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Endocrinology Exam Questions

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Quiz on Endocrinology Exam Questions, created by Uchechukwu Nwanja on 05/10/2022.
Uchechukwu Nwanja
Quiz by Uchechukwu Nwanja, updated more than 1 year ago
Uchechukwu Nwanja
Created by Uchechukwu Nwanja about 2 years ago
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Resource summary

Question 1

Question
Which hormones regulate the levels of calcium in the blood?
Answer
  • 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

Question 2

Question
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?
Answer
  • 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

Question 3

Question
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?
Answer
  • Diazepam
  • Metisol
  • Levothroxine
  • Metroprolol
  • Iodine supplements

Question 4

Question
What can induce hyperprolactinemia?
Answer
  • No correct answer
  • All answers are correct
  • Physical activity
  • Pregnancy
  • Salty food
  • Alcohol use

Question 5

Question
What are the clinical features of diabetes in children?
Answer
  • Anuria
  • Polyuria
  • Weight loss
  • Polydipsia
  • Oedema
  • Vaginal candidiasis in girls

Question 6

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

Question 7

Question
Which surgical procedures increase incretin secretion inside the intestine?
Answer
  • Gastric sleeve resection
  • Gastric band
  • All answers are correct
  • Biliopancreatic diversion
  • Gastric bypass

Question 8

Question
Which test would you recommend if the patient complains of dysphagia and the pressure to the neck organs is suspected?
Answer
  • The ultrasound of the throid
  • FNA of the nodule of the thyroid
  • CT of the neck
  • Oesophagus X-ray with contrast

Question 9

Question
The average age of puberty to begin in girls is between .....
Answer
  • 8-13
  • 10-15
  • 7-12
  • 9-14

Question 10

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

Question 11

Question
What is the cause of hypoglycemia with diabetes?
Answer
  • Overeating
  • Infection
  • Exercise
  • Missed insulin injection

Question 12

Question
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?
Answer
  • Type 2 diabetes
  • Impaired fasting glyceamia
  • Impaired glucose tolerance
  • Normal OGTT results

Question 13

Question
What are the cardiovascular complications of acromegaly?
Answer
  • 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

Question 14

Question
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?
Answer
  • 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

Question 15

Question
Which of the investigations is the best to diagnose thyroid toxic adenoma.
Answer
  • Thyroid scintigraphy
  • Fine needle aspiration of the node
  • Barium swallow
  • Ultrasound examination
  • Free thyroxine investigation

Question 16

Question
Which of these help prevent foot injuries?
Answer
  • 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

Question 17

Question
Which metabolic features are specific to cortisol hypersecretion?
Answer
  • No correct answer
  • Hyperkalemia, hypoglycemia, hypercalcemia
  • Glucose intolerance, dyslipidemia, hypercalcemia
  • Hypotension, hypoglycemia, hypercalcemia
  • All answers are correct
  • Hypercalcemia, hypotension, weight loss

Question 18

Question
Which visual radiological examinations will the surgeon guide before removing the right inferior parathyroid gland adenoma:
Answer
  • Neck ultrasound
  • Neck plain X-ray with barium contrast in the oesophagus
  • Neck plain X-ray
  • Sestamibi (MIBI) scan
  • J131 scan

Question 19

Question
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:
Answer
  • Sex hormones deficiency
  • Growth hormones deficiency
  • SHOX gene mutation
  • Constitutional growth and puberty delay

Question 20

Question
What is the impact of hypokalemia on aldosterone secretion?
Answer
  • Recuces the synthesis of aldosterone because of the inhibition of ACTH-Aldosterone axis
  • Suppresses
  • Stimulates
  • No impact

Question 21

Question
What are the clinical signs and symptoms of primary hyperaldosteronism?
Answer
  • Resistant hypertension, hyperkalemia, hyperpigmentation
  • Hypertension, irregular cycle, hyperkalemia
  • Hypotension, hypokalemia, headache
  • Hypotension, hyperkalemia, headache
  • Resistant hypertension, headache, hypokalemia

Question 22

Question
Clinical manifestation of motor neuropathy?
Answer
  • 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

Question 23

Question
The first sign of puberty for girls is usually?
Answer
  • Acne
  • First period
  • Breast budding
  • Growth of Pubic hair

