Download Endocrinology 2007

Endocrinology 2007
1. Hurthle cells are characteristic of:
a. papillary carcinoma
b. Graves disease
c. Hashimoto thyroiditis
d. Thyroiditis De quervain
e. hyperthyroidism
2. a tumor that originates from C cells:
a. papillary carcinoma
b. medullary carcinoma
c. follicular carcinoma
d. anaplastic carcinoma
e. follicular adenoma
3. regarding medullary carcinoma that is related to MEN, all the following are correct
except for:
a. it usually occurs in younger age than sporadic cases
b. it is accompanied by C cell hyperplasia
c. more common to be bilateral
d. does not include amyloid
4. it possible sometimes to differentiate between parathyroid adenoma and parathyroid
hyperplasia by:
a. the percentage of fat in the gland
b. the presence of normal parathyroid remnant near the finding
c. the weight of the gland
d. fibrotic septa
5. diabetes type 1- what is correct?
a. hereditary disease passed in a recessive autosomal pattern
b. HLA-DR 3-4 is present more commonly in these patients
c. when one of twins develops this disease, the risk of the other twin reaches 90%, and
this testifies to the importance of hereditary factors.
d. cow milk protects from the development of the disease
6. all the following sentences regarding to Insulin are correct , except for:
a. it is secreted in two phases after the right trigger is given
b. with every insulin molecule 2 molecules of C peptide are secreted
c. amino acids in the blood also trigger secretion of insulin.
d. in pathological situations there is a decrease in the secretion of insulin in the first
phase.
e. the first protein created in the cell is preproinsulin
7. all the following sentences regarding DM type 1 are correct except for:
a. use of an insulin pump or a large number of insulin injections are the two acceptable
ways of treatment nowadays.
b. the primary goal of treatment is to preserve the levels of sugar close to the normal
levels- but this approach increases the risk of hypoglycemic attacks
c. it is acceptable today to add another treatment PO like sulfonylurea to patient with DM
1 who are overweight.
d. daily follow up after sugar levels in the blood ( 3-6 times a day)
e. insulin analogues have improved significantly the management of patients with DM 1
8.In DM type 1 all the following sentences regarding the stage before the diabetes
develops are correct except for:
a. in most cases there are antibodies against different components of B cells
b. low sodium diet and physical activity will not postpone the emergence of the disease
c. it is a long process that take months- years
d. today there is a treatment that prevents the emergence of the disease and this is why it
is important to diagnose it in this stage
st
e. 1 degree family members are the primary screening group
9. 25 year old woman presents with a fasting sugar level of 130. 3 years ago during her
pregnancy she was treated with a special diet because her blood sugar level increased.
There is no family history of diabetes. BMI is 27. What is the most suitable diagnosis ?
a. gestational diabetes
b. DM II
c. DM I
d. autoimmune diabetes of adult
e. MODY
10. 55 year old man present at the clinic with these complaints: thirst, polyuria and
weight loss-10 kg in the last 3 months. Sugar level was 180 mg/dL. What is the correct
thing to do in order to exclude diabetes?
a. to perform a second sugar blood test in two hours
b. to perform sugar load with 75 mg glucose on another day
c. to perform sugar load with 50 mg glucose on another day
d. to perform sugar load with 100 mg glucose on another day
e. there is no need for more tests
11. 48 year old man with DM II is treated PO (metformin + glibenclamide). What is the
most trustworthy test that will reflect his state of balance for the long run?
a. fasting glucose
b. postprandial sugar level
c. sugar level at 3 in the morning
d. HbA1c level
e. all the above are correct
12. the combination between galatorrhea, amenorrhea and fertility problems can occur as
a result of all the following disorders except for:
a.hypothyroidism
b.acromegaly
c. pituitary tumor
d. herpes zoster
e.treatment with dopaminergic agents
13. one of the complications not considered that of diabetes is;
a. necrotizing papillitis
b. hyaline atherosclerosis
c. microangiopathy
d.nodular glomerulosclerosis
e.thyroiditis
14. in figure 1. What is the most suitable description?
a.insulitis in DM2
b. hyalinosis in DM2
c. glomerulosclerosis
d. none of the above
15. all the following are considered mechanisms in the pathogenesis of diabetic
complications, except for:
a. non-enzymatic glycosylation
b.activation of protein kinase C
c.influx of intracellular calcium and loss of calcium homeostasis
d.osmotic injury to insulin independent cell due to hyperglycemia
16. what is incorrect regarding anterior pituitary?
a. hyperprolactinemia results from adenoma ant. Pituitary
b. adenoma that secretes GH can cause hypopituitarism
c. necrosis of anterior pituitary can cause diabetes insipidus
d. adenoma of anterior pituitary can be related to MEN syndrome
17. non secretory pituitary adenoma can cause hypopituatirsm:
a. true, because of pressure and atrophy of the rest of the anterior gland
b. true, because of pressure and atrophy of the posterior gland
c. not true because of hyperfunction of anterior pituitary
d. not true, because of atrophy of the anterior pituitary
18. the diagnosis of malignant pheochromocytoma is confirmed by:
a. metosis
b. pleomorphism of cells and necrosis
c. extensive bleeding
d. metastases
e. all above are correct
19. slide number 3 (papillary carcinoma of thyroid):
a. it leads to loss of function of the organ
b. it leads to gain of function of the organ
c. it leads to death in most cases
d. it can occur in regional lymph nodes
e. it tends to extend into bones and lungs
20. Slide number 4 – adenoma of adrenal
21. patient that suffers from rheumatoid arthritis is treated with prednisone 20md per day
for 6 weeks. Which of the following approaches is correct when we decide to quit the
treatment:
a. To test the level of cortisol in the blood at 8 morning and according to the result to
decide what to do next
b. To test the level of ACTH in the blood at 8 morning and according to the result to
decide what to do next
c. because the patient was treated for less than two month we can quit the prednisone
immediately
d. Decrease the dose to 17 mg for the next 4 days.
22. all the following disorders can be explained by cushing syndrome except for:
a. CVA
b. myopathy
c. hirsuitism
d.atrial fibrillation
e. polyuria and polydipsia
23. All following conditions are related with hyperpigmentation except for:
a. conn’s disease
b. Addison disease
c. 21-hydroxylase deficiency
d. nelson’s syndrome
e. pituitary tumor
24.a 2 year old female baby on check up was found to have hair in her genitalia
a. classical 21 hydroxylase deficiency-salt wasting type
b. classical 21 hydroxylase deficiency-simple virilizing
c. non classical 21 hydroxylase deficiency
d. 17 hydroxylase deficiency
e. 11 hydroxylase deficiency
25. what is correct about somatostatin analogues?
a. it is the treatment of choice in acromegaly caused by microadenoma of pituitary
b. in most acromegaly patients they cause decrease of the microadenoma
c. they can worsen hypoglycemia in some patients with insulinoma
d. they attach to the 5 types of somatostatin receptors equally
e. they are not in use for diagnostic goals
Possible answers:
C
.1
B
.2
D
.3
B
.4
B
.5
B
.6
C
.7
D
.8
B
.9
B
.10
D
.11
E
.12
E
.13
E
.14
C
.15
C
.16
A
.17
D
.18
D
.19
A
.20
D
.21
D
.22
A
.23
C
.24
C
.25