ENDOCRINOLOGY MODULE QUESTION

BANK
HYPOTHYRODISM.

1.-In subclinical hypothyroidism the thyroid profile is: Multiple endocrine syndrome
a) Increased T3r, decreased free T4 and increased TSH
b) Increased free T3 Decreased total T4 Increased free T4 1. Most frequent manifestation in multiple endocrine
c) Normal TSH Normal free T4 Increased T3 syndrome type 1
d) Decreased TSH Free T4 Decreased normal T3. a) Insulinoma
e) Increased TSH or normal T4. b) Primary hyperparathyroidism
c) Gastrinoma
2.-Most frequent cause of hypothyroidism d) Pituitary adenoma
a) Treatment with I 131 e) Medullary thyroid carcinoma
b) Iodine deficiency
c) Hasimoto's thyroiditis 2. Type of alteration in NEM 1
d) Pituitary failure. a) Chromosome 11 mutation
e) Graves' disease. b) Mutation in p53
c) RET mutation
3.-Dose of hypothyroidism treatment with levothyroxine d) X deletion
a) 25mcg a day e) Chromosome 6 mutation
b) 1.6/Kg/day
c) 400 mg a day 3. Pathological entities that share MEN 1a and 1b
d) 100 mg a day a) Insulinoma and Neuroma
e) 1.7 / Kg /day b) Insulinoma and Hyperparathyroidism
c) Medullary thyroid carcinoma and insulinoma
4.-What does the Wolf Chaikoff phenomenon consist of? d) Medullary thyroid carcinoma and
Hyperparatoriodism
a) Result of increased iodine
e) Medullary thyroid carcinoma and
b) Peroxidase blockade
Pheochromocytoma
c) NO/I symporter lock
d) Deiodination blocking.
4. Type of alteration in NEM 2
e) Negative counterregulation
a) Translocation 14.22
b) Translocation 11.22
5.-Most frequent cause of hyperthyroidism
c) ACL mutation
a) serious illness
d) BCL mutation
b) Multinodular goiter
e) RET mutation
c) Struma ovarii
d) Fictive thyroiditis
5. Most common enteropancreatic tumor in MEN 1
e) Molar Pregnancy.
a) Insulinoma
b) Gastrinoma
ANSWERS: e,c,b,c, c.
c) Glucagonoma
d) Neuroglioma
e) Prolactinoma
Answers: b, a, e, e, b. c) 24-hour urine collection 30 to 299 mg/dl,
and test strip less than 30 mg/dl
MELLITUS DIABETES d) Albumin-creatinine ratio in 24-hour urine
less than 17 in men
e) Albumin-creatinine ratio in 24-hour urine
1. Patient with random glucose of 180 mg/dl
less than 17 in women
a) Mellitus diabetes
b) Metabolic syndrome
Answers: d, c, b, b, a.
c) Fasting glucose disorder
d) Glucose tolerance disorder
Adrenal insufficiency
e) Gestational Diabetes Mellitus

1. The following drugs can cause primary adrenal

2. Target for HbA1 for ADA glyceric control insufficiency except
a) 5% a) Ketoconazole
b) 6% b) Matirapone
c) 7% c) Megestrol
d) 8% d) Etomidate
e) 9% e) Aminoglutethimide

