2/13/2015

MedicalMCQCenter:Thyroid

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TUES DAY, 29 JANUARY 2013

EndocrinologyforAIPGMEE,JIPMER,MCCEE
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1.Levothyroxin(T4)supplementationinthedoseof25microgramsperday
isapreferredinitialdosefor:
A)Alladultsnewlydiagnosedashypothyroid
B)Ifthediagnosisismadeduringpregnancy
C)Personswithstableangina
D)Personswithmyxedema
2.Overcorrectionofhypothyroidismwithlevothyroxinincreasestherisk
of:
A)Exophthalmos
B)Osteoporosis
C)Hypercholestolemia
D)Goiter

3.Parathyroidhormoneisnormallysecretedinresponseto:
A)Lowcalciumionconcentration
B)LowlevelsofserumvitaminD
C)Highcalciumionconcentration
D)HighVitaminDconcentration

4.FollowingendocrinopathyisassociatedwithPepticulcerdisease:
A)Hyperthyroidism
B)Hypothyroidism
C)Hyperparathyroidism
D)Hypoparathyroidism

5.Estimationofcalciumionconcentrationisimportanttodiagnose
hypertensionsecondaryto:
A)Hyperaldostrerinism
B)Hyperparathyroidism
C)Renalarterystenosis
D)SyndromeofinappropriateAntidiureticHormonesecretion
(SIADH)

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Adrenal(1)
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MedicalMCQCenter:Thyroid

6.HypovitaminosisDcauses:
A)PrimaryHyperparathyroidism
B)Secondaryhyperparathyroidism
C)Tertiaryhyperparathyroidism
D)Malignanthyperparathyroidism

PGIEE(9)
Preventiveandsocial
medicineMCQs(1)
SkinMCQs(1)
StatePGentrance(9)
Thyroid(1)

7.WhichisthecommonestmalignancyinMEN2a(multipleendocrine
neoplasia2a)?
A)Gastrinoma
B)Insulinoma
C)Medullarythyroidcarcinoma
D)Pheochromocytoma

8.Commonestcauseofsecondaryadrenalinsufficiencyis:
A)Iatrogenic
B)Tuberculosis
C)Autoimmunity
D)Waterhousefriederichsensyndrome

TuberculosisMCQs(1)

9.Trueaboutgynecomastia:
A)Estrogen:Androgenratioisincreased
B)Itcannormallyoccuratpuberty
C)Prolactinlevelsareincreased
D)Spironolactonecancauseiatrogenicgynecomastia
10.Whichisthecauseofprimaryhyperaldosteronism?
A)Renalarterystenosis
B)Cirrhosisofliver
C)Congestivecardiacfailure
D)Glucocorticoidremediablealdosteronism

Answers:

Ans:1C
Theusualstartingdoseforanyadultwithhypothyroidismis50100
microgramperday.Elderlypeopleandpeoplewithheartdiseaseshouldbe
givenlowerinitialdosesasincreaseinheartratecanprecipitatemyocardial
ischemia.Pregnantwomencanbetreatedwithusualdosageofthyroxin.
Myxedemaisamanifestationofhypothyroidismandthetreatmentremains
thesame.

Ans:2B
Exophthalmosisoneofthemanifestationsofautoimmuneprocess
associatedwithGravesdisease.HypothyroidismcanelevatelevelsofLDL
cholesterol.Treatmentofhypothyroidismmaycorrect
hypercholesterolemiatosomeextent.Osteoporosisandatrialfibrillation
areassociatedwithovercorrectionoriatrogenichyperthyroidism.

Ans:3A
Lowcalciumionconcentrationistheonlystimulationforsecretionof
parathyroidhormonefromtheglands.VitaminDdoesnotdirectlyaffect
secretionofparathyroidhormone.

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Ans:4A
HyperparathyroidismisassociatedwithAcidpepticdiseasecausing
duodenalulcermorefrequentlythangastriculcers.Itisimportanttodo
calciumlevelsinallcasesofpepticulcerdisease.

Ans:5B
Hyperparathyroidismcancausehypertension.Theconditioncanbe
suspectedifserumcalciumisraised.

Ans:6B
Parathyroidadenoma(80%)andhyperplasia(20%)causeprimary
hyperparathyroidism.LowvitaminDlevelscauselowserumcalciumlevel
stimulatingparathyroidstimulationandsecondaryhyperparathyroidism.
Whenparathyroidglandisstimulatedforlongduration,itmaybecome
autonomouscausinghighcalciumlevelsandhighparathyroidlevels
resultingintertiaryhyperparathyroidism.Secretionofparathyroidrelated
proteinfromsomelung,breastorkidneycancerscausesmalignant
hyperparathyroidism

Ans:7C
Medullarythyroidcarcinomaoccursin100%casesofMEN2a.Gene
involvingMEN2aandbisretprotoonchogene.Thosetestingpositivefor
retmutationcanbetreatedwithprophylacticthyroidectomy,usually
beforethreeyearsofage.
Ans:8A
Tuberculosisandautoimmunityarecommoncausesofprimaryadrenal
insufficiencyorAddisonsdisease,whentheinsultisdirectlytotheadrenal
glandduetowhichtheystopfunctioning.Waterhousefreidrichsen
syndromecausesacuteadrenalinsufficiencyduetoadrenalhemorrhage.
Longtermuseofsteroids(iatrogenic)suppresspituitaryadrenalaxis,which
remainssuppressedevenafterstoppageofsteroid,causingsecondary
adrenalinsufficiency.Duringperiodsofstresssteroidsupplementationis
neededinsuchcases.
Ans:9C
Increaseinprolactinlevelscausesgalactorrhea.

Ans:10D
Glucocorticoidremediablealdosteronismisageneticconditionwhere
aldosteroneproductionisundercontrolofACTH,whensteroidsuppresses
ACTH,aldosteronesecretionreduces.OptionA,BandCarecausesof
secondaryhyperaldostreronism.

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Labels:Adrenal,AIPGMEE,EndocrinologyforMCCEE,FMGE,JIPMER,Parathyroid,PGIEE,
StatePGentrance,Thyroid

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