In primary hyperaldosteronism
a. serum potassium levels are always low
b. aldosterone/renin ratio is elevated
c. aldosterone/renin ratio is normal, because both aldosterone and renin are elevated
d. aldosterone/renin ratio is low
e. hyponatremia is often encountered
b. aldosterone/renin ratio is elevated
Specify the correct statements in a 47-year-old male with growth hormone deficiency:
a. may present with increased fat mass
b. may associate dyslipidemia
c. the oral glucose tolerance test is used for positive diagnosis
d. the dexamethasone suppression test is used for positive diagnosis
e. it may be substituted with human recombinant GH
a. may present with increased fat mass
b. may associate dyslipidemia
e. it may be substituted with human recombinant GH
Which of the following statements about polycystic ovary syndrome are FALSE:
a. It is the rarest cause of oligomenorrhea in women of reproductive age
b. It associates insulin resistance
c. FSH / LH > 2
d. The diagnostic is solely made by ultrasonographic evaluation
e. It may be treated with oral contraceptives
a. It is the rarest cause of oligomenorrhea in women of reproductive age
c. FSH / LH > 2
d. The diagnostic is solely made by ultrasonographic evaluation
Mark the correct statements about papillary thyroid carcinoma:
a. Typically presents as a nodule that is firm and solid on thyroid ultrasound
b. Microscopically, papillary cancer typically consists of single layers of thyroid cells arranged in vascular stalks, with papillary projections extending into microscopic cyst-like spaces
c. It is the most frequent form of thyroid carcinoma
d. Most papillary thyroid cancers grow rapidly
e. Calcitonin is a marker for recurrence or metastasis of the cancer
a. Typically presents as a nodule that is firm and solid on thyroid ultrasound
b. Microscopically, papillary cancer typically consists of single layers of thyroid cells arranged in vascular stalks, with papillary projections extending into microscopic cyst-like spaces
c. It is the most frequent form of thyroid carcinoma
Mixedematous coma is characterized by the following, with the EXCEPTION:
a. it’s a complication of long-term untreated hypothyroidism
b. it associates severe fever
c. gastro-intestinal symptoms (diarrhoea)
d. hypotension
e. alteration of mental status
b. it associates severe fever
c. gastro-intestinal symptoms (diarrhoea)
Radioactive iodine therapy:
a. Can be used to treat Graves disease in young people
b. It is contraindicated in patients with Graves disease and associated severe ophthalmopathy
c. Can be used in pregnant women with severe Graves disease
d. May cause hypothyroidism
e. Is used in the treatment of medullary cancer
a. Can be used to treat Graves disease in young people
b. It is contraindicated in patients with Graves disease and associated severe ophthalmopathy
d. May cause hypothyroidism
Which of the following statements regarding medullary carcinoma are FALSE?
a. thyroglobulin is a sensitive and specific marker useful in postoperative follow-up of patients
b. in a patient with a suspicion of medullary carcinoma, plasma methamphetamine dosing is useful
c. thyroid medullary carcinoma is always a form of sporadic thyroid cancer
d. suppressive doses of thyroid hormones are required after total thyroidectomy for thyroid medullary cancer
e. thyroid medullary carcinoma captures iodine, which is why in advanced cases it is recommended to use radio-iodine therapy after thyroidectomy
a. thyroglobulin is a sensitive and specific marker useful in postoperative follow-up of patients
c. thyroid medullary carcinoma is always a form of sporadic thyroid cancer
d. suppressive doses of thyroid hormones are required after total thyroidectomy for thyroid medullary cancer
e. thyroid medullary carcinoma captures iodine, which is why in advanced cases it is recommended to use radio-iodine therapy after thyroidectomy
The risk factors for Graves ophthalmopathy that can be prevented are the following:
a. Male gender
b. Thyroid dysfunction
c. Old age
d. Smoking
e. All of the above
b. Thyroid dysfunction
d. Smoking
A 35-year-old man diagnosed with a GH secreting pituitary macroadenoma may associate the following:
a. Secondary gonadal insufficiency
b. Hyperprolactinemia
c. Diabetes mellitus
d. Diabetes insipidus
e. All of the above
a. Secondary gonadal insufficiency
b. Hyperprolactinemia
c. Diabetes mellitus
A 28-year-old woman is admitted with polydipsia (approximately 5L/day). What could be the reason of this symptom:
a. Diabetes mellitus
b. Hypocalcemia
c. Idiopathic central insipidus diabetes
d. Sarcoidosis with pituritary stalk infiltration
e. All of the above
a. Diabetes mellitus
c. Idiopathic central insipidus diabetes
d. Sarcoidosis with pituritary stalk infiltration
Which of the following statements are TRUE about the thyrotoxic crisis?