3. How much is 1% HbA1 in mg/dl of 2. Patient with primary adrenal insufficiency El Pual
glucose??? currently has PORT II pneumonia How should
a) 30 mg/dl replacement treatment be adjusted if he currently
b) 35 mg/dl consumes 20 mg hydrocortisone daily?
c) 40 mg/dl a) It does not adjust
d) 45 mg/dl b) Double the usual dose
e) 50 mg/dl c) 50 mg IV is given every 6 hours
d) 100 mg IV every 6 hours
4. It is a criterion for making the diagnosis of e) Methylprednisolone 125 mg every 8 hours
gravidarum diabetes.
a) Fasting plasma glucose greater than 127 3. Mineralocorticoid used as a replacement
mg/dl treatment in primary adrenal insufficiency
b) Fasting plasma glucose greater than 95 a) Hydrocortisone
mg/dl b) Mometasone
c) Plasma glucose greater than 180 mg/dl c) Eplerenone
postprandial
d) Fludrocortisone
d) Plasma glucose greater than 100 mg/dl
e) Not replaced
postprandial
e) Fasting plasma glucose greater than 135
mg/dl 4. Patient with the following characteristics: high
ACTH, low cortisol, hyperkalemia, eosinophilia and
hyperpigmentation: diagnosis
5. Criterion to determine microalbuminuria
a) Cushing's syndrome
a) 24-hour urine collection 30 to 299 mg/dl,
b) Nelson's disease
and test strip more than 30 mg/dl
c) Cohon's disease
b) 12-hour urine collection 30 to 299 mg/dl,
and test strip more than 30 mg/dl d) Addison's disease
e) Sheenhan syndrome
 a)Metoprolol
b)Atenolol
c)Esmolol
5. First choice treatment in adrenal crisis d)Propanolol
a) Fludrocortisone 0.20 mg every 24 hours e)Carvedilol
b) Prednisone 5 mg every 6 hours
c) Prednisone 1 mg/Kg per day Answers: a, e, c and e, b, d.
d) Hydrocortisone 100 mg every 6 hours
e) Hydrocortisone 50 mg every 12 hours Thyroiditis Questions.
1. Spread of bacterial thyroiditis
ANSWERS. C,B,D,D,D, a) Hematology.
b) Lymphatic.
THYROIDITIS c) Contiguity
1. Most common cause of acquired hypothyroidism: d) Post trauma
a) Lymphocytic thyroiditis e) A and B are correct.
b) surgical removal of thyroid
c) Post treatment for hyperthyroidism 2. Duration of thyrotoxic phase in De Quervain's
d) Originated by amiodarone thyroiditis.
e) Riedel's thyroiditis a) 3 weeks
b) 2 weeks
2. Most frequent clinical manifestation of lymphocytic c) 4 weeks
thyroiditis: d) 1 week
a) Cold intolerance e) 5 weeks.
b)Constipation
c) Dysphonia 3. Percentage of TPO found in HASHIMOTO
d) Myxedema thyroiditis.
e) Goiter a) 80%
b) 70%
3. The use of amiodarone can cause: c) 90%
A) Hypothyrodism d) 95%
B)Hyperthyroidism e) 50%.
C)Hyperthyroidism and hypothyroidism 4. The presence of painless lymphocytic thyroiditis
occurs more frequently.
D)None
a) Graves
e)Panhypopituitarism
b) Hashimoto.
c) Smokers
4.- HLA associated with Graves' disease:
d) pregnant
a) HLA –B27
e) CYD are correct.
b)HLA –DR3
c) HLA-DR1
5. Amiodarone iodine percentage.
d) HLA-C15
a) 30%
e) HLA – B24
b) 35%
c) 40%
5.- Treatment of autonomic hyperactivity associated with
Graves' disease: d) 39%
 e) 25% e. 4:00 AM.
Answers. 1 E) 2 C) 3 D) 4 E) 5 D).
Prolactin Releasers:
CUSHING'S SYNDROME a. dopamine.
b. TSH.
1.- Imaging study of choice in the diagnosis of ACTH- c. Steroids.
dependent Cushing's syndrome: d. B and C are correct.
a) skull x-ray e. A and B are correct.
b) abdominal x-ray f. Only A is correct.
c) Tomography
d) Magnetic resonance Example of positive feedback system:
e) Ultrasonography. a. Hypothalamic pituitary ovarian axis.
b. Hypothalamic pituitary testis axis.
2.-They characterize Cushing's syndrome except: c. Hypothalamus-adrenal axis.
a) carbohydrate intolerance d. Hypothalamic pituitary adrenal axis.
b) Dyslipidemia e. Hypothalamus, pituitary, thyroid axis.
c) Hyperkalemia
d) Nephrolithiasis Patient with urinary volume of 2500 cc, density of 1.015,
e) Neuropsychiatric disorders type of decompressive craniectomy, clinical suspicion is:
a. SIADH.
3.-Syndrome associated with Cushing's syndrome b. Patient without hormonal pathology.
a) Fisher syndrome c. Diabetes insipidus.
b) Alport syndrome d. Water intoxication.
c) McCune Albright syndrome e. Salt-wasting brain syndrome.
d) Polycystic ovary syndrome
e) pyramidal syndrome Female patient, 32 years old, with bi-temporal
hemianopia, treated with bromocriptine (dostinex) .5 mg
every 3rd day, which cell line would you try to rule out in
4.-Therapeutic test useful in the diagnosis of Cushing's
case of tumor recurrence or tumor growth.
syndrome
a. corticotrope,
a) carbohydrate tolerance curve
b. Thyrotrope.
b) dexamethasone suppression test
c. Somatotrope.
c) exogenous aldosterone test
d. Recurrence of Lactotrope.
d) catecholamines in urine
e) 24-hour urine clearance.
ANSWERS: A,E,A,B,C.

