1.

In a X- ray of a 14 years old boy, doctor noticed his bones epiphase does not fuse and
there is an increased in GH hormones which lead to ;-
a. Acromegaly
b. Gigantism
c. Bitemporal hemicinopsia
d. Cretinism

2. A 45 years old female has a pituitary mass. What hormone is most commonly secreted
by this mass?
a. Growth hormone
b. Thyroid hormone
c. Prolactin
d. Adrenocorticotropic hormone

3. A female notices discharge from her nipple and amenorrhea. The pregnancy test is
negative. Her exam otherwise is normal except suggestion of a possible slight left
temporal quadrantanopsia. Which is the most likely diagnosis?
a. Prolactin secreting pituitary adenoma
b. FSH pituitary tumor
c. ACTH pituitary tumor
d. Hypothyroidism

4. A 23 years old female died suddenly and unexpectedly after complaining only of a mild
sore throat the day before. At autopsy, her adrenal glands are enlarged and have
extensive bilateral cortical hemorrhage. Infection with which of the following organism
best accounts for these finding?
a. Mycobacterium tuberculosis
b. Streptococcus pneumonia
c. Neisseria meningitidis
d. Cytomegalovirus

5. A middle aged man has experienced diarrhea, nervousness, palpitation and increased
irritability for the past 5 months. Proptosis and lid lag are among physical examination
findings. Which of the following laboratory findings is most likely?
a. Increased plasma insulin level
b. Increased serum T4 level
c. Increased serum TSH level
d. Increased serum cortisol level

6. A 0.7 cm microadenoma of the adenohypophysis is seen by head MRI in a 25 year old

female. Which of the following complication is she most likely to have?
 a. Acromegaly
b. Cushing disease
c. Hyperthyroidism
d. Amenorrhea with galactorrhea

7. A 42 years old male present with a history of polyuria and polydipsia. His history
reveals that he fell off a ladder and hit his head. Laboratory investigation reveal
hypernatremia and increased serum osmolality. The specific gravity of the urine is
1.002. these manifestations are most likely caused by a deficiency of ;-
a. Oxytocin
b. ADH
c. Corticotropin
d. Prolactin

8. Gastric defense mechanisms against peptic ulcer disease include all of the following
EXCEPT ;-
a. Bicarbonate secretion into surface mucus
b. Rapid gastric epithelial regeneration
c. Surface epithelial cell mucus secretion
d. Delayed emptying of gastric contents

9. A 55 years old male experiences marked lethargy and physical examination reveals
hyperpigmentations of his skin. The serum cortisol concentration is low, and the serum
corticotropin levels is high. Which of the following diseases is most likely to accompany
disorder?
a. SLE
b. Hashimoto thyroiditis
c. Addison’s disease
d. Acromegaly

10. Ten years after receiving an aortic valve bioprosthesis because of infective endocarditis,
a 44 years old female is most likely to suffer which of the following complication?
a. Stenosis
b. Hemolysis
c. Embolization
d. MI
11. Restless leg syndrome (RLS) is seen in ;-
a. Acute renal failure
b. Nephrotic syndrome
c. Nephritic syndrome
d. Chronic renal failure
12. A girl aged 8 years has been admitted for dialysis. She has serum K of 7.5meq/l, which
is the fastest way to reduce the hyperkalemia?
a. Infusion of insulin + glucose
b. IV calcium gluconate
c. IV NaHCO3
d. IV K – bicarbonate

13. Which of the following types of glomerulonephritis is least likely to cause CRF;-
a. Post streptococcal glomerulonephritis
b. Membranous GN
c. Membranous proliferative GN
d. Focal segmental glomerulosclerosis

14. Which of the following does not affect the serum creatinine concentration in chronic
kidney diseases?
a. Glomerular filtration rate
b. Tubular secreting function
c. Fluid overload
d. None of the above

15. A 44 years old previously healthy male has experienced worsening exercise, tolerance
accompanied by marked shortness of breath for the past 6 months. A chest
radiography shows an enlarged heart and pulmonary edema. An echocardiogram
shows four-chamber cardiac dilation and demonstrates mitral and tricuspid valvular
regurgitation. A coronary angiogram demonstrates no more than 10% narrowing of the
major coronary arteritis. The underlying condition that’s most likely to be present in
this patients is ;-
a. Rheumatic heart disease
b. Chagas disease
c. Hemochromatosis
d. Idiopathic dilated cardiomyopathy

