2016 exam Flashcards
(90 cards)
1
Q
What field of vision is lost when a pituitary tumor grows anteriorly?
A-central field
B-lateral field in one eye
C-lateral field in both eyes
A
C-lateral field in both eyes
2
Q
Where does the axons of hypothalamic neurons which release oxytocin terminate? A. Pars intermedia B. Pars distalis C. Median eminence D. Pars nervosa E. Infundibulum
A
D. Pars nervosa
3
Q
Injury to which structure should be avoided during a surgery to the posterior aspect of the suprarenal gland? A- Aorta B- Diaphragm C-Pancreas D-Stomach
A
B- Diaphragm
4
Q
Which of the following is a feature of oxyphil cells? A- They’re smaller than chief cells B- they have basophilic cytoplasm C- they secrete calcitonin D- they have lots of mitochondria
A
D- they have lots of mitochondria
5
Q
What is the clinical disorder that results from increased levels of growth hormone in adults? A- Acromegaly B- gigantism C- growth suppression D- cretinism
A
A- Acromegaly
6
Q
Feature of osteoclast: A- there are no receptors for parathormone B- basophilic cytoplasm C- lifespan 20 days D- located between lamellae
A
A- there are no receptors for parathormone
7
Q
What’s the main feature of Leydig cells? A- Basophilic cytoplasm B- Foamy high lipid content C- Rough endoplasmic reticulum D- Controlled by FSH
A
B- Foamy high lipid content
8
Q
Oral drug that inhibits ATP-dependent K+ channels?
A
Glipizide
9
Q
In radioimmunoassay, there was low displacement of the radioactivity from the antibodies. What does that indicate?
A- low hormone levels in serum
B- high levels of hormone
C- high specificity of antibody to the tube
D-low specificity of Ab
E- high radioactivity
A
A- low hormone levels in serum
10
Q
What is the major effect of vit D?
A
Increase absorption of Ca2+ in the gut
11
Q
What does excess thyroid hormone cause?
A
increase BMR
12
Q
Which hormone decreases feeding?
A
Leptin
13
Q
A 29 year-old female with SLE on glucocorticoid treatment. Whats the most likely diagnosis? A- cortical atrophy B- cortical hyperplasia C- cortical nodule D- medullary atrophy E- medullary nodule
A
A- cortical atrophy
14
Q
A 39 year old female with hyperpigmentation hypotension and high Ach levels. A- cortical atrophy B- cortical hyperplasia C- cortical nodule D- medullary atrophy E- medullary nodule
A
A- cortical atrophy
Addison disease
15
Q
What causes somatostatin to inhibit growth hormone? A- Increased cAMP B- Decreased cAMP C- Increased intracellular Ca+2 D- Decreased intracellular Ca+2
A
B- Decreased cAMP
16
Q
These cells secrete a hormone identical to the hormone secreted from the hypothalamus A- D1 cells B- EC cells C- Epsilon cells D- Alpha cells E- Delta cells
A
E- Delta cells
they release somatosstatin and it is structurally the same as GHRH
17
Q
These cells produce a hormone that stimulates appetite A- D1 cells B- EC cells C- Epsilon cells D- Alpha cells E- Delta cells
A
C- Epsilon cells
ghrelin secreting
18
Q
A 22 y/o old female who failed to have pregnancy after 2 years of unprotected intercourse. What would give her an anovulatory menstrual cycle?
A
PCOS
19
Q
male phenotype with 46/XY, 47/XXY mosaic karyotype
A
Klinefelter syndrome
20
Q
131-MIBG is treatment of what?
A
neuroblastomas
21
Q
What is the cause of failure to complete sexual maturation in Klinefelter syndrome?
A
Testosterone release by Leydig cell
22
Q
Organ specific autoimmune disease
A
Hashimoto’s hypothyroidism
23
Q
Which of the following is consistent with HONK?
A- Severe hyperglycemia and dehydration
B- Severe hyperglycemia due to insulin omission
C- Good prognosis less than 1% mortality
D- Associated with metabolic alkalosis
A
A- Severe hyperglycemia and dehydration
24
Q
Patient with DM type 2 and heart failure. What is the least likely treatment that you will give him?
A
Rosiglitazone
25
Female phenotype, 46 XY karyotype with undescended testes and normal testosterone secretion
Androgen insensitivity
26
```
A 20 y/o lady presents with a 9 month history of neck swelling and thyrotoxicosis symptoms. Investigations revealed increased T4 and decreased TSH with a palpable nodule. What will be the next investigation?