ANSWERS: D, C, D, B.
THYROID CANCER .

HYPOTHALAMUS AXIS .
1,. Most common thyroid cancer:
a) follicular
Peak GH secretion:
b) Papillary
a. 5:00 AM.
c) Medullary
b. 6:OO PM.
d) Anaplastic.
c. 8:OO AM
e) Hürthle cells
d. 7:OO PM.
 c. Mild acidosis
2.- Most common thyroid cancer in women. d. Chlorine greater than 102 mEq/L
a) Papillary e. All of the above.
b) Medullary f. elevated uric acid
c) Anaplastic.
d) Hürthle cells 3.- What is the dose of calcitonin in primary
e) follicular hyperparathyroidism?
:
3.-Ablation with iodine 131 in local metastases is: a)4 to 8 IU/kg
a) 50 to 100 mCi b) 7 to 12 IU/Kg
b) 200 to 300 mCi c) 9 to 20 IU/Kg
c) 100 to 120 mCi d) 3 to 9 IU/kg
d) 100 to 130 mCi e) 1 to 12 IU/KG
e) 150 to 200 mCi 4.- Which of the medications is contraindicated in primary
hypoparathyroidism:
a. Thiazides.
4.- Poor prognostic factors in thyroid cancer except:
b. IECAS.
a) Age over 65 years.
c. Loop diuretic
b) Distant metastasis.
d. Beta blockers
c) Large tumors
e. Antiplatelets
d) Extrathyroidal invasion
e)Multicentricity and high-grade tumor.
5.-Indication for surgery in primary hypoparathyroidism
except:
5.-Characteristic of Hürrthle cells:
a) Calcemia 0.4-0.9 mg/dl higher than normal
a) polyclonal cells with abundant oxyphilic
Asymptomatic patients with BMD Z-Score greater than
cytoplasm
-1 in the forearm and/or calciuria < 300 mg/24 h
b) Follicular epithelium with pleomorphism
b) Calcemia > 0.4 mg/dl higher than normal with
c) rare, fusiform giant cells. marked symptoms.
d) parafollicular C cells c) Calcemia 1 mg/dl higher than normal.
a. Round, polyhedral cells. d) Calcemia < 0.4 mg/dl higher than normal
ANSWERS: A,E,C,A, A e) Progressive disease: increasing calcemia,
deterioration of renal function and/or appearance of
HYPERPARATHYROIDISM: symptoms and/or increase in calciuria to > 300 mg/ 24
h
1.-Most frequent clinical manifestations in
hyperparathyroidism except: ANSWERS: C, E, A, A, D,
a. Hypercalciuria and Nephrocalcinosis
b. poliuria and nocturia PRIMARY HYPERALDOSTERONISM
c. Weightloss 1.-According to the definition of primary
d. Osteitis fibrosa cystica hyperaldosteronism, it is characterized by:
e. Subtle cortical osteopenia a) Arterial hypertension
b) hypokalemia
2.-Diagnosis of primary hyperparathyroidism: c) increased secretion of plasma aldosterone
a. Low phosphate and alkaline phosphatase d) suppression of plasma renin activity.
b. Chlorine-phosphate ratio greater than 33 e)All of the above
 b) When after 3 months of treatment the patient has
2.-Most frequent cause of primary hyperaldosteronism: an A1C >8%
a)aldosterone-producing adrenal adenoma. c) Every time a new drug appears on the market
