1. The document contains 44 multiple choice questions about endocrinology. Topics include hypopituitarism, adrenal disorders like Cushing's disease and pheochromocytoma, diabetes, and diabetic ketoacidosis.
2. Correct answers are provided for each question to test the reader's knowledge of endocrine system diseases, hormones, symptoms, treatments, and laboratory findings.
3. The questions cover topics like the causes and presentations of various endocrine disorders, appropriate testing and treatment, and the roles of hormones like cortisol, ACTH, insulin, and others.
1. The document contains 44 multiple choice questions about endocrinology. Topics include hypopituitarism, adrenal disorders like Cushing's disease and pheochromocytoma, diabetes, and diabetic ketoacidosis.
2. Correct answers are provided for each question to test the reader's knowledge of endocrine system diseases, hormones, symptoms, treatments, and laboratory findings.
3. The questions cover topics like the causes and presentations of various endocrine disorders, appropriate testing and treatment, and the roles of hormones like cortisol, ACTH, insulin, and others.
1. The document contains 44 multiple choice questions about endocrinology. Topics include hypopituitarism, adrenal disorders like Cushing's disease and pheochromocytoma, diabetes, and diabetic ketoacidosis.
2. Correct answers are provided for each question to test the reader's knowledge of endocrine system diseases, hormones, symptoms, treatments, and laboratory findings.
3. The questions cover topics like the causes and presentations of various endocrine disorders, appropriate testing and treatment, and the roles of hormones like cortisol, ACTH, insulin, and others.
1. The document contains 44 multiple choice questions about endocrinology. Topics include hypopituitarism, adrenal disorders like Cushing's disease and pheochromocytoma, diabetes, and diabetic ketoacidosis.
2. Correct answers are provided for each question to test the reader's knowledge of endocrine system diseases, hormones, symptoms, treatments, and laboratory findings.
3. The questions cover topics like the causes and presentations of various endocrine disorders, appropriate testing and treatment, and the roles of hormones like cortisol, ACTH, insulin, and others.
following EXCEPT a. Failure to produce sex steroids and gametes b. Hypogonadism and infertility c. Loss of secondary sex characteristics in the male d. Amenorrhea in the female e. Inability to regulate glucose
2. Adrenal crisis is precipitated by all the following EXCEPT a. Prolonged suppressive glucocorticoid therapy without proper coverage in periods of recovery of the pituitary adrenal axis b. Acute illness without recognition of the lack of cortisol c. Pituitary apoplexy d. Growth hormone replacement in a patient with unrecognized ACTH deficiency e. Head injury
3. Which of the following anatomical parts of the adrenal gland produce aldosterone a. Zona Fasciculata b. Zona Reticularis c. Zona Glomerulosa d. All of the above e. None of the above
4. Concerning the adrenal gland negative feedback loop, identify the true statement a. Cortisol promotes release but not the synthesis of ACTH b. Cortisol stimulates synthesis and release of the CRH c. CRH stimulates release of ACTH d. AVP and CRH stimulate release of ACTH e. All of the above are true
5. In primary failure of the adrenal gland, the etiology can be a. infiltrative destruction of the gland itself b. Pituitary apoplexy c. Meningococcemia. d. Cortisol level is low e. ACTH levels are high
6. Which of the following has NOT been associated with primary gland failure a. AIDS b. Metastatic malignancy c. Mutation of the ACTH gene d. Pituitary/hypothalamic radiation e. None of the above
7. In secondary adrenal gland failure: a. There is no hyperpigmentation b. ACTH levels are low c. CRH levels are low d. Aldosterone is still produced e. All of the above are true
8. Secondary adrenal gland failure can be due to all of the following EXCEPT a. Pituitary tumors b. Hypothalamic disease c. Irradiation of the hypothalamus d. Head injury e. Diabetes
9. In tertiary adrenal gland failure a. ACTH release from the pituitary gland will be suppressed by exogenous cortisol a. ACTH release occurs but lacks a diurnal rhythm b. CRH levels are high c. Cortisol levels are high d. Aldosterone levels are high
10. Clinical signs of adrenal gland failure are a. Hypernatremia b. Hyperglycemia c. Low calcium d. Lymphocytosis e. Constipation
11. Primary adrenal gland deficiency clinically results in all of the following EXCEPT a. Inability to tan b. Increased libido in the female c. Abdominal striae d. Oral mucosa hyperpigmentation e. Low blood pressure
12. Meningococcemia can result in a. Paradoxical regeneration of the adrenal gland after surgical removal b. Waterhouse Frederichson syndrome c. Resistance to ACTH stimulation of the zona glomerulosa d. Direct sensitization of CRH to the zona fasciculata e. Increased cortisol feedback to the pituitary gland to block cortisol release.