A- ultrasound scan of the thyroid
B- thyroid scan
C- radioactive iodine uptake
D- CT scan of the pituitary
E- MRI of the pituitary
```
B- thyroid scan
27
```
28 y/o female patient with thyroid nodule she denies pain, hoarseness of voice, obstructive symptoms, the laboratory test reviled normal TSH? What is the next step of investigation?
A- thyroid scan
B- measuring T4
C- ultrasonography
D- no further evaluation
```
C- ultrasonography
thyroid investigations
1. Always start w/ TSH
2. T4 ( you don’t do it if TSH is normal)
3. Thyroid scan (you do it if the patient is symptomatic and TSH is abnormal)
4. Ultrasound (you always do it if you have nodule/goiter to check for nodularity, cystic changes, and vascularity), ( if microcalcifications and solid component = high risk of malignancy)
5. FNAC (you do it if you have a high risk of malignancy = cold nodule, microcalcifications, or solid component)
28
```
What pancreatic tumor is associated with amyloid deposition?
A- VIPoma
B- Glucagonoma
C- insulinoma
D- SSToma
```
C- insulinoma
29
XX female presented with ambiguous genitalia, hyperplasia of both adrenals, What is the mechanism of the condition?
Enzymatic defect
30
Choose the appropriate biochemical laboratory test for a mass in the sella turcica composed of acidophilic cells that stained positive for growth hormone?
Pit1
31
25 years old female presented with fever, myalgia and enlarged thyroid , fine needle aspiration shows granuloma giant cells and destroyed thyroid follicles?
De Quervain thyroiditis
32
35 year old female presented w/ weight gain and abdominal striae on examination and she was on rheumatoid arthritis medications more than 6 month, what is the most likely cause of her symptoms?
iatrogenic Cushing
33
```
53 y/o old female she complains of nausea and constipation, she had recently been diagnosed with hypertension, she had a past history of renal stones?
A- Hyperparathyroidism
B- vit D deficiency
C- Cushing’s syndrome
D- celiac disease
```
A- Hyperparathyroidism
(hypertension is one of the earliest manifestations of Cushing BUT
Nausea, constipation, and renal stones are typical the presentations of hyperparathyroidism)
34
What is the main source of estrogen in the fetus?
Placenta (main estrogen in pregnancy = estriol)
35
```
What is the function of sTAR?
A- cholesterol ester
B- regulation of steroid synthesis
C- degradation of steroids
D- cholesterol to pregnanolone
```
B- regulation of steroid synthesis
36
Ophthalmopathy may be associated in 50% in these patients?
Grave’s disease
37
A 40 year old male presented with a solitary thyroid nodule. Physician suspected it to be a neoplasm. What investigation is appropriate for preoperative diagnosis?
A- Ultrasonography
B- T3, T4 & TSH levels in blood
C- FNAC
C- FNAC
38
What prevents osteoporosis in a female by inhibiting the activation of osteoclasts?
OPG
39
```
20 y/o overweight female went to diabetic clinic to check her risk of developing DMT2, despite her positive family history, which of the following will put her at high risk of DMT2?
A- Waist circumference 75 cm
B- Acanthosis nigricans
C- BMI = 25kg/m2
D- BP = 130/85
E- HR = 100beat/min
```
B- Acanthosis nigricans
40
A woman post-delivery she couldn’t breast feed her baby, and had a blood transfusion due to excessive hemorrhage. Whats the diagnosis?
Sheehan syndrome
41
What stimulates the production of testosterone from testes?
LH
42
in postmenopausal women, which sex hormone and gonadotropin will be elevated?
A- Estriol and FSH
B- Estrone and LH
C- Estrone and FSH
C- Estrone and FSH
43
Why is male sperm auto-immunogenic/ why is there anti-sperm autoimmunity in males?
Because the sperms develop after the immune system learns to distinguish between self and non-self
44
What indicates energy depletion in cells?
a. AMP
b. ATP
c. Phosphate
d. Lactate
a. AMP
45
A 32 y/o female presented w/ palpitations, increased respiratory rate, warm hand, and proptosis, what do you expect to find in lab results?
High T4 and T3, low TSH
46
We do screening for which thyroid disease?
a. Thyroid cancer
b. Adult hyperthyroidism
c. Adult hypothyroidism
d. Infant cretinisim
d. Infant cretinisim
47
```
What inhibits feeding center?