b) aldosterone-producing adrenal carcinoma. d) When the postprandial glucose level exceeds 180
mg/dl
c) only a and b are correct.
e) When the patient loses more than 3kg of weight
d) All of the above
e)None of the above
2) What is a criterion for early insulinization in type 2
diabetics at the time of diagnosis?
3.-Based on the diagnosis of primary hyperaldosteronism,
a) Pregnancy
it is common to find:
b) Obesity
a. Metabolic alkalosis and elevation of serum
bicarbonate due to loss of hydrogen ions in c) Severe Anemia
urine. d) Age over 70 years
b. Alkaline urinary pH e) Epilepsy
c. Normokalemia or Hypokalemia.
d. Hypomagnesemia. 3) In the treatment of Type 2 Diabetes Mellitus, it is
e. All of the above expected that eventually…
a) Only one drug is required to achieve the goals
4.-To make a differential diagnosis between primary and b) Every patient receives an incretin
secondary hyperaldosteronism which is true. c) Patient management requires more than one drug
a) In primary hyperaldosteronism, the plasma d) Metformin falls into disuse
concentration of renin is inhibited and secondary e) All of the above are correct
hyperaldosteronism is elevated.
b) In primary hyperaldosteronism the plasma
4) What percentage of A1C is expected to decrease with
concentration of renin is elevated and in
lifestyle changes (diet, exercise, weight loss)?
secondary hyperaldosteronism it is inhibited.
a) 5 to 7%
c) In primary hyperaldosteronism the plasma
concentration of renin is elevated and in b) 0.5 to 1%
secondary hyperaldosteronism it is elevated. c) 3 to 5%
d) In primary hyperaldosteronism the plasma d) 1 to 2%
concentration of renin is inhibited and in e) 2%
secondary hyperaldosteronism it is inhibited.
e) C and D are correct. 5) What percentage of A1C is expected to decrease with
5.-What figure is used to diagnose plasma renin in primary the use of metformin?
hyperaldosteronism? a) 5 to 7%
a) Greater than 100. b) 0.5 to 1%
b) Less than 100 c) 1.5 to 2%
c) Over 50 d) 3 to 5%
d) Under 50 e) 2%
e) none of the above
ANSWERS E, A, E, A, A. DYSLIPIDEMIA:

1) The treatment of Type 2 Diabetes Mellitus must be 1. Main component of HDL.

modified…
a. ApoB- 100
a) At any time
b. ApoA 1
c. Triglycerides.
 d. Proteins 4. Age
e. ApoB-48. 5. All of the above

2. Most common type of familial dyslipidemia Syndrome characterized by precocious pseudopuberty:

a. Dysbetalipoproteinemia 1. Angelman syndrome
b. Familial hypertriglyceridemia. 2. Mc Cune Albright Syndrome
c. Hypobetalipoproteinemia 3. Down's Syndrome
d. Combined hyperlipidemia 4. Pateau syndrome
e. Lipoprotein lipase deficiency 5. Edwards syndrome

