Med 4LQ1 Flashcards
The following are lipid soluble hormone and bind to intracellular nuclear receptors except:
a. TSH
b. Vitamin D
c. Steroid
d. No exception
d. No exception
The following suppresses the TSH synthesis or release except:
a. Somatostatin
b. TRH
c. FT4
d. Dopamine
e. No exception
b. TRH
The hormone that induces Leydig cell testosterone synthesis and secretion
a. LH
b. FSH
c. Activin
d. Inhibin
a. LH
Match the cell expressing a specific anterior pituitary hormone and its target gland
a. Corticotrope–POMC–Adrenal
b. Somatotrope–TSH–Thyroid
c. Lactotrope–PRL–Ovary
d. Gonadotrope–FSH–Breast
a. Corticotrope–POMC–Adrena
The initial trophic hormone to fail in pituitary compression or destruction
a. Adrenocorticotropic hormone
b. Growth hormone
c. Thyroid stimulating hormone
d. Follicle-stimulating hormone
b. Growth hormone
Which of the following screening tests can be used to diagnose Cushing’s disease?
a. Late night salivary cortisol
b. Serum PRL
c. TRH stimulation test
d. Serum IGF-1
a. Late night salivary cortisol
Which of the following clinical features is seen is seen in Multiple Endocrine Neoplasia 1 (MEN1)?
a. Atrial myxoma
b. Foregut carcinoids
c. Schwannomas
d. Pituitary hyperplasia
b. Foregut carcinoids
The most common cause of cushingoid features
a. Pituitary microadenoma
b. Pituitary macroadenoma
c. Adrenal adenoma
d. Iatrogenic
d. Iatrogenic
The following are typical features of chronic cortisol excess, except
a. Thick skin
b. Mania
c. Osteoporosis
d. Proximal muscle weaknes
a. Thick skin
Oral agents with established efficacy in Cushing’s syndrome?
a. Ketoconazole
b. Fluconazole
c. Dexamethasone
d. None of the above
a. Ketoconazole
Least recovery rate of the HPA axis is expected from
a. Ectopic ACTH syndrome (best recovery; 80%)
b. Adrenal cushings (lowest; 40%)
c. Cushings Disease
d. Posterior pituitary Adenoma
b. Adrenal cushings
Clinical features which when present in an individual with diabetes warrants labaroty evaluation for DKA
A. Glucosuria
B. Nauseaandvomiting
C. Tachycardia
D. Lethargy
B. Nauseaandvomiting
The study which provided a definitive proof that reduction in chronic hyperglycemia can prevent or delay
A. DCCT
B. UKPDS
C. Kumamoto
D. NICE-SUGAR
A. DCCT
What is the first physiologic defense against hypoglycemia?
A. Increaseinglucagon(2nd)
B. Increaseinepinephrine(3rd)
C. Decreaseininsulin
D. Increaseincortisol(inprolonged
hypoglycemia)
C. Decrease in insulin
You have been hired by a BPO company to evaluate all its employees as part of a routine annual physical examination. Who among these employees would you recommend to screen for type 2 diabetes?
A. 30-yearoldmalewithBMIof23 kg/m2 and triglyceride level of 200 mg/dL
B. 25-yearoldfemalewithnormalBMI and a cousin known to have diabetes
C. 45-year old without risk factor for T2DM
D. 40-yearoldfemalewithnormalFPG and HBA1c one year ago
C. 45-year old without risk factor for T2DM
The criteria for the diagnosis of diabetes are based on estimates of the threshold for the complications of diabetes. The primary end point used to evaluate the relationship between glucose levels and complications is:
A. Retinopathy
B. Nephropathy
C. Neuropathy
D. Cardiovascular disease
A. Retinopathy
An asymptomatic 52-year old male underwent screening for diabetes with the following results: HBA1c 6.6% (NGSP certified method), fasting plasma glucose 98 mg/dL. What should be the next step?
