Endocrinology MCQs Past papers

PART 1:

1.     Eosinophils in the islands of Langerhans suggest

A.   insulinoma

B.   newborn child of a diabetic mother (*)

C.   maturity onset diabetes of the young

D.   type I diabetes

E.   type II diabetes, usual type

2.   Cotton wool patches on the diabetic retina are

A.   amyloid deposits

B.   ischemia areas (*)

C.   protein deposits

D.   retinal nicroseparations

E.   thread-like vascular proliferations

3.   Multiple endocrine neoplasia type I features which island

cell tumor?

A.   gastrinoma (*)

B.   glucagonoma

C.   insulinoma

D.   somatostatinoma

E.   VIPoma

4.   Hyperglycemia in the "dawn phenomenon" is mediated by

A.   cortisol

B.   epinephrine

C.   glucagon

D.   growth hormone (*)

E.   somatostatin

5.   Anti-microsomal antibodies suggest

A.   autoimmune addisonism

B.   Hashimoto's disease (*)

C.   mucocutaneous candidiasis / multiple endocrinopathy

D.   myasthenia gravis

E.   type I diabetes

6.   What is "Plummer's disease"?

A.   abdominal adiposity ("the dangers of crack")

B.   diabetes insipidus, with frequent trips to the bathroom

C.   hyperthyroidism from a "hot" adenoma (*)

D.   hyperthyroidism from factitious administration of thyroxine

E.   hyperthyroidism from too-rapid iodine replacement

7.   Which opportunistic infection is the common cause of adrenal

insufficiency in advanced HIV

infection?

A.   cytomegalovirus (*)

B.   Epstein-Barr virus

C.   herpes 6 virus

D.   Kaposi's sarcoma virus

E.   pneumocystis carinii

8.   Which will yield a drop of blood quickest when pricked with

the tip of the scalpel?

A.   collagenous scar

B.   normal fat

C.   lymph node

D.   parathyroid gland (*)

E.   thyroid tissue

9.   Urinary cyclic AMP is an old-fashioned way of estimating

A.   aldosterone levels

B.   antidiuretic hormone levels

C.   atrial natriuretic peptide levels

D.   growth hormone levels

E.   parathyroid hormone levels (*)

10.  Which lung cancer is most likely to produce ectopic ACTH?

A.   adenocarcinoma, common type

B.   bronchiolo-alveolar cell carcinoma

C.   large cell anaplastic carcinoma

D.   oat cell carcinoma (*)

E.   squamous cell carcinoma

11.  Which tumor-family syndrome is LEAST likely to produce a

pheochromocytoma?

A.   Sipple's MEN II

B.   Wermer's MEN I (*)

C.   von Hippel-Lindau syndrome

D.   von Recklinghausen's neurofibromatosis

12.  In diabetic kidney disease, you will usually see marked

hyaline sclerosis of the

A.   afferent arterioles

B.   efferent arterioles

C.   both (*)

D.   neither

E.   C and D

13.  Failure to make red blood cells is a common paraneoplastic

syndrome in patients with

A.   acromegaly

B.   glucagonoma

C.   insulinoma

D.   neuroblastoma

E.   thymoma (*)

14.  Fine-needle aspiration biopsy has found its greatest

usefulness in the examination of

A.   adrenal incidentalomas

B.   LEMON tumors prior to surgery

C.   pituitary masses

D.   suspected pheochromocytoma

E.   thyroid nodules (*)

15.  A high-dose dexamethasone suppression test will result in

suppression of

A.   an ACTH-producing pituitary adenoma (*)

B.   a cortisol-producing adrenal cortical adenoma

C.   both

D.   neither

E.   C and D

16.  Your choice for a lab test in suspected acromegaly?

A.   serum growth hormone, drawn at random

B.   serum growth hormone, stimulated by arginine infusion

C.   serum growth hormone, stimulated by sleep

D.   serum growth hormone, suppressed by glucose infusion

E.   serum insulin-like growth factor I, drawn at random (*)

17.  By common usage, "Sheehan's syndrome" is panhypopituitarism

resulting from

A.   birth defect

B.   obstetrical problems (*)

C.   pituitary adenoma, whether operated or not

D.   radiation therapy

E.   sickle cell disease

PART 2

1.   Rebound hyperglycemia from stress hormones induced by

hypoglycemia of excess insulin

production is called the

A.   dawn phenomenon

B.   Somogyi phenomenon (*)

C.   leprechaunism

D.   Pima syndrome

E.   resistin phenomenon

2.   Which islet cell tumor produces a distinctive, severe rash?

A.   gastrinoma

B.   glucagonoma (*)

C.   insulinoma

D.   somatostatinoma

E.   vipoma

3.   Which physical findings suggests that your atypical

diabetic's disease is caused by

autoantibodies against insulin receptors?

A.   acanthosis nigricans (*)

B.   atrophy of the interossei

C.   lipodystrophy

D.   necrobiosis

E.   proptosis (protruding eyes)

4.   The common thyroid lesion in Down's syndrome is

A.   fibrosis

B.   granulomas

C.   hypoplasia of the thyroid

D.   lymphocytic infiltration without follicles (*)

E.   papillary carcinoma

5.   For which thyroid lesion is a viral etiology

best-established?

