Endocrine Mcq (Dmcg B27)

Front 1

14 years old boy+ 3months of lethargy, Headache, muscle weakness +Drink water excessivly (polydipsia) + Polyuria + brain suprasellar calcification .

Neoplasm?

Back 1

Craniopharyngioma

(Craniopharyngioma, Diabits insepidus)

Front 2

60 year old MAN, Small cell carcinoma of lung ,rushed to emergency in Coma, After Clonic tonic seizure

Temp: 37 C, PR 88, Bp100/50

Serum sodium 103

Cause of sezure

Back 2

Syndrome of inappropriate ADH secretion

Front 3

60 years old Woman with small cell carcinoma of lung, rounding of face, upper truncal obesity , muscle weakness.

Thin wrinkled skin, multiple purple skin lessions

BP175/95

Lab show elevated erum level of :

Back 3

corticotropin

(Cushing syndrome, paraneoplastic syndromE)

Front 4

21 delivering woman abruption placenta and severe bleeding

5 months later, profound lethargy, muscle weakness, pallor, failure of lactation, amenorhea

Pathological finding?

Back 4

Pituitary infarction

(Sheehan Syndrom)

Front 5

25 Man , 3 month polyuria and increased thirst (polydipsia)

trauma to the base of skull in a motorcycle accident 4 months ago

Polyuria WithOUt hematouria glucosuria proteinurea

Lesion to...:

Back 5

Neurohypophysis

( Diabetis insepidis)

Front 6

30 year Woman headache , visual disterbunce, Deeping of voice generalized weakness

Amenorrhea for past year, large shoe size, impaired glucose tolerance

Other useful for establishing your diagnosis?

Back 6

MRI of sella turcia

(acromegaly, pituitary Adenoma)

Front 7

35 woman schizophrenia, headache visual disturbance irregular mensesfor 9 months,

Breast firma nd tender , MRI: enlargment of Anterior pituitary.

Cause of enlargement ?

Back 7

Lactotrope Adenoma

(Galactorrhea, Piuitary adenoma)

Front 8

55 Ma, severe muscle weakness dropping eyelids , worsen with repetive movements, resolve after short rest, XRAY: anterior mediastinal mass. Biopsy would show what patholgy?

Back 8

Thymic Heperplasia

(Myasthenia Gravis)

Front 9

45 Woman, tingling in her hands and feet, 24 hr after surgery to remove thyroid folliculate carcinoma

Symptoms rapidly progress to severe muschle cramps, laryngeal stidor, and convulsion

Which of the following lab finding s would be expected

Back 9

Deceased serum Caclcium and Decreased PTH

D: ( HyperParathyroidism)

Front 10

55 Woman large anterior neck mass, Dysphagia, hoarness , Inspiratory stridor

Lab will show?

Back 10

Euthyroidism

D: ( nontoxic goiter)

Front 11

48 Man recurrent headaches and arthritic pain in his knees of 9 months , Hat size increased, erectile dysfunction, History of kidney sotnes 2 years ago,

BP170/100, couarse facial features and goiter

Glucosuria, hypercalcuria

Explanation?

Back 11

Excess gowth ormone secretion

Diagnosis ( acromegaly)

Front 12

Why does Patient in q11 ( acromegaly ) gave erectile dysfunction?

Back 12

Excess prolactin secretion

Front 13

13

Neonate peculiar genitalia , cytogenic sudies revial a 46 xx karyotype

Lab will reveal deficiency in

Back 13

21 Hydroxylase

(congenital adrenal hyperplasia, adreno.. Syndrome)

Front 14

Infant in Q13: autonomal recissive genetic disorder.

He's expected to manifest development anomolies

Back 14

Adrenal Hyperplasia

( congenital adrenal hyperplasia )

Front 15

7 week infant deveopls severe dehydration and Hypo(...) and Expires. Hypovolemic shock in this infant was likely caused by inadequate synthese of

Back 15

Aldosterone

congenital 21 hydroxxylase deficiency

Front 16

6 month year old girl with Wiskott akdrich syndrome is rushed to emergency rrom shortly after sspiking fever of 38 C. History of chronic respiratory infections GIT infections,

This child has

Back 16

hypoplasia of thymus

(Wiskott aldrich syndrome)

Front 17

17.Female neonate with Digeorge syndrome develope severe muscle cramps and convulsions soon after birth

Cause of convulsions?