Question 24

Question
What macrovascular complications of diabetes mellitus do you know?
Answer
  • Nephropathy
  • Neuropathy
  • All the answers are correct
  • Retinopathy
  • Ischemic heart disease

Question 25

Question
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?
Answer
  • Normal glucose tolerance
  • Impaired fasting glycemia
  • Impaired glucose tolerance
  • Diabetes mellitus

Question 26

Question
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?
Answer
  • Never
  • Several months
  • Several minutes
  • Several days
  • Several hours

Question 27

Question
What are the clinical features of hypothyroidism?
Answer
  • creased blood pressure
  • Thirst, rashes in the skin
  • Weight gain, cold tolerance
  • Heart beats
  • Hyperpigmentation of the skin

Question 28

Question
What microvascular complications of diabetes mellitus do you know?
Answer
  • Ischemic heart disease
  • Peripheral artery disease
  • Retinopathy
  • Myocardial infarction and stroke
  • All the answers are correct

Question 29

Question
The most common pharmacological growth hormone stimulation tests
Answer
  • Clonidine
  • Arginin
  • Insulin tolerance test (ITT)
  • Synacten
  • Glucagon

Question 30

Question
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?
Answer
  • 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

Question 31

Question
According to clinical data, the patient is suspected to have Cushing's syndrome. What test is a screening dynamic test used for outpatients?
Answer
  • Oral glucose tolerance test
  • 24 h urinary free cortisol
  • Circadian rhythm of Cortisol
  • Salt infusion
  • Overnight 1 mg Dexamethasone suppression test
  • Synacthen test

Question 32

Question
Which medication/s can increase the level of prolactin?
Answer
  • No correct answer
  • Metformin
  • Metoclopramide
  • All answers are correct
  • Digestive enzymes
  • Levothyroxine

Question 33

Question
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?
Answer
  • Diabetic keoacidosis
  • Diabetic ketonaemia
  • Uncomplicated hyperglycemia
  • Acidosis of unknown origin

Question 34

Question
What is the type of obesity of a woman whose waist circumference is 107 cm and hip circumference is 109.5cm. 0.97716894977169
Answer
  • Peripheral
  • Central

Question 35

Question
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?
Answer
  • 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

Question 36

Question
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?
Answer
  • 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

Question 37

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

Question 38

Question
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?
Answer
  • 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

Question 39

Question
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?
Answer
  • 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

Question 40

Question
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?
Answer
  • 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

Question 41

Question
The diagnosis of pheochromocytoma was confirmed. What is the first line of treatment.
Answer
  • Observation
  • Preoperative preparation and surgical resection of the dominant adrenal gland
  • α1-arenoreceptor blockers
  • Preoperative preparation and pituitary adenomectomy
  • β-adrenegnic blockers

Question 42

Question
What enzymes deficiencies are relevant to CAH?
Answer
  • 11β-hydroxylase
  • 5α-reductase
  • Aromatase
  • 17β-hydroxysteroid dehydrogenase
  • 17α-hydroxylase
  • 21-hydroxylase
  • 3β-hydroxysteroid dehydrogenase

Question 43

Question
What are the main features of Graves' ophthalmopathy?
Answer
  • All answers are correct
  • Systolic murmur in the upper eyelid
  • Painful movements of the eyes
  • "Moon face"
  • There is no correct answer
  • Frequent blinking

Question 44

Question
What are the clinical features of hyperthyroidism?
Answer
  • 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

Question 45

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

Question 46

Question
What can induce hypopituitarism?
Answer
  • 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

Question 47

Question
What is a macroadenoma of the pituitary?
Answer
  • 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

Question 48

Question
Deficiency of which hormones is observed in adrenal insufficiency?
Answer
  • Aldosterone
  • Adrenaline
  • Cortisol
  • All answers are correct
  • Parathormone
  • Seratonine
  • ACTH

Question 49

Question
What investigations are characteristics for Primary adrenal insufficiency in children?
Answer
  • ACTH low
  • Low sodium
  • High potssium
  • Synacten test: low or absent cortisol rise
  • Low potassium
  • Low cortisol
  • ACTH raised
  • High sodium

Question 50

Question
Differentiated thyroid cancers are:
Answer
  • Papillary and medullary
  • Follicular and papillary
  • Follicular and medullary
  • Papillary, follicullar and medullary
  • Medullary and anaplastic