A- NPY
B- AGRP
C- PPY
D- cortisol
```
C- PPY
48
Compared to leuprolide, what describes ganirelix?
A- it antagonizes GnRH directly
B- initially it increases LH and FSH then it suppresses them
A- it antagonizes GnRH directly
49
A female with a normal 28-days menstrual cycle. 12-hours earlier she had her peak estradiol levels without any significant progesterone. What do you expect after 3 days?
a. Ovulation
b. Menses
c. Corpus luteum will degenerate
a. Ovulation
50
What is involved in tissue destruction in autoimmune oophoritis?
a. Antibody mediated cytotoxic killing
b. Inducers of suppressive T-cells
c. Cytotoxic t cell
d. NK cells
c. Cytotoxic t cell
51
```
Which is responsible in bone formation in osteoporosis?
A- calcitonin
B- calcitriol
C- Estrogen
D- Fluoride
```
D- Fluoride
| the only osteoblastic drug
52
What is the function of dual oxidase?
production of H2O2
53
What hormone synthesis requires vitamin C?
Both oxytocin and vasopressin
54
```
27 year old male presented with hypertension and a pituitary tumor associated with hypokalemia and metabolic alkalosis. What condition is most likely present?
A- Acromegaly
B- Cushing disease
C- Pheochromocytoma
D- Addison’s
E- Ectopic ACTH
```
B- Cushing disease
55
```
Least likely risk factor to develop osteoporosis
A- smoking
B- alcohol
C- parental history (genetic)
D- past history of hip fracture
E- low bone mass density
F- hypothyroidism
```
F- hypothyroidism
56
Mass in sella turcica with cells expressing pit1. Whats the diagnosis?
Acromegaly
57
```
36 year old female with numbness around her mouth for a few weeks came to the emergency room because of carpopedal spasm. Serum calcium is 2.0. Which is the most likely:
A- Low magnesium
B- Low sodium
C- High glucose
D- High anion gap acidosis
```
A- Low magnesium
| Mg is needed for normal parathyroid function; low Mg →low PTH →low Ca
58
A female had a surgery to remove pituitary gland and she didn't take any replacement therapy, what symptom will she experience?
A- Amenorrhea
B- high blood sugar
C- hypoparathyroidism
A- Amenorrhea
59
Patient with increased thyroxine and decreased TSH with smaller than normal thyroid gland, What is the possible cause?
A- Gravis disease
B- Increased iodine intake
C- Patient taking Antithyroid drug
D- Anterior pituitary lesion causing low TSH
E- Patient taking propylthiouracil
B- Increased iodine intake
60
```
What is the most common form of adult thyroid cancer?
A- anaplastic
B- medullary carcinoma
C- Hurthle cell cancer
D- papillary cancer
E- follicular cancer
```
D- papillary cancer
61
What is involved in tissue destruction of DM type 1?
cytotoxic t cell & MPs
62
What inhibits carbohydrate absorption?
A- Glipizide
B- Acarbose
B- Acarbose
63
What is the substrate of 5 alpha reductase?
Testosterone
64
A question about calculating the ovulation day in a female with 30-32 days regular menstrual cycle. When is her ovulation day?
day (16-18)
65
which of the following statements best describes teriparatide?
A- it increases osteoblasts apoptosis
B- it increases the number of osteoblasts
C- is the 1-84 peptide fragment of PTH
D- is given orally, in high doses
B- it increases the number of osteoblasts
66
A diabetic lady who can't control her glucose levels by diet or exercise despite trying, what would you give her?
A- sulphanureas
B- Rosiglitazone
C- Metformin
C- Metformin
67
What cause long loop inhibition?
A- Parathyroid hormones
B- LH and FSH
C- Prolactin
B- LH and FSH
68
```
How does 2,5 T2 stimulate heat generation in brown adipose tissue?
A- Decrease oxygen consumption
B- Increase ATP synthesis efficiency
C- Decrease the activity of TCA enzymes
D- Uncoupling
```
D- Uncoupling
69
Endocannabinoid is derived from?
arachidonic acid
70
chronic stress effect on telomeres?
A- lengthening
B- shortening
B- shortening
71
```
T1D 12 y/o diagnosed 4 years ago. Whats most likely?