Back 17

Hypocalcemia

(Digeorge syndrome)

Front 18

in addition to 17, parathyroid agenesis, she would be exoected to have following condtions

Back 18

Immune deficiency

(Digeorge Syndrome)

Front 19

15 boy, with Albright hereditary osteodystrophy is rushed to emergency room with severe muscle crampos and convulsion. the child has history of mental retardation.

Lab hypocalcemia and elevated blood levels of PTH

Which of following distinguishes this patient endocrinopathy from hghypoparathyroidism seen in Digeorge?

Back 19

End-organ unresponsiveness to PTH

(Pseudohypoparathyroidism, Albright hereditary osteodystrophy

Front 20

20 . 50 woman, acute flank pain of 72 hr in duration. temp 37 C BP: 140/85 pulse 85, CBC normal, stones in right renal oelvis and ureter

This condition may be associated with

Back 20

hyperparathyroidism

Front 21

Lab of 20: elevated serum calcium and PTH

cT: of neck: 3 cm ... posterior surface of right lobe of the thyroid gland

................. ( sorry not clear)

Back 21

Chief

(Hyperparathyroidsim, parathyroid adenoma)

Front 22

72 years old woman with long history of Diabietus type 2 presents with abdominal pain. N euromascular weakness and hpertension

LAb: markedly elevated levels of serum calcium and PTH . Surgical exploration of patient neck symetrical enlarged parathyroid glands.

This patients endocrinopathy caused by

Back 22

Renal insufficiency

(Hyperparathyroidism)

Front 23

20 woman Hirschsprung disease acute leg pain. Glioma 3 years ago. X ray: fracture of left tibia , elevated Serum Ca and PTH . CT scan: solitary parathyoid mass. two years later present with hypertension and cT scan of the abdomen displays a 4 cm mass in the right adrenal. Genetic studies conducted on this Patient would likely reveal gerline mutation in which of following protoncogenes?

Back 23

RET

(Parathyroid adenoma, multiple endocrine neoplasm)

Front 24

40 years old woman wih Hypeparathyroiism , 2 month of burning epigastric pain. Pain relieved with antacids or food. Recent history of tarry (mools?) microcytic hypochromic anemia . Gastroscopy reveals bleeding mucosal defect in the antrum

Best characterizes the pathogenesis of epigastric pain

Back 24

increase secreation of gastin

( Diagnosis: peptic ulcer disease, hyperparathyroidism)

Front 25

25) 4 week old girl apathatic and sluggish abdomen is large , umblical hernia, ksin pale and cold, temp 35C.

Explanation

Back 25

Thyroid agenesis

(Congenital hypothyroidism)

Front 26

26) 55 year old man, who is on dialsis bc of end stage renal disease complain of pain in his jaw and left arm for 6 months Xray: multiple small bone cysts and pathologic fractures

Appropriate diagnosis for bone leisons

Back 26

Osteitis fibrosa cystica

(,,/Hyperparathyroidism)

Front 27

46 old woman, increasing fatigue muscle weakness past 6 months, inability to concerntrate at work and speaks with husky voice. Deny drug or alcohol abuse. cold and clammy skin coarse and brittle hair, boggy face with puffy and peripheral edema. Lab : reduced T3 T4

Underlying cause of S&S?

Back 27

Autoimmune Thyroiditis

(Hypoparathyroidism)

Front 28

28. 65 year woman with history of multiodular goiter complain of increasing nervousness insomina and heart palpitation. lost 9 k, diffusely enlarged thyroid, no exphthalmus,elevated serum T3 and T4 , antithyroid antibody negative,

Back 28

Cardiac Arrythmias

(Hyperparathyroidism , Toxic Goiter)

Front 29

40 woman complain of chronic constipation and anovulatory cycles for last 8 months. Vital signs normal, Peripheral edema, firm diffusely enlaged thyroid gland. T3, T4 low

Back 29

Autoimmune Thyroiditis

(Hashimoto thyroiditis)

Front 30

30.

