Endocrine

Semester and
Module solve
Past paper
Prepared: Sharifullah Momand

Dow 22

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1. A patient presents with weight loss, polyphagia, polydypsia, increased tiredness,
vomiting, and hyperventilation. He is young and his parents are also diagnosed with the same
disease. Which of the following is the most common etiological factor associated with this
disease seen in older populations?
A. Smoking
B. Obesity
C. Hypertension
D. Infections
E. Tumors
Ans: B
2. A patient presents with increased growth of skeletal and soft tissue, hypertension,
arthritis, menstrual disturbances, and diabetes mellitus. Upon administration of oral glucose,
which of the following levels would increase?
A. GH
B. IGF
C. GH and IGF
D. ADH
E. None of the above
Ans: C
3. A patient presents with polyuria and thirst. There appears to be no elevation of glucose
in the body, however, the serum osmolality appears to be low. Upon performing the water
deprivation test, the osmolatity is still low. Which of the following is true?
A. The problem is in the pituitary
B. The problem is in the kidneys
C. The patient has diabetes mellitus
D. The patient has high ADH in the serum
E. B and D
Ans: E
4. A blood test in performed on a patient and it discovered that the patient has very low
levels of sodium. It is also known that the patient has just undergone an operation. In addition
he appears to have a small cell tumor of the lung. Which of the following conditions is most
linked to the disease the patient has?
A. diabetes mellitus
B. cushings syndrome

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C. hyperthyroidism
D. diabetes insipitus
E. none of the abov
Ans: D
5. A patient presents with weight loss, sweating, palpitations, tachycardia, tremors, lid lag,
exopthalmosis, and a goiter. Upon taking a thyroid scan, there appears to be an increased
amount of iodine. What is the pathogenesis of his disease?
A. autoimmune mediated
B. immune complex mediated
C. unknown
D. infection
E. none of the above
Ans: A
6. A patient presents with lethargy, tiredness, cold intolerance, dryness of skin and hair,
hoarsness of voice and weight gain. He also has psychosis and his heart rate appears to be
lower than normal. Which of the following is not associated with the presenting symptoms?
A. hashimoto's disease
B. cretinism
C. protruding tongue, potbelly appearance, dwarflike features
D. iodine deficiency
E increased iodine levels
Ans:E
7. A patient presents with a bump on his neck. Upon taking a tissue sample, there appears
to be parafollicular cells. The tumor is also associated with MEN II, although most of the time it
is sporadic. What is the best way to moniter treatment?
A. measure thyroid hormone levels
B. measure iodine levels
C. measure TSH levels
D. measure calcitonin levels
E. measure iron levels
Ans: D
8. A patient presents with tiredness, weakness, anorexia, apathy, abdominal pain,
hyperpigmentation and postural hypertension. Upon infection he appears to be in cardiogenic

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shock and his blood volume is depleted. His sodium levels are low, potassium levels are high.
Which of the following would also be elevated?
A. TSH
B. T4
C. Adrenal hormone
D. ACTH
E. ADH
Ans: D
9. A patient presents with a moon face, truncal obesity, hypertension, purple straiae,
buffalo hump, fragile skin and impaired glucose tolerance. The opposite of the current
increased levels of the prime hormone involved in this patient is seen in:
A. Addison's disease
B. Pheochromocytoma
C. Hyperaldosteronism
D. Cushing's syndrome
E. None of the above
Ans: A
10. A patient presents with hypertension, anxiety, palpitations, headache, excessive
sweating, and arrhythmias. There appears to be increased levels of catecholamines. The other
diseases that also occur in the same area as this tumor would be:
A. Cushing's
B. Addisions
C. Hyperthyroidism
D. Goiter
E. A and B
Ans: E
11. A patient presents with a tumor of the adrenal gland. It is determined that the levels of
renin-angiotensin is low. Which of the following would lead to increased renin-angiotensin
levels?
A. Cushing's syndrome
B. Secondary hyperaldosteronism
C. Primary hyperaldosteronism, Conn's syndrome
D. A and B

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E. None of the above
Ans: D
12. A girl presents with delayed puberty, absent secondary sexual characteristics, and
primary amenorrhea. She also appears to be hypertensive and hypokalemia. Which of the
following enzymes is increased if there is virilization of a person?
A. 11bHydroxylase
B. 17ahydroxylase
C. 21 b-hydroxylase
D. pyruvate kinase
E. alcohol dehydrogenase

