ENDOCRINE Flashcards by Pootie Poo

The following factors are implicated in the pathogenesis of type 1 DM EXCEPT *
a. prenatal influences
b. diet in infancy
c. viral infections
d. psychologic stress
e. excessive exposure to certain
infections

excessive exposure to certain
infections

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In cerebral salt wasting, vasopressin level is characterized as:
a. Low
b. Normal
c. High
d. Very high

LOW

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Clinical manifestations of pheochromocytomas include the following EXCEPT *
a. hypertension
b. good appetite
c. convulsions
d. pulmonary
edema
e. Obesity

Obesity

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The MOST common cause of acquired hypopituitarism is : *
A. tuberculosis
B. craniopharyngioma
C. eosinophilic granuloma
(histiocytosis)
D. toxoplasmosis meningitis

craniopharyngioma

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The MOST accurate test of thyroid function is *
A. T4
B. free T4
C. T3
D. thyroglobulin
E. TSH

TSH

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The MOST common brain lesion causing central precocious puberty is *
A. postencephalitic scar
B. tuberculous meningitis
C. hypothalamic hamartoma
D. tuberous sclerosis
E. hydrocephalus

hypothalamic hamartoma

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The following are true about Hashimoto’s Thyroiditis EXCEPT: *
A. presence of thyrothropin
receptor-blocking Ab (TRB Ab)
B. patients don’t present with normal
serum T4 and TSH
C. in marked hypothyroidism, there is an
elevated TSH, low FT4
D. in subclinical hypothyroidism, there is an
elevated TSH and normal FT4

presence of thyrothropin
receptor-blocking Ab (TRB Ab)

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Patients with autoimmune Addison disease must be closely observed for the development of
other autoimmune disorders. Of the following, the MOST commonly associated disorder in
children is *
A. alopecia
B. vitiligo
C. chronic active hepatitis
D. type 1 diabetes mellitus
E. hypoparathyroidism

hypoparathyroidism

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The current criteria for the diagnosis of type 1 and type 2 DM is a fasting blood glucose that
exceeds *
A. 110 mg/dL
B. 115 mg/dL
C. 120 mg/dL
D. 125 mg/dL
E. 130 mg/dL

D. 125 mg/dL

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The following features suggest constitutional delay as a cause of short stature no signs or
symptoms of systemic disease: *
A. bone age delayed beyond the height age
B. period of poorest growth often occurring
between the ages of 18 and 30 months
C. parental or sibling history of delayed
development
D. height predictions consistent with family
characteristic

parental or sibling history of delayed
development

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The most common cause of patients presenting with rounded face, prominent cheeks, moon
facies, “Buffalo hump”, generalized obesity, abnormal masculinization and Impaired growth
with hypertension is: *
A. dyshormonogenesis
B. acquired primary adrenal insufficiency
C. autoimmune destruction of
pancreatic islets
D. prolonged exogenous administration
of glucocorticoid hormones

prolonged exogenous administration
of glucocorticoid hormones

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A 1-month old presents with vomiting and severe dehydration. PE shows ambiguous
genitalia.Lab tests show hyponatremia. There is a deficiency in what enzyme/hormone?
A. 11 B-Hydroxylase
B. 17B-Hydroxylase
C. 21A-Hydroxylase
D. 17A-hydroxyprogesterone

21A-Hydroxylase

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In young persons with open epiphysis, overproduction of growth hormone results in: *
A. Acromegaly
B. Gigantism
C. Klinefelter syndrome
D. Sotos syndrome

Gigantism

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A water deprivation test is indicated when pathologic polyuria and polydipsia are present and
serum osmolality is: *
A. >250 mOsm/kg, < 300 mOsm/kg
B. > 260 mOsm/kg, < 300 mOsm/kg
C. > 270 mOsm/kg, < 300 mOsm/kg
D. > 270 mOsm/kg, > 300 mOsm/kg

C. > 270 mOsm/kg, < 300 mOsm/kg

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Rapid correction of a person with serum sodium of 115meq/L will cause: *
A. Lateral pontine myelinolysis
B. Cerebral salt wasting
C. Central cerebellar myelinolysis
D. Central pontine myelinolysis

Central pontine myelinolysis

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Acquired nephrogenic diabetes insipidus (NDI) is associated with the following EXCEPT *
A. lithium
B. amphotericin
C. Methicillin
D. Rifampicin
E. vancomycin

vancomycin

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To diagnose a 2-day old neonate with ambiguous genitalia, vomiting, poor suck, the following
laboratory parameters are needed EXCEPT: *
A. androstenedione
B. dihydrotestosterone
C. 11-deoxycortisol
D. 17-hydroxyprogesterone
E. 17-hydroxypregnenolone

11-deoxycortisol
???

