Revision Questions Flashcards
(78 cards)
1
Q
What is the most common cause of Cushing’s syndrome?
A
Glucocorticoid Treatment
2
Q
Which of the following is NOT a sign of acromegaly?
Decreased Foot Size
Big Hands
Big Feet
A
Decreased Foot Size
3
Q
What is a toxic thyroid adenoma?
A
Benign tumour of Thyroid gland
4
Q
Toxic thyroid adenoma arises from?
A
Follicular Cells of Thyroid
5
Q
Grave’s Disease is what type of disease?
A
Autoimmune directed against TSH Receptors
6
Q
In Grave’s Disease what happens to T3 and T4 Production?
A
Autoantibodies stimulate TSH Receptors causing increased T3 and T4 Production
7
Q
Cushing’s Disease results from what?
A
Benign Pituitary Adenoma secreting excess ACTH
8
Q
High Levels of ACTH causes increased production of what?
A
Cortisol from Adrenal Cortex
9
Q
What is the most common cause of hyperthyroidism?
A
Grave’s Disease
10
Q
Name a common symptom of hypothyroidism?
A
Dry Skin
11
Q
Which common hormone is not produced in anterior pituitary gland?
A
Oxytocin
12
Q
What does the adrenal cortex produce?
A
Cortisol
13
Q
What is a sensitive method of measuring thyroid function?
A
Thyroid Stimulating Hormone
14
Q
What hormone is stored in posterior pituitary gland?
A
Oxytocin
15
Q
Name a symptom of acromegaly related to temperature regulation?
A
Excessive Sweating
16
Q
Which investigation is gold standard for diagnosing acromegaly?
A
Oral Glucose Tolerance Test + Growth Hormone Measurement
17
Q
What best describes an Addisonian Crisis?
A
Severe adrenal insufficiency resulting in dangerously low serum cortisol levels
18
Q
Name a common symptom of hyperthyroidism?
A
Tremor
19
Q
With regards to the investigation of hyperthyroidism, which one of the following antibodies is specific to Grave’s disease?
A
TSH Receptor Antibodies
20
Q
What is the most common cause for the overproduction of growth hormone in acromegaly?
A
Pituitary Adenoma
21
Q
Which of the following are symptoms of Addison’s disease?
A
Hyperpigmentation
22
Q
What is Addison’s disease?
A
Addison’s disease is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones.
23
Q
Which one of the following is the main function of aldosterone?
A
Increase in blood volume
24
Q
Which one of the following hormones binds to the pituitary and stimulates the release of luteinizing hormone (LH) and follicle stimulating hormone (FSH)?
A
Gonadotrophin releasing hormone (GnRH)
25
Which gender is more likely to get Cushing's syndrome?
Women are more likely to develop Cushing's syndrome
26
The risk factors for type 1 diabetes include all of the following except:
1. Diet
2. Genetic
3. Autoimmune
4. Environmental
Diet
27
Type 2 diabetes accounts for approximately what percentage of all cases of diabetes in adults?
1. 55%-60%
2. 35%-40%
3. 90-95%
4. 25-30%
3. 90-95%
28
Risk factors for type 2 diabetes include all of the following except:
1. Advanced age
2. Obesity
3. Smoking
4. Physical inactivity
3. Smoking
29
What percentage of women with gestational diabetes is diagnosed with type 2 diabetes following pregnancy?
1. 25%-30%
2. 5%-10%
3. <5%
4. 20%-25%
2. 5%-10%
30
Untreated diabetes may result in all of the following except:
1. Blindness
2. Cardiovascular disease
3. Kidney disease
4. Tinnitus
4. Tinnitus
31
Prediabetes is associated with all of the following except:
1. Increased risk of developing type 2 diabetes
2. Impaired glucose tolerance
3. Increased risk of heart disease and stroke
4. Increased risk of developing type 1 diabetes
4. Increased risk of developing type 1 diabetes
32
Diabetics are at increased risk of heart disease if they also:
1. Smoke
2. Have high HDL cholesterol levels
3. Take aspirin
4. Consume a high-fiber diet
1. Smoke
33
Blood sugar is well controlled when Hemoglobin A1C is:
1. Below 7%
2. Between 12%-15%
3. Less than 180 mg/dL
4. Between 90 and 130 mg/dL
1. Below 7%
34
Excessive thirst and volume of very dilute urine may be symptoms of:
1. Urinary tract infection
2. Diabetes insipidus
3. Viral gastroenteritis
4. Hypoglycemia
2. Diabetes insipidus
35
Among female children and adolescents, the first sign of type 1 diabetes may be:
1. Rapid weight gain
2. Constipation
3. Genital candidiasis
4. Insomnia
3. Genital candidiasis
36
Untreated hyperglycemia may lead to all of the following complications except:
1. Hyperosmolar syndrome
2. Vitiligo
3. Diabetic ketoacidosis
4. Coma
4.Coma
37
Hyperinsulinemia may be caused by all of the following except:
1. An insulinoma
2. Nesidioblastosis
3. Insulin resistance
4. Type 1 diabetes
4.Type 1 diabetes
38
Which statement about diabetes is false?
