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90 Cards in this Set
- Front
- Back
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Clinical tests for the estimation of ACTH reserve are, EXCEPT
a. / metyrapon test b./ glucagon test c./ insulin hypoglycemia test d./ CRH test |
b. glucagon test
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Give possible cause(s) of Addison’s disease
a./ idiopathic-autoimmune b./ tbc c./ viral d./ ACE-inhibitor induced |
a. idiopathic-autoimmune
b. tuberculosis |
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Tests supporting the diagnosis of Cushing’s disease
a./ high plasma cortisol b./ lost diurnal cortisol rhythm c./ TRH test d./ dexametason suppression test |
a. high plasma cortisol
b. lost diurenal cortisol rythem d. dexamethasone test |
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Causes of hirsutism
a./ polycystic ovarian syndrome b./ cushing’s disease c./ idiopathic-genetic d./ mineralocorticoid-suppressable hypertension |
./ polycystic ovarian syndrome
b./ cushing’s disease c./ idiopathic-genetic |
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Laboratory data indicating Addison’s disease
a./ increased K-excretion, decreased Na-excreation b./ hypercalcemia c./ increased serum K, low serum Na d./ normocytic anemia, neutropenia, lymphocytosis, eosinophilia e./ low cortisol and high ACTH levels |
b. hypercalcemia
c. increased serum K, low Na d. normocytic anemia, neutropenia, lymphocytosis, eosinopilia e. low cortisol levels |
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Symptomes indicating Cushing’s syndrome
a./ ”moon like” face b./ centripetal obesity c./ weekness and decreased mass of muscles d./ red purple striae e./ hypotension |
a. moon-face
b.central obesity c. weakness and decreased mass of muscles d. red purple striae |
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In the differential diagnosis of Addison’s disease, the following should be considered
a./ gastrointestinal diseases b./ depression c./ hemochromatosis d./ diabetes mellitus type 2 e./ chronic heavy metal exposure |
a. GIT disease
b. depression c. hemochromatosis e. chornic heavy metal exposure |
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In the treatment of Addison’s disease the following drugs are used
a./ fludrocortison b./ hydrotosrtison c./ decapeptyl d./ recombinant ACTH e./ metoclopramid |
a. fludrocortison
b. hydrocirtison |
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Complications of Cushing’s syndrome are, EXCEPT
a./ cardiovascular b./ lipid metabolism c./ hypertension and disturbed glucose tolerance d./ galactorrhoea e./ liver cirrhosis |
d. galactorrhea
e. liver cirrhosis |
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What is the most common cause of hypercalcemia?
A. Immobilisation B. Vitamin-D overdose C. Familiar hypocalciuric hypercalcemia D. Primary hyperparathyroidism E. Addison disease |
d. primary hyperparathyroidsm
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Manifestations of primary hyperparathyroidism EXCEPT
A. Bone pain B. Perioral numbness C. Polyuria D. Depression E. Nausea |
b. perioral numbness
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What is the most important abnormality in primary hyperparathyroidism?
A. Hypocalciuria B. Hypophosphaturia C. Elevated serum phosphate level D. Decreased activation of vitamin-D E. Increased calcium absorption |
e. increased calclium absorbtion
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Indications for surgery in primary hyperparathyroidism EXCEPT
A. Increased QT interval on ECG B. Young patient (<40 years) C. Suspicion for parathyroid cancer D. Serum calcium is >3 mmol/l E. Osteoporosis |
a. increased QT interval on ECG
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Which drug is contraindicated in chronic hypercalcemia?
A. famotidin B. hydrochlorothiazid C. furosemid D. methylprednisolon E. enalapril |
b. hydrochlorotiazide
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Which of the following may result in tetany:
A. hypoparathyroidism B. hyperventilation C. osteoporosis |
a. hydroparathyroidism
b. hyperventilation |
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Which condition is associated with secondary hyperparathyroidism?
