Endo N3 2021/22
Mark an INCORRECT statement about osteoporosis:
May be caused by primary hyperparathyroidism
May be caused by medications e.g. denosumab
Vertebral fractures may be give no acute symptoms
First choice treatment are bisphosphonates
Osteoporotic fractures increase risk of further fractures
What is the gold standard for distinguishing between Cushing's disease and an ectopic source of ACTH?
Computer Tomography of the pituitary
The corticotropin-releasing hormone (CRH) stimulation test
Magnetic Resonance Imaging of the pituitary
High dose dexamethasone suppression test
Inferior Petrosal Sinus Sampling
Laboratory findings characteristic for secondary HYPERparathyroidism are:
elevated PTH, hypokalcemia, hyperphosphatemia
Decreased PTH, hypokalcemia, hyperphosphatemia
Normal PTH, hypokalcemia, hyperphosphatemia
decreased PTH, hyperkalcemia, hypophosphatemia
Elevated PTH, hyperkalcemia, hypophosphatemia
Clinical features of primary adrenocortical insufficiency:
Hyperpigmentation
Weakness
Postural hypotension and dizziness
Salt craving
Arthralgia
Laboratory features of primary adrenocortical insufficiency:
Hyperkalemia
Hyponatremia
Hyperglycemia
Normochromic anemia
Lymphocytosis
Subacute viral thyroiditis in the most typical picture of findings of laboratory tests is, choose one answer:
Leucopenia with lymphocytosis, decreased TSH, increased FT4 and FT3 in a range
Elevated CRP, increased TSH, slightly decreased FT4 and FT3
Leucocytosis with elevated CRP, decreased TSH, decreased FT4 and FT3
Leucopenia with lymphopenia , decreased TSH, increased FT4 and FT3 elevated
Elevated erythrocyte sedimentation rate (ESR) , decreased TSH, increased FT4 and FT3
Young pregnant woman (I trimester) come to Endocrinology Outpatient Clinic because of elevated TSH level - 5,6 μIU/ml (0,270 - 4,200). What endocrinologist should to do?
Nothing, this woman don't need endocrinological care
Check TSH in the next trimester (without any treatment at this moment)
Just refer patient to ultrasonography of thyroid
check levels of FT3, FT4 (without any treatment at this moment)
treat immediately
Which of the following symptoms are not common in hypothyroidism?
Weight gain
Fatigue
Constipation
Dry skin
Palpitations
Which of the following hormones is stored and released by the posterior pituitary?
Oxytocin
Thyroid stimulating hormone
Adrenocorticotropin
Prolactin
Human growth hormone
What are the possible complications of thyroidectomy?
Thyrotoxicosis, hypoparathyroidism
Tetany, paralysis of vocal folds
facial nerve palsy
Hyperparathyroidism, paralysis of vocal folds
Hypercalcemic crisis
The most common thyroid cancer in non-iodine deficiency region is:
anaplastic cancer
Medullary cancer
Ductal cancer
Papillary cancer
Follicular cancer
Which of the following is a complication of hypercortisolism?
femoral fracture
Hypotension
Acute kidney injury
Hiperkaliemia
Cachexia
Which of the following signs has the highest specificity for diagnosing hypercortisolism?
Depression
Obesity
Plethora
Red cutaneous striae
Hypertension
What are the criteria of metabolic syndrome?:
Systolic blood pressure > 125 mm Hg or diastolic blood pressure > 80 mm Hg
Raised triglycerides: ≥ 150 mg/dL
Reduced LDL cholesterol
Central obesity: waist circumference ≥ 74 cm in women and ≥ 80 cm in men
Raised HDL cholesterol
Choose the abnormalities in blood morphology which may be caused by hypercortisolism:
Neutrophilia
Leukocytosis
Thrombocytosis
Erythrocytosis
Eosinophilia
The most common cause of Cushing’s Syndrome (CS) is:
ACTH-nondependent CS caused by an adrenal adenoma
exogenous use of glucocorticoids
ACTH-nondependent CS caused by an adrenal carcinoma
Ectopic ACTH dependent CS
pituitary ACTH dependent CS
Which of the following is not a typical symptom of monotropic ACTH deficiency?
Anorexia
Nausea
Weakness
Hyperpigmentation
Hypotension
Which statement about Turner syndrome is incorrect?
