This document contains multiple choice questions about endocrinology. Question 4 asks about insulin and the correct answer is that it is a protein hormone. Question 39 asks about disorders caused by dysfunction of the posterior pituitary gland, and diabetes insipidus is the correct answer. Question 41 asks about which gland is not affected by hypophysectomy, and the pancreas is not affected.

1. 4. a protein hormone
32. b
34. d
37. c
39. c
41. c
65. c
Choose the most correct answer:
1. Diabetes mellitus may be caused by
o Endocrine disease such as Cushing’s syndrome or Acromegaly
o Bacterial infection
o Muscular dystrophy
o Eating too much sugar
2. Oral glucose tolerance test(OGTT)
o A 75 gm glucose load is usually used
o Can be very dangerous and must be avoided in the elderly
o If fasting blood glucose is 100 mg/dl, OGGT is needed t establish the
o diagnosis of diabetes
o OGGT can differentiate between Type 1 and Type 2 diabetes
3. High plasma insulin levels has the following effects
o It stimulates breakdown of adipose tissue
o It stimulates the storage of glycogen in the liver
o It enhances protein catabolism
o It increases the absorption of glucose from the intestine
4. Insulin is
o A carbohydrate
o A protein hormone
o An enzyme
o A catalyst
5. Gestational diabetes
o Occurs when a pregnant eats too much
o Occurs when a diabetic becomes pregnant
o Occurs when a pregnant woman becomes diabetic
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2. o Occurs when the fetus becomes diabetic
6. When there is severe lack of insulin, blood glucose increases and
o Polyuria and dehydration develops
o Edema develops
o Tachycardia develops
o Exophthalmus develops
7. People with Type 2 diabetes
o Are ketosis prone
o Are mostly young
o Are definitely obese
o Have a gradual onset of the disease
8. People with Type 1 diabetes
o Are old and mostly over 30 years
o Type 1 diabetes can be due to autoimmune disease causing damage to
the beta cells
o The disease may be caused by helminthic infestation
o The disease develops gradually in its clinical onset
9. In diabetes mellitus
o People with Type 2 diabetes do easily develop ketoacidosis
o Type 2 diabetes is a mild disease
o People with Type 2 diabetes are usually less than 30 year old
o Obesity is a risk factor
10. Insulin secretion is at its maximum in a normal individual
o During sleep
o Just after a meal
o Several hours after a meal
o During fasting
11. If a doctor suspect diabetes, he will usually test ..
o Urine for the presence of insulin
o Urine for the presence of acetone
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3. o Blood for the presence of insulin
o Blood for the presence of increased glucose levels
12. Which of the following findings in a glucose tolerance test confirm
the diagnosis of diabetes?
o A plasma glucose level in the 2 hours postprandial sample
above 200mg/dl and fasting at 140 mg/dl
o A plasma glucose level throughout the test of more than 120mg/dl
o A blood glucose level in the 2 hours posprandial sample at 150 mg/dl and
fasting at 110 mg/dl
13. Honeymoon period …
o Affects only people with Type 2 diabetes who are less than 30
years old
o Is only meant for newly married people with Type 1 diabetes
o Is another name for remission in Type 1diabetes where the pancreas
permanently has regained its ability to produce insulin
o Usually happens 2-4 months after a person with Type 1 diabetes has been
diagnosed and insulin therapy initiated
14. The most important function of insulin is …
o To release glucose from the liver
o To maintain normal blood glucose level
o To avoid late diabetic complications
o To utilize fat
15. In Type 1 diabetes
o Insulin is unable to promote utilization of glucose
o Pancreas does not produce insulin
o The cells of the body lack insulin receptors
o Blood glucose level may be normal
16. Persistent hyperglycemia may…
o Cause thirst, polyuria and tiredness
o Be asymptomatic for many years
o Cause enlargement of liver
o Cause late complication such as sarcoidosis
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4. 17. Why glucosuria is a consequence of hyperglycemia
o Because the kidneys are damaged
o Because the amount of blood filtered by the kidneys is incorrect
o Because the amount of blood filtered by the kidneys is decreased
o Because the kidneys are unable to reabsorb all the glucose in the
filtered blood
18. Hyperglycemia in diabetes mellitus occurs when there is lack of
insulin. It develops because…
o Glycogen is broken down to glucose in the liver.
o Glucose is not taken up by the brain.
o Glucose is taken up by muscle tissue.
o Protein is not broken down gluconeogenesis
19. Metformin …
o is an example of a sulphonylurea.
o Does not stimulate insulin secretion.
o Causes weight gain.
20. Hyperosmolar hyperglycemaemai ( HHS)…
o is not as dangerous as ketoacidosis.
o Is never seen in elderly people with Type 2 diabetes .
o Will cause much worse dehydration than DKA.
o Will not require hospitalization.