13. Management of adrenal crisis includes all of the following EXCEPT a. IV access b. Chem 7 c. Measurement of CRH levels d. ACTH test e. Measurement of cortisol level
14. Cushing syndrome is caused by all of the above EXCEPT a. Excessive levels of cortisol b. Pituitary adenoma c. Deficiency in ACTH d. Increase in CRH e. All of the above
15. Clinical features of Cushing syndrome include all of the following EXCEPT a. Weight loss b. Violaceous cutaneous striae c. Thin skin d. Buffalo hump e. Moon face
16. Clinical features of Cushing syndrome include all of the following EXCEPT a. Thick skin b. Muscle weakness c. Hirsutism d. Clitoris hypertrophy e. Striae distensae
17. Clinical signs of Cushings disease include all of the following EXCEPT a. Moon face b. Absence of thirst c. Normal menstrual periods d. Personality changes e. Fatigability / Weakness
18. Orthopedic problems in Cushing Disease include a. Osteoporosis b. Vertebral Collapse c. Both of the above d. None of the above
19. The definitive test in the diagnosis of Cushing disease is a. 1 mg Dexamethasone suppression test b. Serum cortisol test c. 2 mg Dexamethasone suppression test d. Measurement of CRH levels e. None of the above
20. In Cushing disease secondary to an adrenal tumor a. ACTH levels are normal b. ACTH levels are high c. Cortisol levels are low d. CRH levels are low e. None of the above
21. Cushing disease treated with surgical adrenalectomy secondary to pituitary tumor has the following characteristics a. ACTH levels are high b. Patients require lifelong replacement of both glucocorticoids and mineralocorticoids c. ACTH levels are low d. Both of the above e. None of the above
22. Nelson syndrome features all of the following EXCEPT a. Excess of cortisol levels b. Increased alpha-MSH. c. Increased CRH levels d. Increased ACTH levels e. Tongue is normal
23. Hypoaldosteronism a. May be independent of cortisol deficiency b. Renin levels may be low c. May occur after heparin administration d. May present with postural hypotension e. All of the above
24. Concerning hypoaldosteronism a. Cortisol is the treatment of choice b. Conn syndrome may result from over treatment of hypoaldosteronism c. Results from an increase in angiotensin I conversion to angiotensin II d. Is precipitated by pituitary apoplexy e. Fludrocortisone 0.10 mg is an effective medical treatment
25. Which of the following may be a sign of primary hyperaldosteronism a. Diastolic hypertension without edema b. Hypokalemia c. Polyuria d. Metabolic acidosis e. All of the above
26. Secondary aldosteronism can be due to a. Renal artery stenosis b. Malignant hypertension c. Heparin administration d. Radiation as the definitive therapy e. None of the above
27. Treatment for bilateral adrenal hyperplasia includes a. Absence of salt restriction as a mode of therapy b. Surgery to correct the underlying defect c. Spironolactone d. None of the above e. All of the above
28. Pheochromocytoma a. Results in the feeling of impending doom b. Presents with painful extremities c. Causes frequent diarrhea d. Is often associated with obesity e. Presents with hypotension
29. Paroxysmal symptoms of a pheochromocytoma include a. Hypotension b. Ulcers on the pretibial surface of both legs c. Respiratory failure d. Acute exacerbations of pain in the great toe e. Sweating
30. Which of the following is associated with pheochromocytoma a. Thyroid medullary cancer b. Astrocytoma c. Glioblastoma d. Liver failure e. Spontaneous fractures of the base of the 5 th metatarsal bone
31. Concerning the treatment of a pheochromocytoma: a. Surgery is a treatment of choice b. Radiation therapy is contraindicated c. Alpha adrenergic blockers are often deleterious d. Beta blockers are contraindicated e. Salt restriction is imperative
32. Systemic manifestation of MEN II syndrome which includes a pheochromocytoma are a. Lichen amyloidosus b. Weight gain c. Bradycardia d. Decreased urine output e. Increased appetite
33. The diagnosis of diabetes can be made with which of the following a. A fasting blood glucose of 125 b. Random sugar of > 200 with symptoms of diabetes c. A 2hr blood glucose of > 180 during an oral GTT d. Ketones in urine e. 34. Concerning diabetes a. Insulin is released from the alpha cells in the liver b. Insulin is synthesized in the beta cells of the pancreas c. C peptide is made in a ratio of 1: 2 to the insulin molecule d. Insulin is active immediately upon release without any further enzymatic action needed for it to become metabolically active. e. Retinal detachment occurs early in the disease process.