A.   DeQuervain's thyroiditis (*)

B.   Graves's thyroiditis

C.   Hashimoto's thyroiditis

D.   Riedel's thyroiditis

E.   thyroid lymphoma (primary)

6.   A euthyroid bodybuilder taking anabolic steroids is most

likely to have

A.   decreased T4, decreased T3RU

B.   decreased T4, elevated T3RU (*)

C.   elevated T4, decreased T3RU

D.   elevated T4, elevated T3RU

E.   both normal

7.   To screen a short kid for growth hormone deficiency, you

will probably order a

A.   dexamethasone suppression test

B.   metyrapone test

C.   serum IGF-1 (*)

D.   somatostatin assay

E.   spot growth hormone assay

8.   Hyperthyroidism is fairly common in choriocarcinoma patients

because

A.   autoimmune thyroiditis is a paraneoplasitc syndrome seen

with "chorio"

B.   choriocarcinomas tend to produce TSH or TSH-like substances

(*)

C.   elevated thyroxine levels predispose to hydatidiform mole

which in turn precedes

choriocarcinoma

D.   the aggressive cancer invades the thyroid gland and frees up

colloid which is hydrolyzed

E.   undifferentiated cancer cells in the "chorio" produce

thyroxine

9.   A patient has an elevated T3 and T4, low TSH, and is

clinically hyperthyroid, but has no goiter

and almost no uptake of radioactive iodine in the gland.  The

most likely diagnosis is

A.   choriocarcinoma

B.   surreptitious ingestion of thyroid pills (*)

C.   pituitary adenoma

D.   pheochromocytoma mimicking hyperthyroidism

E.   Wilson's syndrome

10.  Which is NOT a favorable prognostic sign in neuroblastoma?

A.   calcification in the tumor

B.   intense S100 staining

C.   low mitotic count

D.   normal number of myc genes

E.   normal number of chromosomes (*)

PART 3

1.         The microangiopathy of diabetes is best described as

*           A.        hyalinization of the arteriolar media

B.        hyperplasia of the arteriolar endothelium

C.        hyperplasia of the arteriolar smooth muscle

D.        necrosis of small arteries and veins

E.        thrombosis of the small veins

2.         If the newborn child of a poorly-controlled diabetic mother comes to autopsy, what will you usually see in the pancreas?

A.        atrophic islets with eosinophils only

B.        atrophic islets with a predominantly-lymphocytic infiltrate

C.        atrophic islets with no sign of inflammation

*           D.        hyperplastic islets with eosinophils and lymphocytes

E.        hyperplastic islets with no sign of inflammation

3.         Cancer arises LEAST OFTEN in the

A.        adrenal cortex

B.        adrenal medulla

*           C.        anterior pituitary

D.        parathyroid glands

E.        thyroid gland

4.         Which histologic type of lung cancer is most likely to cause the syndrome of inappropriate antidiuretic hormone production?

A.        adenocarcinoma

B.        large cell anaplastic carcinoma

C.        mesothelioma

*           D.        oat cell carcinoma

E.        squamous cell carcinoma

5.         Common hemochromatosis is most likely to cause insufficiency of the

A.        adrenal medulla

*           B.        islets of Langerhans

C.        parathyroids

D.        pineal

E.        thyroid

6.         Numerous calcifications in these tumors help a radiologist to recognize them:

A.        adrenal cortical adenomas and carcinomas

B.        insulinomas and glucagonomas

*           C.        neuroblastomas and craniopharyngiomas

D.        prolactinomas and chromophobe pituitary adenomas

E.        VIPomas and FSH/LHomas

7.         Post-partum thyroiditis is the result of

*           A.        autoimmune mechanisms that are poorly understood

B.        disseminated intravascular coagulation

C.        ectopic TSH production by involution of the corpus luteum

D.        ectopic TSH released by the dehiscence of the placenta

E.        entry of amniotic fluid into the circulation

8.         Most helpful in recognizing that a follicular thyroid lesion is a carcinoma rather than an adenoma is

*           A.        blood vessel invasion

B.        giant nuclei

C.        hemorrhagic areas

D.        initial size of the mass

E.        psammoma bodies

9.         Pheochromocytomas most often secrete

A.        aldosterone

B.        cortisol

C.        dopamine

*           D.        norepinephrine

            E.        serotonin

10.       A ganglioneuroma is usually

A.        a pineal tumor capable of causing precocious puberty

*           B.        a self-cured neuroblastoma

C.        an iatrogenic lesion caused by thyroglossal duct cyst resection

D.        discovered incidentally where the thymus was once located

E.        the result of diabetic neuropathy

PART 4

1.      Which syndrome does NOT place a person at increased risk for pheochromocytoma?

*        A.        multiple endocrine neoplasia type I

B.        multiple endocrine neoplasia type II-A

C.        mutant succinic acid dehydrogenase

D.        neurofibromatosis

E.        von Hipppel-Lindau

2.      Sheehan's syndrome is destruction of the anterior pituitary as a complication of

A.        autoimmunity

B.        enlarging tumor of any sort

*        C.        obstetrical shock

D.        sickle cell disease

E.        surgery for Cushing's disease

3.      Cancer arises LEAST often in which endocrine gland?

A.        adrenal cortex

B.        adrenal medulla

C.        pineal

*        D.        pituitary

E.        thyroid