52 Woman, swelling in the anterior neck 6 months ago, discomfort during swallowing , no symptoms, symmetrical enlarged thyroid

Back 30

Nontoxic Goiter

(,, / Multinodular goiter)

Front 31

5 years later (Q30) returns with symotoms of hyperthyroidism. which of the following best summarizes the clinical symptoms expected in this patient

Back 31

Tremor, Tachycardia, Weight loss

Front 32

32)

32 woman solitary firm nodule on the left side of her neck. thyroid function tests within normal. fine needle biopsy reveals malignant cells.

(slide of tumor p257)

Pathology?

Back 32

Papillary carcinoma

Front 33

43 year old woman complains of low grade fever and has 3 day history of pain in her neck. Slight enlarged thyroid granulomatous inflammation and the presence of giant cells .

Diagnosis

Back 33

Subacute (DeQuervain) Thyroiditis

Front 34

35 woman swelling in her anterior neck started months ago, discomfort during swallowing only.

Thyroid gland is adhered to other neck structures. thyroid biopsy reports :

the Thyroid parenchyma is Replaced by Dense hyalinated Fibrous tissue

and a chronic inflammatory infiltrate.

Back 34

Riedal thyroditis

Front 35

Q35

25 woman, nervousness and muscle weakness ,intolerant to heat , sweating excessively , lost 9 kg over 6 months with increased calorie uptake. HEart racing and feeling it pounding . missed several menestrual periods. Warm and moist skin, and bulging eyes (exophthalamus)

LAb will find:

Back 35

Anti-TSH receptor antibodies

(Grave's disease

Front 36

thyroid biopsy form Patient Q35: ( image ) best discription

Back 36

Follicular hyperplasia with scalloping of colloid

(Grave's disease)

Front 37

33 woman swelling neck , solitary nonsender nodule of thyroid gland measuring 2 cm.

Nodule does not accumulate Idoine

Back 37

Follicular Adenoma

Front 38

q38)

35 year old woman swelling in neck 3 months + watery diahrreaover the same time period. nontender nodule in the left lobe of the thyroid. Mother died of thyroid cancer 8 years ago. Thyroid nodule "cold"by radioidone. Needle biopsy: malignant cells and homogenous eosinophils material. Lab: elevated blood levels of which of the following hormoned in this patiens?

Back 38

Calcitonin

(Medullary carcinoma of thyroid)

Front 39

Tumor in Q38 removed and stained with congo red to show b... amyloid stroma . study showed familial cancer syndrome, + hyperparathyroidism, in addition what else is the patient in risk for?

Back 39

Phochromocytoma

(multiple endocrine neoplasm

Front 40

45 man, neck swelling, nodular enlarged thyroid. Examination : dominant "hog/hos (?)" nodule . bopsy : neoplastic cells, vascular and capillary invasion. ( image of distant body metastasis)

Back 40

follicular carcinoma of the thyroid

Front 41

Q41)4 years girl with decreased appetite and enlarged belly . Large firm irregular mass in the child's abdomen. a CT guided biopsy reveals neoplasm "small blue cells".

further test useful to moniter the mass

Back 41

Urinaryvanillylmandelic acid

(Neuroblastoma)

Front 42

Genetic analysis of patien Q 41 will show

Back 42

M-myc Amplification

(neuroblastoma

Front 43

45 years man with recent odd behavor sent to a psychiatrist that asked for evaluation of endocrine system: slightly obese, fat accumulation in the supraclavicular fossa, mild hypertension, protrudent abdomen. Hct and Haemoglobin normal, Neutrophilic leukocytosis with no Eosinophilia , mild hypocalcemia , mild metabolic alkalosis, LAb: free urinary cortisol of 150 mg per 24 hr.

