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All-Endocrino-MCQ-test DES

1. According to WHO classification, how many types of diabetes are there?

A. 1

B. 3

C. 5

D. 4

E. 2

2. The answers below are the complications of gestational diabetes for the mother except for one? Which one?

A. High blood pressure

B. Preeclampsia

C. Dyslipidemia

D. Eclampsia

E. Future diabetes

3. The answers below are the complications of gestational diabetes for the baby except for one? Which one?

A. Excessive birth weight

B. Preterm birth and respiratory distress syndrome

C. Hypoglycemia

D. Type 1 diabetes in the future

E. Type 2 diabetes in the future

4. Mrs. Y, 25 year-old, comes to OPD for prenatal consultation. She has gestational diabetes in the first pregnancy 3 years ago. What should you recommend when it comes to GDM screening?

A. Wait until 24-28 weeks of pregnancy

B. Do the OGTT

C. Request A1C

D. Check only fasting blood glucose

E. Check random blood sugar

5. Mrs. A, 20 year-old, comes to OPD for prenatal consultation. In the past she has no medical history. As part of the prenatal consultation with her gynecologist her lab results shows: Hb 10g/dl, fasting blood glucose 110mg/dl, A1C 6.3%. What could be the best option for her?

A. Actrapid 30mn before meals according to the blood glucose

B. Metformin 500mg 1-0-1

C. Diamicron MR 30mg 1-0-0

D. Actos 15mg 1-0-0

E. Sitagliptine 50mg 1-0-0

6. What could be the glycemic cutting points in 75g OGTT for screening for GDM?

a. 0H 92mg/dl, 1H 180mg/dl, 2H 153mg/dl

B. 0H 90mg/dl, 1H 180mg/dl, 2H 153mg/dl

C. 0H 92mg/dl, 1H 183mg/dl, 2H 150mg/dl

D. 0H 92mg/dl, 1H 180mg/dl, 2H 200mg/dl

E. 0H 100mg/dl, 1H 180mg/dl, 2H 153mg/dl

7. Mrs Q, 24 year-old, is a pregnant. She comes to see you in OPD to screen for gestational diabetes. Then before starting the test your nurse checks her capillary blood glucose and finds 170mg/dl. There’re no technical problems regarding the glucometer. Would continue the OGTT? Why?

A. No, because the blood glucose will surely more than 92mg/dl

B. Yes we need OGTT to confirm

C. We need to do A1C to confirm

D. Send the patient home and check it again in two weeks

E. We need to do the random blood sugar

8. Ms T, 20 year-old, is admitted to the emergency of a nationa hospital. She has DKA. The arguments below are the severity cryteria except one.

A. pH < 7

B. Bicarbonate < 10 mmol/l

C. K < 2.5 mmol/l or > 7 mmol/l

D. Conscience normal

E. Coma

9. Mr A, 19 year-old, is admitted to the emergency of a national hospital. He has DKA. It is notes that he has type 1 diabetes. The symptoms below could possibly be the symptoms of DKA except one.

A. Dehydration

B. Kussmaul respiration

C. Polyuria

D. Acantosis nigrigans

E. Coma

10. Mrs A, 69 year-old, is admitted to the emergency of a nationa hospital. She has hyperosmolar coma. It is noted that she has type 2 diabetes. The symptoms below could possibly be the symptoms of hyperosmolar coma except one.

A. Dehydration

B. Kussmaul respiration

C. Polyuria

D. Acantosis nigrigans

E. Severe fatigue

11. Mr. R, 25 year-old is admitted to the inpatient department. We suspect he has type one diabetes. All the symptoms below are in favors for type one diabetes except one

A. Obese

B. No family history

C. Polyuria

D. Polydypsia

E. Lost weight

12. Mr. T, 25 year-old is admitted to the inpatient department. We suspect he has type one diabetes. All the findings below are in favors for type one diabetes except one.

