection of the obtained sperm into
the cytoplasm of the oocyte (ICSI method)
c. In the case of germ cell aplasia (Sertoli-cell-only-syndrome), sperm are obtained
An 18-year-old beauty with well-developed breasts, without secondary hair growth, has
not yet had her period. She felt a round lump in her left groin. Ultrasound of the
abdomen shows that there is no uterus, ovaries and fallopian tubes, the vagina is short
and ends blind. Similar induration to the left inguinal one is also found in the right small
pelvis. They find increased testosterone levels in the upper normal range for men and
increased gonadotropin levels. What will be the most likely findings of further
investigations?
a. He has Turner syndrome
b. She has a 46 XY karyotype
c. He has a complete failure of androgen receptors
d. The diagnosis is testicular feminization or Morris syndrome
e. The lumps in the left groin and right in the small pelvis are testicles
b. She has a 46 XY karyotype
c. He has a complete failure of androgen receptors
d. The diagnosis is testicular feminization or Morris syndrome
e. The lumps in the left groin and right in the small pelvis are testicles
If the patient reports signs and symptoms of testosterone deficiency and brings with
him a result of reduced testosterone concentration, we perform the following tests to
define hypogonadism,except:
a. Testosterone concentration is determined again between 7 and 11 o’clock
b. We determine the concentration of gonadotropins LH and FSH
c. We determine the concentration of prolactin, because hyperprolactinemia can cause
hypogonadism
d. We examine the prostate, determine PSA and hemogram
e. We examine the background of the eye
e. We examine the background of the eye
A patient with hypogonadism is treated with testosterone replacement. Which of the following
statementsit is notcorrect?
a. Testosterone is contraindicated in prostate cancer
b. Testosterone is contraindicated with increased hematocrit > 0.52
c. Testosterone can worsen heart failure due to fluid retention
d. Testosterone can make sleep apnea worse
e. Testosterone can worsen osteoporosis
e. Testosterone can worsen osteoporosis
After the age of 40 or even earlier, the secretion of testosterone in a man begins to
gradually decrease, eventually signs of testosterone deficiency develop. What a
statement is NOT correct?
a. The excretion of total testosterone decreases by 1% per year, and free
testosterone by 2-3% per year
b. Testosterone deficiency is manifested by a decrease in libido and potency
c. Signs of testosterone deficiency are a decrease in muscle mass and bone
mineral density and an increase in fat stores
d. The lack of testosterone causes an improvement in a man’s mentalcognitive abilities
e. A lack of testosterone can cause hot flashes and night sweats, as well as
depressed mood
d. The lack of testosterone causes an improvement in a man’s mentalcognitive abilities
Testosterone replacement therapy in the form of injections or skin gel has the following
beneficial effects,except:
a. Increases sexual desire and improves erectile function
b. Increases muscle mass and reduces the amount of fat tissue, especially
visceral, thereby improving metabolic regulation, especially in patients with
metabolic syndrome and type 2 diabetes
c. Improves a man’s mood and cognitive abilities
d. It worsens the depressive state
e. Increases erythropoiesis
d. It worsens the depressive state
Congenital hypogonadotropic hypogonadism is often associated with:
a. excessive secretion of the hormone from the endocrine tumor
b. destruction of the endocrine gland by tumor, trauma or infarction
c. stimulation of the endocrine gland by autoimmune mechanisms
d. destruction of the endocrine gland by autoimmune mechanisms
e. anomaly of the olfactory lobe and surrounding structures of the CNS
e. anomaly of the olfactory lobe and surrounding structures of the CNS
Disorders in the functioning of the testicles are manifested by the following signs:
a. With infertility - azoospermia
b. Absence of puberty
c. Eunuchoid physique
d. With osteoporosis