Question 51

Question
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:
Answer
  • 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

Question 52

Question
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?
Answer
  • Subacute thyroiditis, hyperthyroidism
  • Autoimmune thyroiditis, hypothyroidism
  • Chronic fibrosing thyroiditis
  • Riedel thyroiditis, hypothyroidism
  • Subacute thyroiditis, hypothyroidism

Question 53

Question
What is the treatment for hypothyroidism?
Answer
  • Thyroidectomy
  • Levothyroxine replacement therapy
  • Betablockers are the first line of treatment option
  • Steroids are necessary for the treatment
  • Antithyroid drug replacement therapy

Question 54

Question
What are the possible causes for the hyperthyroidism?
Answer
  • Toxic adenoma
  • All answers are correct
  • Grave's disease
  • Hyperfunction phase of autoimmune thyroiditis
  • Toxic multinodular goiter

Question 55

Question
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?
Answer
  • 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

Question 56

Question
What can induce hypoglycemia for patient with diabetes mellitus?
Answer
  • Physical activity
  • Insufficient dose of basal insulin
  • Insufficient dose of insulin for a meal
  • Hyperglycemia
  • There is no correct answer

Question 57

Question
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?
Answer
  • Stage 1
  • Stage 2
  • Stage 3
  • Stage 4
  • Stage 5

Question 58

Question
What is the target of fasting glucose in gestational diabetes?
Answer
  • ≤6.1 mmol/l
  • ≤5.3 mmol/l
  • ≤6.7 mmol/l
  • ≤6.5 mmol/l

Question 59

Question
How can ankle/brachial index be checked?
Answer
  • 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

Question 60

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

Question 61

Question
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?
Answer
  • 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

Question 62

Question
What are the target organs of parathyroid hormone?
Answer
  • There is no correct answer
  • Liver, Kidney
  • Bones, Kidney, Intestine
  • Muscles, bones

Question 63

Question
Which part of the bone is responsible for the bone formation?
Answer
  • Collagen
  • Osteocyte
  • Osteoblast
  • Minerals: Calcium, Phosphorous, Strontium
  • Osteoclast

Question 64

Question
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
Answer
  • Peripheral
  • Central

Question 65

Question
Which of the diseases of endocrine ophthalmopathy is most specific?
Answer
  • 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

Question 66

Question
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?
Answer
  • 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

Question 67

Question
What is the first stage (screening) test of primary hyperaldosteronism is clinically suspected?
Answer
  • Aldosterone/renin ratio
  • Determination of aldosterone concentration
  • Cortisol/aldosterone ratio
  • Aldosterone level in 24 hrs urine
  • Renin/cortisol ratio
  • Salt infusion test

Question 68

Question
Primary adrenal insufficiency is characterized by:
Answer
  • Deficiency of mineralcorticosteroids
  • Hyperpigmentation
  • Signs of failure of other endocrine glands
  • No correct answer
  • Orthostatic hypotension
  • All answers are correct
  • Hyperglycemia

Question 69

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

Question 70

Question
What metabolic features are specific to cortisol hypersecretion?
Answer
  • Hypoglycemia/decreased levels of cholesterol
  • Hyperglycemia/decreased levels of cholesterol
  • Hyperglycemia/Dislipidemia
  • Hypoglycemia/Dislipidemia
  • There is no correct answer

Question 71

Question
The patient was diagnosed with ACTH independent Cushing's syndrome. What is the first line of treatment?
Answer
  • Unilateral adrenalectomy
  • Search of ectopic tumor and the treatment of primary disease
  • Medication treatment
  • Bilateral adrenalectomy and glucocorticoids replacement therapy
  • Transfenoidal adenectomy

Question 72

Question
What are the cardiovascular complications of acromegaly?
Answer
  • 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

Question 73

Question
Which dynamic test confirms growth hormone deficiency?
Answer
  • All answers are correct
  • The levels of IGF-1 repeated twice
  • Glucose tolerance test
  • Synacten test
  • 1 mg Dexamethasone suppression test
  • Insulin tolerance test

Question 74

Question
Which of these hormones are not synthesized in the anterior pituitary?
Answer
  • Thyreotropin
  • Vasopressin
  • Somatotropin
  • Adrenocorticotropin
  • Prolactin