A. Ketone (-)

B. Ac-anti GAD65 (+)

C. Ac-anti IA2 (+)

D. Glycemia 290mg/dl and C-peptide low

E. Ac-anti GAD65 and IA2 (+)

13. For diabetic patients what is the cut-off point to diagnose hypoglycemia?

A. 65mg/dl

B. 70mg/dl

C. 50mg/dl

D. 30mg/dl

E. 25mg/dl

14. The following statements are criterias of severe hypoglycemia except one.

A. Coma

B. Fever

C. Glycemia low and not able to swallow sugary water

D. Glycemia 30mg/dl and not able to swallow sugary water

E. Seizure

15. The following statements are the risk factors for hypoglycemia except one.

A. Miss foods

B. Taking overdose Sulfonylureas

C. Inject too much insulin

D. Eating snacks before exercises

E. Excercises too much

16. The following statements are the symptoms of neuroglycopenic symptoms except one.

A. Confusion

B. Seizure

C. Trembling

D. Coma

E. Ataxia

17. The following staments are the main objectifs for the management of hyperosmolar coma except one.

A. To vigorously rehydrate the patient while maintaining electrolyte homeostasis

B. Correct hyperglycemia

C. Patient education

D. Treat underlying diseases

E. Monitor and assist cardiovascular, pulmonary, renal, and CNS function

18. The following statements are the diagnosis methods for Cushing syndrom except one.

A. Urinary free cortisol level

B. Low-dose dexamethasone suppression test

C. Evening serum and salivary cortisol level

D. High dose dexamethasone suppression test

E. Dexamethasone–corticotropin-releasing hormone test

19. What is the common cause of the Cushing syndrom?

A. Abuse glucocorticoid

B. Lung cancer

C. Adenoma of the adrenal gland

D. Cushing disease

E. Adenocarcinoma of the adrenal gland

20. In case of suspision of Cushing syndrom caused by adenama of the adrenal gland. What is the radiological test to request?