A- Anti-insulin antibodies
B- undetected levels of c-peptide
C- hyperinsulinemia
D- Lipolysis
E- Hypoglyecemia
```
B- undetected levels of c-peptide
(in T1DM, the major pathophysiology is insulin deficiency because of autoimmune destruction of beta cells, with insulin deficiency you can not detect c-peptide levels since they are both from pro-insulin which is also deficient, this is found in ALL T1DM cases; on the other hand the anti-insulin Abs are only found in approximately 50% of the pts.)
72
```
45 year old male with impaired glucose tolerance. Whats most likely?
A- Anti-insulin antibodies
B- undetected levels of c-peptide
C- hyperinsulinemia
D- Lipolysis
E- Hypoglyecemia
```
C- hyperinsulinemia
73
```
18 year old female T1D found comatosed. Whats most likely?
A- Anti-insulin antibodies
B- undetected levels of c-peptide
C- hyperinsulinemia
D- Lipolysis
E- Hypoglyecemia
```
D- Lipolysis
| Complication of T1DM →DKA; in DKA we have increased lipolysis
74
A 15 y/o adolescent presented to the outpatient 3 weeks after being discharged having meningitis. He showed no neurological symptoms but had increased urine output of 7 liters per day & increased thirst.
What do you expect to find in his urine analysis?
A- Osmolality Of 200 mOsmol/kg
B- Positive for ketone
C- Positive for nitrites
D- Glucose Of 30 mmol/L
E- Protein more than 400 mg/day
A- Osmolality Of 200 mOsmol/kg
75
```
Which form of thyroid hormone is most potent on genome?
A- T4
B- T3
C- rT3
D- 3,5-T2
E- 5,5-T2
```
B- T3
76
```
Which form of thyroid hormone is a pro-hormone?
A- T4
B- T3
C- rT3
D- 3,5-T2
E- 5,5-T2
```
A- T4
77
```
What hormone produced by hypothalamus inhibits growth hormone?
A- Ghrelin
B- Igf11
C- Igf1
D- Somatostatin
```
D- Somatostatin
78
```
Which of the following correlates positively with BMI?
A- Insulin
B- Resistin
C- Adiponectin
D- Cortisol
E- Growth hormone
```
B- Resistin
79
Proportional rate of growth between two body parts?
Isometric growth
80
```
Which secretes testosterone?
A- Sertoli cells
B- Leydig cells
C- Theca leutia
D- Granulosa cells
E- Theca interna
```
B- Leydig cells
81
```
Which secretes inhibin?
A- Sertoli cells
B- Leydig cells
C- Theca leutia
D- Granulosa cells
E- Theca interna
```
A- Sertoli cells
82
What is true with regards children and pain?
A- as children grow their pain tolerance increases
B- children behavior reflect their pain intensity
C- children get addicted to necrotic fast
D- children get accustomed to pain
A- as children grow their pain tolerance increases
83
```
The resected tumor in a 30- year old female shows pale nucleus, nuclear groove and psammoma bodies. Whats most likely?
A- Follicular carcinoma
B- Papillary carcinoma
C- Medullary carcinoma
D- Non-Hodgkin lymphoma
```
B- Papillary carcinoma
84
```
Calcitonin positive tumor
A- Follicular carcinoma
B- Papillary carcinoma
C- Medullary carcinoma
D- Non-Hodgkin lymphoma
```
C- Medullary carcinoma
85
A 50 year old lady with a history of hypertension, sweating and palpitations, What is the diagnosis?
Pheochromocytoma
86
34 year man with hypertension, central obesity, striae and peripheral myopathy. What biochemical test must be carried out?
24h urine cortisol
87
```
A 12 year old girl presented to the emergency department after 2 months history of lethargy, polyuria, & weight loss. Hb1c 10.5%.
A- subcutaneous insulin
B- intravenous insulin
C- no treatment
D- Diet & exercise
```
A- subcutaneous insulin
88
```
17 y/o female presented to ER with polyuria
A- subcutaneous insulin
B- intravenous insulin
C- no treatment
D- Diet & exercise
```
?
| if DKA give IV
89
```
45 y/o female with hyperglycemia and polyuria.
A- subcutaneous insulin
B- intravenous insulin
C- no treatment
D- Diet & exercise
```
D- Diet & exercise
| the q had many RFs for DMT2 so we start off the management by diet and exercise
90
How does Tolvaptan work in hyponatremia?
A- Increases sensitivity of V2 receptors
B- Competitively blocks V2 receptors
B- Competitively blocks V2 receptors
