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Pathophysiology > Block 3 Endocrine System > Flashcards

Block 3 Endocrine System Flashcards

1
Q

In a patient with Cushing disease you will not find:
A. Reduced plasma ACTH
B. A lack of diurnal rhythm of secretion of glucocorticoids
C. Increased plasma cortisol
D. Osteoporosis
E. Hyperglycemia

A

A. Reduced plasma ACTH

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2
Q

Adrenal insufficiency is associated with:
A. Augmented water excretion by the kidneys and sodium loss in the urine
B. Improved resistance to infection and shock
C Euphoria
D. Increased mobilization and utilization of fatty tissue
E. Hyperglycemia with decreased insulin sensitivity

A

A. Augmented water excretion by the kidneys and sodium loss in the urine

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3
Q

Hyperglycemia in diabetes is related to:
A. Increased ketogenesis
B. Glucosuria
C Decreased gluconeogenesis
D. Decreased glucose uptake by peripheral tissues
E. Decreased glycogenolysis

A

D. Decreased glucose uptake by peripheral tissues

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4
Q

Insulin therapy in type 1diabetes is:
A. Required only in undernourished patients as insulin act as a growth factor
B. Required only when insulin requirements increase after heavy meals
C. Usually not required as this form of diabetes is easily managed with proper diet
D. Mandatory, as it compensates for the loss of B-cells
E. Mandatory, as it is necessary to overcome insulin resistance

A

D. Mandatory, as ti compensates for the loss of B-cells

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5
Q

Patients with diabetes have an increased risk of all of the following, exeept:
A. Neuropathy
B. Infections
C. Pancreatic cancer
D. Cataraets
E. Athereselerosis

A

C. Pancreatic cancer

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6
Q

Which of the following disorders is not present in a patient with Addison disease:
A. Skin hyperpigmentation
B. Hyponatremia
C Muscle weakness
D. Hypotension
E Hypokalemia

A

E Hypokalemia

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7
Q

Which of the following disorders is not present in a patient with adrenal secondary deficiency:
A. Skin hyperpigmentation
B. Hyponatremia
C. Muscle weakness
D. Hypotension
E. Hyperkalemia

A

A. Skin hyperpigmentation

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8
Q

Primary hyperthyroidism is characterized by:
A. Increased TSH, increased T4
B. Decreased TSH, decreased T4
C Increased TSH, decreased T4
D. Decreased TSH, increased T4
E. Decreased T4, increased T3

A

D. Decreased TSH, increased T4

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9
Q

Which of the following changes is not probable in a patient with growth hormone (GH) deficiency:
A. Immature facial appearance
B. Hypolipidemia
C. Delay in skeletal maturation
D. Hypoglycemia
E. Short stature

A

B. Hypolipidemia

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10
Q

In a patient with primary adrenal insufficiency you will find the following changes, except:
A. Hypotension
B. High ACTH levels
C. Skin hyperpigmentation
D. Low sodium levels
E. Low potassium levels

A

E. Low potassium levels

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11
Q

60 yo patient, heavy smoker, with diagnosed lung squamous cell carcinoma. He reports weakness, constipation, lethargy. His blood calcium is high and phosphorous is low. You expect an excess of:
A. Endogenous 1.25 (OH) 20 (1.25-dihydroxyvitamin D)
B. None of the listed
C. Parathyroid hormone related peptide
D. Parathyroid hormone
E Caleitonin

A

C. Parathyroid hormone related peptide

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12
Q

A 21 yo diabetic patients with abdominal pain, nausea, and vomiting of 16 hours duration. His insulin pump has stopped functioning. Which of the following are likely to be associated with his presentation?
A. High plasma insulin levels
B. Increased serum ketones
C. Increased glucagon concentrations
D. Increased blood ph
E. Decreased hepatic glycogen breakdown

A

B. Increased serum ketones

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13
Q

Which of the following statements about infections in diabetes is false:
A. Infections increase insulin requirements
B. Diabetes impaired phagocyte function
C. Diabetic often suffer from asymptomatic bacteriuria
D. Infections are often protracted due to angiopathy-related tissue ischemia
E. All of the above are true

A

E. All of the above are true

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14
Q

Risk factors for type 1diabetes mellitus include:
A. Family history
B. Gender
C. Obesity
D. Inactivity
E. All of the factors listed above

A

A. Family history

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15
Q

Which of the following will not occur in diabetes?
A. Increased protein breakdown in skeletal muscles
B. Increased gluconeogenesis
C. Increased glucose uptake by skeletal muscles
D. Increased glucose excretion in urine
E. Increased degradation of adipose tissue

A

C. Increased glucose uptake by skeletal muscles

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16
Q

The abnormality that can be seen both in Cushing’s disease and in Addison’s disease is:
A. High ACTH
B. Low calcium
C Low cortisol
D. Low glucose
E. Low sodium