A. MRI of the head

B. Heart ultrasound

C. Abdominal CT

D. Chest X-Ray

E. Abdomen X-ray

21. In case of suspision of Cushing disease. What is the radiological test to request?

A. MRI of the head

B. Heart ultrasound

C. Abdominal CT

D. Chest X-Ray

E. Abdomen X-ray

22. What is non-physiologic cause of hyperprolactinoma?

A. Pregnancy

B. Sexual intercourse

C. Nipple stimulation/suckling

D. Macro-prolactinoma

E. Stress

23. All the drugs mentioned below could possibly increase the prolactine except one.

A. Domperidone

B. Metoclopromide

C. Acetaminophene

D. Haldol

E. Amitryptiline

24. In case of suspision of macro-prolactinoma, what is the radiological test to request?

A. Head CT

B. Head MRI

C. Abdominal CT

D. Abdominal MRI

E. Chest X-ray

25. In wemen what is the first thing to ask before exploring the causes of hyperprolactinoma?

A. Sexual intercourse

B. Stress

C. Pregnancy

D. Head trauma

E. Macroprolactinoma

26. What is the cause of hyperthyroidism that gives clinical features of thyrotoxicosis and opthalmopathy

A. Graves disease

B. Adenoma toxic

C. Thyroidititis

D. Toxic multinodular goiter

E. Pituitary tumor

27. What is the worsening factor of opthalmopathy?

A. Beers

B. Pregnancy

C. Smoking

D. Sugary drinks

E. Wiskey

28. What is the most useful test to diagnose the cause of hyperthyrodism?

A. Neck CT

B. Thyroid ultrasound

C. Chest X-Ray

D. Neck MRI

E. ECG

29. In the lab result of a patient shows: TSH low, fT3 and fT4 high. What is the diagnosis?

A. Hyperthyroidism

B. Hypothyroidism

C. Euthyroidism

D. Subclinical hypothyroidism

E. Subclinical hyperthyroidism

30. In the lab result of a patient shows: TSH elevated, fT3 and fT4 normal. What is the diagnosis?

A. Subclinical hyperthyroidism

B. Hypothyroidism

C. Euthyroidism

D. Subclinical hypothyroidism

E. Hyperthyroidism

31. In the lab result of a patient shows: TSH decreased, fT3 high and fT4 normal. What is the diagnosis?

A. Subclinical hyperthyroidism

B. T3 thyrotoxicosis

C. Euthyroidism

D. Subclinical hypothyroidism

E. Hyperthyroidism

32. What is the most common cause of hypothyroidism?

A. Post-thyroidectomy

B. Amiodarone

C. Iodine deficiency

D. Congenetal hypothyroidism

E. Neo-mercazol

33. In case of myxedoema coma what is the management not to do.

A. Give T3

B. IV glucose

C. Give propylthiouracil

D. Give O2

E. Admitted the patient in ICU

34. What is the test to confirm Harshimoto’s thyroiditis?

A. Ac-anti TPO

B. Ac-anti TSH receptor

C. THS

D. fT3

E. fT4

35. All the diseases mentiened below are the causes of hypocalcemia except one.

A. Post-thyroidectomy

B. Chronic renal failure

C. Hyperparathyroidism

E. Vitamin D deficiency

36. Severe hypocalcemia can induces all below except one. Which response?

A. Seizures

B. Bronchospasm

C. Laryngospasm

D. Constipation

E. Prolongation of the QT interval

37. In which case we use Calcium IV?

A. Acute symptomatic hypocalcemia

B. Moderate asymptomatic hypocalcemia

C. Hyperthyroidism

D. Hyperparathyroidism

E. Hypothyroidism

38. If we want to interprete calcemia which test should we request?

A. Albuminemia

B. Glycemia

C. CRP

D. Electrolytes

E. Procalcitonin

39. What are the 2 common causes of hypercalcemia?

A. Hyperparathyroidism and malignancy

B. Malignancy and Hypoparathyroidism

C. Renal failure and Hyperparathyroidism

D. Hyperparathyroidism and vitamine A intoxication

E. Renal failure and Hyperparathyroidism

A. Hyperparathyroidism and malignancy

40. Among the statements below what is not the management of hypercalcemia crisis?

A. IV seline hydration and diuresis

B. Calcitonin

C. Biphosphonate

D. Gluconate calcium IV

E. Admitt the patient to ICU

41. Among the statements below what is not the microvascular complication of diabetes?

A. Diabetic nephropathy

B. Diabetic neuropathy

C. Diabetic retinopathy

D. Glaucoma

E. Peripheral neuropathy

42. Among the statements below what is not the macrovascular complication of diabetes?

A. Carotide stenosis

B. Myocardal infarction

C. Osteoarthritis

D. Ischemic strokee. Lower limbs ischemic

E. Lower limbs ischemic

43. Diabetic nephropathy is one of the common causes of renal failure. What is the cause of diabetic nephropathy?

A. Glomerulopathy

B. Tubulopathy

C. Mixte

D. Interstitial nephritis

E. Obstructive nephropathy

44. What is the best indicator of diabetic nephropathy?

A. Microalbuminuria

B. Creatinin

C. BUN

D. A1C

E. eGFR

45. What is the best to diagnosis diabetic neuropathy?

A. Clinical examination

B. EMG

C. ECG

D. A1C

E. Lumbar MRI

46. When should we screen for diabetic retinopathy for type 2 diabetic patients?

A. At the diagnosis

B. 5 years after the diagnosis

C. When the patients has renal complication

D. When the patients has diabetic neuropathy

E. 10 years after the diagnosis

47. When should we screen for diabetic retinopathy for type 1 diabetic patients?

A. At the diagnosis

B. 5 year after the diagnosis

C. When the patients has renal complication

D. When the patients has diabetic neuropathy

E. 10 years after the diagnosis

48. What is the worsening factor of diabetic retinopathy mentioned below?

B. Male patients

A. Pregnancy

C. Old patients

D. Adults patients

E. Young patients

49. A patient comes to consult you because of fatigue and he presents a Cushing syndrom. And in the interrogation you find that the patient uses lots of Prednisone but recently stops because of gastric intolerence. What do you suspect?

A. Acute hypoadrenalism

B. Cushing disease

C. Ectopic ACTH secretion

D. Adrenal tumor

E. Pituitary tumor

50. A patient comes to consult you because of fatigue and he presents a Cushing syndrom. And in the interrogation you find that the patient uses lots of Dexamethasone but recently stops because of gastric intolerence. Clinical examination shows: BP 100/50, HR 100/mn. What you do first?

A. IV Normal seline and IV Hydrocortisone

B. Request Cortisol

C. Request ACTH

D. Request Cortisol and ACTH

E. Request Gastroscopy

51. You suspect a patient having adrenal insuffucency because he abuses streoids. There are no signs of acure hypoadrenalism. What you request to confirm the diagnosis?