Ans: A

13. A patient presents with polyuria and thirst, stones, and nephrocalcinosis. He also has
muscle weakness and bone cysts. All of the following is associated with his disease except:
A. hyperparathyroidism
B. excessive vitamin D
C. high bone turnover
D. Paget's disease
E. less sunlight
Ans: E
14. A patient presents with a decreased amount of T cells in the body. He presents with
tetany , parasthesias, and muscle cramps. His condition has similarities to all of the following
except:
A. Rickets
B. hypoparathyroidism
C. Osteomalacia
D. Acute pancreatitis
E. Hypercalcemia
Ans: E
15. 16.A patient presents with rhabdomyolysis and depletion of 2-3-diphosphoglycerate. A
common complication of high levels of the molecule being affected in this patient would be:
A. metastatic calcification

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B. dystrophic calcification
C. heart failure
D. respiratory failure
E. none of the above
Ans: A
1) Mutation seen in pendred syndrome?
a. SLC26A4 (BASIS)
2) Hallmark in medullary Carcinoma of thyroid?
a. Amyloid deposits (BASIS)
3) False about anaplastic Carcinoma?
a. Amyloid deposits (BASIS)
b. Spindle cells and giant cells
c. Has worse prognosis
4) Achondroplasia, how to confirm?
a. Short limbs
b. Upper segment scan:lower segment scan
5) In cretinism?
a. Impaired skeletal and CNS development (BASIS)
b. Impaired physical and mental development
c. It is GULL disease
6) A patient with short stature, mental retardation, protruding tongue, umbilical
hernia,diagnosis?
a. Cretinism (BASIS)
7) Regarding diabetes?
a. FBG>126 on more than one occasion (BASIS)
8) A patiend having cushingoid symptoms, high dose dexamethasone suppression test
does not suppress cortisol levels?
a. Ectopic ACTH secretion (DAVID)
9) In organophosphorus poisoning, death is due to all except?
a. Uremia (TERSE)
b. Paralysis of muscles
c. Respiratory paralysis
d. Circulatory arrest
e. Edema of lungs or brain
10) Postmortem appearance of lead poisoning shows all except?
a. Of acute gastroenteritis
b. Black line on stomach walls

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 c. Gastric mucosa congested
d. Large intestine may containblack coloured feces
11) Peptide hormones are derived from?
a. Tyrosine
b. cysteine
12) True about steroid hormones?
a. Derived from cholesterol
13) Best desk type in school?
a. Minus type (LECTURE)
b. Zero type
c. Plus type
14) An asymmetric painless swelling in the neck with palpitation?
a. Multinodular goitre
st
15) 1 generation sulphonylureas include?
a. Tolbutamide (LIPPIN)
16) Following is the somatostatin analogue?
a. Octreotide (LIPPIN)
17) Best treatment for acromegaly?
a. Surgery (DAVID)
b. octreotide
18) Treatment for diabetic ketoacidosis?
a. Crystalline insulin
b. Anti diabetic drugs
c. Lente insulin
d. Glargine
19) Insulin given in acute emergency?
a. Rapid acting insulin (KATZUNG)
b. Lente insulin
c. Long acting insulin
20) Severe Diabetic ketoacidosis is when?
a. pH<7.15
b. glucose 400 mg/dl
c. HCO3 16 mg/dl
21) Empty sella syndrome?
a. Lack of pituitary in sella but usually hormones are normal (P.KUMAR)
b. present with specific radiological signs on Xrays
22) Excretion of insulin occurs by?
a. Liver and kidney

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23) Percentage of methylalcohol excreted by lungs?
a. 80%
24) Following has no value in adrenal insufficiency?
a. Single cortisol level
b. Urinary renin activity
25) 40 year old patient had hypothyroidism, most common cause?
a. Iodine deficiency
b. Autoimmune thyroiditis
26) Most common cause of hypopituatarism?
a. Pituitary macroadenoma
27) Glucocorticoid inhibits?
a. Phospholipase A2
28) Desmopressin is not given in?
a. Bronchoconstriction (LIPPIN and KAPLAN)
b. Diabetes insipidus
c. Colonic diverticula
d. Esophageal varices
e. Von willebrand disease
29) Which of these is a long acting corticosteroid?
a. Betamethasone (LIPPIN)
30) Indication of artificial insemination homology?
a. Husband impotent but fertile (LECTURE)
31) Other than their specialized functions, which of these do not have endocrine secretions?
a. Spleen
b. Heart
c. Kidney
d. liver
32) Zona glomerulosa causes the release of?
a. aldosterone
33) Not present in hypocalcemia?
a. Carpopedalspasm
b. Stridor
c. Polyurea (DAVID)
d. Convulsions
34) All of the following are used for the treatment for hyperthyroidism but which one of
these complicates the process?
a. Propylthiouracil
b. Triiodothyronine

