endocrin path board review.ppt

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endocrin path board review.ppt

  1. 1. A 47-year-old man is seen for "swelling" of his fingers. Physical exam show coarsening of his facial features with enlarged jaw, ears, and nose. His feet are also enlarged. This disorder is characterized by an excess of (A) antidiuretic hormone (B) glucocorticoids (C) growth hormone ** (D) mineralocorticoids (E) thyroid hormone
  2. 2. Of the following, inappropriate secretion of antidiuretic hormone is most commonly caused by (A) chronic renal disease (B) obliteration of the hypothalamic-hypophyseal axis by metastatic carcinoma (C) severe head injury (D) small cell undifferentiated carcinoma of the lung ** (E) surgical injury to the hypothalamus
  3. 3. Compression of the optic chiasm with hemianopsia, headaches, and decreased libido in an otherwise normal 52-year-old man most likely result from a/an (A) glioma of the optic nerve (B) non-functional pituitary adenoma ** (C) pituitary adenoma secreting ACTH (D) pituitary adenoma secreting growth hormone (E) retinoblastoma
  4. 4. A 27-year-old man is seen at the University Eye Institute because he has noticed a gradual loss of peripheral vision. Subsequent skull x-rays reveal an enlarged sella turcica. Analysis of the patient's serum would most likely reveal an elevation of (A) adrenocorticotropic hormone (B) antidiuretic hormone (C) growth hormone (D) luteinizing hormone (E) prolactin **
  5. 5. A 32-year-old woman presents with a nine month history of amenorrhea, and decreased libido. A pregnancy test is negative. A skull MRI reveals a mass in the anterior pituitary. Plasma concentration of which of the following hormones is most likely to be increased? (A) adrenocorticotropin (ACTH) (B) human chorionic gonadotropin (HCG) (C) prolactin (PRL) ** (D) somatotropin (STH) (E) vasopressin (ADH)
  6. 6. The most common cause of adrenal cortical atrophy is (A) adrenal cortical carcinoma (B) genetic metabolic defect (C) inflammation of adrenal glands (D) steroid therapy ** (E) vascular insufficiency
  7. 7. Conn syndrome is characterized by excess (A) antidiuretic hormone (B) glucocorticoids (C) growth hormone (D) mineralocorticoids ** (E) thyroid hormone
  8. 8. In the United States, the most common adrenal lesion resulting in Addison disease is (A) amyloidosis (B) fungal infection (C) idiopathic atrophy ** (D) metastatic carcinoma (E) tuberculosis
  9. 9. The syndrome of adrenal hyperfunction characterized by sodium retention, potassium loss and hypertension is known as (A) Addison disease (B) Conn syndrome ** (C) Cushing syndrome (D) Sheehan syndrome (E) Waterhouse-Friderichsen syndrome
  10. 10. The most common cause of adrenocortical insufficiency is (A) abrupt withdrawal of adrenocorticosteroid therapy ** (B) metastatic carcinoma (C) panhypopituitarism (D) tuberculosis (E) Waterhouse-Friderichsen syndrome
  11. 11. Primary hyperaldosteronism (Conn syndrome) is associated with (A) elevation of plasma renin levels (B) hypokalemia ** (C) hyponatremia (D) hypotension (E) pheochromocytoma
  12. 12. The most common cause of Waterhouse-Friderichsen syndrome is (A) adrenocortical adenoma (B) allergy to penicillin (C) meningococcemia ** (D) severe postpartum hemorrhage (E) severe sodium depletion
  13. 13. A patient with small cell carcinoma of the lung has elevated plasma ACTH levels. These findings are associated with (A) adrenal adenoma (B) adrenal hyperplasia ** (C) metastatic carcinoma to the adrenal glands (D) multiple endocrine neoplasia syndrome, type I (E) multiple endocrine neoplasia syndrome, type II
  14. 15. Which of the following is the most common cause of Cushing syndrome? (A) adrenal cortical carcinoma (B) basophilic adenoma of the pituitary (C) exogenous corticosteroids ** (D) oat cell carcinoma of the lung
  15. 16. Which of the following type of thyroid carcinomas has the best prognosis? (A) follicular (B) giant cell (C) papillary ** (D) small cell (E) undifferentiated
  16. 17. The most common malignant thyroid neoplasm would be (A) follicular carcinoma (B) papillary carcinoma ** (C) medullary carcinoma (D) primary lymphoma (E) undifferentiated carcinoma
  17. 18. Patients with anaplastic carcinoma of the thyroid generally survive (A) less than one year ** (B) five to ten years (C) in excess of ten years (D) regardless of therapy
  18. 19. A surgeon explores the thyroid because of a "cold" nodule of the left upper pole. The nodule is firm, non-encapsulated, and has a granular cut surface. There is an enlarged, hard lymph node in the adjacent internal jugular chain. The most likely diagnosis is (A) anaplastic carcinoma (B) follicular adenoma (C) follicular carcinoma (D) lymphoma (E) papillary carcinoma **
  19. 20. The uncompensated action of calcitonin would result in (A) decreased bone resorption ** (B) dystrophic calcification (C) exophthalmos (D) hypocalcemia (E) metastatic calcification
  20. 21. Osteoporosis and kidney stones are most likely to be associated with (A) acromegaly (B) gigantism (C) hyperparathyroidism ** (D) inappropriate ADH secretion (E) pheochromocytoma
  21. 22. Which of the following sets of screening laboratory data is most suggestive of hypoparathyroidism? (A) high glucose 2 hours after a meal (B) low serum calcium and high serum phosphorous ** (C) low serum chloride in a peptic ulcer patient (D) low glucose provoked by exercise (E) low potassium in a hypertensive patient
  22. 23. The initial clinical manifestation of functional parathyroid adenomas is usually (A) nephrolithiasis ** (B) pain in the neck (C) spontaneous fracture (D) subcutaneous calcinosis (E) uremia
  23. 24. The most common cause of hypoparathyroidism is (A) aplasia of parathyroids (B) calcitonin-secreting tumor (C) high phosphate diet in infancy ** (D) inadvertent surgical removal of parathyroids (E) sarcoidosis
  24. 25. In primary hyperparathyroidism, the most likely set of chemical values in a patient would be (A) high calcium, high phosphate, low urine phosphate (B) high calcium, high phosphate, low alkaline phosphatase (C) high calcium, low serum phosphate, high alkaline phosphatase ** (D) low calcium, low serum phosphate, low alkaline phosphatase

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