e. With short stature
a. With infertility - azoospermia
b. Absence of puberty
c. Eunuchoid physique
d. With osteoporosis
The organic part of bone consists of:
a. calcium phosphate
b. osteoblasts
c. osteoclasts
d. collagen
e. hydroxyapatite
b. osteoblasts
c. osteoclasts
d. collagen
The following applies to bone remodeling:
a. involves breaking down and building bones
b. it is a disease process
c. it is a physiological process
d. it only takes place during the growth period
e. it can be influenced by hormones and drugs
a. involves breaking down and building bones
c. it is a physiological process
e. it can be influenced by hormones and drugs
The most common osteoporotic fractures include:
a. ankle
b. the hip
c.vertebra
d. facial bones
e. wrists
b. the hip
c.vertebra
e. wrists
Risk factors for a new osteoporotic fracture include:
a. low bone mineral density
b. old age
c. previous fractures
d. tendency to fall
e. regular consumption of milk and milk products
a. low bone mineral density
b. old age
c. previous fractures
d. tendency to fall
Osteoporosis can be treated with:
a. glucocorticoids
b. vitamin D
c. calcium
d. bisphosphonates
e. iron
b. vitamin D
c. calcium
d. bisphosphonates
Primary hyperparathyroidism can be complicated by:
a. kidney stones
b. gallstones
c. osteoporosis
d. depression
e. diarrhea
a. kidney stones
c. osteoporosis
d. depression
Osteomalacia can be distinguished from osteoporosis due to:
a. bone pain
b. increased calcium in the blood
c. decrease in muscle strength
d. bone deformities
e. too much vitamin D in the blood
a. bone pain
c. decrease in muscle strength
Secondary causes of osteoporosis include:
a. obesity
b. hyperthyroidism
c. high blood pressure
d. plasma cells
e. hyperlipidemia
b. hyperthyroidism
d. plasma cells
Patients with primary hyperparathyroidism usually have:
a. increased calcium
b. elevated phosphate
c. increased parathormone
d. increased alkaline phosphatase
e. increased bilirubin
a. increased calcium
c. increased parathormone
d. increased alkaline phosphatase
Which of the listed diseases, conditions and drugs are among the probable causes of osteomalacia:
a. vitamin D deficiency
b. celiac disease
c. anticonvulsants
d. chronic kidney disease
e. resection of the stomach or part of the small intestine
All of them
Bone mass falls into the area of osteoporosis when it decreases compared to the maximum bone
mass in adulthood by:
a. 1.5 standard deviation
b. 2.0 standard deviation
c. 2.5 standard deviations
d. 3.0 standard deviation
e. 3.5 standard deviations
c. 2.5 standard deviations
Osteomalacia is characterized by the following laboratory constellation:
a. hypercalcemia
b.hypocalcemia
c. hyperphosphatemia
d.hypophosphatemia
e.increased alkaline phosphatase activity
b.hypocalcemia
d.hypophosphatemia
e.increased alkaline phosphatase activity
In the treatment of osteoporosis, inhibitors of bone breakdown (as opposed to accelerators
of new bone formation) include all the listed types of drugs, except:
a. estrogens
b. calcitonin
c.teriparatide
d. bisphosphonates
e. vitamin D
c.teriparatide
Secondary osteoporosis can occur as part of the following diseases:
a. hypogonadism
b. hyperthyroidism
c. hypothyroidism
d. Cushing’s syndrome
e. Hypoparathyroidism
a. hypogonadism
b. hyperthyroidism
d. Cushing’s syndrome
The following statements apply to primary hyperparathyroidism:
a. the disease is more common in women
b. the disease can occur as part of multiple endocrine neoplasia (MEN)
c. the disease is most often caused by a solitary parathyroid adenoma
d. the constellation of hypercalcemia with elevated PTH concentration is diagnostic
e. serum phosphate concentration is usually decreased
All of them
The following statements apply to secondary hyperparathyroidism:
a. in secondary hyperparathyroidism, all four parathyroid glands are usually
enlarged
b. secondary hyperparathyroidism can progress to tertiary
c.serum calcium concentration is always decreased in
hyperparathyroidism
secondary
d. the concentration of serum PTH is usually higher than in primary
hyperparathyroidism