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 c. Surgical removal
35) Regarding treatment of hypopitutarism?
a. it is mostly incurable
b. surgical and medical treatment
c. medication for life time
36) Not found in hyperthyroidism?
a. Cold intolerance
37) Mutation of a gene involved in the development of diencephalon can affect secretion of
which hormone?
a. ACTH
b. Oxytocin
38) School services made for?
a. School children
39) Most common site of burton’s lines?
a. Gums (TERSE)
40) Doctor should have what other than attitude…..?
a. thinks of the best treatment for the patient
b. show respect towards time and punctuality
41) Patient taking amiodarone, atenalol and aspirin, (showing hypothyroid symptoms)?
a. Drug induced hypothyroidism
42) Type 2 diabetes histologically have?
a. amyloid deposition (BASIS)
43) Patient With increased aldosterone and decreased renin?
a. Adrenal cortex adenoma
44) Cortisol does not cause?
a. Hypoglycemia
45) Patient With palpitations, anxiety and exophthalmos, Diagnosis?
a. Graves disease (BASIS)
46) Graves disease most discrete feature?
a. Exophthalmos (BASIS)
47) Patient having pituatary adenoma with increased GH secretion, investigation of choice?
a. IGF (KAPLAN)
b. OGTT
48) Patients With smoking history and increased episode of hemoptysis, have cushing
syndrome?
a. Small cell carcinoma
49) Sulphonylurea acts on?
a. Potassium channels (LIPPIN)

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 50) How does exophthalmus occurs in grave’s disease?
51) Postmortem finding in dhatura poisoning?
52) Treatment of choice for Cushings?
53) Most common cause of hypercalcemia?
a. primary hyperparathyroidism
54) drug that causes both synthesis n formation of insulin?
a. sulfonylurea
55) Patient with renal stones, head mass, hyperglycemia?
a. MEN I
56) Patient with tumor producing Vasoactive intestinal polypeptide,treatment?
a. Octreotide (DAVID)
57) Lesion on optic chiasma
a. Bitemporal Hemianopsia
58) Drug given in thyroid storm?
a. propranolol
59) Type of Diabetes in < 20 years patient?
a. Diabetes mellitus type 1
60) Increased parathyroid hormone , increased calcium cardiac findings?
a. aortic and mitral calcification (BASIS)
b. aortic calcification
c. mitral calcification
61) Mechanism of action of alpha-glucosidase inhibitor?
a. Carbohydrate malabsorption
62) Child with short stature and pituatary tumor?
a. Craniopharyngioma

OSPE-1

Basis Fig: 24-19 B

63) Diagnosis ?

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 a. papillary Carcinoma
64) All of these is true except?
a. Orphan annie eye nuclei
b. intranuclear inclusions
c. it is the most common thyroid malignancy
d. Hurthle cells (BASIS)
65) The tumor spreads by?
a. Lymphatic route (BASIS)
66) Following causes the paraneoplastic syndrome?
a. Medullary Carcinoma of thyroid (BASIS)

OSPE-2

Basis Fig: 24-25

67) Identification?
a. Parathyroid adenoma
68) Gene involved?
a. Cyclin D1 (BASIS)
b. RET
69) Most common manifestation?
a. Hypercalcemia
b. hypocalcemia
70) Osteolytic lesions on legs ?
a. Browns tumor

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OSPE-3

71) Name the structure marked A?

a. Inferior parathyroid gland
b. Facial artery
72) The structure marked B is a branch of?External carotid artery
73) Name the structure labeled D?
a. Recurrent laryngeal nerve
74) The structure marked C is a branch of?
a. Thyrocervical trunk
b. External carotid artery
75) inferior thyroid vein drains?
a. Superior parathyroid
b. Inferior parathyroid
c. Both

CASE-1 (Infanticide) A dead child recovered from garbage and shifted to the mortuary
76) Infanticide is upto?
a. 1 year (PARIKH)
77) Fetal hemoglobin coverted to adult one in?
a. 6 months
78) Following is not found in in a dead born child?
a. Edema of head
b. Maceration
c. Mummification

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 d. Rigor mortis
79) Lungs after birth if respired ?
a. Voluminous (TERSE)
80) Act of omission include?
a. Starvation (TERSE)
b. Pithing
c. Strangulation
d. Suffocation

CASE-2
81) Diagnosis?
a. Adrenal insufficiency
82) Most common cause? (Exogenous drug inappropriate withdrawal something like that)

CASE-3 A lady with low BP,, pallor, atrophic breast

83) Diagnosis?
a. Sheehan syndrome
b. Pituitary apoplexy
c. Adrenal crisis
84) Which hormone should be corrected first?
a. Cortisol (DAVID)
85) Why patient has pallor?
a. FSH and LH deficiency (DAVID)
b. Decreased TSH
86) Which hormone won’t be affected?
a. ADH
b. TSH
c. ACTH
d. GH

CASE-4 Glucose 400mg/d, pH 7.2, HCO3 12mg/dll………

87) Diagnosis?
a. Diabetic ketoacidosis
b. hyperosmolar coma
88) What is the initial management?