35. In diabetic ketoacidosis, the most important initial therapy (after the ABCs) is : a. Insulin b. Potassium c. Fluids d. Magnesium e. Bicarbonate
36. Glucose should be administered to a patient in DKA when the glucose levels approaches
a. 50 b. 100 c. 150 d. 250 e. 400 37. Insulin should be administered in a patient with DKA a. As long as the patient is ketotic b. Only until the glucose falls below 200 c. Until the patient is transferred from the ER to the ICU d. As long as the patient is hypokalemic e. Until the patient is euglycemic
38. Which of the following hormones opposes insulin action a. Growth hormone b. Epinephrine c. Cortisol d. Glucagon e. All of the above
39. Diabetic ketoacidosis is associated with a. Decreased gluconeogenesis b. Increased glycogenolysis c. Ketone formation d. No change in insulin levels e. Hyponatremia
40. Symptoms of diabetic ketoacidosis include all of the following EXCEPT a. Polyuria b. Shortness of breath c. Well hydrated mucosa d. Kussmaul respirations e. Altered mental status
41. Precipitating events of diabetic ketoacidosis are a. Hypoglycemia b. Infection c. Medical compliance d. Low HBA1c levels e. Well controlled diabetes
42. Laboratory findings in diabetic ketoacidosis include a. Low glucose levels b. Absence of ketones in the urine c. Hypermagnesemia d. Hyperphosphatemia e. Acidosis
43. Diabetic ketoacidosis gives a strongly positive nitroprusside test due to a. Acetoacetate b. Beta hydroxybutyric acid formation c. Acetone d. Glucose e. Insulin
44. The nitroprusside test becomes more positive as you are (correctly) treating the patient with DKA. This is because a. total ketone bodies increase as effective therapy is initiated b. Beta hydroxybutyric acid (negative on nitroprusside test) is converted to acetoacetate which (positive on nitroprusside test). c. Acetone formed as the final oxidation product is strongly reactive with nitroprusside d. A fourth yet unknown ketone body is produced which give a positive nitroprusside test e. Insulin which is given to the patient in DKA is strongly reactive with nitroprusside.
45. Bicarbonate is not given routinely to a patient with DKA because a. Cerebral edema occurs commonly b. The patient will produce their own bicarbonate as they are given insulin and fluids c. There is decreased tissue oxygenation as the HbO 2 curve shifts to the left d. It promotes hyperkalemia e. It increases CSF pH
46. A patient who develops a nonketotic hyperglycemic state (coma) will have a. A low glucose level b. Severe ketoacidosis c. Hyposmolality d. Pre-renal azotemia e. Arterial pH less than 7.00
47. The most important treatment for NKHC (non ketotic hyperosmolar state/coma) is: a. Fluids b. Insulin c. Potassium d. Magnesium e. Bicarbonate
48. Which of the following infections in chronic diabetes results in malignant external otitis? a. Escherichia coli b. Pseudomonas aeruginosa c. Mycoplasma pneumoniae d. Hemophiles Influenzae e. Enterococcus
49. Which of the following is a significant complication in diabetics a. Rhinocerebral mucormycosis b. Clostridium difficile colitis c. Osteomyelitis d. Optic neuritis e. Endophthalmitis
50. In thyroid regulation a. TRH is synthesized by the pituitary b. TSH is synthesized by the hypothalamus c. Thyroid hormone inhibits release of TSH but not TRH d. T4 is less potent than T3 e. TSH stimulates TRH release
51. Comparing T4 vs T3 a. T3 is bound to prealbumin b. The half life of T3 is longer than T4 c. T3 binds less to the receptor than does T4 d. T4 is more potent than T3 e. T3 is formed by peripheral conversion of T4 to T3
52. Symptoms of hypothyroidism include a. Hoarse voice b. Cold intolerance c. Constipation d. Amenorrhea e. All of the above
53. Signs of hypothyroidism include a. Puffy face / hands and feet b. Delayed DTR c. Carpal tunnel syndrome d. Alopecia e .All of the above
54. Treatment of hypothyroidism a. May unmask adrenal insufficiency b. Is associated with pseudotumor cerebri in children c. May need to be increased in pregnancy d. Includes daily doses of levothyroxine e. All of the above
55. Hyperthyroidism symptoms include a. Irritability b. Cold intolerance c. Increased appetite d. Constipation e. Bradycardia
56. Hyperthyroidism signs include a. Weight gain b. Cold skin c. Normal menstrual periods d. Increased perspiration e. Slow heart rate
57. Physical signs of hyperthyroidism include which of the following a. Pretibial myxedema b. Puffy face c. Increased nail growth d. Yellow teeth e. Hyperpigmentation on the oral mucosa
58. Precipitating events of thyroid storm include a. Infection b. CVA c. DKA d. Emotional stress e. All of the above
59. Treatment of thyroid storm includes a. Propylthiouracil b. Potassium iodide c. Propranolol d. Dexamethasone e. All of the above
60. All of the following are symptoms of thyroid eye disease a. Diplopia b. Proptosis c. Lid lag /retraction d. Conjunctival injection / chemosis e. All of the above are true
Endocrinology Answers
1. e 2. d 3. c 4. c 5. a (c can also be correct) 6. d 7. e 8. e 9. a 10. d 11. a, b, & c 12. b 13. c 14. c 15. a 16. a 17. c 18. c 19. c 20. d 21. a & b 22. a 23. e 24. e 25. a, b, & c 26. a 27. b 28. a 29. e 30. a 31. a 32. a 33. b 34. b 35. c 36. d 37. a 38. e 39. c 40. c 41. b 42. e 43. a 44. b 45. c 46. d 47. a 48. b 49. a 50. d 51. e 52. e 53. e 54. e 55. a & c 56. d 57. a 58. e 59. e 60. e