21. What treatment modes should be used in type 2 diabetes in order of
importance?
o Education, diet, exercice, OA’s, insulin.
o OA’s, exercise, diet, insulin, education.
o Exercise, diet, OA’s.
o Education, insulin, OA’s, exercise, diet.
22. Obesity:
o Obesity will improve insulin resistance.
o Obesity is best measured by the Body Mass Index (BMI).
o BMI over 20 is taken as indicator of obesity.
23. Chronic complications in diabetes…
o Tend to decrease with age.
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5. o Can be reduced or delayed by good metabolic control.
o Are reversible in the late stages.
24. The WHO recommendations for daily calorie intake are:
o 30% fat, 20% protein, 50% carbohydrate.
o More than 20% saturated fat.
o Less than 12 g of salt a day.
25. Intensified insulin therapy…
o Means injecting insulin minimum 3 times a day.
o Does not improve glycemic control.
o Is the same as conventional therapy.
26. The classical endocrine action
o Hormone may be secreted by a neighboring cell.
o Hormone may be secreted by the same cell.
o Hormone carried via blood from a secreting gland.
o Hormone may be manufactured in situ.
27. Hormone membrane receptors respond to the following hormone
o Steroid.
o Catecholamine.
o Thyroid hormones.
o Insulin.
28. Homeostasis means
o Arrest of bleeding.
o Keeping external environment stable.
o Maintaining stable internal environment of the body.
o Maximizing reaction towards internal environment.
29. Hormones are
o Chemical messengers which are secreted by glands via ducts.
o Secreted by the exocrine glands.
o Non-specialized chemical messenger.
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6. o Chemical messenger produced by specialized cells of the endocrine
system.
30. Hyperprolactinemia in females causes
o Galactorrhea amenorrhea syndrome.
o Obesity.
o Hypertension.
o Hyperglycemia.
31. Excess growth hormone secretion leads to
o Gigantism if it occurs after puberty.
o Acromegaly if it occurs before puberty.
o Gigantism if it occurs before puberty.
o Diabetes insipidus if it occurs after puberty.
32. The hormone vasopressin (AVP)
o Is synthesized in the posterior pituitary.
o Its secretion is defective in diabetes insipidus.
o Is important for lactation.
o Is released by a trophic hormone from hypothalamus.
33. The anterior lobe of the pituitary secrets
o Thyroid stimulating hormone (TSH).
o Anti diuretic hormone (ADH).
o Corticotrophin releasing hormone (CRH).
o Thyroid releasing hormone (TRH).
34. The level of total thyroxin (T4)
o Will be increased during pregnancy.
o Is usually normal in thyrotoxicosis.
o Is usually elevated in hypothyroidism.
o May be increased due to TBG deficiency.
35. In Graves' disease
o TSH is usually elevated.
o T4 elevated and T3 is low.
o Both FT4 and FT3 are elevated.
o ACTH is elevated.
36. Congenital adrenal hyperplasia
o Is due to ACTH deficiency.
o Is due to pituitary adenoma.
o Usually caused by 21-hydroxylase deficiency.
o Estrogen is produced in excess.
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7. (37) Which of the following is known as the master gland?
o Thyroid gland.
o Adrenal gland.
o Anterior pituitary gland.
o Ovary.
(38) The hypertension associated with phaeochromocytoma results
from:
o Increased release of glucocorticoids.
o Increased release of catecholamines.
o Increased secretion of adrenocorticotrophic hormone (ACTH).
o Increased secretion of aldosterone.
(39) Dysfunction of the posterior pituitary gland may cause which of
the following disorders:
o Gigantism.
o Graves' disease.
o Diabetes insipidus.
o Dwarfism.
(40) All of the following statements about corticosteroids are true
except:
o They are beneficial in inhibiting rejection of orgasm transplant.
o They are beneficial in combating inflammation.
o They are associated with changes in physical appeasers.
o They can be discontinued immediately when no longer needed.
(41) Hypophysectomy or destruction of the anterior pituitary seriously
affects the endocrine production of the following glands except the:
o Adrenal cortex.
o Thyroid.
o Pancreas.
o Testes.
o Ovaries.
(42) The thyroid gland produces these hormones: thyroxine (T4), tri-
iodothyronine
(T3), and calcitonin; the first two hormones are important for:
o Sexual development.
o Intellectual maturation.
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8. o Bone formation.
o Fertility.
(43) The element most essential for the biosynthesis of thyroid
hormones is:
o Sodium.
o Phosphorus.
o Calcium.
o Iodine.
(44) Graves' disease (diffuse toxic goitre) can cause a broad range of
symptoms that includes all the following except:
o Muscle weakness.
o Exophthalmus.
o Tremors.
o Cold intolerance.
(45) Myxedema is associated with following:
o Hypopituitarism.
o Hypoparthyroidism.
o Hyperthyroidism.
o Hypothyroidism.
(46) The symptoms of Addison's diseases result from dysfunction of
the:
o Adrenal cortex.
o Adrenal medulla.
o Pancreas.
o Hypothalamus.
o Posterior pituitary.