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 a. Fluids I/V
1) Best Treatment for myxedema coma
a. IV Triiodothyronine*
b. Levothyroxine
c. Keep the patient warm
d. IV fluids and electrolytes
2) Cholinesterase is seen in venom of which snake?
a) Cobra*
b) Russel viper
3) Short stature is defined as height below which centile?
a) 3rd
4) Infertility definition?
a) unable to conceive after 1 yr of having unprotected intercourse
b) unable to conceive after 2 yr of having unprotected intercourse
5) Impotence definition?
a) Inability to perform sexual act
6) SLUDGE syndrome occurs in which type of poisoning?
a) Organophosphorus
7) Short stature with short trunk occurs in?
a) Mucopolysaccharidoses (Lec outlines)
b) Downs syndrome
c) Nonas syndrome
8) A short statured child having short limbs is suffering from ?
a) Achondroplasia (Lec outlines)
9) Levothyroxin dose in neonates?
a) 15-20 ug/kg/day (this was the closest as it is 10-15 in KUNDI)
10) Hypothyroidism patient with ischemic heart disease. Which of these drugs will be used for
the initiation therapy?
a) Optimization of thyroxine
b) Beta blockers
11) Most common cause of impotency?
a) Psychogenic
12) Most common cause of erectile dysfunction in male?
a) Vasculogenic
b) Hernia
c) Congenital anomalies
d) Neurogenic
13) Carbamate poisoning antidote?

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 a) Atropine
14) Radio iodine(131) is suitable for treatment in..?
a) >45yrs old
b) young patients
c) Pregnant females
15) Mechanism of action of antidote of organophosphates i.e Cholineestrase reactivators?
a) Dephosphorylation of inactivated Cholineestrase (PARIKH)
16) If male reproductive organs are okay, what statement you will give?
a) There is nothing to suggest that the person is impotent (TERSE pg 200)
17) Which of the following used in DM acts by delaying digestion/absorption of food?
a) alpha glucosidase inhibitor (KAtzung)
18) Which of the following is not a characteristic of sheehans syndrome?
a) It is defined as Ante-partum hemorrhage
b) It occurs in DIC
19) Which of the following is not a function of insulin? Lipid degradation
20) A person comes with hyper prolactinemia , what will you give?(dopamine agonist)
21) A person with probable hypothyroidism, your first investigation?
a) TSH
22) Most common cause of hypocalcemia?
a) Hypoalbuminemia (DAVID)
b) Hypothyroidism
23) What is the antidote of Organophosphorus poisoning?
a) Pralidoxime
24) Which of these is not a classic definition of diabetes?
a) Random Glucose is greater than 300mg/dl*
b) With classic signs and symptoms glucose is 20mg/dl
c) Fasting glucose greater than 126 mg/dl
25) Which of these do not match with a GH/somatotropin secreting pituitary tumor?
a) person with gigantism
b) acromegaly when epiphyses closed
c) Increased secretion of growth hormone
26) Which of these is wrong about Type 2 Diabetes?
a) There is insulin deficiency
b) There is resistance to the action of insulin
c) It is a result of multifactorial causes*
27) A dead body has cherry red discolouration. What percentage of carbon monoxide would
have caused this effect?
28) Which of the following is not a feature of simple colloid goiter?

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 a) Euthyroid
b) Cabbage and cauliflower increases it
c) Multiple nodules may be seen
29) lab findings in hyperparathyroidism?
a) high calcium, low PO4, high pth
30) not present in hypocalcemia?
a) Carpopedalspasm
b) Stridor
c) Polyuria (DAVID)
d) Convulsions
31) Rhambdomyolysis is seen in?
a) Sea snake bite (PARIKH)
32) Drug decreasing protein binding of thyroxine?
a) aspirin
33) Not a feature of hypothyroidism?
a) diarrhea
34) In snake bite, oxygen is given before atropine to avoid?
a) Respiratory depression
b) Ventricular tachyarrythmia
35) Which is not true about the parathyroid glands?
a) oxyphil cells secrete PTH
b) parathyroids from the 3rd and 4th branchial cleft
36) A 34 year old female presents with an increased free urinary cortisol level. High dose
dexamethasone test decrease the cortisol level more than 50%. What is the probable
diagnosis?
a) Pituitary tumor (DAVID)
37) How much a patient needs to be monitored in Parathion poisoning?
a) 2 weeks
38) A 32 year old female presents with hyperprolactinemia having a pituitary lesion on MRI .
Whats the 1st line treatment?(Dopamine agonist)
39) Increase in the height of baby during first 12months is?
a) 9-11 inches (25cm)
40) Acromegaly symptoms, not responding to OGTT... Investigation?(MRI head)
41) Moon face, inc. Cortisol, dec ACTH, investigation? (CT abdomen)
42) Kallmann Syndrome?
a) Hypogonadotrophic hypogonadism
43) 35 year old Black woman recognized a 2x1 cm mass 2 days ago on the lower right thyroid
lobe. No palpitation tachycardia diaphoresis. No pain dysphagia or voice hoarseness. Mass