3. The following are causes of secondary Cause of precocious puberty true except
dyslipidemia except: 1. encephalitis
a. Liver disease 2. Meningitis
b. Associated with drugs such as estrogens 3. Neurofibromatosis
c. Ethanol 4. Tuberous sclerosis
d. Hyperthyroidism 5. Dysgerminoma
e. Obesity
Expected effects of testosterone replacement therapy,
4. Lipid-lowering treatment in patients with multiple except
risk factors for atherosclerotic coronary artery 1. Hypercholesterolemia
disease should begin with cholesterol and
2. Polycythemia
triglyceride levels of:
3. Weight gain
a. LDL < 100,
4. Prostatic hyperplasia
b. LDL > 100,
5. HDL increase
c. LDL > 130
d. LDL >160
In hypergonadotropic hypogonadism we expect to find:
e. LDL >190
1. High testosterone, high FSH, high LH
2. elevated testosterone, elevated FSH, decreased LH
5. Medication indicated for the treatment of
dyslipidemia in pregnant women: 3. elevated testosterone, decreased FSH, decreased
LH
a. HMG CoA inhibitors
4. Testosterone decreased, FSH decreased, LH
b. Fibrates
decreased
c. Nicotinic acid
5. Decreased testosterone, elevated FSH, elevated LH
d. Bile acid sequestrants
e. Ezetimibe

Thyroid nodule
1. Which of the following is not a risk factor for
PRECOCIOUS PUBERTY, HYPOGONADISM malignancy in thyroid nodule?
a. History of Cervical Radiation
Etiology of Hypogonadism b. People over 70 years old
c. Female gender
1. Chronic diseases
d. Hyperthyroid Symptoms
2. Trauma e. C and D are correct
3. Radiation
 2. All of the following are indications for performing 2. In the treatment of diabetic ketoacidosis, indicate which
FNAB, except: is the correct answer
a. Nodule in people with a history of familial a) Regular insulin .1 IU/K/hr infusion until reaching a
thyroid carcinoma glucose of 200 mg/dl
b. Nodule in patients with Multiple Endocrine
b) Regular insulin .15IU/k/IV bolus and infusion of
Neoplasia type 2
0.1IU/K/hr
c. Nodule in people with a history of cervical
radiation c) Insulin 0.4 IU ½ sc and ½ iv or im, followed by infusion of
d. Nodule + Lymph nodes regular insulin .1 IU/K/hr until a decrease of 50 to 75 mg/dl
e. All Palpable Nodules in one hour is achieved.
d) Regular insulin .1IU/k/hr infusion with a decrease of 50-
3. Indication for performing a thyroid scan: 75 mg/dl/hr and if necessary double the dose
a. Normal TSH e) Maintain regular insulin infusion until glycemia is
b. USG Suspect corrected, then suspend and start INPH
c. Low TSH
d. USG not Suspect
3. Treatment of choice in lactic acidosis due to metformin
e. High TSH
a) Hemodialysis
4. Indicate which of the following statements is b) Peritoneal dialysis
incorrect: c) Intensive hydration and HCO3 IV
a. Multiple nodules are identified by USG in
d) Suspend the drug and support measures
50% of palpable nodules.
b. Malignant lesions are less common in e) Discontinue all oral hypoglycemic agents for 7 days
nodules <10mm in diameter.
c. The risk of cancer is not greater in solitary 4. Drugs that are associated with drug-related
nodules than in Multinodular Goiter hypoglycemia by increasing the sensitivity of B cells to
d. In the absence of goiter, symptoms of glucose and because they enhance insulin secretion:
tracheal compression suggest malignancy a) Pentamidine
e. There is no relationship between
b) Quinidine
histological characteristics and
symptomatology c) Glucocorticoids
d) Salicylates
5. Risk factors for malignancy except: e) Nephrotoxic
a. Rapid growth
b. sudden pain
c. Firm or hard consistency 5. Treatment agent of choice for mucormycosis
d. “Spindle” shape a ) Amphotericin B
e. All are correct b) Voriconazole
c) Ketoconazole
d) Griseofulvin
e) Itraconazole