(47) Long term corticosteroid therapy is associated with development
of the following complications except:
o Diabetes mellitus.
o Osteoporosis.
o Psychosis.
o Goitre.
(48) The beta cells of pancreatic islets secret:
o Insulin.
o Glucagon.
o Epinephrine.
o Amylase.
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9. (49) The rate of insulin secretion is regulated chiefly by the:
o Amount of food ingested.
o Degree of physical activity.
o Blood glucose level.
o Endocrine response to emotional stress.
(50) When insulin production is inadequate, supplementary insulin
must be given parenterally rather than orally because the
hormone:
o Irritates gastrointestinal mucosa.
o Is inactivated by proteolytic enzymes.
o Has an emetic action.
o Destroying normal intestinal flora.
(51) The basic cause of diabetes mellitus is:
o A high sugar diet.
o Food intolerance.
o Insulin excess.
o Insulin deficiency.
(52) Diabetes mellitus may be caused by
o Endocrine disease such as Cushing’s syndrome or Acromegaly.
o Bacterial infection.
o Muscular dystrophy.
o Eating too much sugar.
(53) Oral glucose tolerance test(OGTT)
o A 75 GM glucose load is usually used.
o Can be very dangerous and must be avoided in the elderly.
o If fasting blood glucose is 100 mg/dl, OGGT is needed to
establish the diagnosis of diabetes.
o OGGT can differentiate between Type 1 and Type 2 diabetes.
(54) High plasma insulin levels has the following effects
o It stimulates breakdown of adipose tissue.
o It stimulates the storage of glycogen in the liver.
o It enhances protein catabolism.
o It increases the absorption of glucose from the intestine.
(55) Gestational diabetes
o Occurs when a pregnant eats too much.
o Occurs when a diabetic becomes pregnant.
o Occurs when a pregnant woman becomes diabetic.
o Occurs when the fetus becomes diabetic.
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10. (56) The most important function of insulin is …
o To release glucose from the liver.
o To maintain normal blood glucose level.
o To avoid late diabetic complications.
o To utilize fat.
(57) In Type 1 diabetes (IDDM)
o Insulin is unable to promote utilization of glucose.
o Pancreas does not produce insulin.
o The cells of the body lack insulin receptors.
o Blood glucose level may be normal.
(58) Persistent hyperglycemia may…
o Cause thirst, polyuria and tiredness.
o Be asymptomatic for many years.
o Cause enlargement of liver.
o Cause late complication such as sarcoidosis.
(59) Why glucosuria is a consequence of hyperglycemia
o Because the kidneys are damaged.
o Because the amount of blood filtered by the kidneys is incorrect.
o Because the amount of blood filtered by the kidneys is decreased.
o Because the kidneys are unable to reabsorb all the glucose in the filtered
blood.
(60) Glucocorticoids and mineralocorticoids are secreted by the:
o Pancreas.
o Adenohypophysis.
o Adrenal glands.
o Gonads.
(61) A female patient with Cushing's syndrome is expected to have
the following:
o "Buffalo hump" and hypertension.
o Dehydration and menorrhagia.
o Migraine headaches.
o Loss of weight.
(62) The most common cause of Cushing's syndrome is:
o Insufficient ACTH production.
o Hyperplasia of the adrenal cortex.
o Pituitary hypofunction.
o Deficient adrenocortical hormones.
(63) In Addison's disease, hypotension can be explained by a
disturbance in the production of :
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11. o Glucocorticoids.
o Androgens.
o Mineralocorticoids.
o Estrogens.
(64) In hypoglycemic reaction to insulin, emergency rapid
adjustments made by the body are associated with the increased
activity of:
o Pituitary gland.
o Thyroid gland.
o Adrenal gland
o Pancreas.
(65) Which of the following diseases is characterized by arrhythmias,
tremors, diarrhea and weight loss:
o Cushing's syndrome.
o Hypothyroidism.
o Addison's disease.
o Hyperthyroidism.
(66) Follicle stimulating hormone (FSH):
o Released from the posterior pituitary.
o Responsible for the release of adrenal medullary hormones.
o Released in response to TRH stimulation.
o Responsible for growth of ovarian follicle / spermatogenesis.
(67) Steroid hormones act by:
o Activatring adenyl cyclase.
o Binding to cellular membrane.
o Infleuncing RNA synthesis.
o Binding to plasma proteins.
(68) Hormones may have the basic molecular structure, which is :
o fatty acid.
o Steroid.
o Glucoside.
o Triglyceride.
(69) Acute infarction of the anterior pituitary gland may be followed by
features of :
o Cushing's disease.
o Acromegaly.
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12. o Panhypopituitrism.
o Diabetes insipidus.
Prepared by Dr Suhail S Kishawi
Head of medical Department Shifa Hospital
Consultant Diabetologist & Endocrinologist
18 March 2005
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