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 is nontender. She has a medicinal history of Hypertension for which she uses atenolol.
Physical exam unremarkable. Blood urea creatinine calcium phosphate normal. What do
you do now?
a) thyroid function test
b) history of neck and head irradiation
c) family history for thyroid cancer
d) parathyroid function test.
e) FNAC
44) Adverse effects of PTU and methimazole?
a) Agranulocytosis (Katzung)
45) When should you perform thyroid hormone levels in a newborn infant?
a) 5-8 days after birth
b) after 6 hours of life
c) at first day of life
46) Pituitary:
a) shrinks during pregnancy
b) has two lobes
c) lies at the base of the skull
d) is controlled by the hypothalamus
e) controls other major endocrine organs
47) Blue line in gums due to lead poisoning?
a) Lead sulphide
b) Lead iodide
c) Lead chromate
48) Erethism?
a) Chronic mercury poisoning
b) Chronic lead poisoning
c) Chronic arsenic poisoning
d) Chronic phosphorus poisoning
49) Barbiturate toxicity potentiated by?
a) Organophosphorus
50) A couple had 7 children out of which two were obese. Couple were black haired and they
had a son who was 13 yrs old with weight that I dont remember and BMI was, I think 52. He
was red haired and was diagnosed at time of birth having adrenal problem so has been
treated for cortisol. What should be given?
a) Leptin
51) ATP guidelines for Hyperlipidemia??
a) LDL should be maintained at 100mg/dl

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 b) LDL should be maintained at 130mg/dl
c) LDL should be maintained at 160mg/dl
52) Which of these is not a feature of hyperpituatarism?
a) hypoglycemia
53) Mechanism of action of Propylthiouracil?
a) Inhibits iodination and coupling
54) Not true about pituitary gland?
a) Anterior pituitary is called neurohypophysis
b) Corticotroph cells are basophils
55) Gas used in world war 1 and 2?
a) Mustard Gas
b) Hydrogen sulphide
c) CO
d) CO2
e) Nitrogen
56) Combustible gas of autolysis is?
a) Carbon monoxide
b) Hydrogen sulphide
c) Carbon dioxide
d) NO2
e) CH4
57) 36yr, Male, head ache, visual disturbance , MRI shows pituitary tumor, glucose tolerance
positive, not suitable for surgery? What to give?
a) Pegvisomant
b) Octreotide*
c) Transsphenoidal surgery
d) Lanreotide
e) Gamma knife radiation
58) true about chlorinated hydrocarbon insecticide is?
a) Absorption is rapid and complete from skin
59) mutation of a gene involved in the development of diencephalon can affect secretion of
which hormone?
a) ACTH
b) Oxytocin
60) 60 year male who lives in high mountainous area, constipated, H/R is 60, thick skin, tongue
edges scalloped, teeth identation, what is probable diagnosis?
a) Iodine deficiency
61) Not true about endocrine is ?

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 a) Somatostatin promote breakdown of glycogen
62) Not true about addison’s Disease?
a) clinical pigmentation does not occur
b) Mucosal pigmentation occurs
63) Autopsy findings in carbon monoxide poisoning?
a) Haemolytic shock
b) Froth
64) Complications of DM except???
a) MI
b) neuropathy
c) ischemic limbs
d) diarrhea
e) preeclampsia
65) Which of these is not correct about DM?
a) Single disease entity
b) It is a metabolic disorder
66) Acute toxicity of organophosphate?
a) Acute tubular necrosis
b) Oliguria
c) Uremia
d) Anuria
67) In comatose pt of 4 days, pupil constricted, twisting of facial muslces, additional specimen is
required of?
a) Facial muscles
b) Brain
c) Both lungs
68) Serum Cortisol high, urinary cortisol high, ACTH low, what are further investigations?
69) A 50 year old smoker has high serum and urinary cortisol. Serum ACTH is very high. MRI
brain shows no lesion. What do you do next?
a) repeat urinary cortisol
b) repeat MRI brain
c) ct chest and xray chest
d) ct abdomen
70) A patient has cushionoid face, raised cortisol and ACTH, your next investigation?
a) MRI head
71) A patient has slightly elevated Cortisol levels, undergoes dexamethasone overnight test,
cortisol levels become normal, he has?
a) pseudo cushings

