Endocrinology Exam Questions

Question 1 of 161

1

Which hormones regulate the levels of calcium in the blood?

Select one of the following:

TSH, fT4, fT3
Cortisol, ACTH
Increase lunch dose of rapid acting insulin
Increase dinner dose of rapid acting insulin
Decrease dose of basal insulin
Decrease breakfast dose of rapid acting insulin
Decrease lunch dose of rapid acting insulin
Decrease dinner dose of rapid acting insulin
No treatment adjustment required
Add Metformin 850 mg/d

Explanation

Question 2 of 161

1

25 y/o pregnant female (26 weeks gestation, 1 pregnancy) complains of low energy, No feeling of thirst. Mother is diagnosed with diabetes mellitus, type 2. Physical evaluation: height - 168cm, weight - 86kg, BP - 116/76 mmHg, HR - 88/min. Blood tests (fasting in the morning, in venus plasma): complete blood count - in normal range, K - 4.4 mmol/l, Creatinine - 70 mmmol/l, glucose - 5.0 mmol/l, urine test - no pathology. What test should be done to confirm the diagnosis?

Select one of the following:

75 g oral glucose tolerance test at 0, 60 and 120 min
No further evaluation is needed. The information is sufficient for diagnosis of gestational diabetes
Glucose levels 2 hours after meal should be assessed
Fasting plasma glucose should be repeated
75 g oral glucose tolerance test at 0 and 120min

Explanation

Question 3 of 161

1

A 4 year old girl is seen in clinic for fatigue, insomnia, increase appetite, nervousness. Review of symptoms includes "eyes buldging", a growth spurt, tachycardia and diffusely enlarged thyroid gland. The hormone analyses are TTH < 0.01 mU/l, FT4 55pmol/l, thyroid peroxidase antibody 20kU/l (normal range 0-12), antithyroglobulin antibody 60kU/l (normal range 9-199), anti-TSH receptor antibodies 35 (normal range <9). What is the treatment of this hyperthroidism?

Select one of the following:

Diazepam
Metisol
Levothroxine
Metroprolol
Iodine supplements

Explanation

Question 4 of 161

1

What can induce hyperprolactinemia?

Select one of the following:

No correct answer
All answers are correct
Physical activity
Pregnancy
Salty food
Alcohol use

Explanation

Question 5 of 161

1

What are the clinical features of diabetes in children?

Select one or more of the following:

Anuria
Polyuria
Weight loss
Polydipsia
Oedema
Vaginal candidiasis in girls

Explanation

Question 6 of 161

1

Patient has T2 breast cancer and axillary lymph nodes are not palpable. Before the surgery, we need to:

Select one or more of the following:

Mark a sentinel lymph node with a radioisotope-bound protein
There is no need of marking because all axillary lymph need to be removed
Mark a sentinel lymph node with a dye
Mark a sentinel lymph node with a radiosotope bound protein and dye

Explanation

Question 7 of 161

1

Which surgical procedures increase incretin secretion inside the intestine?

Select one or more of the following:

Gastric sleeve resection
Gastric band
All answers are correct
Biliopancreatic diversion
Gastric bypass

Explanation

Question 8 of 161

1

Which test would you recommend if the patient complains of dysphagia and the pressure to the neck organs is suspected?

Select one of the following:

The ultrasound of the throid
FNA of the nodule of the thyroid
CT of the neck
Oesophagus X-ray with contrast

Explanation

Question 9 of 161

1

The average age of puberty to begin in girls is between .....

Select one of the following:

8-13
10-15
7-12
9-14

Explanation

Question 10 of 161

1

Breast cancer mortality among women in Lithuania are approximately 20 cases/100000 habitants. As compared to the world average morbidity, it is

Select one of the following:

Lower
Higher
Equal

Explanation

Question 11 of 161

1

What is the cause of hypoglycemia with diabetes?

Select one of the following:

Overeating
Infection
Exercise
Missed insulin injection

Explanation

Question 12 of 161

1

A 14-year old overweight male (no other complaints/pathological findings) was referred to pediatric endocrinologist for evaluation of OGTT (oral glucose tolerance test) results.
OGTT results:
Fasting glucose 6.5 mmol/l
2-hour plasma glucose 7 mmol/l
What is your diagnosis?

Select one of the following:

Type 2 diabetes
Impaired fasting glyceamia
Impaired glucose tolerance
Normal OGTT results

Explanation

Question 13 of 161

1

What are the cardiovascular complications of acromegaly?

Select one or more of the following:

All answers are correct
The dilatation of peripheral vessels due to high levels of IGF-1
There is no correct answer
Arterial hypertension
Acute heart failure
Arterial hypotension due to decreased blood circulation
Cardiomegaly

Explanation

Question 14 of 161

1

A patient is being investigated for suspected endocrine hypertension (BP ranges from 150/95 mmHg to 180/110 mmHg). The morning serum hormone levels are: Cortisol - 450 nmol/L (n. 289-600 nmol/l), Aldosterone - 1260 pmol/l, Metaneferin - 0.3 nmol/; (n. <0.5nmol/l), Normetanefrin - 0.6 nmol/l (n. <0.9 nmol/l).
What dynamic test needs to be performed for further evaluation?

Select one of the following:

No further tests needed - possible endocrine hypertension has been excluded
Salt infusion test
Catheterization of v. cava inferior
Abdominal CT to evaluate for possible adrenal adenoma
No further tests needed - oversecretion of Aldosterone has been confirmed

Explanation

Question 15 of 161

1

Which of the investigations is the best to diagnose thyroid toxic adenoma.

Select one of the following:

Thyroid scintigraphy
Fine needle aspiration of the node
Barium swallow
Ultrasound examination
Free thyroxine investigation

Explanation

Question 16 of 161

1

Which of these help prevent foot injuries?

Select one or more of the following:

Regular footwear and foot inspection
Training the patients and their family to properly maintain feet and nails
None of the above
Special soles in the shoes
Proper footwear selection

Explanation

Question 17 of 161

1

Which metabolic features are specific to cortisol hypersecretion?

Select one of the following:

No correct answer
Hyperkalemia, hypoglycemia, hypercalcemia
Glucose intolerance, dyslipidemia, hypercalcemia
Hypotension, hypoglycemia, hypercalcemia
All answers are correct
Hypercalcemia, hypotension, weight loss

Explanation

Question 18 of 161

1

Which visual radiological examinations will the surgeon guide before removing the right inferior parathyroid gland adenoma:

Select one or more of the following:

Neck ultrasound
Neck plain X-ray with barium contrast in the oesophagus
Neck plain X-ray
Sestamibi (MIBI) scan
J131 scan

Explanation

Question 19 of 161

1

Situation: The 14 y.o boy comes to your office for short stature. Mother notes that the boy's growth according to lower percentile has been observed since early childhood. Father's height caught up and puberty was delayed. Currently, the height and weight of the boy is between 3-10 percentiles, growth rate is 5 cm/year, sexual maturity P1G1. Your suspected diagnosis:

Select one of the following:

Sex hormones deficiency
Growth hormones deficiency
SHOX gene mutation
Constitutional growth and puberty delay

Explanation

Question 20 of 161

1

What is the impact of hypokalemia on aldosterone secretion?

Select one of the following:

Recuces the synthesis of aldosterone because of the inhibition of ACTH-Aldosterone axis
Suppresses
Stimulates
No impact

Explanation

Question 21 of 161

1

What are the clinical signs and symptoms of primary hyperaldosteronism?

Select one of the following:

Resistant hypertension, hyperkalemia, hyperpigmentation
Hypertension, irregular cycle, hyperkalemia
Hypotension, hypokalemia, headache
Hypotension, hyperkalemia, headache
Resistant hypertension, headache, hypokalemia

Explanation

Question 22 of 161

1

Clinical manifestation of motor neuropathy?

Select one of the following:

Innervation of the foot muscles are disturbed resulting in the atrophy of the foot muscles and alteration of the foot architecture - new support points are formed resulting in cracks and calluses
Pain, temperature, tactile sensations are damaged which increases the chance to damage the foot
Dehydrates the skin, cracks appear and soft tissue infection can occur

Explanation

Question 23 of 161

1

The first sign of puberty for girls is usually?

Select one of the following:

Acne
First period
Breast budding
Growth of Pubic hair

Explanation

Question 24 of 161

1

What macrovascular complications of diabetes mellitus do you know?