Question 75

Question
Which visual radiological examinations will the surgeon guide before removing the right inferior parathyroid gland adenoma:
Answer
  • Neck plain X-ray
  • JT31 scan
  • Sestamibi (MIBI) scan
  • Neck plain X-ray with Barium contrast in the oesophagus
  • Neck ultrasound

Question 76

Question
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:
Answer
  • Aldosteroma
  • Carcinoma
  • Incidentaloma
  • Insulinoma
  • Hyperplasia

Question 77

Question
Age limit and periodicity for Mammography Program in EU is:
Answer
  • 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

Question 78

Question
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?
Answer
  • 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

Question 79

Question
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?
Answer
  • 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

Question 80

Question
Thyrotoxicosis is treated with the following medicines except:
Answer
  • Beta blockers
  • Antithyroid medicines
  • Glucocorticoids
  • Sedative
  • Antibiotics

Question 81

Question
During the surgery, the limb is removed at the joint - this procedure is called:
Answer
  • Excision
  • Exarticulation
  • Incision
  • Amputation

Question 82

Question
Which of these may cause ulcers in the foot?
Answer
  • Neuropathy
  • Ischemia
  • Trauma
  • Infection
  • None of these are correct

Question 83

Question
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?
Answer
  • Thyroid follicular cell hyperfunction
  • Thyroid follicular cell destruction
  • Ingestion iodide preparations or thyroid hormone

Question 84

Question
What are the causes of primary congenital adrenal insufficiency in children?
Answer
  • Waterhouse-Friedrichsen syndrome
  • Panhypopituitarism
  • Adrenal dysplasia
  • 21 hydroxylase deficiency
  • CNS malformations
  • Adrenoleucodystrophy

Question 85

Question
What is relevant to 17α-hydroxylase deficiency?
Answer
  • Hypogonadism
  • Increased blood pressure
  • Precocious puberty
  • Virilization in females
  • Males incomplete masculinization
  • Decreased blood pressure

Question 86

Question
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?
Answer
  • Diabetics ketonaemia
  • Diabetic ketoacidosis
  • Pneumonia
  • Gastroenteritis

Question 87

Question
Two main reasons of growth hormone discontinuation
Answer
  • Adult height reached or the growth rate is less than 3cm/yr
  • Growth plate fusion
  • Precocious puberty

Question 88

Question
If a girl started puberty at the age of 9 would it be considered early?
Answer
  • True
  • False

Question 89

Question
What is relevant to Central Precocious Puberty?
Answer
  • 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

Question 90

Question
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?
Answer
  • Appendicitis
  • Bacterial gastroenteritis
  • Crohn disease
  • Irritable bowel disease
  • Coeliac disease

Question 91

Question
What are the most common clinical and biochemical findings in children with type 2 diabetes?
Answer
  • Dyslipidemia
  • Positive autoimmune markers for diabetes
  • Obesity
  • All answers are correct
  • Acantosis nigricans
  • Hyperglycemia
  • Hypertension

Question 92

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

Question 93

Question
What is the target fasting glucose for the patient with diabetes mellitus?
Answer
  • ≤6.5 mmol/l + no hipos
  • ≤7.8 mmol/l + no hipos
  • ≤6.1 mmol/l + no hipos
  • ≤ 7.0 mmol/l + no hipos

Question 94

Question
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?
Answer
  • 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

Question 95

Question
What are the specific metabolic changes of arterial blood pH in diabetic ketoacidosis?
Answer
  • Diabetic acidosis
  • Metabolic acidosis
  • Metabolic alkalosis
  • Diabetic alkalosis
  • Respiratory acidosis

Question 96

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

Question 97

Question
Which drug may induce hypercalcemia?
Answer
  • Antidepressants
  • Denosumab
  • Antibiotics
  • Thiazide diuretics
  • Bisphosphonates

Question 98

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

Question 99

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

Question 100

Question
What ultrasound features are indicative of a malignant nodule of a thyroid?
Answer
  • There is no correct answer
  • Macrocalcinate
  • Anechoic nodule
  • Isoechoic spongiform appearance
  • Multinodular goitre
  • Hypoechoic nodule

Question 101

Question
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?
Answer
  • 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