a. The thyrotoxic crisis is a form of life‑threatening hyperthyroidism.
b. The values of TSH and thyroid hormones can make a difference between hyperthyroidism and thyrotoxic crisis.
c. Stress, infections and acute conditions can precipitate a thyrotoxic crisis.
d. Surgery or treatment with ¹³¹I in unbalanced hyperthyroid patients may trigger a thyrotoxic crisis.
e. Hydric, electrolytic and cardiovascular balancing and adjustment of serum free T3 and T4 levels are the therapeutic targets in thyrotoxic crisis management.
a. The thyrotoxic crisis is a form of life threatening hyperthyroidism
c. Stress, infections and acute conditions can precipitate a thyrotoxicosis.
d. Surgery or treatment with 1311 in unbalanced hyperthyroid patients may trigger a
thyrotoxic crisis.
e. Hydric, electrolytic and cardiovascular balancing and adjustment of serum free T3 and T4
levels are the therapeutic targets in thyrotoxic crisis management
The following investigations are mandatory in the evaluation of a thyroid nodule over 1 cm in size:
a. anterior cervical computed tomography
b. fine needle aspiration
c. serum thyroglobulin level
d. evaluation of thyroid function
e. thyroid ultrasound
b. fine needle aspiration
d. evaluation of thyroid functio
e. thyroid ultrasound
A 65‑year‑old lady suffers a fragility fracture in the right forearm. DXA showed T‑score L1‑L4 = –2.7 SD, Z‑score = 0.105; hip T‑score = –3.0 SD, Z‑score = –1 SD. You establish the diagnosis of severe osteoporosis and you recommend adequate amount of calcium and vitamin D. Besides general measures, what treatment options do you have for your patient?
a. Bisphosphonates
b. Biological therapy with denosumab
c. Magnesium sulphate
d. Recombinant PTH
e. Testosterone undecanoate
a. Bisphosphonates
b. Biological therapy with denosumab
d. Recombinant PTH
Which are the correct statements about a patient diagnosed with a prolactin secreting pituitary macroadenoma?
a. Neurosurgical treatment is carried out urgently
b. The patient may clinically present with infertility and reduced libido
c. One of the goals of the drug treatment is the disapearrance of the goiter
d. treatment may be done with dopamine agonists
e. treatment may be done with somatostatin
b. The patient may clinically present with infertility and reduced libido
c. One of the goals of the drug treatment is the disapearrance of the goiter
d. treatment may be done with dopamine agonists
Which of the following therapies may be useful in a patient with Cushing’s disease?
a. Treatment with pevismogranil (pegvisomant)
b. Pituitary adenomectomy
c. Bilateral adrenalectomy
d. Radioactive iodine radiotherapy
e. Treatment with pasireotide
b. Pituitary adenomectomy
e. Treatment with pasireotide
Which of the following are risk factors for osteoporosis?
a. Hypogonadism
b. Early menopause
c. Advanced age
d. Maternal antecedents of hip fracture
e. All of the above
e. All of the above
A 52‑year‑old woman presents to your office accusing increase in the size of the extremities, decrease in peripheral vision, and the fact that she requires increasing amounts of insulin to control her diabetes diagnosed about four years ago. At the clinical examination, you notice macroglossia, BP = 170/90 mmHg, hepatomegaly. Which of the following statements are true about your patient?