Select one of the following:

Nephropathy
Neuropathy
All the answers are correct
Retinopathy
Ischemic heart disease

Explanation

Question 25 of 161

1

A Patient undergoes an oral glucose tolerance test:
Fasting glycemia - 6.8 mmol/L
2 hours post-challenge with 75 g glucose solution - 7.4 mmol/L
Which glucose metabolism impairment are such results indicative of?

Select one of the following:

Normal glucose tolerance
Impaired fasting glycemia
Impaired glucose tolerance
Diabetes mellitus

Explanation

Question 26 of 161

1

How long does it take to develop the diabetic ketoacidosis in case of technical failure in a patient with type 1 diabetes if he is on insulin pump therapy?

Select one of the following:

Never
Several months
Several minutes
Several days
Several hours

Explanation

Question 27 of 161

1

What are the clinical features of hypothyroidism?

Select one of the following:

creased blood pressure
Thirst, rashes in the skin
Weight gain, cold tolerance
Heart beats
Hyperpigmentation of the skin

Explanation

Question 28 of 161

1

What microvascular complications of diabetes mellitus do you know?

Select one of the following:

Ischemic heart disease
Peripheral artery disease
Retinopathy
Myocardial infarction and stroke
All the answers are correct

Explanation

Question 29 of 161

1

The most common pharmacological growth hormone stimulation tests

Select one or more of the following:

Clonidine
Arginin
Insulin tolerance test (ITT)
Synacten
Glucagon

Explanation

Question 30 of 161

1

Patients underwent lab tests for a suspected thryroid disease - these are the results: TSH - 0.24 (n. 0.5-4.75) mIU/l, fT4 - 7.3 (n. 10-20) pmol/l, fT3 - 1.6 (n. 2-6) pmol/l; anti-TPO - 21.9 (n. <34), anti-TG - 82.4 (n. <100), antiTSH (stimulating) - 9.5 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Grave disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypthroidism
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 31 of 161

1

According to clinical data, the patient is suspected to have Cushing's syndrome. What test is a screening dynamic test used for outpatients?

Select one of the following:

Oral glucose tolerance test
24 h urinary free cortisol
Circadian rhythm of Cortisol
Salt infusion
Overnight 1 mg Dexamethasone suppression test
Synacthen test

Explanation

Question 32 of 161

1

Which medication/s can increase the level of prolactin?

Select one of the following:

No correct answer
Metformin
Metoclopramide
All answers are correct
Digestive enzymes
Levothyroxine

Explanation

Question 33 of 161

1

You are seeing a patient in the ER who complains of nausea, vomiting aand general malaise. The tests are performed: blood glucose 21.9 mmol/L, blood ketones 3mmol/L (n. 0.4mmol/L), arterial blood gas pH - 7.18. What condition is most likely?

Select one of the following:

Diabetic keoacidosis
Diabetic ketonaemia
Uncomplicated hyperglycemia
Acidosis of unknown origin

Explanation

Question 34 of 161

1

What is the type of obesity of a woman whose waist circumference is 107 cm and hip circumference is 109.5cm.
0.97716894977169

Select one of the following:

Peripheral
Central

Explanation

Question 35 of 161

1

The patient was diagnosed with type 1 diabetes 4 years ago. He is currently on insulin Glargine 22 IU daily at bedtime, Insulin Humalog 9 IU for breakfast, 10 IU for lunch, 6 IU for dinner.
HbA1c - 7.5%. His SMBG values: fasting - up to 2.2 mmol/L, post lunch - 6.5 mmol/L, post dinner - 5.1 mmol/L.

How should you proceed with treatment adjustment?

Select one of the following:

Increase dose of basal insulin
Increase breakfast dose of rapid acting insulin
Increase lunch dose of rapid acting insulin
Increase dinner dose of rapid acting insulin
Decrease dose of basal insulin
Decrease breakfast dose of rapid acting insulin
Decrease lunch dose of rapid acting insulin
Decrease dinner dose of rapid acting insulin
No treatment adjustment required
Add Metformin 850 mg/d

Explanation

Question 36 of 161

1

A patient has been diagnosed with type 2 diabetes 3 years ago. He is currently on Metformin 850 mg tid, Gliclazide MR 120 mg daily and Liraglutide 1.8 mg daily. HbA1c - 7.5%.
His self monitoring blood glucose results are: fasting - up to 5.9 mmol/L; 2 hours post meal - 11.3 mmol/L.
Based on these results, what is the next step in adjusting the treatment?

Select one of the following:

Start basal insulin
Discontinue Gliclazide and Liraglutide and start rapid acting insulin for the meal resulting in the highest glycemia
Discontinue Gliclazide and start basal, as well as rapid acting insulin
Discontinue all current medications and start basal insulin
Discontinue all current medications and start rapid acting insulin

Explanation

Question 37 of 161

1

A 46 year old female complains of general weakness, headaches, weight gain, irregular menses, mood swings. Weight is increasing for about 2 years, she has gained 22 kg.
Amenorrhea for the past 9 months. Her work is sedetary. Parents are not obese. She does not use any medications. Physical examination: Height - 166 cm, weight - 102 kg. Temperature - 36.6°C, skin is normally moist with hyperpigmentation, "acanthosis nigricans" in the neck. Thyroid is invisible, enlarged when palpable. HR 94/min, regular, BP 180/100 mmHg. Central obesity with purple striate in abdomen and hips is observed. Mild lower leg edema bilaterally. Lab tests: oral glucose tolerance test: fasting 6.3 mmol/l; 2 hours after 75 g, glucose - 7.8 mmol/l; lipidogram: total cholesterol 6.8 mmol/l. FT4 - 10.5 pmol/l (9-19), TSH - 3.6 mIU/l (0,4-4), 8 A.M. Cortisol - 760nmol/l (240-580), ACTH 0.8 nmol/l (2-10). What is the most probable cause of obesity?

Select one of the following:

Hyperglycemia
Hypothalamic dysfunction
Reduced physical activity, gentic predispostion
ACTH dependent Cushing syndrome
ACTH independent Cushing syndrome
Secondary hypothyroidism

Explanation

Question 38 of 161

1

61 years old patient complains of dryness in the mouth, general weakness, somnolence. Father was diagnosed with arterial hypertension, his mother has a history diabetes mellitus. Physical examination: Height 182 cm, weight 118kg, waist circumference 120cm, hip circumference 110cm. Temperature - 36.7°C. Skin and mucous membranes are normal color, dry. BP - 160/94 mmHg, HR - 88/min. Blood test: fasting in the morning in venus plasma; Complete blood count: in normal range, K - 4.4 mmol/l, creatinine - 70 mkmol/l, glucose - 6.9 mmol/l, urine test - no pathology. 75 g oral glucose test was performed: 0 min - 6.8 mmol/l, 120 min - 9.8 mmol/l. Do you hae enough data to confirm the diagnosis of diabetes mellitus?

Select one or more of the following:

No. Fasting glucose is below 7 mmol/l
Yes, the glucose is over 6.1 mmol/l for 2 times
No. The diagnosis of diabetes mellitus can be made if the glucose 2 hours after oral glucose is ≥ 11.1 mmol/l
Yes. The patient has complains of diabetes mellitus and the levels of glucose are increased
Yes. Plasma glucose 2 hours after

Explanation

Question 39 of 161

1

Patient has been on antiresorptive drugs for a couple of years of osteoporosis without fratures treatment. The bone mineral density on DXA in spine and hip has since decreased. Serum Calcium is elevated. What further evaluation is needed?

Select one of the following:

Discontinue the use o calcium and vitamin D and repeat the blood test after a few days
Assess the level of parathyroid hormone
Check serum phosphorous
Perform ultrasound examination of the neck
All answers are correct

Explanation

Question 40 of 161

1

The patient is admitted with a wound on the plantar surface of his right foot. An ankle branchial index is 0.54. What should be the next step?

Select one of the following:

Angiography and angioplasty is needed to restore arterial blood flow
The index is nomal, check inflammatory markers and consider antibacterial treatment
Possibly a non-compressible calcified vessel, further testing required
None applicable
Severe ischemia, consider urgent amputation

Explanation

Question 41 of 161

1

The diagnosis of pheochromocytoma was confirmed. What is the first line of treatment.

Select one of the following:

Observation
Preoperative preparation and surgical resection of the dominant adrenal gland
α1-arenoreceptor blockers
Preoperative preparation and pituitary adenomectomy
β-adrenegnic blockers

Explanation

Question 42 of 161

1

What enzymes deficiencies are relevant to CAH?