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(There were many a questions of cushings syndrome with different parameters given in each
question. Alhamdolillah I had the algorithm of cushings syndrome in my mind which is given in
davidson and it helped me solve all the questions. Hopefully I marked all of them correctly
inshaAllah. Do have a look at it please.)
72) adverse effect of methimazole and propylthiouracil: agranulocytosis
73) most common cause of primary hyperparathyroidism
a) single adenoma*
b) Multiple adenoma
c) Carcinoma
74) Which of the following statement is wrong abt cushing’s : aldosterone causes cushing
syndrome
75) All follow the RAI treatment in thyroid condition except?
a) thyroid lymphoma
b) papillary carcinoma
c) follicular carcinoma
d) MNG
e) Grave disease
76) An old man was suffering from diabetes, hypertension, high cholesterol. Two of his anti-
diabetic drugs were mentioned. One metformin, second dont remember. He had chest pain
and was brought to the CCU department. Primary angioplasty was performed. What drug
regimen should the patient be kept on for his glycemic control?
a) Same dosage of the two anti-diabetic drugs
b) sliding scale adjustment of insulin
c) biphasic insulin regimen
d) monophasic insulin regimen
77) 35 yr old Black women. Recognized a 2x1 cm mass 2 days ago on the lower right thyroid
lobe. No palpitation tachycardia diaphoresis. No pain dysphagia or voice hoarseness. Mass
is nontender. She has a medicinal history of Hypertension. For which she uses atenelol.
Physical exam remarkable. Blood urea creatinine calcium phosphate normal. What do u do
now?
a) thyroid function test
b) history of neck and head irradiation
c) family history for thyroid cancer
d) parathyroid function test.
e) FNAC
78) A mutation which results in the malformation of the diencephalon would result in the
deficiency of which hormone? Oxytocin

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79) An overweight person with type 2 diabetes is taking glicazide(sulfonylurea) but he has poor
glycemic control. All his lab reports were given with an HbA1c of 9%. What drug will you
prescribe to improve his glycemic control? Metformin
80) A person had hyperlipidemia with LDL 166 mg/dl. No history of cigarette smoking,
hypertension or any family history. What do ATP III guidelines suggest for controlling his LDL
levels? ATP III suggests taking medication to keep his LDL levels below 160 mg/dl
81) regarding treatment of hypopitutarism...
a) it is mostly incurable
b) surgical and medical treatment
c) medication for life time*
82) All of the following are used for the treatment for hyperthyroidism but which one of these
complicates the process?
a) Propylthiouracil
b) Triiodothyronine
c) Surgical removal
83) A case of hypercalcemia was given with its sign and symptoms mentioned. Levels of urea
and creatinine were given in mmol/L(the irritating part). What is the most probable cause of
hypercalcemia?
a) Chronic renal failure
b) primary hyperparathyroidism
c) Increased Vitamin D
84) levothyroxine is indicated for treatment in the following cases except: simple treatment of
obesity
85) Glucagon acts by: promoting glycogenolysis and gluconeogenesis
86) A person has hypercalcemia with normal PTH of 52 ( range 15-55). What is your conclusion
about his condition?
a) I marked that the person has abnormally high sensitivity to PTH such that normal levels
of PTH have caused calcium levels to rise.
87) Mechanism of release of PTH is such that calcium: binds to a protein receptor and activates
intracellular enzyme formation.
88) True about thyroid hormone synthesis: Iodine is recovered from mono,diiodotyrosines in
thyroglobulin by cleavage inside the thyrocyte.
89) two questions in which a typical case scenario of acromegaly was given. One of the question
mentioned signs and symptoms of acromegaly with no lesion on MRI. It was asked which
test will confirm the diagnosis. I marked OGTT.
Another question mentioned that there are visual disturbances in a person, a lesion on MRI
and it was asked again which of these is the investigation of choice to establish the
diagnosis. I marked OGTT again.