e. serum phosphate concentration is usually decreased
a. in secondary hyperparathyroidism, all four parathyroid glands are usually
enlarged
b. secondary hyperparathyroidism can progress to tertiary
c.serum calcium concentration is always decreased in
hyperparathyroidism
secondary
d. the concentration of serum PTH is usually higher than in primary
hyperparathyroidism
The following statements apply to hypoparathyroidism except:
a. hypoparathyroidism is divided into autoimmune, congenital and acquired
b. hypomagnesemia inhibits PTH secretion
c. hypoparathyroidism is characterized by hypocalcemia and hypophosphatemia
d. in 20% of patients, calcifications in the area of the basal ganglia are visible on CT
e. hypercalciuria with subsequent nephrolithiasis may occur during treatment
c. hypoparathyroidism is characterized by hypocalcemia and hypophosphatemia
The following statements apply to Paget’s disease:
a. pain in the affected bones is characteristic
b. hearing loss due to bone pressure on the auditory nerve is common
c. sarcoma occurs in 1% of patients with symptomatic polyostotic form
d. the best indicator of disease activity is acid phosphatase activity
e. bisphosphonates are mostly used to treat symptomatic disease
A,B,C,E
All statements apply to osteogenesis imperfecta except:
a. the disease is a rare congenital connective tissue disorder
b. the disease is characterized by increased joint mobility
c. the disease may be accompanied by aortic or mitral valve insufficiency
d. radiographically, the disease in adulthood is very similar to osteoporosis
e. the disease is characterized by increased activity of alkaline phosphatase
c. the disease may be accompanied by aortic or mitral valve insufficiency
e. the disease is characterized by increased activity of alkaline phosphatase
A 36-year-old man who had a successful kidney transplant 6 months ago was referred
for the diagnosis of persistent hypercalcemia (2.7-3.0 mmol/L). The measured serum
PTH concentration was greatly increased. Radiograph of the hands shows subperiosteal
resorption. What would be the most appropriate treatment?
a. calcitriol
b. calcium carbonate
c. parathyroidectomy
d. antacids that bind phosphate
e. none of the above
c. parathyroidectomy
Which of the following findings is the most characteristic and diagnostically useful in the X-ray
diagnosis of osteomalacia:
a. generalized bone demineralization
b. subperiosteal bone resorption
c. compression fractures of the spine
d. pseudofractures (Milkman’s lines or Looser’s zones)
e. none of the above
a. generalized bone demineralization
d. pseudofractures (Milkman’s lines or Looser’s zones)
Which of the following is NOT among the laboratory signs of vitamin D deficiency?
a. hypocalcemia
b. hypophosphatemia
c. increased concentration of PTH
d.decreased alkaline phosphatase activity
e. low concentrations of 25-OH-D3 vitamin
d.decreased alkaline phosphatase activity
Which of the following is NOT a risk factor for osteoporosis?
a.Obesity
b. smoking cigarettes
c. taking glucocorticoids
d. increased alcohol intake
e. physical inactivity
a.Obesity
The group of bisphosphonate drugs does NOT include:
a. alendronate
b. ibandronate
c. risedronaţ
d.teriparatide
e. etidronate
d.teriparatide
For which of the following drugs is there no evidence for the prevention of non-vertebral
fractures?
a. alendronate
b. risedronate
c. strontium ranelate
d. raloxifene
e. teriparatide
d. raloxifene
Risedronate is a bisphosphonate. Choose one answer:
a. True
b. It’s not true
a. True
Glucocorticoid osteoporosis is considered to be:
a. does not develop after glucocorticoids in the spray
b. glucocorticoids accelerate resorption, but do not reduce bone formation
c. treatment with bisphosphonates is introduced already at bone mineral density with T less than -1
SD
d. due to the accelerated excretion of calcium, only vit D is added, but not Ca
e. start treatment only if GK administration is planned for > 6 months
a. does not develop after glucocorticoids in the spray
Which of the following statements is correct?