Select one or more of the following:

11β-hydroxylase
5α-reductase
Aromatase
17β-hydroxysteroid dehydrogenase
17α-hydroxylase
21-hydroxylase
3β-hydroxysteroid dehydrogenase

Explanation

Question 43 of 161

1

What are the main features of Graves' ophthalmopathy?

Select one of the following:

All answers are correct
Systolic murmur in the upper eyelid
Painful movements of the eyes
"Moon face"
There is no correct answer
Frequent blinking

Explanation

Question 44 of 161

1

What are the clinical features of hyperthyroidism?

Select one of the following:

Weight gain, cold intolerance
Bradycardia, increased blood pressure, weight loss
Hyperpigmentation of skin and mucous membranes, thirst
Tachycardia, arrhythmias
No symptoms are present, this is an asymptomatic disorder

Explanation

Question 45 of 161

1

Patient had a fever (up to 38.5°C) and sore throat two weeks ago. He got well since but a few days later; heart palpitations, general weakness and pain in the neck occurred. Physical examination: Body temperature - 37.2°C, HR - 96/min, tremor in the fingers. Thyroid is IB, rigid and painfuk in the right side on palpitation. What disease would you suspect?

Select one of the following:

Hashimoto's thyroiditis
Acute thyroiditis
Subacute thyroiditis
None of the mentioned diseases is suspected
Autoimmune thyrioditis
Riedel thyrioditis

Explanation

Question 46 of 161

1

What can induce hypopituitarism?

Select one or more of the following:

Macroadenoma - due to compression to the surrounding tissues
This may be a chronic complication of diabetes mellitus
Antipsychotic drugs as they increase the levels of of prolactin
There is no correct answer
Hyperthyrosis - overactive thyrod "wears-out" the pituitary
All responses are correct

Explanation

Question 47 of 161

1

What is a macroadenoma of the pituitary?

Select one of the following:

Adenoma >5 mm in size
When adenoma suppresses the chiasma opticum
Adenoma >10 mm in size
Adenoma that can be detected by a pituitary scintigraphy
Adenoma that manifests in macrosome

Explanation

Question 48 of 161

1

Deficiency of which hormones is observed in adrenal insufficiency?

Select one or more of the following:

Aldosterone
Adrenaline
Cortisol
All answers are correct
Parathormone
Seratonine
ACTH

Explanation

Question 49 of 161

1

What investigations are characteristics for Primary adrenal insufficiency in children?

Select one or more of the following:

ACTH low
Low sodium
High potssium
Synacten test: low or absent cortisol rise
Low potassium
Low cortisol
ACTH raised
High sodium

Explanation

Question 50 of 161

1

Differentiated thyroid cancers are:

Select one of the following:

Papillary and medullary
Follicular and papillary
Follicular and medullary
Papillary, follicullar and medullary
Medullary and anaplastic

Explanation

Question 51 of 161

1

A 2.8 cm tumour was detected in the left adrenal during ultrasound testing. Yhe patient is using antihypertensive agents. The endocrinologist did not detect any changes in the hormonal activity. CT scan was done and adenoma of the left adrenal gland is suspected. The patient was assigned to:

Select one of the following:

High risk of adrenal cancer - left adrenalectomy through laparatomy is needed.
High risk of adrenal cancer - diagnostic laparoscopy is needed
High risk of adrenal cancer - laparoscopic adrenalectomy is needed
Conduct control tests after 1 year
Perform positron emission tomography and compare with CT scan data

Explanation

Question 52 of 161

1

Patient complains of general weakness, constipation, hair loss, weight gain. Physical evaluation: Body temperature - 36.4°C, Height - 168cm, weight - 82kg, dry skin, HR - 68k/min. Thyroid II°. The ultrasound of the thyroid: Thyroid is enlarged, normoechogenic, non-homogeneus, with numerous hypoechoic areas. What disease is it, most likely?

Select one of the following:

Subacute thyroiditis, hyperthyroidism
Autoimmune thyroiditis, hypothyroidism
Chronic fibrosing thyroiditis
Riedel thyroiditis, hypothyroidism
Subacute thyroiditis, hypothyroidism

Explanation

Question 53 of 161

1

What is the treatment for hypothyroidism?

Select one of the following:

Thyroidectomy
Levothyroxine replacement therapy
Betablockers are the first line of treatment option
Steroids are necessary for the treatment
Antithyroid drug replacement therapy

Explanation

Question 54 of 161

1

What are the possible causes for the hyperthyroidism?

Select one of the following:

Toxic adenoma
All answers are correct
Grave's disease
Hyperfunction phase of autoimmune thyroiditis
Toxic multinodular goiter

Explanation

Question 55 of 161

1

The patient was diagnosed with type 1 diabetes 3 years ago. He is currently on insulin Glargine 20 IU daily at bedtime, insulin Humalog 6 IU for breakfast, 9 IU for lunch, 4 IU for dinner.
HbA1c - 7.4%. His SMBG valaues: fasting - up to 6.7 mmol/L; 2 hours post breakfast - 4.4 mmol/L, post lunch - 8.7 mmol/L, post dinner - 7.9 mmol/L.

How should you proceed with treatment adjustment?

Select one of the following:

Increase dose of basal insulin
Increase breakfast dose of rapid acting insulin
Increase lunch dose of rapid acting insulin
Increase dinner dose of rapid acting insulin
Decrease dose of basal insulin
Decrease breakfast dose of rapid acting insulin
Decrease lunch dose of rapid acting insulin
Decrease dinner dose of rapid acting insulin
No treatment adjustment required
Add Metformin 850 mg/d

Explanation

Question 56 of 161

1

What can induce hypoglycemia for patient with diabetes mellitus?

Select one of the following:

Physical activity
Insufficient dose of basal insulin
Insufficient dose of insulin for a meal
Hyperglycemia
There is no correct answer

Explanation

Question 57 of 161

1

A patient has been diagnosed with type 2 diabetes 6 years ago.
He just underwent routine tests and these are the results: estimated glomerular filtration rate - 23 mL/min; Urinary Albumin - 317 mg/L. Amount of urine - 2L/24 hrs.
What is the stage of diabetic nephropathy?

Select one of the following:

Stage 1
Stage 2
Stage 3
Stage 4
Stage 5

Explanation

Question 58 of 161

1

What is the target of fasting glucose in gestational diabetes?

Select one of the following:

≤6.1 mmol/l
≤5.3 mmol/l
≤6.7 mmol/l
≤6.5 mmol/l

Explanation

Question 59 of 161

1

How can ankle/brachial index be checked?

Select one of the following:

The measurements are performed during angiography
The diastolic blood pressure is measured in the lower calf and in the upper arm. The ratio is calculated
The pulses of a. dorsalis pedis and a. radialis are assessed, the ratio is calculated
The systolic blood pressure is measured in the foot and in the upper arm. The ratio is calculated
f. The systolic blood pressure is measured in the lower calf and in the upper arm. The ratio is calculated

Explanation

Question 60 of 161

1

Patient is diagnosed with diabetes mellitus type 2 for the first time. The following changes on fundoscopy is found: abnormal growth of new blood vessels. What diabetic retinopathy can be diagnosed?

Select one of the following:

Makulopathy
Preproliferative retinopathy
Proliferative retinopathy
Non-proliferative retinopathy
The changes are clinical insignificant, there is no enough data to diagnose diabetic retinopathy

Explanation

Question 61 of 161

1

A patient has been diagnosed with type 2 diabetes 4 years ago. He is currently on Metformin 850 mg tid, Gliclazide MR 120 mg daily, Insulin Glargine 33 IU daily.
After downloading his recent self-montoring blood glucose readings you see that in the past week his SMBG results are: fasting - up to 7.4 mmol/L; 2 hours post meal - 6.9 mmol/L.
Based on these results, how should the treatment be adjusted?

Select one of the following:

Increase the dose of basal insulin
Discontinue gliclizade, add rapid acting insulin for the meal that results in the highest glycemia
Results are acceptable, no treatment adjustment required
Add a Sulphonylurea class medication

Explanation

Question 62 of 161

1

What are the target organs of parathyroid hormone?

Select one of the following:

There is no correct answer
Liver, Kidney
Bones, Kidney, Intestine
Muscles, bones

Explanation

Question 63 of 161

1

Which part of the bone is responsible for the bone formation?

Select one of the following:

Collagen
Osteocyte
Osteoblast
Minerals: Calcium, Phosphorous, Strontium
Osteoclast

Explanation

Question 64 of 161

1

What is the type of obesity of a man whose waist circumference is 111.5 cm and hip circumference is 109.5 cm. 1.0182648401826

Select one of the following:

Peripheral
Central

Explanation

Question 65 of 161

1

Which of the diseases of endocrine ophthalmopathy is most specific?