16. Linear deposits of IgG on glomerular basements membrane is seen in ;-

a. CRF
b. Good pasteur’s syndrome
c. Nephrotic syndrome
d. Shunt nephritis

17. In a patients with diabetic nephropathy and proteinuria, which of the following is not
associated with the rate of decline in GFR?
 a. Glycated haemoglobin (HbA1c) concentration
b. Urinary angiotensinogen
c. Mean arterial pressure
d. Serum bicarbonate

18. Which of the following is not associated with chronic kidney diseases?
a. Polyhydramnios
b. Intrauterine growth retardation
c. Premature delivery
d. Down’s syndrome

19. In IgA nephropathy, which of the following does not indication an increased risk of
renal failure?
a. Macroscopic haematuria
b. Interstitial fibrosis on kidney biopsy
c. Reduced glomerular filtration rate
d. Proteinuria

20. Which one of the following electrolytes usually must be restricted in patients with
acute renal failure?
a. Chloride
b. Potassium
c. Bicarbonate
d. Calcium

21. An acute renal failure patients receiving continuous hemofiltration and citrate anti-
coagulation develops a cardiac arrhythmia. What is the likely cause?
a. Inadequate anticoagulation
b. Inappropriate free serum calcium concentration
c. Excessive ultrafiltration production
d. Acute reaction to the hemofilter membrane
22. A49-year-old man who smokes two packs of cigarettes a day
presents with a lung mass on x-ray and recent weight gain.
Laboratory examination shows hyponatremia with hyperosmolar
urine. The patient probably has
e. a. Renal failure
f. b. Pituitary failure
g. c. Conn’s syndrome
 h. d. Cardiac failure
i. e. Inappropriate ADH
23. Which of the following hormones are stored in the posterior
pituitary gland?

a-Luteinizing hormone

b-vasopressin

c-Adrenocorticotropic hormone

d-Growth hormone

e-Follicle stimulating hormone

24. A 50-year-old man has episodic headaches for 3 months. On

physical examination his blood pressure is 185/110 mm Hg, with
no other remarkable findings. Laboratory studies show Na+145
mmol/L, K+ 4.3 mmol/L, chlorine 103 mmol/L, C02 26 mmol/L,
glucose 91 mg/dL, and creatinine 1.3 mg/dL. An abdominal CT
scan shows a 7 cm left adrenal mass. During surgery, as the left
adrenal gland is removed, there a marked rise in blood pressure.
Which of the following laboratory test findings most likely
explains his findings?

A  Decreased serum cortisol

B  Decreased urinary homovanillic acid

C  Increased serum ACTH

D  Increased urinary free catecholamines

E Elevated serum ANCA

 25. Which of the following is not a causes of Addison's disease?

a-Tuberculosis

b-Pyelonephritis

c-Adrenoleukodystrophy

d-Autoimmune destruction of the adrenal cortex

26. A 49-year-old female presents with signs of anemia and

states that every morning her urine is dark. Workup reveals that
her red blood cells lyse in vitro with acid (positive Ham’s test).
What is the best diagnosis for this patient?

a. Warm autoimmune hemolytic anemia

b. Paroxysmal nocturnal hemoglobinuria

c. Paroxysmal cold hemoglobinuria

d. Isoimmune hemolytic anemia

e. Cold-agglutinin autoimmune hemolytic anemia

27. Antibodies made in the spleen that are directed against the cell
surface antigens GpIIb/IIIa or GpIb/IX are characteristically seen in
individuals with

a. Cold autoimmune hemolytic anemia

b. Felty’s syndrome
c. Hashimoto’s thyroiditis
d. Immune thrombocytopenic purpura
e. Warm autoimmune hemolytic anemia
 28. Porphyrias result from the abnormal synthesis of
a. α-globin
b. β-globin
c. Heme
d. Spectrin
e. Transferrin
29. An anemic patient has the following red cell indexes: MCV,
70 mm3; MCH, 22 pg; and MCHC, 34%. These values are most
consistent with a diagnosis of
a. Folic acid–deficiency anemia
b. Iron-deficiency anemia
c. Pernicious anemia
d. Sideroblastic anemia
e. Thalassemia minor
30. The serum total iron-binding capacity (TIBC) is inversely
proportional to serum levels of
a. Bilirubin
b. Ferritin
c. Haptoglobin
d. Hemopexin
e. Iron

B
D