Internal Med Flashcards
Competition Q
Patient with adrenal hypofunction and severe infection; treatment
a. Stop cortisol
b. Reduction in cortisol
c. Elevation in cortisol
d. Unchanged cortisol
c. Elevation in cortisol
Cause of Chronic primary adrenal insufficiency
a. Autoimmune adenitis
b. Tuberculosis
c. Amyloidosis
d. Sepsis with adrenal hemorrhage.
a. Autoimmune adenitis
Treatment of hypothyroidism includes…
a. L-thyroxine
b. High-dose radioiodine
c. Propylthiouracyl
d. Any of the above
a. L-thyroxine
Treatment for diabetic nephropathy, EXCEPT
a. Optimize glucose control
b. Optimize blood pressure control
c. Limit protein intake to 0,8-1g/kg/day in early chronic kidney disease
d. Treat with ACE inhibitors and ARB if albuminuria
d. Treat with ACE inhibitors and ARB if albuminuria
Fibrate therapy in dyslipidemia is the most efficient therapy to…
a. Halt the progression of coronary atherosclerosis
b. Decrease triglycerides level
c. Decrease cholesterol level
d. All of the above
b. Decrease triglycerides level
Glucocorticoids effect on protein metabolism
a. Enhance protein catabolism in the periphery
b. Increase amino acid uptake in extrahepatic tissues
c. Decrease amino acid uptake in liver
d. Stimulates lipolysis
a. Enhance protein catabolism in the periphery
Cause of secondary amenorrhea
a. Hypothyroidism
b. Prolactinoma
c. Polycystic ovary syndrome
d. All
d. All
In case of diffuse thyroid tumor, treatment
a. Surgery+high dose of radioiodine+chemotherapy
b. Surgery+chemotherapy+suppressive thyroxine
c. Surgery+high dose radioiodine+suppressive thyroxine
d. Surgery+inhibition of hormone production+chemotherapy
c. Surgery+high dose radioiodine+suppressive thyroxine
Causes of Cushing’s syndrome, EXCEPT
a. Adrenal adenoma
b. Congenital adrenal hyperplasia
c. Ectopic ACTH production
d. ACTH producing tumor in the pituitary
b. Congenital adrenal hyperplasia
Diagnosis of pohechromocytoma is based on…
a. Precutaneous biopsy and histologic evaluation of the tumor
b. Measurement of the plasma norepinephrine level
c. Measurement of the urine epinephrine level
d. Measurement of the urine metanephrine level
d. Measurement of the urine metanephrine level
Prevention of osteoporotic fractures include…
a. Vitamin D and calcium supplementation
b. Biphosphonates
c. PTH analogs
d. Any of the above
d. Any of the above
Absolute indication for insulin therapy, EXCEPT:
a. Significant hyperglycemia (HbA1c >10%)
b. Type 2 diabetes
c. Metabolic decompensation related to infection
d. Allergy to oral anti diabetic drugs
b. Type 2 diabetes
The combination of normal TSH and low fT3/fT4 suggests…
a. Subclinical secondary hyperthyroidism
b. Subclinical hypothyroidism
c. Primary hypothyroidism
d. Non-thyroidal illness
d. Non-thyroidal illness
Effects associated with hypercalcemia, EXCEPT,
a. Constipation
b. Fatigue
c. Nausea
d. Oliguria
d. Oliguria
Osteoporosis
a. T-score > -2,5
b. T-score < -2,5
c. T-score > 2,0
d. T-score < -1,5
b. T-score < -2,5
Mitochondrial diabetes
a. Diabetes + deafness
b. Diabetes Mellitus + Diabetes insipidus
c. Diabetes + Hasimoto thyroiditis
d. Diabetes + renal insufficiency
a. Diabetes + deafness
Autonomous symptoms of hypoglycemia, EXCEPT,
a. Palpitations
b. Tremor
c. Sweating
d. Aggression
d. Aggression
Treatment of hypercalcemia includes
a. Thiazide diuretics
b. Vitamin D supplementation
c. Biphosphonates
d. Decreased fluid intake
c. Biphosphonates
MEN IIA syndrome, EXCEPT:
a. Ovarian cancer
b. Medullary thyroid carcinoma
c. Pheochromocytoma
d. Hyperparathyroidism
a. Ovarian cancer
Dyslipidemia in metabolic syndrome
a. Elevated cholesterol + elevated triglycerides
b. Elevated triglycerides + decreased LDL
c. Elevated cholesterol + decreased LDL
d. Elevated triglycerides + decreased HDL
d. Elevated triglycerides + decreased HDL
Genetic disease that cause primary hypogonadism in male
a. Turner syndrome
b. Marfan syndrome
c. Tourette syndrome
d. Klinefelter syndrome
d. Klinefelter syndrome
Hirsutism in body parts, EXCEPT
a. Breast
b. Lower back
c. Forearm
d. Upper lip
c. Forearm
Metformin
a. First choice in diabetes with impaired kidney function
b. Increases the risk of hypoglycemia
c. May decrease HbA1c by 1-1,5%
d. Associated with significant weight gain
c. May decrease HbA1c by 1-1,5%
Polycystic ovary syndrome, elevation of hormones, EXCEPT
a. FSH
b. LH
c. Androstenedione
d. Insulin
a. FSH
Paracetamol overdose requires… as an antidote.