Select one or more of the following:

Secondary hyperthyroidism
Multinodula toxic goiter
Grave's disease
It is not a specific feature, it is a sign of hypothyrosis
It is not a specific feature, it is a sign of thyrotoxicosis

Explanation

Question 66 of 161

1

Patient complains of discomfort in the throat when swallowing. Physical evaluation: Thyroid is III°, rigid, palpable nodules. The ultrasound of the thyroid: Thyroid is enlarged, normal echogenicity, homogenous. There are multiple nodules up to 2.5 cm in both sides of the thyroid. What tests would show if there is any pressure to the neck organs induced by the nodules of the thyroid?

Select one of the following:

X-ray of the esophagus using contrast
The ultrasound of the thyroid
MRI of the neck
CT scan of the neck
All answers are correct
Thyroid scan

Explanation

Question 67 of 161

1

What is the first stage (screening) test of primary hyperaldosteronism is clinically suspected?

Select one of the following:

Aldosterone/renin ratio
Determination of aldosterone concentration
Cortisol/aldosterone ratio
Aldosterone level in 24 hrs urine
Renin/cortisol ratio
Salt infusion test

Explanation

Question 68 of 161

1

Primary adrenal insufficiency is characterized by:

Select one or more of the following:

Deficiency of mineralcorticosteroids
Hyperpigmentation
Signs of failure of other endocrine glands
No correct answer
Orthostatic hypotension
All answers are correct
Hyperglycemia

Explanation

Question 69 of 161

1

You diagnosed a patient with Pheochromocytoma and a surgery is planned. What are the required steps prior to the surgical resection:

Select one of the following:

Spironolactone/Eplerenone at least 4 weeks before surgery
Adrenoreceptor blockers, glycemic correction
Discontinue treatment with spironolactone, ACE inhibitors or ARBs for at least 4 weeks before surgery
Metformin should be stopped at least 2-3 days before the surgery
ACE inhibitors or ARB at least 1 week before surgery
BP management of BP using α-adrenergic blockers and β-adrenegic blockers at least 2 weeks before surgery

Explanation

Question 70 of 161

1

What metabolic features are specific to cortisol hypersecretion?

Select one of the following:

Hypoglycemia/decreased levels of cholesterol
Hyperglycemia/decreased levels of cholesterol
Hyperglycemia/Dislipidemia
Hypoglycemia/Dislipidemia
There is no correct answer

Explanation

Question 71 of 161

1

The patient was diagnosed with ACTH independent Cushing's syndrome. What is the first line of treatment?

Select one of the following:

Unilateral adrenalectomy
Search of ectopic tumor and the treatment of primary disease
Medication treatment
Bilateral adrenalectomy and glucocorticoids replacement therapy
Transfenoidal adenectomy

Explanation

Question 72 of 161

1

What are the cardiovascular complications of acromegaly?

Select one or more of the following:

The dilatation of peripheral vessels due to high levels of IGF-1
Cardiomegaly
All answers are correct
Arterial hypertension
Arterial hypotension due to decreased blood circulation
Acute heart failure
There is no correct answer

Explanation

Question 73 of 161

1

Which dynamic test confirms growth hormone deficiency?

Select one of the following:

All answers are correct
The levels of IGF-1 repeated twice
Glucose tolerance test
Synacten test
1 mg Dexamethasone suppression test
Insulin tolerance test

Explanation

Question 74 of 161

1

Which of these hormones are not synthesized in the anterior pituitary?

Select one or more of the following:

Thyreotropin
Vasopressin
Somatotropin
Adrenocorticotropin
Prolactin

Explanation

Question 75 of 161

1

Which visual radiological examinations will the surgeon guide before removing the right inferior parathyroid gland adenoma:

Select one or more of the following:

Neck plain X-ray
JT31 scan
Sestamibi (MIBI) scan
Neck plain X-ray with Barium contrast in the oesophagus
Neck ultrasound

Explanation

Question 76 of 161

1

75 y/o patient suffering from type 2 diabetes and arterial hypertension. BMI - 27kg/m2. Blood test: Potassium 4.1 mmol/l, Na 140 mmol/l. Ultrasound and abdominal CT detected a 1.1 cm tumour in the left adrenal gland. Most likely diagnosis is:

Select one of the following:

Aldosteroma
Carcinoma
Incidentaloma
Insulinoma
Hyperplasia

Explanation

Question 77 of 161

1

Age limit and periodicity for Mammography Program in EU is:

Select one of the following:

Base mammography at the age of 35. Mammography is performed each year for 50-69 year old women
Base mammography at the age of 40-49. Mammography is performed 2 years for 45-60 year old women
Base mammography at the age of 45. Mammography is performed 2 years for 55-69 year old women
Base mammography at the age of 35. Mammography is performed 2 years for 45-60 year old women
Base mammography at the age of 40-49. Mammography is performed 2 years for 50-69 year old women

Explanation

Question 78 of 161

1

A patient (45 years of age, BMI 47 kg/m2), comorbidities-type II diabetes and arterial hypertension caame to an appointment with bariatric surgeon and wants to know more about surgery of obesity. What are the advantages of surgical obesity treatments against conservative ones?

Select one or more of the following:

Greater long term weight loss
All answers are correct
Better correction of comorbidities associated with obesity
Lower mortality during long term follow-up
Lower complication risk in the short term follow-up period

Explanation

Question 79 of 161

1

A patient (45 years of age, BMI 47 kg/m2), comorbidities-type II diabetes and arterial hypertension came to an appointment with bariatric surgeon and wants to know more about the effectiveness of surgery of obesity. What is the probable weight loss after surgery for obesity?

Select one of the following:

Restrictive procedures - 50% malabsorptive - 100% combined - 80% excess weight
All answers are correct
Restrictive procedures - 90% malabsorptive - 70% combined - 40% excess weight
Restrictive procedures - 50% malabsorptive - 70% combined - 60% excess weight
Restrictive procedures - 30% malabsorptive - 100% combined - 60% excess weight

Explanation

Question 80 of 161

1

Thyrotoxicosis is treated with the following medicines except:

Select one of the following:

Beta blockers
Antithyroid medicines
Glucocorticoids
Sedative
Antibiotics

Explanation

Question 81 of 161

1

During the surgery, the limb is removed at the joint - this procedure is called:

Select one of the following:

Excision
Exarticulation
Incision
Amputation

Explanation

Question 82 of 161

1

Which of these may cause ulcers in the foot?

Select one or more of the following:

Neuropathy
Ischemia
Trauma
Infection
None of these are correct

Explanation

Question 83 of 161

1

A 4 year old girl is seen in clinic for fatigue, insomnia, increase appetite, nervousness. Review of symptoms includes "eyes buldging", a growth spurt, tachycardia and diffusely enlarged thyroid gland. The hormone analyses are TTH < 0.01 mU/l, FT4 55pmol/l, thyroid peroxidase antibody 20kU/l (normal range 0-12), antithyroglobulin antibody 60kU/l (normal range 0-100), anti-TSH receptor antibodies 35 (normal range <9). What is the etiology of this hyperthroidism?

Select one of the following:

Thyroid follicular cell hyperfunction
Thyroid follicular cell destruction
Ingestion iodide preparations or thyroid hormone

Explanation

Question 84 of 161

1

What are the causes of primary congenital adrenal insufficiency in children?

Select one or more of the following:

Waterhouse-Friedrichsen syndrome
Panhypopituitarism
Adrenal dysplasia
21 hydroxylase deficiency
CNS malformations
Adrenoleucodystrophy

Explanation

Question 85 of 161

1

What is relevant to 17α-hydroxylase deficiency?

Select one or more of the following:

Hypogonadism
Increased blood pressure
Precocious puberty
Virilization in females
Males incomplete masculinization
Decreased blood pressure

Explanation

Question 86 of 161

1

8 - year old boy, weight 18kg. presents to the pediatric emergency room with complaints of polyuria, thirst, pain in abdomen, vomitting for 1 day. On examination, he was drowsy, had deep sighing respiration and dehydration. Temperature 36.9°C, heart rate 140/min., respiratory rate 30/min., blood sugar 28 mmol/l, pH 7.0. What condition is most likely?

Select one of the following:

Diabetics ketonaemia
Diabetic ketoacidosis
Pneumonia
Gastroenteritis

Explanation

Question 87 of 161

1

Two main reasons of growth hormone discontinuation

Select one of the following:

Adult height reached or the growth rate is less than 3cm/yr
Growth plate fusion
Precocious puberty

Explanation

Question 88 of 161

1

If a girl started puberty at the age of 9 would it be considered early?