Question 102

Question
What hormonal changes are specific for primary adrenal insufficiency?
Answer
  • 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

Question 103

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

Question 104

Question
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?
Answer
  • 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

Question 105

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

Question 106

Question
What are the clinical signs of thyrotropinoma?
Answer
  • Clinical symptoms of hyperthyrosis
  • Clinical symptoms of hypothyrosis
  • Clinical symptoms of hypercorticism
  • Signs of acromegaly
  • No correct answer

Question 107

Question
What can induce hypopituitarism?
Answer
  • 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

Question 108

Question
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?
Answer
  • 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

Question 109

Question
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?
Answer
  • Skin and areola preserving mastectomy
  • Radical (Patey) mastectomy
  • Extended radical mastectomy (Halsted)
  • Subcutaneous mastectomy

Question 110

Question
The most common Thyroid Cancer
Answer
  • Follicular
  • Medullar
  • Solid
  • Anaplastic
  • Papillary

Question 111

Question
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?
Answer
  • 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

Question 112

Question
What conditions should be maintained whe directing the patient to undergo a prosthetic treatment after a high leg amputation?
Answer
  • A fully healed wound
  • All responses are correct
  • Patients younger than 70 years
  • Sufficient physical activity of the patient
  • Pateints without concomitant disease

Question 113

Question
Clinical manifestation of autonomic neuropathy?
Answer
  • 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.

Question 114

Question
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:
Answer
  • Jaundice
  • Bradycardia
  • Large fontanelle
  • Tachycardia

Question 115

Question
What is the cause of hypoglycema in children with diabetes?
Answer
  • Insufficient dosage of rapid acting insulin for food
  • Excessive dose of insulin
  • No correct answers
  • Insufficient dosage of basal insulin

Question 116

Question
What curves are used to follow up child's growth?
Answer
  • Height, weight, body mass index, head circumference
  • Height, weight, Height and sitting height ratio, head circumference
  • Eight, weight, growth rate, body mass index

Question 117

Question
What are the most common causes of physiologic short height?
Answer
  • Constitutional growth nd puberty delay, familial (genetic) low height
  • Short height in chronic diseases
  • Short height due to hypogonadism

Question 118

Question
What is the usual chronology of changes FEMALES go through during puberty:
Answer
  • Thelarche→pubarche→menarche→peak height velocity (PHV)
  • Thelarche→menarche→PHV→pubarche
  • Pubarche→thelarche→PHV→menarche
  • Thelarche→pubarche→PHV→menarche

Question 119

Question
Premature thelarche and prematue pubarche and normal puberty variants.
Answer
  • True
  • False

Question 120

Question
What is the most common cause of diabetes mellitus in children?
Answer
  • Genetic defects of insulin action
  • Autoimmune β-cell destruction
  • No correct answer
  • Genetic defects of β-cell function

Question 121

Question
What are the clinical features of diabetes in children?
Answer
  • Anuria
  • Vaginal candidiasis in girls
  • Oedema
  • Weight loss
  • Polyuria

Question 122

Question
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?
Image:
20221011 142209[1] (binary/octet-stream)
Answer
  • Increased bone density
  • The test can not be interpreted because of incorrect execution
  • Osteopenia
  • There is not enough data
  • Osteoporosis

Question 123

Question
Match the Gonadal Dysgenesis type with its description. 46,XY [blank_start]ANSWER[blank_end] 45,X/46,XY [blank_start]ANSWER[blank_end] 46,XX [blank_start]ANSWER[blank_end] Asymmetric [blank_start]ANSWER[blank_end] Symmetric [blank_start]ANSWER[blank_end] 47,XXY [blank_start]ANSWER[blank_end] 45,X0 [blank_start]ANSWER[blank_end]
Answer
  • Mixed Gonadal Dysgenesis
  • Seminiferous tubule dysgenesis
  • Pure Gonadal Dysgenesis
  • Pure Gonadal Dysgenesis
  • Mixed Gonadal Dysgenesis
  • Seminiferous tubule dysgenesis
  • Mixed Gonadal Dysgenesis
  • Pure Gonadal Dysgenesis
  • Seminiferous tubule dysgenesis
  • Pure Gonadal Dysgenesis
  • Seminiferous tubule dysgenesis
  • Mixed Gonadal Dysgenesis
  • Mixed Gonadal Dysgenesis
  • Pure Gonadal Dysgenesis
  • Seminiferous tubule dysgenesis
  • Seminiferous tubule dysgenesis
  • Mixed Gonadal Dysgenesis
  • Pure Gonadal Dysgenesis
  • Pure Gonadal Dysgenesis
  • Mixed Gonadal Dysgenesis
  • Semininferous tubule Dysgenesis