a. Nothing (as there is no known antidote)
b. N-acetylcystein
c. Active charcoal
d. Flumazenil
b. N-acetylcystein
Syndrome that is NOT associated with hypopituitarism
a. Kallman syndrome
b. Bardet-Biedl syndrome
c. Creutzfeldt-Jakob syndrome
d. Prader-Willi syndrome
c. Creutzfeldt-Jakob syndrome
Specific test for pheochromocytoma
a. Plasma epinephrine
b. Plasma dopamine
c. VMA (vanillyl mandelic acid) excretion in urine
d. Metanephrine excretion in urine
d. Metanephrine excretion in urine
Klinefelter’s syndrome is associated with…
a. Elevated FSH and LH levels
b. Streak gonade
c. Short stature
d. 47, XYY karyotype
a. Elevated FSH and LH levels
Characteristics of hyperthyroidism, EXCEPT:
a. Lack of lateral eyebrows
b. Exophtalmus
c. Pretibial myxedema
d. Loss of weight despite having appetite
a. Lack of lateral eyebrows
Pancreatic cholera is equivalent to:
a. Zollinger-Ellison syndrome
b. Somatostatinoma
c. Werner-Morrison syndrome
d. Waterhouse-Friderichsen syndrome
c. Werner-Morrison syndrome
Diagnostic measures for diabetic ketoacidosis, EXCEPT:
a. Elevated blood glucose at least > 20 mmol/l
b. Arterial pH <7.3 (or 7.35)
c. Plasma bicarbonate < 15 mmol/l
d. Increased anion gap
a. Elevated blood glucose at least > 20 mmol/l
Treatment of hypercalcemia includes
a. Thiazide diuretics
b. Vitamin D supplementation
c. Bisphosphonates
d. Decrease fluid intake
c. Bisphosphonates
A low TSH and normal fT3/fT4 suggests…
a. Secondary hypothyroidism
b. Subclinical hypothyroidism
c. Subclinical hyperthyroidism
d. Non-thyroidal illness
c. Subclinical hyperthyroidism
Acromegaly:
a. Consequence of pre-pubertal excess of GH
b. Accompanied with excess sweating
c. Represents only a cosmetic problem
d. Always requires surgical intervention
b. Accompanied with excess sweating
Thyroid scan molecule
a. Selenium 74
b. Technetium 99
c. Stronium 89
d. Samarium 153
b. Technetium 99
Treatment of prolactinoma
a. Dopamine antagonists
b. Transsphenoidal surgery
c. Radioiodine treatment
d. All
b. Transsphenoidal surgery
Cervical pain is associated with
a. Graves’ disease
b. Chronic lymphocytic thyroiditis
c. Subacute thyroiditis
d. Nodular goiter
c. Subacute thyroiditis
True for diabetic ketoacidosis
a. It is best treated with large dose of subcutaneous insulin
b. Associated with Cheyne-Stokes respiration
c. Complication seen only in DM1
d. None of the above
d. None of the above
Disturbed vision in the following, EXCEPT
a. Amanita phalloides mushroom poisoning
b. Methanol poisoning
c. Digitalis poisoning
d. Botulism
a. Amanita phalloides mushroom poisoning
Most common malignancy in the background of SIADH
a. colorectal carcinoma
b. planocellular carcinoma
c. small cell lung carcinoma
d. multiple myeloma
c. small cell lung carcinoma
Older patients with hyperthyroidism…
a. Often have atrial fibrillation
b. May not show the classical symptoms of sympathetic hyperactivity
c. May present with apathy
d. All of the above
d. All of the above
Treatment of acute attack of gout
a. Loop diuretics
b. Colchicine
c. Allopurinol
d. Antibiotics
b. Colchicine
Depending on the clinical situation, treatment of prolactinoma may include…
a. Bromocriptin, quinagolid
b. Transsphenoidal operation
c. Irradiation
d. Any of the above
d. Any of the above
Tests of pituitary-adrenal responsiveness include…
a. Metyrapone test
b. Insulin hypoglycemia test
c. CRH test
d. All of the above
d. All of the above