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 I marked IGF for both of them but later on I thought that I havent seen davidson mention
IGF anywhere in the investigations for acromegaly so I went back to marking OGTT.
90) A person has visual disturbance, lesion on MRI, high levels of prolactin in blood. What is the
most probable diagnosis? Prolactinoma
91) A person had slightly elevated thyroid levels following a viral infection which became
normal after 6 weeks without any treatment: subacute thyroiditis

ENDOCRNE MODULE
1) Treatment for myxedema coma (intravenous infusion)
2) Cholinesterase is seen in venom of which snake?(Cobra)
3) Short stature....centile?(3rd centile)
4) Infertility definition?(unable to perform intercourse)
5) Fatal dose of dry venom of Krait(15-20ms?
6) Halsbury law is related to ......
7) Hyme sludge syndrome poisoning?(high level of acetylcholine)
8) Most common cause of hypothyroidism in developed countries?(HAshimotos)
9) Short stature with obesity...which syndrome? (Downs syndrome)
10) Levothyroxin dose in neonates?
11) Quoad refers to_____?
12) Hypothyroidism patient with ischemic heart disease...treatment?(beta blockers)
13) Most common cause of impotency?
14) Carbamatepoisoning antidote?
15) Radio iodine(131) is suitable for treatment in..?(young patients)
16) Mechanism of action of antidote of organophosphates?
17) Male:Female ratio inn thyroid dysgenesis?
18) Treatment plan for type 1 DM?
19) If male reproductive organs are okay, what statement you will give?
20) Corstisol serum high, urnary cortisol high, ACTH low, what are firther investigations?
21) Which of the following used in DM acts by delaying digestion/absorption of food?( alpha
glucosidase inhibitor)
22) Which of the following is not a characteristic of sheehans syndrome?(Ante-partum
hemorrhage)
23) Most common cause of type1 diabetes?
24) Which of the following is not function of insulin?(protein breakdown)
25) A person comes with hyper prolactinemia , what will you give?(dopamine antagonist)
26) A person with probable hyperthyroidism, your first investigation?(a.t3 b.t4 c. TSH)
27) Somatotrophs consists how much of anterior pitituary?
28) Most common cause of hypocalcemia? (1.dec. vitD 2.hypoparathyroidism)

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29) A person sleeping, gets up due to pain, burning sensation, redness at the site of snake
bite and quadriplegia, he was bitten by? (Krait bite)
30) What is given in DDT poisoning(insecticide poisoning)? (Atropine)
31) Normal shape of hymen?( its usually annular or cresentric)
32) Advantage of Lispro over short acting insulin?(less chances of hypoglycaemia)
33) A patient has cushionoid face, raised cortisol and ACTH, your next investigation?(MRI)
34) In which of the following cases insulin increased?(insulinoma)
35) Not classic definition of diabetes?(Glucose>300md/dl)
36) Which doesnot match?( old person with gigantism)
37) Type2 Diabetes? (due to multifactorial causes)
38) Which of the following is not a feature of goiter?( a.Euthyroid b. Cabbage)
39) A patient undergoes dexamethasone overnight test, cortisol level falls more than 50
percent, he has?(pseudo cushings)
40) Metabolic syndrome linked to? (Diabetes)
41) lab findings in hyperparathyroidism? (-high CA , low PO4, high pth)
42) not present in hypocalcemia? (carpopedalspasm-stridor-polyurea)
43) Rhambdomyolysis in (-viper bite -krait bite -sea snake bite)
44) drug decreasing protein binding of thyroxine?(-aspirin)
45) symmetrical notches on anterior wall? (-fimbraited hymen)
46) not a symptom of hypothyroidism?(-diarrhea)
47) The treatment for a 72 year old with multinodular goitre?
48) How long does a snake bite patient need to be monitored?
49) Why do we give oxygen before atropine?
50) Which is not true about the parathyroid glands?( 1.oxphil cells secrete PTH 2.
parathyroids from the 3rd and 4th branchial cleft)
51) Which of the following is not a feature of solitary thyroid module? ( multiple nodules,
endemic, associated with cabbage n cauliflower)
52) Mechanism of action of cholinesterase reactivators :

53) A 34 year old female presents with an increased free urinary cortisol level. High dose

dexamethasone test decrease the cortisol level more than 50%. What is the probable

diagnosis?

54) A 40 year old male presents with visual field problems. On exaamination he has

prognathism and prominent periorbital ridges. There a pituitary lesion on MRI .Whats

the best therapy: (Surgery, GH receptor blocker)

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 55) Average fatal dose of parathion:

56) A 32 year old female presents with hyperprolactinemia having a pituitary lesion on MRI

. Whats the 1st line treatment?(Dopamine agonist)

57) Neurotoxicity is caused by which snake”s venom:

58) A short statured child having short limbs is suffering from :

59) Increase in the height of baby during first 12months is?