1. The U.S. prevalence of diabetes is decreasing
2. Diabetes is the seventh leading cause of death in the United States
3. Diabetes is the leading cause of blindness among persons age 20 to 74
4. Diabetes is the leading cause of kidney failure
1. The U.S. prevalence of diabetes is decreasing
39
The lifetime risk of developing diabetes for a male born in 2000 is:
1. 1 in 5
2. 1 in 3
3. 2 in 5
4. 1 in 2
2. 1 in 3
40
Which of the following measures does not help to prevent diabetes complications?
1. Controlling blood glucose
2. Controlling blood pressure and blood lipids
3. Eliminating all carbohydrates from the diet
4. Prompt detection of diabetic eye and kidney disease
3. Eliminating all carbohydrates from the diet
41
Proliferative retinopathy is often treated using:
1. Tonometry
2. Fluorescein angiogram
3. Antibiotics
4. Laser surgery
4. Laser surgery
42
Which of the following diabetes drugs acts by decreasing the amount of glucose produced by the liver?
1. Sulfonylureas
2. Meglitinides
3. Biguanides
4. Alpha-glucosidase inhibitors
3. Biguanides
43
The benefits of using an insulin pump include all of the following except:
1. By continuously providing insulin they eliminate the need for injections of insulin
2. They simplify management of blood sugar and often improve A1C
3. They enable exercise without compensatory carbohydrate consumption
4. They help with weight loss
4. They help with weight loss
44
Which of the following regimens offers the best blood glucose control for persons with type 1 diabetes?
1. A single anti-diabetes drugs
2. Once daily insulin injections
3. A combination of oral anti-diabetic medications
4. Three or four injections per day of different types of insulin.
4. Three or four injections per day of different types of insulin.
45
Diabetic neuropathies are diagnosed using all of the following except:
1. Nerve conduction studies or electromyography
2. Ultrasound
3. Foot examinations
4. Minnesota Mutiphasic Personality inventory (MMPI)
4. Minnesota Mutiphasic Personality inventory (MMPI)
46
Question 1
Which of the following confirmed values meet the diagnostic threshold for diabetes?
a) fasting blood glucose ? 140 mg/dl
b) random glucose > 160 mg/dl
c) 2 hour post prandial glucose ≥ to 126 mg/dl
d) fasting blood glucose ≥ 126 mg/dl
d) fasting blood glucose ≥ 126 mg/dl
47
Which of the following statements is correct?
a) Insulin suppresses the activity of glycogen synthase
b) Insulin mediates glucose uptake in the brain
c) "Prediabetes" is a condition characterized by an increased risk for the future development of type 2 diabetes
d) The rise in insulin concentration after meal ingestion is reduced in type 1 but not in type 2 diabetes
c) "Prediabetes" is a condition characterized by an increased risk for the future development of type 2 diabetes
48
Insulin deficiency is associated with
a) Reduced lipolysis
b) Increased ketogenesis
c) Reduced gluconeogenesis
d) Reduced proteolysis
b) Increased ketogenesis
49
The risk factors for type 2 diabetes mellitus include:
a) family history
b) being overweight
c) high intake of dietary fat
d) All of the options listed are correct
d) All of the options listed are correct
50
The pathogenesis of hyperglycemia in type 2 diabetes includes all the following mechanisms except for:
a) Increased glucose production by the liver
b) Impaired insulin secretion
c) Decreased glucose uptake from the skeletal muscle
d) All of the options given are correct
d) All of the options given are correct
51
The test for checking mean plasma glucose concentration over the previous 8-10 weeks is:
a) Hemoglobin A1c
b) Oral glucose tolerance test (OGTT)
c) Fructosamine test
d) Fasting plasma glucose concentration
a) Hemoglobin A1c
52
Which statement best describes the differences between the characteristics of type 1 and type 2 diabetes:
a) persons with type 2 diabetes usually require lower doses of insulin than person with type 1 diabetes because they have a milder form of diabetes
b) persons with type 1 diabetes rapidly develop chronic complications
c) autoimmune factors are involved in the pathogenesis of type 1 but not type 2 diabetes