A. Heart failure B. Liver cirrhosis C. MEN-1 syndrome D. Chronic renal failure E. Vitamin-D overdose |
d. chronic renal failure
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A 50 year old male patient was operated for a thyroid nodule which was 2 cm in diameter. Follicular neoplasia was assumed based on FNA biopsy. On the first postoperative day the patient complains perioral numbness and increased neuromuscular irritability. Which urgent laboratory test is required?
A. Blood glucose B. Parathormone C. Ionized calcium D. Free T4 E. Calcitonin |
c. ionized calcium
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The following conditions can produce hyperparathyroidism:
A. Parathyroid carcinoma B. Vitamin-D deficiency C. Tumor hypercalcemia D. Chronic renal failure E. Parathyroid adenoma |
a. parathyroid carcinoma
b. vit.D defic c. chronic renal failure e. parathyroid adenoma |
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The diagnosis of primary hyperparathyroidism is based on the following:
A. Hypercalcemia and elevated parathormone level B. Severe osteoporosis C. Hypocalcemia and elevated parathormone level D. Nodule on the neck ultrasound in the area a parathyroid glands E. Low serum phosphate |
a. hypercalcemia and elevated parathyroid hormone
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What is the prevalence of thyroid nodules by autopsy, at age 70 years?
A. 10% B. 20% C. 30% D. 40% E. 50% |
e. 50%
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The risk of malignancy in a thyroid nodule is increased by the following EXCEPT:
A. female gender B. old age C. neck irradiation D. rapid growth E. huskiness |
a. female gender
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A 70 year old female patient was diagnosed with a toxic adenoma causing mild hyperthyroidism, 2,5 cm in diameter. How would you treat the patient?
A. observation, follow up B. radioiodine treatment C. surgery D. metimazol or carbimazol E. iodine supplementation of table salt |
b. radioiodide treatment
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Which of the following neoplasms has the best prognosis?
A. Anaplastic thyroid cancer B. Follicular thyroid cancer C. Papillary thyroid cancer D. Adrenal cortical cancer E. Parathyroid cancer |
c. papillary thyroid cacner
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The treatment and follow-up of patients with papillary thyroid cancer involves the following EXCEPT:
A. Near total or total thyroidectomy B. Remnant ablation with radioiodine C. TSH suppression D. Life-long follow-up E. Genetic screening |
e. genetic screening
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Multiple endocrine neoplasia syndromes are characterized by
A. Autosomal recessive inheritance B. Tumors of unifocal origin C. All tumors are malignant D. Hyperplasia usually precedes neoplasia E. Any of the endocrine organs can be affected |
d. hyperplasia usually precedes neoplasia
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What is the most common manifestation of MEN-2 syndrome?
A. Medullary thyroid cancer B. Pheochromocytoma C. Hyperparathyroidism D. Prolactinoma E. Carcinoid tumor |
a. medullary thyroid caner
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What is the presumed diagnosis if diarrhea is associated with paroxysmal flush and bronchial spasm?
A. Pheochromocytoma B. VIPoma C. Carcinoid tumor D. Medullary thyroid cancer E. ACTH-producing pituitary adenoma |
c. carcinoid tumor
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What is the most effective treatment of carcinoid syndrome?
A. Interferon B. Serotonine antagonists C. Histamine antagonists D. Somatostatin analogs E. Alfa-adrenergic antagonists |
d. somatostatin analongs
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Which laboratory test are required in case of paroxysmal hunger, weakness, sweating and blurred vision?
A. Insulin B. C-peptide C. Blood glucose D. Urine catecholamines E. Serum calcium |
a. insulin.