A. Request for a repeat fasting plasma glucose
B. Repeatbothtestsafteroneyear
C. Request for a repeat HBA1C
D. Start treatment with OHA
C. Request for a repeat HBA1C
68 year old male newly diagnosed with type 2 DM. BMI 31. HbA1c 7.2%. eGFR is below 40 mL/min/1.73 m2. Which of the following medications would be indicated and best initiated in this patient?
a. Metformin 500 mg 2x day
b. Canaglifozin 100 mg once daily
c. Sitagliptin 25 mg once daily
d. Liraglutide 1.2 mg once daily
c. Sitagliptin 25 mg once daily
65 year old female with CAD and history of CHF.
HbA1c 7.4%
eGFR is 50 ml/min/1.73m2
Which of the following medications would you start that would also benefit patient’s cardiovascular problem
a. Metformin
b. Gliclazide
c. Dapagliflozin
d. Liraglutide 3 mg once daily
c. Dapagliflozin
- 28 year old male patient came in with polyuria, weight loss and fatigue. Random blood glucose was 188 mg/dl. What should be the next step?
a. Repeat RBS
b. Start metformin
c. Get 75g OGTT
d. Start insulin
c. Get 75g OGTT
Individuals with type 1 or type 2 DM should be assessed for clinical stability including mentation and hydration of with severe hyperglycemia of
a. > 250 mg/dl
b. > 300 mg/dl
c. > 500 mg/dl
d. HI on a glucometer reading
a. > 250 mg/dl
- Preferred test to measure ketones in DKA
a. Urine ketones
b. Acetoacetate
c. Acetone
d. B-hydroxybutyrate
d. B-hydroxybutyrate
Medication that can induced euglycemia DKA
a. Gliclazide
b. Metformin
c. Sitagliptin
d. Empagliflozin
d. Empagliflozin
Central to the development of type 2 DM
a. Genetic component
b. Insulin resistance and abnormal insulin secretion
c. Environmental factors
d. Obesity
b. Insulin resistance and abnormal insulin secretion
Treatment goals for adults with DM
a. RBS < 200
b. HbA1c < 6.5%
c. BP < 140/90
d. Pre meal HGT 70-120 mg/dl
b. HbA1c < 6.5%
In Type 1 DM, symptoms will appear once pancreatic beta cells are destroyed by
a. 30% b. 50% c. 80% d. 100%
C. 80%
The following defines normal glucose tolerance except 3096
a. fasting plasma glucose <5.6 mmol/L
b. Plasma glucose < 7.9 mmol/l following an oral glucose challenge
c. Random plasma glucose < 11.0 mmol/L
d. HbA1c < 5.7%
a. fasting plasma glucose <5.6 mmol/L
Rate-limiting step that controls glucose regulated insulin secretion 2098
a. Glucose phosphorylation by glucokinase
b. Metabolism of glucose-6-phosphate via glycolysis
c. Inhibition of ATP-sensitive K+ channels leading to beta cell depolarization
d. Opening of voltage-dependent calcium channels to stimulate insulin secretion
a. Glucose phosphorylation by glucokinase
This agent used for treatment of Type 1 and Type 2 Diabetes has a disadvantage of causing flatulence?
a. Biguanides
b. A-glucosidase inhibitors
c. Dipeptidyl peptidase IV inhibitors
d. Sulfonylureas
b. A-glucosidase inhibitors
A regular human insulin has an effective duration of
a. 3-5 hours
b. 4-8 hours
c. 10-16 hours
d. 20-24 hours
b. 4-8 hours
A 55-year old male came in due to fever and lower back pain. On KUB ultrasound, he was noted to have a staghorn calculi. The following organisms are commonly associated with this nephrolithiasis EXCEPT
a. Proteus mirabilis
b. Klebsiella pneumoniae
c. Providencia species
d. Escherichia coli
d. Escherichia coli
A 45 male known diabetic, poor compliance to his insulin, came in to hospital due to nausea and vomiting, consideration was a DKA, what will you do, except
A. Replace fluids 2-3 Lover 1-3h
B. Administer Short acting regular insulin
C. Correct electrolyte abnormality
D. measure blood glucose 3x/day premeals
D. measure blood glucose 3x/day premeals