Select one of the following:

True
False

Explanation

Question 89 of 161

1

What is relevant to Central Precocious Puberty?

Select one or more of the following:

5 times more common in girls
Central Nervous System Lesions (organic causes) in >60% of boys
Most cases are idiopathic
Premature activation of the HPG axis

Explanation

Question 90 of 161

1

A 7-year old girl came to outpatient clinic with complaints of failure to thrive, chronic diarrhoea, abdominal distention and pain, body temperature is normal. Symptoms last for 6 months. From the history, she was diagnosed with type 1 diabetes 2 years ago, she had optimal glycemia control for one year but now her HbA1c is 9.5% with unexplained hypoglycemia events.
What is the most probable diagnosis?

Select one of the following:

Appendicitis
Bacterial gastroenteritis
Crohn disease
Irritable bowel disease
Coeliac disease

Explanation

Question 91 of 161

1

What are the most common clinical and biochemical findings in children with type 2 diabetes?

Select one or more of the following:

Dyslipidemia
Positive autoimmune markers for diabetes
Obesity
All answers are correct
Acantosis nigricans
Hyperglycemia
Hypertension

Explanation

Question 92 of 161

1

Patient is a Type 2 diabetic and having arterial hypertension. He came to a consultation on restrictive obesity surgery and wants to know more about this type of surgery. What are the most common complications of restrictive obesity surgery?

Select one of the following:

Complications associated wih foreign body
Nausea, vomitting
Reflux symptoms
All answers are correct
Postoperative wound infection

Explanation

Question 93 of 161

1

What is the target fasting glucose for the patient with diabetes mellitus?

Select one of the following:

≤6.5 mmol/l + no hipos
≤7.8 mmol/l + no hipos
≤6.1 mmol/l + no hipos
≤ 7.0 mmol/l + no hipos

Explanation

Question 94 of 161

1

The patient was diagnosed with type 1 diabetes 7 years ago. He is currently on insulin Glargine 30 IU daily at bedtime, insulin Humalog 7 IU for breakfast, 8 IU for lunch, 5 IU for dinner.
HbA1c - 7.2%. His SMBG values: fasting - up to 3 mmol/L; 2 hours post breakfast - 8.6 mmol/L, post lunch - 4.5 mmol/l, post dinner - 5.6 mmol/L.
How should you proceed with treatment adjustment?

Select one of the following:

lncrease dose of basal insulin
Increase breakfast dose of rapid acting insulin
Increase lunch dose of rapid acting insulin
Increase dinner dose of rapid acting insulin
Decrease dose of basal insulin
Decrease breakfast dose of rapid acting insulin
Decrease lunch dose of rapid acting insulin
Decrease dinner dose of rapid acting insulin
No treatment adjustment required
Add Metformin 850 mg/d

Explanation

Question 95 of 161

1

What are the specific metabolic changes of arterial blood pH in diabetic ketoacidosis?

Select one of the following:

Diabetic acidosis
Metabolic acidosis
Metabolic alkalosis
Diabetic alkalosis
Respiratory acidosis

Explanation

Question 96 of 161

1

What is the first step to check if arterial blood flow is sufficient in patient with diabetes mellitus?

Select one of the following:

Palpation of a dorsalis tibalis
The palpation of a femoralis
Palpation of a femoralis superficialis
Palpation of a tibialis anterior
Palpation of a dosalis pedis

Explanation

Question 97 of 161

1

Which drug may induce hypercalcemia?

Select one of the following:

Antidepressants
Denosumab
Antibiotics
Thiazide diuretics
Bisphosphonates

Explanation

Question 98 of 161

1

According to WHO classificaation of thyroid enlargement. What is the size of III°?

Select one of the following:

The goitre is visible from a distance
The goitre is palpable and visible when the neck is in reclined position
Thyroid is not enlarged
The goitre is palpable but not visible

Explanation

Question 99 of 161

1

A 58 year old man presents with a painless tumor in the neck, increased sweating and episodes of tachycardia. No discomfort on swallowing is present. Physical evaluation: Temperature 36.7°C, Heart rate 96/min. The ultrasound of the thyroid: thyroid is normal in size, echogenity, homogenous. In the left side, there is a 2x3 cm solid isoechoic nodule with regualr margins. Lab tests: TSH - o.3IU/l (n. 0.4-4.2), FT4 - 19pmol/l (n. 9-21). On the scan, there is a toxic adenoma. What are the acceptable treatment options?

Select one or more of the following:

Antithyroid drugs
Surgery
The injection of ethanol into the nodule
Radioactive iodine
No treatment is needed, a toxic adenoma is a benign nodule

Explanation

Question 100 of 161

1

What ultrasound features are indicative of a malignant nodule of a thyroid?

Select one of the following:

There is no correct answer
Macrocalcinate
Anechoic nodule
Isoechoic spongiform appearance
Multinodular goitre
Hypoechoic nodule

Explanation

Question 101 of 161

1

The patient is being evaluated for a cause of obesity. He has no other complaints. Clinical examination. Height - 178cm, weight - 121kg,. No striae are visible. The following test results are received. FT4 - 15.2 pmol/l (n. 9-19), TTH - 2.3 mIU/l (n. 0.5-4.8), 8 A.M. Cortisol - 848 nmol/l (n. 424-724). Fasting plasma Glycemia - 5.8 mmol/l. Patient undergoes an overnight 1 mg. Dexamethasone test: 9 A.M. Cortisol - 61.7 nmol/l. What is your next step?

Select one of the following:

No further tests needed - no signs of pathologic Cortisol secretion
Perform a low dose of Dexamethasone test to evaluate for posible adrenal pathology
Perform catheterization of v.cava inferior
Perform abdominal CT for possible adrenal adenoma
Perform high dose Dexamethasone test for possible adrenal pathology

Explanation

Question 102 of 161

1

What hormonal changes are specific for primary adrenal insufficiency?

Select one of the following:

Decreased levels of cortisol/Decreased ACTH/ a response of cortisol ( > 550 nmol/l) after ACTH stimulation
Decreased levels of cortisol/Decreased ACTH/ No response of cortisol ( > 550 nmol/l) after ACTH stimulation
Decreased levels of cortisol/Decreased ACTH/ Decreased CRH
Decreased levels of cortisol/Increased ACTH/ No response of cortisol (<550 nmol/l) after ACTH stimulation

Explanation

Question 103 of 161

1

Which of the following symptoms are most commonly associated with phaeochromocytoma?

Select one of the following:

Hypotension accompanied by increased sweating, hunger, headache
Hypertension accompanied by increased hypoglycemia, sweating, hunger
Hypotension accompanied by tachycardia, hyperglycemia, nausea, vomiting
Nausea, vomitting, excess sweating, normal blood pressure
Hypertension accompanied with headache, sweating, achycardia

Explanation

Question 104 of 161

1

The patient with Cushing syndrome has undergone a high dose dexamethasone suppression test with a baseline cortisol concentration of 980 nmol/l, followed by the 360 nmol/l after the test. What s the most probable cause of Cushing's syndrome?

Select one of the following:

Functionality inactive pituitary adenoma
Cortisol hypersecretion due to adrenal adenoma
Not enough data to set the diagnosis
ACTH secreting pituitary adenoma
None of the options is correct
Ectopic ACTH synthesis

Explanation

Question 105 of 161

1

A patient was diagnosed with Cushing syndrome. Could it have any effect on the secretion of growth hormone, prolactin and sex hormones?

Select one of the following:

It suppresses growth hormone but stimulates prolactin and sex hormones
Has no effect on secretion of other hormones
Yes, it may impair secretion of other hormones
Yes, it may stimulate secretion of other hormones
No correct answer
It stimulates growth hormone and prolactin but does not affect secretion of sex hormones

Explanation

Question 106 of 161

1

What are the clinical signs of thyrotropinoma?

Select one of the following:

Clinical symptoms of hyperthyrosis
Clinical symptoms of hypothyrosis
Clinical symptoms of hypercorticism
Signs of acromegaly
No correct answer

Explanation

Question 107 of 161

1

What can induce hypopituitarism?