b. C-peptide c. blood glucose |
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Hypothalamic regulatory hormones are:
A. TRH B. GHRH C. Dopamine D. CRH E. ADH F. Somatostatin |
a, b, c, d, f
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The following hormones are produced by the anterior lobe of pituitary; except:
A. GH B. TSH C. ADH D. ACTH E. GnRH |
ADH, GnRH
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Characteristic signs of acromegalia are, except:
A. Enlarged ears B. Thick lips C. Tall stature D. Macroglossia E. Obesity F. Prognathia |
tall statrue, obesity
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Characteristic signs and symptoms of Cushing’s disease are, except:
A. Centripetal obesity B. Hypotension C. Purple striae on the skin D. Hyperkalemia E. Decreased glucose tolerance |
hypotension, hyperkalemia
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The size of a pituitary microadenoma, by definition, is:
A. 1mm B. 5 mm C. 10 mm D. 20 mm |
< 10 mm
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Causes of polyuria are:
A. Central diabetes insipidus B. Renal diabetes insipidus C. Psychogenic D. Diabetes mellitus E. Renal failure |
all are correct
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Clinical signs and symptoms of diabetes insipidus are:
A. Thirst B. Increased appetite C. Urinary specific gravity decreases D. Pain on urination E. Urinary volume increases |
thirst, urinary specific gravity decreases, urinary volume increases
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Signs and symptoms of prolactinoma are:
A. Amenorrhoea B. Decreased libido C. Hypertension D. Infertility E. Hirsutism F. Galactorrhoea in females |
amenorrhea, decreased libido, infertility, galactorrhea in females
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Characteristic signs and symptoms of Addison’s disease are:
A. Hyperpigmentation B. Weakness C. Hypertension D. Hyponatremia E. Weight loss F. Hematuria |
hyperpigmentation, weakness, hypotonia, weight loss
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Radioiodine (131I) therapy may be successfull in the following diseases, except:
A. Graves-Basedow disease B. Differentiated thyroid cancer C. Chronic lymphocytic thyroiditis (Hashimoto’s thyroiditis) D. Toxic thyroid nodule E. Medullary thyroid carcinoma |
Hashimoto's, medullary thyroid carcinoma
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In the case of suspected hypothyroidism, the appropriate test to perform is
A. free thyroxine B. total thyroxine C. free triiodothyronine D. total triiodothyronine E. TSH |
tsh
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In the case of suspected hyperthyroidism, the first test to perform is
A. sTSH B. free thyroxine C. total thyroxine D. free triiodothyronine E. total triiodothyronine |
sTSH
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In the case of already proven hyperthyroidism, the parameter(s) to best characterize severity is/are
A. free thyroxine and free triiodothyronine B. total thyroxine and total triiodothyronine C. TSH D. TSH receptor antibody E. cholesterol |
free thyroxine and free triiodothyronine
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The size and structure of the thyroid gland can be best visualized by
A. trachea x-ray B. ultrasound C. computer tomography D. MRI E. angiography |
ultrasound
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The suggested methods of screening for thyroid diseases in seemingly healthy individuals are
A. TSH and ultrasound B. TSH and neck palpation C. free thyroxine and neck palpation D. free thyroxine and TSH E. TSH and trachea x-ray |
TSH and neck palpation
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Which statement(s) applies to the technetium (99mTc) imaging of the thyroid gland?
A. best approach to estimate the function of a thyroid nodule B. a good substitute for 131I imaging C. a could nodule may be, or may contain, differentiated thyroid cancer D. the radiation exposure of then patient is larger than with 131I scanning E. differentiates between Graves’ disease and toxic adenoma |
a, b, c, e
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During fine needle aspiration biopsy (FNA) of a thyroid nodule the sample has suficient number of evaluable cells. The cytology report states ’indeterminate’ regarding malignancy. What is next?