A. 8am Cortisol

B. 8pm Cortisol

C. Midnight Cortisol

D. Cortisol at anytime

E. Urinary free cortisol

52. What is the indication of Statin?

A. Hypercholesterolemia

B. Hypertriglyceridemia

C. Hyperglycemia

D. Hyperuricemia

E. Hypertension

53. What is the indication of Fibrates?

A. Hypercholesterolemia

B. Hyperglycemia

C. Hypertriglyceridemia

D. Hyperuricemia

E. Hypertension

54. What is the diagnosis method of gestational diabetes?

A. 75g OGTT

B. Fasting glycemia

C. A1C

D. 50g OGTT

E. 100g OGTT

55. The statements mentioned below are the creterias to diagnosis diabetes militus except one?

B. A1C ≥ 6.5%

C. Fasting cappilary glycemia ≥ 126mg/dl

D. 75g OGTT

E. Random plasma glycemia ≥ 200mg/dl with classic symptoms

56. In the treatment of type 1 diabetes we must start the insulin. Which proposition is correct?

A. Rapid insulin only

B. Intermediate insuline only

C. Rapid and long-acting insulin

D. Inhale insulin only

E. Long-acting insulin only

57. In type 2 diabetes which treatment we start?

A. Life style modification

B. Insulin

C. Metformin

D. Sulfonylurea

E. Pioglitazone

58. In type 2 diabetes if the life style modification fails. Which medication we start according to the recommendations?

A. Sulfonylurea

B. Metformin

C. Rapid insulin

D. Long acting insulin

E. Pioglitazone

59. In type 2 diabetes medications below which drug could causes hypoglycemia?

A. Sulfonylurea

B. Metformin

C. Life style modification

D. Lyfe style modification and metformin

E. Pioglitazone

60. In coma hyperosmolar which insulin therapy we use?

A. Rapid insulin IV continuesly

B. Rapid insulin injection subcutanously

C. Long-acting insulin injection subcutanously

D. Inhale insulin

E. Basal Bolus

1. La calcitonine chez l’homme:

A. Provoque une hypercalcémie

B. Provoque une hyperphosphorémie

C. Agit essentiellement la formation de la vitamine D

D. Bloque la résorption osseuse ostéoclastique

E. Constitue un traitement efficace des hypocalcémies

2. Un syndrome d'hypercalcémie peut s'accompagner d'un des plusieurs signes suivants:

A. Polydypsie

B. Prurit

C. Diarrhée

D. Polyphagie

E. Trouble mentruel

3. Laquelle est la cause d’une hypercalcémie à PTH augmenté:

A. Intoxication par la vitamine D

B. Une hyperthyroïdie

C. Hémopathies malignes

D. Un adénome parathyroïdien

E. Syndrome des buveurs de lait

4. Parmi les causes d'hypercalcémie suivantes, quelle est celle comportant une hyperabsorption digestive du calcium?

A. Maladies inflammatoires

B. Cancer osseux métastatique

C. Hypervitaminose D

D. Immobilisation prolongée

E. Maladie de Basedow

5. Parmi les propositions suivantes, lequel est trouvé dans l’hypercalcémie?

A. Signe de Trousseau

B. Allongement de l’espace QT

C. Hyperreflexie

D. Constipation

E. Insomnie

6. La calciurie est abaissée par:

A. L'hypercalcémie

B. L'acidose métabolique

C. Le traitement par le furosémide

D. L’hyperhydratation salée

E. Le traitement par les diurétiques thiazidiques

7. Parmi les circonstances suivantes, laquelle peut révéler une hyper-parathyroidie primitive ?

A. Insuffisance rénale chronique

B. Hypercalcémie de découverte fortuite

C. Fracture osseuse

D. Hypertension artérielle

E. Polyarthrite rhumatoïde

8. Au cours d'une hypercalcémie maligne sans insuffisance rénale, laquelle est la premiàre mesure thérapeutique à mettre en place en urgence?

A. Diurétiques de l'anse (furosémide)

B. Réhydratation salée isotonique IV

C. Prednisone

D. Digitaline

E. Diphosphonates

9. Pour traiter une hypercalcémie, vous pouvez prescrire:

A. Diurétique du groupe thiazide

B. Diurétique de l'anse (furosémide)

C. Anti-inflammatoires non stéroïde

D. Anti-thyroïdiens de synthèse

E. Les vitamines D3 actives

10. Au cours d'une hypercalcémie, les traitements suivants peuvent être employés sauf un, lequel?

A. Diurétiques de l'anse (furosémide)

B. Réhydratation

C. Prednisone

D. Biphosphonate

E. Indométhacine

Mr B. 65 ans, est adressé aux urgences par son médecin traitant. Il a aimablement joint une lettre: “Cher confère, merci de prendre en charge Mr B., qui présente une hypercalcémie à 3,05 mmol/L, chez qui je suspecte une hyperparathyroïdie primitive. QRU 1: Lequel est un signe clinique d’hypercalcémie?

A. Anorexie

B. Fébricule

C. Convulsion

D. Clonus

E. Hyperréflexie

Mr B. 65 ans, est adressé aux urgences par son médecin traitant. Il a aimablement joint une lettre: “Cher confère, merci de prendre en charge Mr B., qui présente une hypercalcémie à 3,05 mmol/L, chez qui je suspecte une hyperparathyroïdie primitive. QRU 2: Quelle atteinte met en jeux le prognostic vital?