Select one of the following:

Hyperthyroidism - increased function of thyroid gland exhausts the pituitary gland
This is the one of the chronic diabetes mellitus complications
All answers are correct
Excessive bleeding during delivery
Antipsychotic drugs because of the increase levels of prolactin
No correct answer

Explanation

Question 108 of 161

1

40 y/o female is suffering from chronic kidney failure and needs hemodialysis. 10 years ago, total parathyroidectomy was performed and about 4.6 mg of parathyroid gland was reimplanted to the forearm muscles. The first few years after surgery, PTH was within normal range. Recent blood test: Ca - 2.6 pmol/l, Ca ++ - 1.2 pmol/l, PTH = 120pg/l. What are the least likely causes of hyperparathyroidism?

Select one or more of the following:

Hyperplasia of the reimplanted parathyroid gland
Hyperplasia of the residual parathyroid tissue
Atrophy of the reimplanted parathyroid gland
Not all of the parathyroid glands have been removed
Presence of the pituitary adenoma

Explanation

Question 109 of 161

1

Breast removal surgery was performed for 70 year old patient having Paget disease of right breast nipple(Tis NO). Breast with nipple and skin was removed during the surgery, lymph nodes were not removed. What surgery was performed for patient?

Select one of the following:

Skin and areola preserving mastectomy
Radical (Patey) mastectomy
Extended radical mastectomy (Halsted)
Subcutaneous mastectomy

Explanation

Question 110 of 161

1

The most common Thyroid Cancer

Select one of the following:

Follicular
Medullar
Solid
Anaplastic
Papillary

Explanation

Question 111 of 161

1

You are discussing the case, when patient regained weight 6 years after bariatric surgery. Your colleague struggles to indicate how bariatric surgery procedures are classified according to the mechanism of action. What is your opinion?

Select one of the following:

Procedures, reducing stomach volume & gt; 50% procedures, reducing stomach by It; 50% procedures not reducing stomach volume
Procedures which treat Type 2 diabetes procedures which doesn't treat Type 2 diabetes
Restrictive, malabsorptive, metabolic
Restrictive, stomach resection, combined
Restrictive, malabsorptive, combined

Explanation

Question 112 of 161

1

What conditions should be maintained whe directing the patient to undergo a prosthetic treatment after a high leg amputation?

Select one of the following:

A fully healed wound
All responses are correct
Patients younger than 70 years
Sufficient physical activity of the patient
Pateints without concomitant disease

Explanation

Question 113 of 161

1

Clinical manifestation of autonomic neuropathy?

Select one of the following:

Dehydrates the skin, cracks appear and soft tissue infection can occur
Innervation of the foot muscles are disturbed resulting in the atrophy of the foot muscles and alteration of the foot architecture - new support points are formed resulting in cracks and calluses
Pain, temperature, tactile sensations are damaged which increases the chance of damage to the foot.

Explanation

Question 114 of 161

1

Situation: A 14 day old female baby born at 40 weeks with a birth weight 4100 g is reported to have an abnormal newborn thyroid screen. Her newborn screening test results: TTH > 100mU/l. The bay comes to pediatric endocrinology department, the repeated test were: TTH 100ml, FT4 < 1.29 pmol/l. The most clinical features of congenital hypothyroidism are:

Select one or more of the following:

Jaundice
Bradycardia
Large fontanelle
Tachycardia

Explanation

Question 115 of 161

1

What is the cause of hypoglycema in children with diabetes?

Select one of the following:

Insufficient dosage of rapid acting insulin for food
Excessive dose of insulin
No correct answers
Insufficient dosage of basal insulin

Explanation

Question 116 of 161

1

What curves are used to follow up child's growth?

Select one of the following:

Height, weight, body mass index, head circumference
Height, weight, Height and sitting height ratio, head circumference
Eight, weight, growth rate, body mass index

Explanation

Question 117 of 161

1

What are the most common causes of physiologic short height?

Select one of the following:

Constitutional growth nd puberty delay, familial (genetic) low height
Short height in chronic diseases
Short height due to hypogonadism

Explanation

Question 118 of 161

1

What is the usual chronology of changes FEMALES go through during puberty:

Select one of the following:

Thelarche→pubarche→menarche→peak height velocity (PHV)
Thelarche→menarche→PHV→pubarche
Pubarche→thelarche→PHV→menarche
Thelarche→pubarche→PHV→menarche

Explanation

Question 119 of 161

1

Premature thelarche and prematue pubarche and normal puberty variants.

Select one of the following:

True
False

Explanation

Question 120 of 161

1

What is the most common cause of diabetes mellitus in children?

Select one of the following:

Genetic defects of insulin action
Autoimmune β-cell destruction
No correct answer
Genetic defects of β-cell function

Explanation

Question 121 of 161

1

What are the clinical features of diabetes in children?

Select one or more of the following:

Anuria
Vaginal candidiasis in girls
Oedema
Weight loss
Polyuria

Explanation

Question 122 of 161

1

A 77 y/o man complains of the pain all over the body. A DXA scan was performed. What is your interpretation of bone mineral density in this scan?

Select one of the following:

Increased bone density
The test can not be interpreted because of incorrect execution
Osteopenia
There is not enough data
Osteoporosis

Explanation

Question 123 of 161

1

Select from the dropdown lists to complete the text.

Match the Gonadal Dysgenesis type with its description.

46,XY ( Mixed Gonadal Dysgenesis, Seminiferous tubule dysgenesis, Pure Gonadal Dysgenesis )
45,X/46,XY ( Pure Gonadal Dysgenesis, Mixed Gonadal Dysgenesis, Seminiferous tubule dysgenesis )
46,XX ( Mixed Gonadal Dysgenesis, Pure Gonadal Dysgenesis, Seminiferous tubule dysgenesis )
Asymmetric ( Pure Gonadal Dysgenesis, Seminiferous tubule dysgenesis, Mixed Gonadal Dysgenesis )
Symmetric ( Mixed Gonadal Dysgenesis, Pure Gonadal Dysgenesis, Seminiferous tubule dysgenesis )
47,XXY ( Seminiferous tubule dysgenesis, Mixed Gonadal Dysgenesis, Pure Gonadal Dysgenesis )
45,X0 ( Pure Gonadal Dysgenesis, Mixed Gonadal Dysgenesis, Semininferous tubule Dysgenesis )

Explanation

Question 124 of 161

1

The adrenal CT scan is first line test that should be performed for everybody who is suspected for the primary hyperaldosteronism.

Select one of the following:

True
False

Explanation

Question 125 of 161

1

Unilateral adrenalectomy is first line treatment for the ACTH independent Cushing Syndrome

Select one of the following:

True
False

Explanation

Question 126 of 161

1

The most common causes of the secondary chronic adrenal insufficiency are brain tumors and trauma

Select one of the following:

True
False

Explanation

Question 127 of 161

1

Which of those are the actions of androgens?

Select one or more of the following:

Stimulates potassium excreation from
the organism
Stimulates the pubic and axillary hair
growth
Increases indirectly blood pressure
Stimulates gluconeogenesis
Influences libido, sexual behavior
Increases the secreation of H* from the
organism
Increases bone mass
Stimulates lipolysis
Increase proteins synthesis in muscles,
bone tissue
Increases the glucose level in the blood

Explanation

Question 128 of 161

1

How do you classify a person whose weight is 85.7 kg and height is 1.93 m based on Body Mass Index?

Select one of the following:

Underweight
Normal
Overweight
Obesity Class I
Obesity Class Il
Obesity Class IlI

Explanation

Question 129 of 161

1

How do you classify a person who is 170 cm tall, weighs 95.4 kg and has a body mass index of 33?

Select one of the following:

Underweight
Normal
Overweight
Obesity Class I
Obesity Class II
Obesity Class Ill

Explanation

Question 130 of 161

1

What is the type of obesity of a woman whose waist circumference is 102 cm and hip circumference is 98 cm 1.0408163265306

Select one of the following:

Peripheral
Central

Explanation

Question 131 of 161

1

Which of those are the actions of mineralcorticoids?

Select one or more of the following:

a. Stimulates potassium excretion from the organism
b. Influences libido, sexual behavior
c. Stimulates lipolysis
d. Has anti-inflammatory activity
e. Secretes H from the organism
f. Stimulates the reabsorbtion Na+ from the urine back to the organism
g. Increase blood volume
h. Increases indirectly blood pressure
i. Increases proteins synthesis in muscles, bone tissue
j. Decreases renin-angiotensin activity

Explanation

Question 132 of 161

1

The patient is suspected to have Cushing's syndrome. What hormonal test is used for screening?

Select one of the following:

a. Testosterone
b. Cortisol
C. TSH or STH
d. Aldosterone and renine
e. Epinefrine and norepinefrine
f. Aldosterone
g. Renin

Explanation

Question 133 of 161

1

Which of the hormally active substance does not affect prolactin secretion?