A. Repeat FNA B. Surgical removal of the nodule C. Follow up with ultrasound to see if the size of the nodule changes D. computer tomography E. thyreoglobulin measurement |
surgical removal of the nodule
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Iodine intake
A. is sufficient in Hungary B. required for adults is 150 g daily C. required during pregnancy and nursing is at least 200 g per day D. iodine deficient goiter can be corrected by iodized salt E. iodine deficiency can be prevented at the population level |
b, c, e
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The 24 hour radioactive iodine uptake of the thyroid gland (RAIU)
A. is proportionate to the functional state of the thyroid gland B. is proportionate to the iodine supply C. is inversely proportionate to the functional state of the thyroid gland D. is inversely proportionate to the iodine supply E. has a circadian rhythm |
a, d
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The order of events when toxic multinodular goiter develops
A. palpable diffuse thyroid enlargement – hyperthyroidism – nodules on ultrasound – palpable nodules B. palpable diffuse thyroid enlargement – nodules on ultrasound– hyperthyroidism – palpable nodules C. hypothyroidism – palpable diffuse thyroid enlargement – nodules on ultrasound – palpable nodules D. palpable diffuse thyroid enlargement – nodules on ultrasound – palpable nodules – hyperthyroidism E. nodules on ultrasound – hyperthyroidism – palpable diffuse thyroid enlargement – palpable nodules |
palpabale diffuse thyroid enalrgmenet-nodules on ultrasound-palpable nodules-hyperthyrodism
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Primary hyperaldosteronism is characterized by the following finding(s)
A. serum aldosterone high, serum renin high B. serum aldosterone low, serum renin low C. serum aldosterone high, serum renin low D. aldosterone is not suppressible in the salt loading test |
serum aldosterone high
aldosterone is not suppresable in the salt loading test |
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Symptoms/signs of primary hyperaldosteronism include
A. hypertension B. edema C. hypokalaemia D. polyuria E. acidosis |
hypertension
hypokalemia polyuria |
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Primary hyperaldosteronism is characterized by the following finding(s)
A. serum aldosterone high, serum renin high B. serum aldosterone low, serum renin low C. serum aldosterone high, serum renin low D. aldosterone is not suppressible in the salt loading test |
serum aldosterone high
aldosterone is not suppresable in the salt loading test |
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If the cause of aldosteronism is aldosterone producing adenoma (APA)
A. it is also called Conn’s syndrome B. surgical removal of the adenoma is the treatment of choice C. hypertension may be absent D. side localization can be made using 131I-iodocholesterol-scintigraphy (SPECT) E. the adenoma can be extraadrenal |
a.k.a Conn's syndrome
surgical remonal of adenoma is treatement of choice, side localization can be done by spect |
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If the cause of aldosteronism is idiopathic hyperplasia (IHA)
A. it is also called Conn’s syndrome B. surgery is the treatment of choice C. hypertension may be absent D. aldosteron antagonist is a good choice for medical treatment E. ACE inhibitor is not among the medical treatment choices F. triamteren or amiloride are good choices for medical treatment |
aldosterone antagoist is a good choice,
trimteren or amiloride are good choices |
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Symptoms/signs of primary hyperaldosteronism include
A. hypertension B. edema C. hypokalaemia D. polyuria E. acidosis |
hypertension
hypokalemia polyuria |
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If the cause of aldosteronism is aldosterone producing adenoma (APA)
A. it is also called Conn’s syndrome B. surgical removal of the adenoma is the treatment of choice C. hypertension may be absent D. side localization can be made using 131I-iodocholesterol-scintigraphy (SPECT) E. the adenoma can be extraadrenal |
a.k.a Conn's syndrome
surgical remonal of adenoma is treatement of choice, side localization can be done by spect |
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Which of the states below result in secondary hyperaldosteronism?
A. treatment with diuretics B. nephrotic syndrome C. cardiac decompensation D. polyglobulia E. liver cirrhosis |
b, c, e
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If the cause of aldosteronism is idiopathic hyperplasia (IHA)
A. it is also called Conn’s syndrome B. surgery is the treatment of choice C. hypertension may be absent D. aldosteron antagonist is a good choice for medical treatment E. ACE inhibitor is not among the medical treatment choices F. triamteren or amiloride are good choices for medical treatment |
aldosterone antagoist is a good choice,
trimteren or amiloride are good choices |
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In the workup for pheochromocytoma we measure
A. catecholamines in fasting blood B. catecholamines in blood during paroxysm/crisis C. catecholamines in 24 hours collected urine D. catecholamines in random urine sample E. VMA, HVA in 24 hour collected urine after appropriate diet and cessation of drugs known to interfere with the test |
clonidine suppresion test
adrenolytic (regitine) test |
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Which of the states below result in secondary hyperaldosteronism?