1. Which of the following is NOT a diagnostic criterion for

severe diabetic ketoacidosis? 1. In relation to hypercalcemia, which of the following is
INCORRECT?
a) pH <7.0
a) It is probably the most common endocrine complication
b) HCO3 <10
of malignant tumors
c) Glc >600
b) Malignant tumors are the most common cause of
d) AG >12 severe hypercalcemia in hospitalized patients
e) Variable osmolarity c) The prognosis is poor with a mean survival of 4 to 8
months, except for that associated with CaMa and MM.
d) It is never associated with an increase in serum PTHRP R=E**
levels and no phosphaturetic effect has been
documented in them.
Pituitary Incidentaloma Questions
e) It is usually rapid in onset and EP and chest X-ray can
1.-Glands that most frequently show incidental glands.
show the tumor in approximately 98% of cases.
a)Pituitary, adrenal and thyroid+
b) Gonads, pituitary and thyroid
2. Which of the following is NOT a criterion for SIADH?
c) Adrenals, gonads and tonsils
a) Hyponatremia and hypoosmolarity.
b) High Osm u (>100 mosml/kg). d) Tonsils, gonads and thyroid
c) Na U >40 mEq/L. e) Gonads, adrenals and thyroid
d) Normovolaemia.
e) Altered kidney, adrenal and thyroid function 2.-Macroadenoma growth trend
a) to 2 years
3. Which of the following is not part of the treatment in b) to 3 years
patients with ectopic Cushing's syndrome?
c) to 4 years++++
a) Surgical treatment
d) to 5 years
b) Amnoglumetamide
e) to 6 years
c) Ketoconazole
d) Rifampicin
3.-The most common non-functional adenoma is
e) Metapyrone
a) Gonadotropoma++++++
b) Corticotropoma
4. In the treatment of malignant hypercalcemia, which is
c) Prolactinoma
correct?
d) Somatotropinoma
a) Aggressive infusion with sun. salt, loop diuretic,
bisphosphonates, calcitonin e) Thyrotropinoma
b) Sun infusion. glc, loop diuretic, bisphophonates,
calcitonin 4.-More serious complication of the incidentalota in young
c) Infusion with sun. salt, hydrochlorothiazide, people
bisphosphonates, calciumnin a) chiasmatic compression
d) Start with bisphosphonates and diuretics b) mass effect
e) Start with glucocorticoids (prednisone) and diuretics c) Pituitary apoplexy++++++++
d) Temporary fractures
5. Which of the following statements regarding ectopic e) Ethmoid fractures
hormone secretion is FALSE?
a) Hormonal secretion can rarely be suppressed 5.-Treatment of symptomatic pituitary inicdentaloma
b) Clinical syndromes are usually associated with advanced a) Chemotherapy
malignancy
b) Radiotherapy
c) Hormones are not a useful marker for non-endocrine
c) Surgery++++++++
tumors
d) Doctor
e) The hormone is undetectable in tumor tissue
e) Observational
d) Serum or urinary hormone levels are inappropriately
elevated
Adrenal Incidentaloma

1.-Functioning adrenal incidentaloma syndrome

+a)Pheochromocytoma
b)Hyperthyroidism
c) Addison's disease
d)Acromegaly
e)Hypothyroidism

2.-Most frequent metastases of adrenal incidentalota type carcinoma

a)Mom
b) Testicle
+c)Stomach
d)Bone
e)Pancreas

3.-Most frequent syndrome of functional incidentalosis

+a)Pheochromocytoma
b)Insulinoma
c) Sx Cushing
d)Hyperaldosteronism
e)Prolactinoma

4.-Diagnostic test in Pheochromocytoma

a)Urinary cortisol
b)Nocturnal cortisol in saliva
+c)Urinary metanephrines
d) Serum catecholamines
e)K serum

5.-Specific triad of Pheochromocytoma

a) HAS +headache, low weight and lymph nodes
b) HAS+ low weight, sweating and hepatomegaly
c) HAS + headache, sweating and palpitations++++++++
d) HAS+ sweating, hepato and splenomegaly
e) HAS+ splenomegaly, headache and low weight