Select one of the following:

a. All answers are correct
b. Dopamine
c. TRH
d. Vasopresine
e. Estrogenes

Explanation

Question 134 of 161

1

What are the clinical signs of mineralcorticoid excess when treating the chronic adrenal insufficiency?

Select one of the following:

a. Arterial hypertension, edemas
b. Loss of consciousness, hypotension
c. Hypotension, edemas
d. Edemas, frequent urination

Explanation

Question 135 of 161

1

What is the most probable cause of chronic primary adrenal insufficiency?

Select one of the following:

a. MEN 2A syndrome
b. Radiotherapy of the abdomen region
c. Non-functioning pituitary adenoma
d. Chronic renal failure
e Autoimmune adrenal damage

Explanation

Question 136 of 161

1

The results of the patient's lab test are: Cortisol 200 nmol/l (n 177-700), ACTH 25 (n 4-14). What dynamic test will confirm the diagnosis?

Select one of the following:

a. Synacthen test
b. Oral glucose tolerance test
c. Sampling of v. cava inferior
d. Salt infusion test
e. Overnight 1mg Dexamethasone supression test
f. CRH test

Explanation

Question 137 of 161

1

A patient has been diagnosed with type 2 diabetes 7 year ago. He is currently on Metformin 850 mg tid, Gliclazide MR 120 mg daily, Insulin Glargine 34 IU daily.
His self-monitoring blood glucose results are: fasting-up to 5.1 mmol/L; 2 hours post meal-10.6 mmol/t.
Based on these results, how should the treatment be adjusted?

Select one of the following:

Increase the dose of basal insulin
Discontinue gliclazide, add rapid acting insulin for the meal that results in the highest glycemia
Results are acceptable, no treatment adjustment required

Explanation

Question 138 of 161

1

A patient who is 24 weeks pregnant undergoes an Oral Glucose Tolerance Test
Fasting blood glucose is 4.9 mmol/L;
1 hour post challenge with 75 g of glucose solution 11.7 mmol/L
2 hours post-challenge -7.8 mmol/L
Indicative of what glucose metabolism impairment are such results?

Select one of the following:

Normal glucose tolerance
Gestational diabetes mellitus, as pre-challenge glucose is elevated
Gestational diabetes mellitus, as 1 hour post-challenge glucose is elevated
Gestational diabetes mellitus, as 2 hours post-challenge glucose is elevated
Gestational diabetes mellitus, as pre-challenge and 1 hour post-challenge glucose are elevated
Gestational diabetes mellitus, as pre-challenge and 2 hours post-challenge glucose are elevated
Gestational diabetes mellitus, as 1 hour and 2 hour post-challenge glucose are elevated
Gestational diabetes mellitus, as all blood glucose results are elevated
Impaired glucose tolerance as only a single value is elevated
Insufficient data to establish diagnosis

Explanation

Question 139 of 161

1

A patient has been diagnosed with type 2 diabetes 4 years ago. He is currently on Metformin 850 mg tid, Gliclande MR 120 mg daily, Insulin Glargine 21 IU daily
After downloading his recent self-monitoring blood glucose readings you see that in the past week his SMBG results are
fasting up to 6.1 mmol/t 2 hours post meal-6.6 mmol/L
Based on these results, how should the treatment be adjusted?

Select one of the following:

Increase the dose of basal insulin
Discontinue gliclazide, add rapid acting insulin for the meal that results in the highest glycemia
Results are acceptable, no treatment adjustment required
Add a Sulphonylures class medication

Explanation

Question 140 of 161

1

A patient has been diagnosed with type 2 diabetes 4 year ago. He is currently on Metformin 850 mg tid, Gliclazide MR 120
Studentul/ for Student
mg daily, and Liraglutide 1.8 mg daily HbA1c-7.5% His self monitoring blood glucose results are: fasting-up to 9 mmol, 2 hours post meal 7:3 mmol/1
Based on these results, what is the next step in adjusting the treatment?

Select one of the following:

Start basal Insulin
Discontinue Gliclazide and Liraglutide and start rapid acting insulin for the meal resulting in the highest glycemia
Discontinue Gliclazide and start basal as well as rapiting insulin
Discontinue all current medications and start basal insulin
Discontinue all current medications and start rapid acting insulin

Explanation

Question 141 of 161

1

A patient has been diagnosed with type 2 diabetes 6 year ago. He is currently on Metformin 850 mg tid, Gliclazide MR 120 mg daily, and Liraglutide 1.8 mg daily. HbA1c -7.5%.
His self monitoring blood glucose results are: fasting- up to 7.4 mmol/L; 2 hours post meal -7.7 mmol/L.
Based on these results, what is the next step in adjusting the treatment?

Select one of the following:

Start basal Insulin
Discontinue Gliclazide and Liraglutide and start rapid acting insulin for the meal resulting in the highest glycemia
Discontinue Gliclazide and start basal, as well as rapid acting insulin
Discontinue all current medications and start
basal insulin
Discontinue all current medications and start rapid acting insulin

Explanation

Question 142 of 161

1

Patient underwent lab tests for a suspected thyroid disease- these are the results: TSH -0.2 (n. 0.5-4.75) mIU/I, fT4-24.1 (n. 10-20) pmol/l, fT3 8.5 (n. 2-6) pmol/l; anti-TPO-23 (n. <34), anti-TG 105.9 (n.<100), antiTSH (stimulating) - 7.1 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 143 of 161

1

Patient underwent lab tests for a suspected thyroid disease - these are the results: TSH-13.2 (n. 0.5-4.75) mIU/l, fT4 -24.7 (n. 10-20) pmol/l, fT3 - 12.7 (n. 2-6) pmol/l; anti-TPO-13.1 (n. <34), anti-TG 32.5 (n.<100), antiTSH (stimulating) -2.3 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically
irrelevant

Explanation

Question 144 of 161

1

Patient underwent lab tests for a suspected thyroid disease these are the results: TSH-0.13 (n. 0.5-4.75) maut, fT4-222 (n. 10-20) pmolt, FT3-11.8 (n. 2-6) pmolt, anti-TPO 155.9 (n. 34), and TG-35.30100), and TSH (stimulating)-157 (n <10), What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 145 of 161

1

Patient underwent lab tests for a suspected thyroid disease- these are the results: TSH-0.28 m 0.5-4.75) mat, fT4-51 mm 10-20) pmol/l, f13-1.4 (n. 2-6) pmol/t; anti-TPO 32.2 (n. 34), anti-TG-29.2 (n100), antiTSH (stimulating) 7.8 (n. 10). What disease is the most probable based on such results?

Select one of the following:

Graves disease.
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroon producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 146 of 161

1

Patient underwent lab tests for a suspected thyroid disease- these are the results: TSH-1.9 (n. 0.5-4.75) mai (74-15.9m 10-20) pmol/l, fT3-4.8 (n. 2-6) pmol/t anti-TPO-288.7 (n. 34), anti-TG-88.1 (n-100), antiTSH (stimulating)-7.6 (n. 10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 147 of 161

1

Patient underwent lab tests for a suspected thyroid disease- these are the results: TSH-5.6 (n. 0.5-4.75) mU/L (T4-9.6 (n. 10-20) pmolt 113-1.6 (n. 2-6) pmol/t anti-TPO-295.6 (n. 34), anti-TG-137.8 (n<100), antiTSH (stimulating)-5.6 (n. 10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 148 of 161

1

Patient comes in with complaints of rapid weight gain and decreased libido. Further complaints include hirsutism and recent onset of acne. Hypercortisolemia is suspected and so 24 hour urine cortisol is performed and result was 320 μg/24h.
What is the appropriate next step?

Select one of the following:

a. ACTH should be checked to verify the cause of hipercortisolemia X
b. A high-dose dexamethasone suppression test should be done to verify the cause of hypercortisolemia
c. Overnight 1 mg dexamethasone suppression test should be done to rule out physiologic hypercortisolemia
d. The level of Cortisol is slightly elevated because of the obesity - no further tests are necessary
e. Further tests are not necessary. increased level of cortisol is the cause of obesity

Explanation

Question 149 of 161

1

Patient develops hypoglycemia while at the hospital and is currently unconscious. His current blood glucose is 2.1mmol/l. What is the recommended approach?