A. treatment with diuretics B. nephrotic syndrome C. cardiac decompensation D. polyglobulia E. liver cirrhosis |
b, c, e
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To detect/localize an extraadrenal pheochromocytoma, we may use
A. computer tomography B. MRI C. metaiodobenzyl-guanidin (MIBEG) scintigraphy (SPECT) D. 131I-iodocholesterol-scintigraphy (SPECT) E. catheter blood sample collection from different levels of the vena cava |
CT, MRI, MIBEG/SPECT, catheter blood sample collection from different levels of vena cava
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In the workup for pheochromocytoma we measure
A. catecholamines in fasting blood B. catecholamines in blood during paroxysm/crisis C. catecholamines in 24 hours collected urine D. catecholamines in random urine sample E. VMA, HVA in 24 hour collected urine after appropriate diet and cessation of drugs known to interfere with the test |
clonidine suppresion test
adrenolytic (regitine) test |
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To detect/localize an extraadrenal pheochromocytoma, we may use
A. computer tomography B. MRI C. metaiodobenzyl-guanidin (MIBEG) scintigraphy (SPECT) D. 131I-iodocholesterol-scintigraphy (SPECT) E. catheter blood sample collection from different levels of the vena cava |
CT, MRI, MIBEG/SPECT, catheter blood sample collection from different levels of vena cava
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In the medical treatment of phaeochromocytoma, possible first choices are
A. metoprolol B. phentolamine C. propranolol D. prazosine E. carvedilol |
phentolamine, prazosine, carvediol
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In the medical treatment of phaeochromocytoma, possible first choices are
A. metoprolol B. phentolamine C. propranolol D. prazosine E. carvedilol |
phentolamine, prazosine, carvediol
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The late onset form of congenital adrenal hyperplasia is characterized by
A. C11-hydroxylase defect B. serum ACTH is often low C. serum cortisol may be low D. serum 17-hydroxyprogesteron is always high E. medical treatment is low dose mineralocorticoids |
serum cortisol may be low, serum 17-hydroxyprogesterone is always high
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Aldosterone is secreted by
a./ the pancreas b./ the zona glomeruloza of the adrenals c./ the zona reticularis of the adrenals d./ the zona fasciculata of the adrenals |
the zona glomerulosa of the adrenals
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Cortisol is secreted by the
a./Zona fasciculata of the adrenals b./Pituitary gland c./Parathyroids d./Zona reticularis of the adrenals |
zona fasiculata
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Which changes may indicate Cushing’s syndrome?
a./Obesity affecting mainly extremities b./Obesity affecting mainly the face (moon like) c./ Obesity affecting mainly the neck (buffalo hump) d./ Lipodystrophy |
obesity affecting mainly face (moon like), obesity affecting the neck (buffalo hump)
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Which skin changes characterize Cushing’s syndrome?
a./.Atrophy of the dermis b./ Red purple striae c./ Hyperpigmentation d./ Hyperkeratosis |
atrophy of the dermis, red purple striae
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Frequent clinical findings present in Cushing’s syndrome
a./Hyperglycemia b.deafness c./hirsutism d./osteoporosis |
hyperglycemia, hirsutism, osteoperosis
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Most frequent cause(s) of chronic adrenal insufficiency are:
a./autoimmunity b./viral infection c./bacterial infection d./TBC |
autoimmunity, TBC
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Give the major sites of pigmentation of Addison’s disease
a./ Hyperpigmentation of the buccal mucosa b/ Hyperpigmentation of the buccal gum c./ Hyperpigmentation of the palmar creases d./ Hyperpigmentation of the sun exposed areas e./ Hyperpigmentation of the body hair |
a./ Hyperpigmentation of the buccal mucosa
b/ Hyperpigmentation of the buccal gum c./ Hyperpigmentation of the palmar creases d./ Hyperpigmentation of the sun exposed areas |
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Give the clinical features of acute adrenal crisis
a./Hypotension and shock b./Fever c./Eosinophilia d./Dehydration, nausea, vomiting |
a./Hypotension and shock
b./Fever d./Dehydration, nausea, vomiting |
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The harmful side effects of long term corticosteroid treatment are
a./ Gastrointestinal ulceration b. Diabetes mellitus c./ Gastrointestinal bleeding d./ Double vision e./ Osteoporosis f./ Cushing’s syndrome |
a./ Gastrointestinal ulceration
b. Diabetes mellitus c./ Gastrointestinal bleeding e./ Osteoporosis f./ Cushing’s syndrome |
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he most frequent cause of Cushing’s syndrome is:
a./ Glucocorticoid medication b./ Increased sodium intake c./ Loss of potassium d./ Spontaneous excessive corticosteroid production |
a./ Glucocorticoid medication
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Hashimoto’s thyreoiditis is characterised by
a../ elevated anti-tyhroid antibodies (anti-TPO, anti-TG) b./ elevated anti TSH-receptor antitbodies c./ elevated iodine uptake (RAIU) d./ high WBC count |
a../ elevated anti-tyhroid antibodies (anti-TPO, anti-TG)
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Which of the symptomes my indicate hypothyroidism?