a. Probable diagnosis is a pituitary macroadenoma secreting GH
b. She may associate carpal tunnel syndrome
c. The diagnosis is based on IGF1 and mean GH 24h measurement
d. The diagnosis is based on the dexamethasone inhibition test
e. First‑line treatment is radiotherapy
a. Probable diagnosis is a pituitary macroadenoma secreting GH
b. She may associate carpal tunnel syndrome
c. The diagnosis is based on IGF1 and mean GH 24h measurement
Congenital adrenal hyperplasia can be characterized by:
a. adrenal hyperplasia due to excessive stimulation with ACTH
b. Some variants may cause disorders of sexual differentiation
c. There are enzymatic defects in adrenal steroidogenesis
d. They are mild forms of illness, never life‑threatening
e. the 21 hydroxlase deficiency is the rarest form
a. adrenal hyperplasia due to excessive stimulation with ACTH
b. Some variants may cause disorders of sexual differentiation
c. There are enzymatic defects in adrenal steroidogenesis
A patient with a non‑secreting pituitary macroadenoma treated with radiotherapy and surgery shows suggestive symptoms for secondary adrenal insufficiency. How do you diagnose the patient and what is the right treatment in this case?
Answer:
a. Positive diagnosis is based on serum cortisol values that will be decreased and that of ACTH that will be increased.
b. The positive diagnosis is made by the stimulation test with insulin‑induced hypoglycemia.
c. The positive diagnosis is made by performing a glucose‑stimulation test.
d. The substitution treatment is carried out with glucose and mineralocorticoids.
e. The substitution treatment is performed with glucocorticoids only.
b. The positive diagnosis is made by the stimulation test with insulin‑induced hypoglycemia.
e. The substitution treatment is performed with glucocorticoids only.
The treatment for chronic hypocalcaemia includes:
Answer:
a. Low calcium diet
b. Diet rich in phosphates to increase gut absorption
c. Calcium supplements
d. Vitamin D supplements
e. Teriparatide Bone anabolic
c. Calcium supplements
d. Vitamin D supplements
A 38‑year‑old female patient is referred for secondary amenorrhea. Biologically, she has an increased serum prolactin level of 34 ng/dl (normal values ≤ 20 ng/dl). Which of the following may be the cause of hyperprolactinaemia?
a. primary hypothyroidism
b. pregnancy
c. polycystic ovary syndrome
d. thyroid hormone therapy
e. all the above
a. primary hypothyroidism
b. pregnancy
c. polycystic ovary syndrome
Which of the following causes of hypercortisolism associate bilateral adrenal hyperplasia?
Answer:
a.Congenital adrenal hyperplasia due to 21‑OHase deficiency
b. Cushing paraneoplastic syndrome
c. Adrenal adenoma
d. Cushing disease
e. Tetrogenic cushing syndrome
b. Cushing paraneoplastic syndrome
d. Cushing disease
e. Tetrogenic cushing syndrom?
The following can cause hypercalcemia:
Answer:
a. primary hyperparathyroidism
b. thyrotoxicosis
c. osteolytic metastasis
d. secondary hyperparathyroidism
e. vitamin D intoxication
a. primary hyperparathyroidism
b. thyrotoxicosis
c. osteolytic metastasis
e. vitamin D intoxication
For the diagnosis of pheochromocytoma, the following investigations are useful:
Answer:
a. Scintigraphy with Tc‑Sestamibi
b. Dosage of plasma metanephrine and normetanephrine
c. Metanephrine and normetanephrine dosing in urine / 24 hours
d. Scintigraphy with radioactive iodine
e. Abdominal MRI
b. Dosage of plasma metanephrine and normetanephrine
c. Metanephrine and normetanephrine dosing in urine / 24 hours
e. Abdominal MRI