Select one of the following:

20 mg glucose orally
80 ml 20% glucose i/v
1 mg glucagon i/m
4 IU rapid acting insulin s/c

Explanation

Question 150 of 161

1

Patient underwent lab tests for a suspected thyroid disease - these are the results: TSH-0.24 (n. 0.5-4.75) mIU/l, fT4-26.4 (n. 10-20) pmol/l, fT3-9.9 (n. 2-6) pmol/l; anti-TPO-276.5 (n. <34), anti-TG-83.5 (n.<100), antiTSH (stimulating) - 11.3 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin-producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 151 of 161

1

Patient underwent lab tests for a suspected thyroid disease - these are the results: TSH -0.15 (n. 0.5-4.75) mIU/l, fT4-7.2 (n. 10-20) pmol/l, fT3 1.8 (n. 2-6) pmol/l; anti-TPO -2.9 (n. <34), anti-TG 6 (n.<100), antiTSH (stimulating) - 2.7 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 152 of 161

1

Patient underwent lab tests for a suspected thyroid disease - these are the results: TSH 9.1 (n. 0.5-4.75) mIU/l, fT4-5.1 (n. 10-20) pmol/l, fT3-1.4 (n. 2-6) pmol/l; anti-TPO - 56.8 (n. <34), anti-TG-142.7 (n.<100), antiTSH (stimulating) 9.2 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically
irrelevant

Explanation

Question 153 of 161

1

Patient underwent lab tests for a suspected thyroid disease - these are the results: TSH -8.6 (n. 0.5-4.75) mIU/l, fT4-7.5 (n. 10-20) pmol/l, fT3-1.6 (n. 2-6) pmol/l; anti-TPO-240.4 (n. <34), anti-TG-147.3 (n.<100), antiTSH (stimulating) 3 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 154 of 161

1

Patient underwent lab tests for a suspected thyroid disease - these are the results: TSH -6.3 (n. 0.5-4.75) mIU/l, fT4-5.4 (n. 10-20) pmol/l, fT3-1.8 (n. 2-6) pmol/l; anti-TPO-59.2 (n. <34), anti-TG 143.4 (n.<100), antiTSH (stimulating) - 3.2 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 155 of 161

1

Patient underwent lab tests for a suspected thyroid disease- these are the results: TSH-2.1 (n. 0.5-4.75) mIU/l, fT4-14.5 (n. 10-20) pmol/l, fT3-5.6 (n. 2-6) pmol/l; anti-TPO-89.1 (n. <34), anti-TG-34.8 (n.<100), antiTSH (stimulating) 3.5 (n. <10), What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically
irrelevant

Explanation

Question 156 of 161

1

Patient underwent lab tests for a suspected thyroid disease - these are the results: TSH - 0.44 (n. 0.5-4.75) mIU/l, fT4-6.5 (n. 10-20) pmol/l, fT3-1.5 (n. 2-6) pmol/l; anti-TPO-17.3 (n. <34), anti-TG-75.8 (n.<100), antiTSH (stimulating)-5.8 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 157 of 161

1

Patient underwent lab tests for a suspected thyroid disease- these are the results: TSH-0.12 (n. 0.5-4.75) mIU/l, fT4-26.9 (n. 10-20) pmol/l, fT3-11.4 (n. 2-6) pmol/l; anti-TPO-15.6 (n. <34), anti-TG-150 (n.<100), antiTSH (stimulating)-3 (n. <10), What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 158 of 161

1

Patient underwent lab tests for a suspected thyroid disease - these are the results: TSH-16 (n. 0.5-4.75) mIU/l, fT4-22.9 (n. 10-20) pmol/l, fT3 12.2 (n. 2-6) pmol/l; anti-TPO-8.2 (n. <34), anti-TG -21.1 (n.<100), antiTSH (stimulating) - 4.4 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 159 of 161

1

Patient underwent lab tests for a suspected thyroid disease - these are the results: TSH -0.33 (n. 0.5-4.75) mIU/l, fT4-25.4 (n. 10-20) pmol/l, fT3 -10.7 (n. 2-6) pmol/l; anti-TPO - 14.8 (n. <34), anti TG-121 (n.<100), antiTSH (stimulating) - 3.1 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 160 of 161

1

Patient underwent lab tests for a suspected thyroid disease - these are the results: TSH-0.4 (n. 0.5-4.75) mIU/l, fT4-26.4 (n. 10-20) pmol/l, fT3-8.2 (n. 2-6) pmol/l; anti-TPO-20.6 (n. <34), anti-TG-126.4 (n.<100), antiTSH (stimulating) -8.4 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

Explanation

Question 161 of 161

1

Patient underwent lab tests for a suspected thyroid disease - these are the results: TSH-12.6 (n. 0.5-4.75) mIU/l, fT4-25.2 (n. 10-20) pmol/l, fT3-8.4 (n. 2-6) pmol/l; anti-TPO-5.9 (n. <34), anti-TG-12.4 (n.<100), antiTSH (stimulating) - 6.6 (n. <10). What disease is the most probable based on such results?

Select one of the following:

Graves disease
Hypothyroid phase of Hashimoto thyroiditis
Euthyroid phase of Hashimoto thyroiditis
Hyperthyroid phase of Hashimoto thyroiditis
TSH producing pituitary adenoma
Central hypothyroidism
Acute thyroiditis
Thyroxin producing pituitary adenoma
Deviation of lab results is clinically irrelevant

	Created by Uchechukwu Nwanja about 2 years ago

Quiz on Endocrinology Exam Questions, created by Uchechukwu Nwanja on 05/10/2022.

Endocrinology Exam Questions

Question 1 of 161

Which hormones regulate the levels of calcium in the blood?

Select one of the following:

Explanation

Question 2 of 161

Select one of the following:

Explanation

Question 3 of 161

Select one of the following:

Explanation

Question 4 of 161

What can induce hyperprolactinemia?

Select one of the following:

Explanation

Question 5 of 161

What are the clinical features of diabetes in children?

Select one or more of the following:

Explanation

Question 6 of 161

Patient has T2 breast cancer and axillary lymph nodes are not palpable. Before the surgery, we need to:

Select one or more of the following:

Explanation

Question 7 of 161

Which surgical procedures increase incretin secretion inside the intestine?

Select one or more of the following:

Explanation

Question 8 of 161

Which test would you recommend if the patient complains of dysphagia and the pressure to the neck organs is suspected?

Select one of the following:

Explanation

Question 9 of 161

The average age of puberty to begin in girls is between .....

Select one of the following:

Explanation

Question 10 of 161

Breast cancer mortality among women in Lithuania are approximately 20 cases/100000 habitants. As compared to the world average morbidity, it is

Select one of the following:

Explanation

Question 11 of 161

What is the cause of hypoglycemia with diabetes?

Select one of the following:

Explanation

Question 12 of 161

A 14-year old overweight male (no other complaints/pathological findings) was referred to pediatric endocrinologist for evaluation of OGTT (oral glucose tolerance test) results. OGTT results: Fasting glucose 6.5 mmol/l 2-hour plasma glucose 7 mmol/l What is your diagnosis?

Select one of the following:

Explanation

Question 13 of 161

What are the cardiovascular complications of acromegaly?

Select one or more of the following:

Explanation

Question 14 of 161

Select one of the following:

Explanation

Question 15 of 161

Which of the investigations is the best to diagnose thyroid toxic adenoma.

Select one of the following:

Explanation

Question 16 of 161

Which of these help prevent foot injuries?

Select one or more of the following:

Explanation

Question 17 of 161

Which metabolic features are specific to cortisol hypersecretion?

Select one of the following:

Explanation

Question 18 of 161

Which visual radiological examinations will the surgeon guide before removing the right inferior parathyroid gland adenoma:

Select one or more of the following:

Explanation

Question 19 of 161

Select one of the following:

Explanation

Question 20 of 161

What is the impact of hypokalemia on aldosterone secretion?

Select one of the following:

Explanation

Question 21 of 161

What are the clinical signs and symptoms of primary hyperaldosteronism?

A 14-year old overweight male (no other complaints/pathological findings) was referred to pediatric endocrinologist for evaluation of OGTT (oral glucose tolerance test) results.
OGTT results:
Fasting glucose 6.5 mmol/l
2-hour plasma glucose 7 mmol/l
What is your diagnosis?

A Patient undergoes an oral glucose tolerance test:
Fasting glycemia - 6.8 mmol/L
2 hours post-challenge with 75 g glucose solution - 7.4 mmol/L
Which glucose metabolism impairment are such results indicative of?

What is the type of obesity of a woman whose waist circumference is 107 cm and hip circumference is 109.5cm.
0.97716894977169