a./ Increased apetite b / Sweating c./ Dry skin d./ Loss of memory |
c./ Dry skin
d./ Loss of memory |
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The treatment of hypothyroidism is
a./ small dose of methimasole b./ high dose of corticosteroids c./ cyclosporin d./ levothyoxine e./ combined antibiotic treatment |
d./ levothyoxine
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Iodine uptake (RAIU) in hypothyroidism is
a./. increased b./ normal c./ decresad d./ varies |
c./ decresad
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Which clinical signes may indicate thyroxine overdose?
a./ Nervousnes b./ Sweting c./ Weight loss d./ Weight gain e./ Decreased apetite |
a./ Nervousnes
b./ Sweting c./ Weight loss |
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Hashimotho’s patients usually present with:
a./ Neck pain b./ Unilateral exophthalmos c./ Enlarged thyroid gland d./ Diarrhea |
a./ Neck pain
c./ Enlarged thyroid gland |
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DeQuervain’s thyroiditis on cytology (FNA) is characterised by
a./ Infiltrating lymphocytes b./ Infiltrating premature muscle cells c./.Giant cells d./ Proliferating fibroblasts |
c./.Giant cells
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Treatment of the hypothyroid patent should
a./”start low, go slow” b./be controlled by chance c./be adapted to the level of free thyroxine d./be adapted to the level of TSH |
a./”start low, go slow”
d./be adapted to the level of TSH |
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Frequent cause(s) of hypothyroidism are
a./Thyroid surgery b.Irradiadion of the neck c./Radioiodine therapy d./Neck injury d./Thyrostatic therapy |
a./Thyroid surgery
b.Irradiadion of the neck c./Radioiodine therapy d./Thyrostatic therapy |
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Causes of endocrine hypertension are
A. acromegaly B. Cushing’s disease C. primary hyperaldosteronism D. hyperprolactinaemia E. pheochromocytoma F. diabetes insipidus G. thyroid cancer |
A. acromegaly
B. Cushing’s disease C. primary hyperaldosteronism E. pheochromocytoma |
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Hypocalcemia my be suspected in the presence of
A. positive Chvostek’s sign B. positive Graefe’s sign C. carpal spasm D. positive Trousseau sign E. orthostatic hypotension |
A. positive Chvostek’s sign
C. carpal spasm |
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Frequent findings in Graves’ disease are
A.goiter B. tachycardia C. weight gain D. heat intolerance E. neck pain |
A.goiter
B. tachycardia D. heat intolerance |
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The treatment of severe hypercalcaemia includes
A. bisphosphpnates parenteral B. loop diuretics after volume loading infusions C. volume loading infusions after loop diuretics D. corticosteroids in tumor hypercalcaemia E. phosphate parenteral |
A. bisphosphpnates parenteral
B. loop diuretics after volume loading infusions D. corticosteroids in tumor hypercalcaemia |
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In the case of the compression of the pituitary by an adenoma, the first lost function is
A. thyroid regulation B. adrenal regulation C. gonadotrop regulation D. prolactin synthesis E. vasopressin synthesis |
C. gonadotrop regulation
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