a. every second woman and every fifth man experience a fracture due to osteoporosis after the age
of 50
b. bisphosphonates increase the risk of venous thrombosis
c. vertebral fractures are asymptomatic in 10-15%
d. the number of fractures in people with bone mineral density greater than T= -2.5 SD is
negligibly small
e. US bone measurement is more accurate than DXA measurement
c. vertebral fractures are asymptomatic in 10-15%
A 60-year-old female patient was successfully treated surgically for primary
hyperparathyroidism by removing a solitary parathyroid adenoma. After the operation, a
prolonged period of hypocalcemia developed, during which it was necessary to treat the
patient with high doses of the active form of vitamin D and calcium. After 2-3 months, the
need for vitamin D and calcium decreased, the patient became normocalcemic without
medication. In the case of the described patient, it was most likely:
a. accidental destruction of the other three parathyroid glands
b. removal of the wrong parathyroid gland
c. severe pancreatitis caused by hyperparathyroidism
d. unrecognized pseudohypoparathyroidism
e. severe bone disease (“hungry bones”)
e. severe bone disease (“hungry bones”)
Bone breakdown is reduced by all of the factors listed below, except:
a. parathyroid hormone
b. estrogens
c. calcitonin
d. calcium
e. bisphosphonates
a. parathyroid hormone
Elevated bone alkaline phosphatase is found in (Combination of answers):
a. Osteoporosis
b. Paget’s disease
c. Primary hyperparathyroidism
d. Osteomalacia
e. Hepatitis
f. All of the above
a. Osteoporosis
b. Paget’s disease
c. Primary hyperparathyroidism
Causes of osteomalacia include:
a. Vitamin D deficiency
b. Celiac disease
c. Anticonvulsants
d. Kidney diseases
e. Resection of the stomach or part of the small intestine
All of them
They are characteristic of osteomalacia. Choose one or more answers:
a. pain in the joints
b. worse kidney function
c. weaker muscle strength
d. supraventricular premature beats
e. fragile bones that tend to break in falls
f. hypercalcemia
c. weaker muscle strength
Milkman’s lines are found at
a. Osteomalacia
b. Cushing’s syndrome
c. Pituitary adenoma
d. Bazedovka
e. Hyperprolactinemia
a. Osteomalacia
Causes of nephrogenic diabetes insipidus include:
a. Sheehan syndrome
b. craniopharynx
c. hypercalcemia
d. lithium
e. glibenclamide
c. hypercalcemia
d. lithium
A 23-year-old man was admitted to the hospital for the diagnosis of polyuria.
Diabetes, hypokalemia, hypercalcemia, and renal failure were ruled out. During the
concentration test, the maximum osmolality of urine was 300 mK, while it was
serum osmolality 570 mK. During the concentration test and three hours after desmopressin
administration, the urine osmolality was 307 mK. Which statement is correct?
a. We will treat the patient with dDAVP
b. We will treat the patient with lithium
c.The patient has nephrogenic diabetes insipidus
d. The patient has central diabetes insipidus
e. The patient has psychogenic polydipsia
c.The patient has nephrogenic diabetes insipidus
Diabetes insipidus (DI) is a disease manifested by polyuria (more than 3 l per day) and polydipsia.
The causes of DI can be all of the above except:
a. Deficient secretion of arginine-vasopressin (AVP) (adiuretin)
b. Renal insensitivity to AVP
c. Defective aquaporin tubules in distal renal tubules due to hypercalcemia,
hypokalemia, or lithium
d. Accelerated degradation of AVP in pregnancy
e. Hypothyroidism
e. Hypothyroidism
Which of the following statements about diabetes insipidus (DI) is not true?
a. Central idiopathic DI results from autoimmune inflammation of neurons in the
supraoptic nucleus
b. Idiopathic DI is the most common form of DI
c. Hereditary central DI is more often inherited dominantly and appears in early
childhood
d.Wolfram syndrome presents with DI, uropoietic tract abnormalities,
diabetes, deafness, and gigantism
e. Gestational DI is the result of excessive breakdown of AVP (adiuretin) by the
placental enzyme vasopressinase and resolves after delivery
d.Wolfram syndrome presents with DI, uropoietic tract abnormalities,
diabetes, deafness, and gigantism
Which statements about diabetes insipidus (DI) are correct?
a. symptoms of idiopathic DI appear suddenly, the patient can tell the day and time of
onset of thirst, polyuria and polydipsia
b. DI is characterized by the patient getting up at night, going to the toilet and drinking
c. after surgery in the hypothalamic-pituitary area, DI can occur in three phases -
first the patient has signs of DI, then signs of the syndrome of inadequate
secretion of adiuretin, then DI again.
d. DI is proven by a dilution experiment(concentration)
e. DI is treated with dDAVP (desmopressin) in spray or tablets
A, B, C, E