Question 124

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

Question 125

Question
Unilateral adrenalectomy is first line treatment for the ACTH independent Cushing Syndrome
Answer
  • True
  • False

Question 126

Question
The most common causes of the secondary chronic adrenal insufficiency are brain tumors and trauma
Answer
  • True
  • False

Question 127

Question
Which of those are the actions of androgens?
Answer
  • 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

Question 128

Question
How do you classify a person whose weight is 85.7 kg and height is 1.93 m based on Body Mass Index?
Answer
  • Underweight
  • Normal
  • Overweight
  • Obesity Class I
  • Obesity Class Il
  • Obesity Class IlI

Question 129

Question
How do you classify a person who is 170 cm tall, weighs 95.4 kg and has a body mass index of 33?
Answer
  • Underweight
  • Normal
  • Overweight
  • Obesity Class I
  • Obesity Class II
  • Obesity Class Ill

Question 130

Question
What is the type of obesity of a woman whose waist circumference is 102 cm and hip circumference is 98 cm 1.0408163265306
Answer
  • Peripheral
  • Central

Question 131

Question
Which of those are the actions of mineralcorticoids?
Answer
  • 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

Question 132

Question
The patient is suspected to have Cushing's syndrome. What hormonal test is used for screening?
Answer
  • a. Testosterone
  • b. Cortisol
  • C. TSH or STH
  • d. Aldosterone and renine
  • e. Epinefrine and norepinefrine
  • f. Aldosterone
  • g. Renin

Question 133

Question
Which of the hormally active substance does not affect prolactin secretion?
Answer
  • a. All answers are correct
  • b. Dopamine
  • c. TRH
  • d. Vasopresine
  • e. Estrogenes

Question 134

Question
What are the clinical signs of mineralcorticoid excess when treating the chronic adrenal insufficiency?
Answer
  • a. Arterial hypertension, edemas
  • b. Loss of consciousness, hypotension
  • c. Hypotension, edemas
  • d. Edemas, frequent urination

Question 135

Question
What is the most probable cause of chronic primary adrenal insufficiency?
Answer
  • a. MEN 2A syndrome
  • b. Radiotherapy of the abdomen region
  • c. Non-functioning pituitary adenoma
  • d. Chronic renal failure
  • e Autoimmune adrenal damage

Question 136

Question
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?
Answer
  • 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

Question 137

Question
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?
Answer
  • 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

Question 138

Question
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?
Answer
  • 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

Question 139

Question
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?
Answer
  • 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

Question 140

Question
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?
Answer
  • 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

Question 141

Question
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?
Answer
  • 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

Question 142

Question
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?
Answer
  • 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

Question 143

Question
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?
Answer
  • 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

Question 144

Question
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?
Answer
  • 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

Question 145

Question
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?
Answer
  • 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

Question 146

Question
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?
Answer
  • 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

Question 147

Question
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?
Answer
  • 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

Question 148

Question
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?
Answer
  • 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

Question 149

Question
Patient develops hypoglycemia while at the hospital and is currently unconscious. His current blood glucose is 2.1mmol/l. What is the recommended approach?
Answer
  • 20 mg glucose orally
  • 80 ml 20% glucose i/v
  • 1 mg glucagon i/m
  • 4 IU rapid acting insulin s/c

Question 150

Question
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?
Answer
  • 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

Question 151

Question
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?
Answer
  • 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

Question 152

Question
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?
Answer
  • 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

Question 153

Question
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?
Answer
  • 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

Question 154

Question
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?
Answer
  • 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

Question 155

Question
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?
Answer
  • 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

Question 156

Question
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?
Answer
  • 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

Question 157

Question
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?
Answer
  • 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

Question 158

Question
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?
Answer
  • 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

Question 159

Question
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?
Answer
  • 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

Question 160

Question
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?
Answer
  • 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

Question 161

Question
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?
Answer
  • 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
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