A. Hépatite

B. Rénale

C. Cérébrale

D. Cardiaque

E. Respiratoire

A. Allongement du QT

B. Elargissement du QRS

C. Raccourcissement du QT

D. Bradycardie

E. Apparition d’une onde U

Mr B. 65 ans, est adressé aux urgences par son médecin traitant. Il a aimablement joint une lettre: “Cher confère, merci de prendre en charge Mr B., qui présente une hypercalcémie à 3,05 mmol/L, chez qui je suspecte une hyperparathyroïdie primitive.QRU 4: Quelle est le profil biologique retrouvé dans une hyperparathyroïdie primitive?

A. Hypercalcémie, hyperphosphorémie, PTH basse

B. Hypercalcémie, hypophosphorémie, PTH basse

C. Hypocalcémie, hyperphosphorémie, PTH basse

D. Hypercalcémie, hyperphosphorémie, PTH élevée

E. Hypercalcémie, hypophosphorémie, PTH

Mr B. 65 ans, est adressé aux urgences par son médecin traitant. Il a aimablement joint une lettre: “Cher confère, merci de prendre en charge Mr B., qui présente une hypercalcémie à 3,05 mmol/L, chez qui je suspecte une hyperparathyroïdie primitive.QRU 5: Quel médicament peut donner d’hypercalcémie?

A. Antibiotiques

B. Anti-inflammatoires

C. Litium

E. Calcitonine

D. Biphosphonates

Mr B. 65 ans, est adressé aux urgences par son médecin traitant. Il a aimablement joint une lettre: “Cher confère, merci de prendre en charge Mr B., qui présente une hypercalcémie à 3,05 mmol/L, chez qui je suspecte une hyperparathyroïdie primitive.QRU 6: Quel est le traitement d’une hypercalcémie moderée?

A. Hydratation PO

B. Hydratation IV

C. Biphosphonate PO

D. Corticothérapie PO en cas de cause maligne

E. Diurèse forcée au Lasilix

1. A 50-year-old woman presents to accident and emergency complaining of excessive lethargy. In addition, she mentions that she has been constipated. On examination, there are clinical features of dehydration. Blood tests have revealed a corrected calcium of 3.3 mol/L. Her chest x-ray shows bilateral streaky shadowing throughout both lung fields. She is given 3 L of saline in 24 hours after admission. The following day her blood tests are repeated and her corrected calcium level is now 3.0 mmol/L. Results of parathyroid hormone levels and thyroid function tests are still awaited. What is the most appropriate management?

Intravenous saline rehydration

B. Intravenous saline rehydration and pamidronate

C. Pamidronate

D. Calcitonin

E. Intravenous saline rehydration plus calcitonin

2. A 62-year-old asymptomatic woman is noted to have multiple myeloma and an elevated calcium level, but no bone lesions or end-organ damage. Which of the following therapies is useful for immediate treatment of the hypercalcemia?

A. Bisphosphonates.

B. Erythropoietin.

C. Dexamethasone plus thalidomide.

D. Interferon-alfa

E. Observe without treatment since she is asymptomatic.

3. A 66-year-old man with known metastatic squamous cell carcinoma of the esophagus is brought to the emergency room for increasing lethargy and confusion. He is clinically dehydrated, his serum calcium level is 14 mg/dL, and his creatinine level is 2.5 mg/dL but 1 month ago was 0.9 mg/dL. Which therapy for his hypercalcemia should be instituted first?

A. Intravenous bisphosphonate

B. Intravenous furosemide

C. Glucocorticoids

D. Intravenous normal saline

E. Chemotherapy for squamous cell carcinoma

4. A 76-year-old man with squamous cell lung carcinoma attends accident and emergency with his wife who is his full-time carer. She has become concerned as he has become extremely depressed over the last couple of weeks, along with being extremely thirsty and having little energy. Up until then he was coping very well with his diagnosis. What is the most likely cause of these symptoms?

A. Hypercalcaemia

B. Hypocalcaemia

C. Hyperkalaemia

D. Hypokalaemia

E. Hypophosphataemia

5. Madame M. 56 ans a été opérée voilà 4 ans d'une mastectomie droite type Patey avec chimiothérapie et radiothérapie complémentaire. Le bilan de surveillance annuel montre une hypercalcémie à 2,8 mmol/I, la protidémie est à 65 g/l, la créatininémie à 55 mmol/I, mais ne retrouve pas d'argument en faveur d'une récidve. Son hypercalcémie peut-être causée par une:

A. Mastectomie

B. Chimiothérapie

C. Radiothérapie

D. Hyperparathyroïdie primitive

E. Tumeur maligne du sein droite

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