d) persons with type 1 diabetes can increase endogenous insulin production by taking oral hypoglycemic agents
c) autoimmune factors are involved in the pathogenesis of type 1 but not type 2 diabetes
53
Which of the following is not a beneficial effect of exercise in people with diabetes:
a) Reduction of triglycerides
b) Hypoglycaemia
c) increase of insulin sensitivity
d) help controlling hypertension
b) Hypoglycaemia
54
According to trials on diabetes prevention, high-risk individuals can reduce their risk to develop diabetes by doing the following:
a) Eating a very low carbohydrate diet
b) Consuming a diet high in monounsaturated fats
c) Losing 5-7% of body weight through a hypocaloric low fat diet and 30 minutes of daily activity
d) Initiating metformin 850 mg BID and practicing daily vigorous exercise
c) Losing 5-7% of body weight through a hypocaloric low fat diet and 30 minutes of daily activity
55
Which of the following are the recommended blood pressure and lipid goals for the prevention of cardiovascular disease in adults with diabetes?
a) BP < 140/90, Trig <150, LDL < 100
b) BP < 130/85, Trig < 300, LDL < 100
c) BP < 135/80, Trig < 200, LDL < 130
d) BP < 130/80, Trig <150, LDL < 100
d) BP < 130/80, Trig <150, LDL < 100
56
What is the first-line drug for patients with type 2 diabetes and obesity?
a) Acarbose
b) Metformin
c) Sulphonylureas
d) Insulin
b) Metformin
57
According to the recommendations for the nutritional management of patients with diabetes, the consumption of saturated fat should be:
a) <10% of total daily energy
b) <12%
c) <15%
d) <16%
a) <10% of total daily energy
58
Which one of the following is the main function of aldosterone?
Increase in Blood Pressure
59
A 26 year old man is diagnosed with Type 1 diabetes. He works offshore on a ‘2 week on 3 week off’ rota. He drives a car. He has just got married and his wife is expecting their first child. What information should he receive shortly after diagnosis?
A. He should be told he cannot drive.
B He may be able to work offshore depending on his employer and where he is going.
C He is likely to pass on his diabetes to his child.
D He should be advised to stop drinking any alcohol.
E He should be told he is unlikely to ever have any hypos (hypoglycaemic episodes) if he monitors his blood glucose regularly.
B He may be able to work offshore depending on his employer and where he is going.
60
An 80 year old lady who is keen to stay healthy and well comes to see you in clinic. She has been having daily episodes of sweating and palpitations and been feeling hungry. She has had type 2 diabetes for 30 years and is on Metformin 1g bd and Glipizide 5mg bd. Her renal function has deteriorated but her GFR is 50 with a creatinine of 88. Her HbA1c is 51mmol/mol.
During one of the episodes she checked her blood glucose and found that it was 3.0mmol/l.
What action should be taken initially with regard to her management?
```
A. Stop metformin
B. Stop glipizide
C. Check blood glucose more regularly
D. Repeat HbA1c
E. Request a Holter monitor
```
B. Stop glipizide
61
A 53 year old man diagnosed with T2 Diabetes Mellitus 6 months ago. He has lost 1 stone in weight his BMI is 28 and HbA1c is 75 mmol/mol (9%). What is the next appropriate medication in his management?
A. Insulin
B. Thiazolidinedione (e.g. pioglitazone)
C. Sulphonylurea (e.g. glimepiride)
D. Biguanide (e.g. metformin)
E. DPP IV inhibitor (e.g. Sitagliptin)
D. Biguanide (e.g. metformin)
62
```
Which symptom below is NOT typical of hypoglycaemia?
A. Headache
B. Itch
C. Poor concentration
D. Sweating
E. Irritability
```
Itch
63
```
A 32 year old patient with T1 Diabetes Mellitus is reviewed at the diabetes clinic. His blood sugar is 3.2 mmol/l and he tells you he is feeling well. What is the best course of action next?
A. Administer IM glucagon
B. Send him home for lunch
C. Give 200ml fresh orange juice
D. Give digestive biscuit
E. Administer his lunchtime insulin
```
C. Give 200ml fresh orange juice
64
```
A 25 year old with Type 1 Diabetes Mellitus presents with vomiting and diarrhoea. BP 80/54 and Respiratory Rate is 24 breath/min. Which test is least important for immediate management?