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The gold standard for diagnosis of tall stature is: *
A. MRI
B. IV glucose challenge test
C. IGF-1 challenge test
D. Oral Glucose challenge test

IGF-1 challenge test

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The following criteria are needed for the diagnosis of syndrome of inappropriate secretion of
antidiuretic hormone (SIADH) EXCEPT *
A. absence of volume
depletion
B. excessive urinary
sodium
concentration
C. hyponatremia with
normal serum
osmolality
D. elevated urine
osmolality D. normal
renal, adrenal, and
thyroid function

hyponatremia with
normal serum
osmolality

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All the following tests are of diagnostic utility in the diagnosis of Cushing syndrome EXCEPT *
A. midnight cortisol levels
B. nighttime salivary cortisol levels
C. glucose tolerance test
D. urinary excretion of free cortisol
E. dexamethasone suppression test

glucose tolerance test

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The cardinal clinical feature of gigantism includes: *
A. Longitudinal growth acceleration
B. Coarse facial features
C. Enlarging hands and feet
D. Visual problems

Longitudinal growth acceleration

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The following stimulate vasopressin (VP) secretion EXCEPT *
A. nausea
B. hyperosmolality
C. hyperglycemia
D. hypovolemia
E. hypotension

hyperglycemia

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Fluid resuscitation in patients with Congenital Adrenal Hyperplasia are needed to correct the
following EXCEPT: *
A. hypoglycemia
B. hyponatremia
C. hypokalemia
D. hyperkalemia
E. dehydration

hypokalemia

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Physiologic factors play a role in stimulating and inhibiting growth hormone (GH). One of the
following inhibit GH release : *
A. sleep
B. exercise
C. Fasting
D. hyperglycemia
E. Acute illness

hyperglycemia

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A 1-month old presents with vomiting and severe dehydration. PE shows ambiguous genitalia. Lab tests show hyponatremia. One of the following is the most reliable laboratory parameter to diagnose this patient: An increase in serum _________________? * A. 17-hydroxylase B. 21A-Hydroxylase C. 17A- OH progesterone D. 17A-OH pregnenolone

17A- OH progesterone

Diabetic ketoacidosis (DKA) is the end result of the metabolic abnormalities resulting from a severe deficiency of insulin or insulin effectiveness. DKA is characterized by the following EXCEPT * A. ketonuria B. decreased pH There is a large amount of ketonuria, an increased ion gap, a decreased serum bicarbonate (or total C. normal ion gap D. elevated effective serum osmolality E. decreased serum bicarbonate decreased pH elevated effective serum osmolality

normal ion gap

In older children with Cushing syndrome, in addition to obesity, a common early manifestation is * A. purplish striae on abdomen B. short stature C. hypertension D. hyperglycemia E. osteoporosis

short stature

Congenital X-linked Nephrogenic Diabetes Insipidus (NDI) results from mutations in the gene/receptor: * A. Aquaporin-1 gene B. Aquaporin-2 gene C. Vasopressin V1 receptor D. Vasopressin V2 receptor

Vasopressin V2 receptor

This is the major cause of morbidity and mortality in children with Type 1 Diabetes milletus. * A. Ketoacidosis B. Cerebral edema C. Hyperglycemia D. Nonketotic Hyperosmolar coma

Cerebral edema

A well-educated 11-year old female sought consult due to short stature. Family history showed a few short maternal aunts. Which is the most likely test that will help you with your diagnosis? * A. Bone aging B. Thyroid hormone tests C. Serum cortisol levels D. Serum insulin levels

Bone aging ???

The maximum days of estrogen priming needed prior to GH testing to achieve greater diagnostic specificity is: * A. 2 days B. 3 days C. 4 days D. 5 days

3 days

Treatment options of patients with Congenital Adrenal Hyperplasia include the ff. EXCEPT: * A. prednisone B. hydrocortisone C. dexamethasone D. Fluodrocortisone E. potassium chloride supplements F. sodium chloride supplements

potassium chloride supplements

Chronic SIADH is BEST treated with one of the following : * A. Diuretics B. Oral fluid restriction C. Demeclocycline D. Sodium supplementation

Oral fluid restriction

A 2-month old appears to be having inadequate weight gain. His mother claims that he is constipated.On PE, he has decreased muscle tone, a large fontanel, a large tongue, an umbilical hernia. The most common cause for this case is: * A. Iodine deficiency B. Thyroid malformation C. TSH unresponsiveness D. Defect in thyroid hormone synthesis E. Maternal Abs: Thyrotropin receptor-blocking Ab (TRB Ab)

Thyroid malformation ???

