Question 1

Which statement is false about pheochromocytomas?

Accepted Answer

A)  clinically they may present with attacks of pallor, palpitations, sweating, headache and anxiety
B)  clinicaaly they present with hypertension alone, or sometime abdominal pain and vomiting
C)  investigations include urinary VMA and catecholamines
D)  beta blockade is the temporary treatment of choice and possibly long term
E)  the treatment of choice is surgical resection D

Question 2

Which may not cause an adrenal crisis?

Accepted Answer

A)  Waterhouse Freidrichson syndrome
B)  Sheehans syndrome
C)  Acute discontinuation of steroids therapy
D)  Anticoagulant use
E)  Fulminant septicemia B

Question 3

Which is not a feature of hyperthroidism?

Accepted Answer

A)  lid lag
B)  lid retraction
C)  amenorrhea
D)  peripheral neuropathy
E)  hyperreflexia D

Question 4

Which agent should not be used in the treatment of a thyroid storm?

Accepted Answer

A)  propranolol
B)  propylthiouracil
C)  steroids
D)  salicylates
E)  panadol

Question 5

Which is not true regarding drug therapy in diabetes?

Accepted Answer

A)  the use of ACEI even in normotensive patients, delays the onset of diabetic nephropathy
B)  the use of simvistatin in pts with CHD significantly reduces the risk of future CHD
C)  sulphonylureas stimulate the pancreatic secretion of insulin
D)  Acorbase(Glucobay)  interferes with GIT absorption of carbohydrate
E)  Metformin is an oral insulin analogue

Question 6

Which is not a feature of Hyperosmolar, hyperglycemic non ketotic states?

Accepted Answer

A)  very high glucose, often greater than 40 mmol/l
B)  ph>7.3
C)  serum osmalality often greater than 350 mmol/L
D)  low bicarbonate
E)  lack of ketones in the urine

Question 7

Which is not a potential etiology of hypoglycemia in adults?

Accepted Answer

A)  alcohol
B)  salbutamol
C)  insulinoma
D)  salicylates
E)  adrenal insufficiency

Question 8

Which is false regarding the treatment of a myxoedema coma?

Accepted Answer

A)  thyroxine should be given i.v. initially
B)  thyroxine should be given in full dosage prior to blood results
C)  steroids should be given
D)  hyponatremia should be treated with fluid restriction
E)  dextrose may be required

Question 9

Which is not a feature of alcoholic ketoacidosis?

Accepted Answer

A)  Dehydration
B)  Positive dipstick for ketones
C)  ABG = acidosis, alkalsos or normal
D)  Increased anion gap, regardless of pH
E)  hyperglycemia

Question 10

Which is false regarding alcoholic ketoacidosis?

Accepted Answer

A)  it is usually seen in chronic alcoholics
B)  usually there has been a recent cessation in drinking with several days of vomiting and poor oral intake
C)  Thiamine should be given
D)  Mainstay of treatment is IV fluids, including dextrose
E)  Low dose insulin given judiciously hastens recovery

Question 11

Which statement is false about the fluid deficit in HHNS?

Accepted Answer

A)  it is usually 5L
B)  if not shocked then 0.45% saline should be given
C)  fluid replacement should always precede insulin therapy in the non shocked pt
D)  fluid replacement should be done over a longer period of time than in DKA
E)  normal saline should be given to the shocked patient

Question 12

What biochemical abnormality is possible in an addisonian crisis?

Accepted Answer

A)  hyponatremia
B)  hypokalemia
C)  hypoglycemia
D)  normokalemia and normonatremia
E)  all of the above

Question 13

Which drug is not a possible precipitant of myxoedema coma?

Accepted Answer

A)  lithium
B)  amioderone
C)  benzodiazepines
D)  phenytoin
E)  ranitidine

Question 14

Which is not true about non ketotic hyperosmolar states?

Accepted Answer

A)  these patients usually present with a GCS >8
B)  total body potassium is not reduced as in DKA as there is no acidosis
C)  focal neurological deficits are sometimes seen
D)  they are prone to arterial and vascular thrombosis
E)  insulin administration should be at the same rate as in DKA

Question 15

Which is the most common precipitant of alcoholic ketoacidosis?

Accepted Answer

A)  pancreatitis
B)  GI bleed
C)  Alcohol withdrawl without precipitating illness
D)  Infection
E)  hepatitis

Question 16

Which is false about chronic steroid administration and illness?

Accepted Answer

A)  no suppression of the pituatry-adrenal axis occurs if the dose is 
B)  no suppression of the axis occurs regardless of the dose as long axis is taken for less than 3 weeks
C)  in a time of physical stress the glucocorticoid dose should be increased 2-3 times for a few days
D)  in a time of physical stress the mineralocorticoid dose should be increased 2-3 times for a few days
E)  there is no need for glucose supplementation when physical stress occurs

Question 17

Which statement is incorrect with regards to treatment of an addisonian crisis?

Accepted Answer

A)  i.v. normal saline should be given to treat shock
B)  i.v.dextrose will also be required
C)  i.v. fludrocortisone is required
D)  i.v. dexamethase or hydrocortisone should be given
E)  fluoxymesterone (androgen replacement)  does not need to be given

Question 18

Which is the major precipitant of DKA?

Accepted Answer

A)  infection
B)  missed doses of insulin
C)  AMI
D)  Pancreatitis
E)  PE

Question 19

Which is not usually a feature of DKA?

Accepted Answer

A)  seen type 1 diabetics mainly
B)  serum osmalality 275-295mmol/l
C)  fluid deficit usually less than that in HHNS
D)  glucose usually lower than that in HHNS
E)  acidosis

Question 20

Which is the most common cause of hyperthroidism in Australia?

Accepted Answer

A)  Graves disease
B)  Toxic multinodular goiter
C)  Toxic adenoma
D)  Pituatry aetiology
E)  Excess iodine

Exam 1: Endocrine Disorders