Question would be most helpful:

Back 43

Are you receiving corticosteroids for some other disease?

(Cushing Syndrome)

Front 44

42 woman, amenorrhea, emotional disturbance, and upper truncal obesity, elevated serum of cortisosteroids that can be lowered by dexamethason, suspected Cushing S.

Most likely cause of hypercoticotism :

Back 44

Pituitary adenoma

(Cushing Syndrom)

Front 45

40 woman, history of diabitis complain of recent changes in her bodily appearance ( hirstuisim ) Elevated levels of corticosteroids, can NOT be lowered by dexamethasone.

Most likely has tumor arising from:

Back 45

Adrenal cortez , zona fasciculata

(Cushing Syndrome)

Front 46

45 woman severe asthma, increase in wight and back pain past 9 months, + corticosteroids (for asthma)

Which likely pathological finding in Xray of back vertebra?

Back 46

Osteoporosis

(Cushing sYndrome)

Front 47

4o man, nausea vomiting diarrhea, cramping abdomenal pain, 38 C , BP 90/50, pulse 90 /min ,dehydrated, sunken eyeballs, dry tongue. Hyperpigmentation at palmer creases and gingival margins. Likely cause

Back 47

Autoimmunity

(addison Disease)

Front 48

50 Man, muscle weakness dizziness, BP 185/100, hypokalemia, elevated aldosteron, low renin and Angiotensin II, Hypernatremia.

Cause of Hypernatremia?

Back 48

Conn Syndrome

Front 49

34 man attack of dizziness, blurred vision, exruciating headaches, of 4 months . BP: 181/120

treated for thyroid cancer about 15 years ago, normal serum levels of aldosteron,renin angiotensin II.

increased metanphrines

Cause of hypertension?

Back 49

Adrenal

(Pheochromocytoma)

Front 50

(Pharma)

Patient prescribed alendronate advised to take plenty of water and remain in standing position for at least half an hour till she had the first meal of the day.

Why?

to reduce the risk of

Back 50

Erosive gastritis

Front 51

Teriparatide used

Back 51

osteoporosis

Front 52

Biphosphonate M/A:

Back 52

Decreasing osteoclast mediated resorption of bone

Front 53

Pamidronate

Used for

route of administration

Back 53

Osteoporosis

Intravenous

Front 54

Conversion of T4 to T3 inhibition

Back 54

propylthyouracil

Front 55

Fastest acting thyroid Hormone inhibitor

Back 55

Pottasium iodide

Front 56

Safest treatment for hyperthyroidism in Pregnant

Back 56

propylthiouracil

Front 57

NOT antithyroid Drug

Back 57

Carbamezapine

Front 58

L-thyroxin used

Back 58

Cretinism

Front 59

Half life of Radiaiodine (I 131)

Back 59

8 days

Front 60

NOT used in thyroid storm?

Back 60

Reserpine

Front 61

patient of hypothyroidism described L-thyroxine,

Reliable guide for dose adjustment

Back 61

Serum TSH level

Front 62

Pregnant lady, thyrotoxicosis, going for surgery, What's given before to reduce vascularity of the gland?

Back 62

Iodide ion

Front 63

T3 compared to T4 is

Back 63

shorter acting

Front 64

M/A of Propylthiouracil in Hyperthyroidism

Back 64

Inhibiting of orginification of iodine

inhibition of oxidation f iodine

inhibtion of coupling of 2 DITs

All of above

Front 65

inhibits 5-deiodinase

Back 65

propylthiouracil

Front 66

Beta blocker in hyperthyroidism

Back 66

as short symptomatic effect till effects cabimazole develops

Front 67

Thyroxine prefered to T3 in most cases , only place T3 prefered

Back 67

Myxedema coma

Front 68

Carbimazole compared to propylthiouracil

Back 68

does not inhibit peripheral conversion of T4 to T3

Front 69

Radioactive iodine prefered in treatment of

Back 69

elderly patients with ischemic heart disease

Front 70

Hypothyroidism , Thyroxine prefered to iothyronin

Back 70

has longer half life