A

A. High ACTH

17
Q

Addison’s disease is characterized by:
A. Ectopic ACTH production
B. Secondary hyperadrenocorticism
C. Increased mineralocorticoid secretion
D. Primary adrenal insufficiency
E. Compensatory adrenal hyperplasia

A

D. Primary adrenal insufficiency

18
Q

Infusion of ACTH into a patient with Addison’s disease will:
A. Decrease cortisol levels and increase aldosterone levels
B. Fail to increase both cortisol and aldosterone levels
C. Make cortisol and aldosterone levels undetectable
D. Increase cortisol levels but decrease aldosterone levels
E. Increase both cortisol and aldosterone levels

A

B. Fail to increase both cortisol and aldosterone levels

19
Q

Which of following signs may develop as a result of hypocalcemia?
A. Rumpet-leede sign
B. Trousseau’s sign
C Cullen’sign
D. Babinski’s sign
E. None of the above

A

B. Trousseau’s sign

20
Q

All of the following may lead to hypocalcemia, except:
A. Acute pancreatitis
B. Rhabdomyolysis
C. Pseudohypoparathyroidism
D. Hyperparathyroidism
E.Renal failure

A

D. Hyperparathyroidism

21
Q

Hyperglycemia in Cushing’s syndrome results from:
A. Decreased insulin secretion
B. Impaired glucose excretion
C. Increased growth hormone secretion
D. Increased gluconeogenesis
E. The basic statement is false; cushing’s syndrome leads to hypoglycemia

A

D. Increased gluconeogenesis

22
Q

An overnight suppression test with a low dose of dexamethasone:
A. Wil not produce a decrease in cortisol levels in healthy individuals
B. Will not produce a decrease in cortisol levels in cushing’s syndrome
C. Will produce a decrease in cortisol levels in cushing’s syndrome
D. Wil produce a decrease in cortisol levels ni patient with ectopic ACTH- production
E. None of the above statements is correct

A

B. Will not produce a decrease in cortisol levels in Cushing’s syndrome

23
Q

Which of the following statements is true?
A.normal TSH level excludes hyperthyroidism and primary hypothyroidism
B. The presence of proptosis and pretibial myxedema indicates Hashimoto’s disease
C. Elevated levels of plasma free T4 are diagnostic of clinical hypothyroidism
D. Assay of total T4 alone is the initial test of choice in most patients with suspected thyroid disease
E. Hypothyroidism in the elderly may present only with sinus tachycardia or atrial fibrillation

A

A. A normal TSH level excludes hyperthyroidism and primary hypothyroidism

24
Q

Which of the following findings is least likely to occur in a patient with hypothyroidism?
A. Hypotension
B. Hyperventilation
C. Hypothermia
D. Bradycardia
E. Hypercholesterolemias

A

B. Hyperventilation

25
Q

Which of the following abnormalities would be most likely to occur as a result of impaired growth hormone action?
A. Low birth weight and failure to thrive
B. Failure to double birth weight in 6 month
C. Short statue in a 12 yo boy
D. Fasting hypoglycaemia
E. Deepening of the voice and increased fascial hair

A

C. Short statue in a 12 yo boy

26
Q

A patient with chronic autoimmune (Hashimoto’s) thyroiditis develops a rapidly enlarging thyroid mass. Mostly likely this is:
A. Thyroid lymphoma
B. Medullary thyroid carcinoma
C. Papillary thyroid carcinoma
D. Anaplastic thyroid carcinoma
.E Follicular thyroid carcinoma

A

C. Papillary thyroid carcinoma

27
Q

Elevated plasma calcitonin is seen with:
A. Thyroid lymphoma
B. Medullary thyroid carcinoma
C. Anaplastic thyroid carcinoma
D. Papillary thyroid carcinoma
E. Follicular thyroid carcinoma

A

B. Medullary thyroid carcinoma

28
Q

A low TSH, high T4 and high T3 suggests:
A. Hyperthyroidism
B. Nonthyroidal illness (sick euthyroidism)
C. Estrogen therapy
D. Subclinical hypothyroidism
E. Familiar (euthyroid) dysalbuminenic hyperthyroxinaemia

A

A. Hyperthyroidism

29
Q

Infiltration of orbital soft tissue and extraocular muscles with lymphocytes, mucopolysaccharides, and fluid is seen with:
A. Graves disease
B. lodine-induced hyperthyroidism
C. Choriocarcinoma
D. Struma ovarii
E. Toxic multinodular goiter

A

A. Graves disease

30
Q

In a patient with sever hypoglycaemia (39 mg Di), the differential diagnosis self-administered insulin overdose and a tumor that produces excess insulin can be made by determining plasma levels of:
A. Insulin
B. Somatostatin
C. C-peptide
D. Gastrin
.E Insulin like growth factor 1(IGF-1)

A

C. C-peptide

Pathophysiology (6 decks)

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