The classic manifestations of polyuria, polydipsia, optic atrophy, and brain abnormalities characterize this disorder: * A. Hyponatremia B. Diabetes insipidus C. Cerebral salt wasting D. Syndrome of Inappropriate Anti-Diuretic hormone

Diabetes insipidus

Syndrome of inappropriate antidiuretic hormone secretion is characterized by hyponatremia and an inappropriately concentrated urine mOsm/kg value of: * A. > 100 B. > 200 C. > 300 D. > 400

> 100

When a person consumes more than 2L per day, he would have increased urine output and the serum sodium would be: * A. Normal B. Decreased C. Increased D. Absent

Normal ???

The first clinical manifestation of acquired hypothyroidism is * A. goiter B. weight gain C. constipation D. poor schoolwork E. deceleration of growth

deceleration of growth

This is the end result of metabolic abnormalities from a severe insulin deficiency or insulin effectiveness. * A. Hyperglycemia B. Ketoacidosis C. Metabolic alkalosis D. Pheochromocytoma

Ketoacidosis

The MOST common cause of permanent congenital hypothyroidism is * A. dyshormonogenesis B. defect of iodide transport C. thyroid dysgenesis D. Iodine deficiency

thyroid dysgenesis

One of the following conditions are associated with Graves’ disease EXCEPT * A. Type 1 diabetes mellitus B. alopecia areata C. celiac disease D. vitiligo E. Anemia

Anemia

Approximately 10% of infants with congenital hypothyroidism have associated congenital anomalies. Of the following, the MOST common are * A. nervous system anomalies B. cardiac anomalies C. genitourinary anomalies D. lungs anomalies E. eye anomalies

cardiac anomalies

The following statements are TRUE about Type 2 Diabetes Mellitus EXCEPT: * A. Non-insulin dependent diabetes B. Noted peripheral insulin resistance C. With absolute insulin deficiency D. non-autoimmune destruction of B cells

With absolute insulin deficiency

Congenital autosomal recessive NDI results from mutations in: * A. Aquaporin-1 gene B. Aquaporin-2 gene C. Vasopressin V1 receptor D. vasopressin V2 receptor

Aquaporin-2 gene

One of the following is NOT part of the management of diabetic ketoacidosis. * A. Sodium HC03 only if pH is <7.2 B. Initial hydration fluid of hypertonic 3% NaCl C. Administration of glucose (5% soln in 0.2 N saline) D. Give K+ added after the initial 20ml/kg if UO is adequate

Initial hydration fluid of hypertonic 3% NaCl

The following are main features of Diabetic Ketoacidosis (DKA) EXCEPT: * A. ketonuria B. venous pH <7.20 C. serum HCO3<15 mEq/L D. ketonemia (serum ketones >3 mmol/L) E. hyperglycemia (glucose usually >300 mg/dL)

venous pH <7.20 ???

It is the most common recessive form of Multiple Pituitary Hormone Deficiency (MPHD). * A. Mutations in PTX2 B. Mutations in PROP1 C. Mutations in POU1F1 D. Mutations in POU1F2

Mutations in PROP1

The definitive diagnosis of growth hormone deficiency is the demonstration of: A. high levels of IGF1 B. High levels of GH C. Low levels of GH D. Low levels of IGF1

Low levels of GH

The thyroid hormones are transported in plasma bound to thyroxine-binding globulin (TBG), a glycoprotein synthesized in the liver. TBG binds approximately 70% of T4 and 50% of T3. TBG level increase with administration of : * A. estrogens B. androgens C. glucocorticoids D. nicotinic acid E. l-asparaginase

estrogens

Extracellular fluid volume is regulated by this mechanism. * a. Potassium intake and secretion b. Potassium intake and excretion C. Sodium intake and secretion d. Sodium intake and excretion

Sodium intake and excretion

The following are true in the management of severe Hyponatremia: * a. Fluid restriction b. Raise serum Na+ @ 0.5mEq/L/Hr using isotonic 3% NaCl C. Do emergency fluid challenge when serum sodium is <130 meq/L d. Raise serum Na+ no higher than 12 mEq/L/24hrs with hypertonic 3% NaCl

Raise serum Na+ no higher than 12 mEq/L/24hrs with hypertonic 3% NaCl

A consequence of Radioactive iodine Ablation in patients with Grave's disease would be: * a. Hashimoto’s thyroiditis b. Permanent hypothyroidism C. Transient diabetes insipidus d. Transient hypoparathyroidism

Permanent hypothyroidism

In systemic dehydration, the intravascular volume characterized as: * a. Low b. High C. Normal d. Very high