Patients are infertile
The patients have short stature
It can be associated with some cardiac defects
May be diagnosed by amniocentesis during pregnancy
It is also known as 46 X,0 syndrome
Select one:
Calcitonin is a marker of anaplastic thyroid cancer
Hypothyroidism we treat initially with high doses of levothyroxine, decreased stepwise at monthly intervals
Elevated anti-TPO antibodies are always and indications for treatment
Amiodaron treatment always causes hyperthyroidism
Thyroid thrills and bruits may be heard in Graves Disease
What are the health consequences of obesity?
Sleep apnea
Hypertension
Diabetes mellitus type 2
Colon cancer
Osteoarthritis
What could be the consequence of pituitary adenoma?
Bilateral hemianopsy
Pressure on the optic chiasm
Infiltrating cavernous sinus
Headaches
Hypogonadism
Macroprolactinoma
Should be always operated
Typical is lack of increasing PRL after stimulation with metoclopramide
Is treated with dopamine antagonist
Doesn't lead to the osteoporosis
Increases the chances of getting pregnant
What is the most common cause of primary adrenocortical insufficiency?
Autoimmune adrenalitis
long-term glucocorticoid administration
Tuberculosis
pituitary adenoma
Metastatic tumors
55-year-old man was admitted to outpatient clinic due to hypercholesterolemia. He reported weight gain (8 kg in 5 months), constipation and dry skin. In lab. tests: TSH 16,80 uIU/ml (normal 0,4 - 4,0), fT3 2,11 pg/ml (2 - 4), fT4 0,62 ng/dl (normal 0,8 - 1,7). What is the test and treatment You choose?
Anti-TRH anibodies - treat with levothyroxin
Pituitary MRI - treat with radio-iodine
anti-TPO anibodies - treat with levothyroxin
Thyroid ultrasound - treat with methimazole
Radio-iodine uptake scintigraphy – treat with beta-blockers
What hormonal findings are typical for primary adrenocortical insufficiency?
Low ACTH, elevated cortisol, normal ACTH stimulation test
Low ACTH, low cortisol, normal ACTH stimulation test
Elevated ACTH, low cortisol, abnormal ACTH stimulation test
Elevated ACTH, low cortisol, normal ACTH stimulation test
Low ACTH, low cortisol, abnormal ACTH stimulation test
Thyrotoxicosis is characterized by:
lowered TSH, normal range FT3 and FT4
elevated TSH, elevated FT3 and FT4
Lowered TSH, lowered FT3 and FT4
elevated TSH, normal range FT3 and FT4
Lowered TSH, elevated FT3 and FT4
False about polyglandular autoimmune syndrome type 1 (PAS-1):
It is the most common of all polyglandular autoimmune syndromes
It is caused by pathogenic variants of the autoimmune regulator (AIRE) gene, which causes impairment of lymphocyte T maturation in thymus
Other autoimmune disorders may occur concomitantly, including type 1 diabetes, hypergonadotropic hypogonadism, ovarian failure, hepatitis
Addison’s disease develops in 60% of the cases during adolescence
Hypoparathyroidism and candidiasis occur in childhood
50-years old woman with hypertension and diabetes who gain weight in last year was sent to the endocrinologist with the suspicion of Cushing's syndrome. Test with 1 mg of dexamethasone was performed. The result of the test was: cortisol 1,0 ug/dl. What does it mean?
It suggests Cushing's disease
test with 1 mg dextamethason can't be used for the diagnosis of Cushing's syndrome
Cushing syndrome was confirmed
Cushing syndrome was excluded
it suggests iatrogenic Cushing's syndrome
Which statement about multiple endocrine neoplasia is correct:
MEN 1 is characterized by tumors involving mainly the parathyroid glands, the prostate gland, and the pituitary
MEN 2B includes medullary carcinoma of the thyroid, gastrinoma and pheochromocytoma
MEN 2B is also called Wermer’s syndrome
In MEN the tumors are always functional
MEN 2A includes medullary carcinoma of the thyroid, pheochromocytoma, and hyperparathyroidism
Which imaging studies should be done in the suspicion of primary hyperparathyroidism?
Neck ultrasound, abdominal MRI
Abdominal ultrasound, radio-iodine uptake scintigraphy
Neck ultrasound, scintigraphy with Tc-99m-sestaMIBI, DXA-absorptiometry
DXA of the tibia, neck ultrasound
Scintigraphy with the Tc-99m-sestaMIBI, abdominal MRI
What are the treatment options in hyperthyroidism in Graves disease:
Methimazole, irradiation, operation
Methimazole, radio-iodine, gamma-knife
Methimazole, radio-iodine, operation
Metformin, irradiation, operation
Levo-thyroxin, radio-iodine, operation
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