60) A women presented with tachycardia, sweating, diarehea, neck swelling and eye

changes. Diagnosis?(Graves disease)

61) Recommended dose of levothyroxine in children?

62) Which doesn’t occur in hypothyroidism?(diarrhea)

63) Acromegaly symptoms, not responding to OGTT... Investigation?(MRI head)

64) Moon face, inc. Cortisol, dec ACTH, investigation? (CT abdomen)

1) *decrease the iodination? PTU ,methimazole,iodide, RAI

2) *solitary nodules? More neoplastic if it is in young
3) *tetany treatment? IV Caglucoanate infusion
4) *DKA initial treatment? IV fluids
5) *diabetic coma treatment? Crystalline insulin
6) *multinodular goiter ?by recurrent episode of hyperplasia n involution
7) *phosgene gas effects on? Lung*, brain , heart
8) *vesicant war gas is? phosgene, mustard gas, CL
9) *diabetic nephropathy and retinopathy is? Microangiopathy
10) *professional skill for verbal communication? For patient counseling
11) *pituitary tumor present as? Visual defect
12) *how to diagnose hypopituitarism? MRI,TRH insulin GnRH response ,baseline level of
hormone,
13) *whipples triad?
14) *MOA of sulphonyurea incorrect? Regeneration of beta cell
15) *cause release of insulin?Ca
16) *MOA of PTH? Increase resorption of both Ca n po4

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17) *somatotroph? GH
18) *GH increase by? Decrease Glucose
19) *GH decrease by? Octreotide
20) *acromegaly confirmatory test? OGTT
21) *decrease ADH by ?phenytoin
22) .*bromocriptine is not indicated in? dwarfism.
23) *patient with GH adenoma with failed surgery? Next treatment is octreotide
24) *suture for PTH adenoma? Ant triangle , post triangle, 2 cm above the sternal notch
25) *cretinism ?levothyroxine
26) *thyroid storm patient die of? Cardiac arrhythmia
27) *patient undergoes thyroidectomy develop swelling in the neck. And become dyspnea next
management is? Explore in the ward, send to OT, Intubation, tracheostomy
28) *patient after thyroidectomy complain of tingling sensation investigation ? PTH level
29) *MOA of organophosphate? Inhibit acetylcholine esterase
30) *type 1 DM? ketonuria
31) *krait poisoning? 6 mg
32) *not true about pituitary? Hormones travel through lymphatic’s from hypothalamus to post
pituitary
33)
34) Sblcushing
35) *least likely? Increase k+
36) *least likely?Thick skin.
37) *diff b/w pituitary n cushing syndrome? High dose dexamethasone
38) Sblhashimoto
39) * histo? Hurthe cell
40) *characteristic feature? Gradual thyroid failure
41) *most common lymphoma?Maltoma
42) *most common Ca of thyroid is? Papillary
43) Sbl graves
44) *investigation? TSH/T4
45) *other investigation? Cortisol
46) *primary hypothyroidism investigation? TSH
47) *not a compliacation? Constipation
48) Sbl hypothyroidism case and also symptm of pericardial effusion
49) *investigation? TSH/T4
50) *cardiac sin are due to? Pericardial effusion
51) *most characteristic? Levothyroxine
52) *treatment?Levothyroxine

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53) Sbl; pain in whole body
54) *diagnosis? Primary hyperparathyroidism
55) *function of PTH? Maintenance of extra cellular Ca.
56) *drug can be given
57) *treatment?surgery
58) Ospe on papillary Ca
59) *morphology cell absent in?Hurthe cell
60) *most aggressive? Anaplastic Ca
61) *most common with paraneoplastic syndrome? Medullary
62) *metastasis through?Lymphatics.

63) OSPE ON SHORT STATURE.

64) *initial diagnosis by ? US:LS ratio, wt, height
65) *further question should b ask? Family hx,birth weight n height, developmental hx
66) *investigation initialy ? GH level, bone age
67) *if chronological =bone age then? Familial, normal, constitutional delay.
68) *what will you say to the parent about the progress of height? Height will b normal, height
achieved but delay
69) OSPE: SCHOOL
70) Dr.farzana as health officer.
71) *responsibility? To do periodical medical examination ,to do periodical vaccinaton
72) *routine vaccination? Cholera, typhoid, hep, polio
73) *function of public health service?Referral , to prevent disease?
74) *public health service is a branch of? Preventive medicine
75) *further health checkup is required except? Student ,teacher,school personnel
76)
77) *most common problem in school children ?dental caries
78) *a class should contain? No more then 40 student
79) *psychosocial model consist of? Ask the patient perception first

Prepared: Sharifullah Momand

Dow 22

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