LOW

The following are TRUE of Type 1 Diabetes Milletus EXCEPT: * a. utilization of glucose by muscle and fat decreases b. dependent on insulin to prevent metabolic alkalosis C. Due to autoimmmune destruction of pancreatic B cells d. if uncontrolled, would lead to a nonlabored, rapid breathing

dependent on insulin to prevent metabolic alkalosis

The diagnosis of diabetes insipidus is established when: * 3. Serum osmolality is >200; urine osmolality is <200 b. Serum osmolality is >300; urine osmolality is >300 C. Serum osmolality is <200; urine osmolality is >200 d. Serum osmolality is >300; urine osmolality is <300

Serum osmolality is >300; urine osmolality is <300

Diagnostic criteria for Diabetic Milletus includes the following EXCEPT: * a. FBS>126mg/dL b. RBS > lOOmg/dL C. HbAlcof>6.5% d. 2-hour plasma glucose of 200mg/dL

RBS > lOOmg/dL

This is the mainstay for the management of Central Diabetes Insipidus. * 3. Pitressin b. Fluid therapy C. Desmopressin d. Caloric load for osmotic load

Fluid therapy

The following are true of Pheochromocytoma EXCEPT: * a. the lesion involve the right kidney b. Sx-free in between attacks of HPN C. Most common site is the adrenal cortex d. Surgical removal is the mainstay of management

Most common site is the adrenal cortex

Vasopressin insufficiency is found in what condition? * a. Central Diabetes insipidus b. Genetic Nephrogenic Diabetes Insipidus C. Acquired Nephrogenic Diabetes Insipidus d. Both Genetic, Acquired Nephrogenic Diabetes Insipidus

Central Diabetes insipidus

The triphasic response mechanism involved after a surgery or trauma is as follows : * a. Transient Diabetes insipidus — Permanent Diabetes insipidus— Syndrome of Inappropriate ADH secretion b. Syndrome of Inappropriate ADH secretion — Transient DI — Permanent DI C. Transient DI— SIADH — Permanent DI d. Permanent DI— SIADH — Transient DI

Transient DI— SIADH — Permanent DI

This is the main goal for the treatment of Nephrogenic Diabetes insipidus. * 3. Diuretics b. Treat underlying problem C. Provide enough calories d. High dose Desmopressin

Treat underlying problem

Excessive urine excretion and excessive thirst are common clinical manifestations in the following EXCEPT: * 3. Primary polydipsia b. Cushing syndrome C. Pheochromocytoma d. Maturity onset Diabetes of the Young

Cushing syndrome

A patient had recently a meningococcal infection and manifested the following : muscular weakness, malaise, anorexia, nausea, vomiting, wt loss, with saltcraving. On PE, there are highly pigmented- skin creases, mucosa, scars. The definitive test to confirm diagnosis is: * 3. Catecholamine levels b. Water deprivation test C. Single-dose Dexamethasone Suppression Test d. Cortisol levels before and after ACTH administration

Cortisol levels before and after ACTH administration

A 2-month old appears to be having inadequate weight gain. His mother claims that he is constipated. On PE, he has decreased muscle tone, a large fontanel, a large tongue, an umbilical hernia. The drug of choice for this patient is: * a. PTU b. Levothyroxine C. Desmopressin d. Hydrocortisone

Levothyroxine

A 12- year old female has a 6-month history of hyperactivity with declining school performance. Although her appetite is increased , she doesn't gain weight. PE showed mild exopthalmos, slight tremors of the fingers and a neck mass. The following are true for this case EXCEPT: a. LowTSH b. Thyroxine is increased C. Thyroid Receptor Antibody confirms the diagnosis d. Aside from PTU, may give Carbimazole Dtent) as treatment

Aside from PTU, may give Carbimazole Dtent) as treatment

A 2-month old appears to be having inadequate weight gain. His mother claims that he is constipated. On PE, he has decreased muscle tone, a large fontanel, a large tongue, an umbilical hernia. The earliest manifestation of this patient would have been: * 3. Hypotonia b. Cold, mottled skin C. Prolonged physiologic j aundice d. Edematous genitalia, extremities

Prolonged physiologic j aundice

Vasopressin release is stimulated by this process: * 3. Decreases in plasma tonicity b. Increases in plasma tonicity C. Decreases in urine volume d. Increases in urine volume

Increases in plasma tonicity

Match the following defects with the corresponding types of Nephrogenic DI. * Receptor mutations of Vasopressin 2 Direct on the Aquaporin-2 gene Processing mutations of Aquaporin-2 gene

MATCHING TYPES

ENDOCRINE Flashcards

(70 cards)