A. Blood Glucose
B. pH
C. Urine/Blood Ketones
D. Electrolytes
E. Liver function tests
```
E. Liver function tests
65
```
A 23 year old man diagnosed with hyperthyroidism and has been commenced on carbimazole. What do you need to counsel him regarding?
A. Neutropenia
B. Fertility
C. Metallic taste in mouth
D. Renal Function
E. Discoloration of Urine
```
A. Neutropenia
66
A man with a large prolactinoma complains of impaired vision.
What is the most likely pattern of visual field loss to be found on clinical confrontation?
A. Homonymous hemianopia
B. Bitemporal hemianopia
C. Total loss of vision in one eye
D. Homonymous quadrantanopia
E. Nasal hemianopia
B. Bitemporal hemianopia
67
```
A 38 year old lady presents feeling tired and dizzy. She is tanned and her investigations show Na 123 (low) K 5.6 (high). Thyroid function tests are normal and calcium is normal. Her cortisol 50 (low). What is her diagnosis?
A. Hyperparathyroidism
B. Addison’s Disease
C. Cushing’s Disease
D. Grave’s Disease
Conn’s Syndrome
```
B. Addison’s Disease
68
```
All the conditions below are well recognised causes of secondary diabetes except one. Which condition is not a recognised cause of secondary diabetes?
A. Acromegaly
B. Haemochromatosis
C. Addison’s Disease
D. Cushing’s Disease
E. Chronic Pancreatitis
```
Addisons Disease
69
A patient with hypothyroidism would demonstrate which of the following symptoms:
```
A. Exophthalmos
B. Increased heart rate
C. Heat intolerance
D. Increased protein catabolism
E. Lethargy
```
Lethargy
70
Goitre is a common symptom of thyroid dysfunction and can be present in both hypo- and hyper-thyroidism. However, it would not be present in which of the following thyroid pathologies?
```
A. Primary hypothyroidism
B. Secondary hypothyroidism
C. Primary hyperthyroidism
D. Secondary hyperthyroidism
E. Graves’ disease
```
Secondary hypothyroidism
71
A decrease in circulating cortisol levels would result in which of the following physiological responses:
A. Enhanced gluconeogenesis in the liver.
B. Hypotension
C. Decreased ACTH secretion from the anterior pituitary
D. Elevated fatty acid levels in the plasma
E. Suppression the immune system
B. Hypotension
72
A person with primary hypercortisolism would demonstrate:
```
A. Depressed ACTH
B. Elevated CRH
C. Hypotension
D. Hypoglycaemia
E. Increased bon
```
A. Depressed ACTH
73
Chronic glucocorticoid therapy is associated with which of the following:
A. Enhanced cortisol release from the adrenal glands
B. Enhanced ACTH release from the anterior pituitary
C. Enhanced CRH release from the hypothalamus
D. Adrenal insufficiency
E. Adrenal hypertrophy
D. Adrenal insufficiency
74
Which of the following will elevate free calcium levels in plasma?
```
A. Alkalosis
B. Activation of osteoblasts
C. Increased phosphate excretion at the kidney
D. Calcitonin
E. All of the above
```
C. Increased phosphate excretion at the kidney
75
Regarding Growth Hormone which of the following is correct:
A. It is also known as Somatostatin
B. It is also known as Somatomedian
C. It is a steroid hormone
D. Levels in adults are at their highest during REM sleep
E. It is relatively insignificant in terms of foetal and neonatal growth
E. It is relatively insignificant in terms of foetal and neonatal growth
76
The adrenal zona glomerulosa secretes which hormone:
```
A. Testosterone
B. Progesterone
C. Aldosterone
D. Cortisol
E. Epinephrine/adrenaline
```
C. Aldosterone
77
Which of the following responses would you expect following insulin release:
```
A. Hepatic gluconeogenesis
B. Increased ketone formation
C. Increased uptake of glucose by the brain
D. Adipose lipolysis
E. Stimulation of Na+/K+ ATPase
```
E. Stimulation of Na+/K+ ATPase
78
Which of the following is not a Glucose Counter Regulatory Hormone:
```
A. Thyroid hormone
B. Epinephrine (adrenaline)
C. Glucagon
D. Cortisol
E. Growth hormone
```
A. Thyroid hormone
