Endo Quiz

1.
5- You are reviewing a 24 years old man who has recently been diagnosed with type 1 diabetes
mellitus. He has no comorbidities and works as an accountant. What HbA1c target should he aim for
initially?
A. 42 mmol mol
B. 45 mmol mol
C. 48 mmol mol
D. 50 mmol mol
E. 52 mmol mol
2. A 45-year-old man is referred to the acute medical unit. He had complained of ongoing fatigue and
polydipsia. On examination he is an obese man (BMI 36kg/m2) with a pulse of 84 bpm and blood
pressure of 144/84 mmHg. Blood tests reveal the following:
Na+ 140 mmol/l K+ 3.9 mmol/l
Bicarbonate 23 mmol/l Urea 5.2 mmol/l
Creatinine 101 μmol/l Glucose 21.2 mmol/l
What is the most appropriate initial management?
A. Gliclazide
B. Pioglitazone
C. Weight loss
D. Metformin
E. Commence insulin therapy
3. A 56-year-old man is reviewed in the Cardiology outpatient clinic following a myocardial infarction
one year previously. During his admission he was found to be hypertensive and diabetic. He
complains that he has put on 5kg in weight in the past 6 months. Which of his medications may be
contributing to his weight gain?
A. Metformin
B. Losartan
C. Clopidogrel
D. Gliclazide
E. Simvastatin
4. A 46-year-old man with suspected diabetes mellitus has an oral glucose tolerance test, following the
standard WHO protocol. The following results are obtained:
Time (hours) Blood glucose (mmol/l)
0 5.7
2 7.6
How should these results be interpreted?

A. Normal
B. Impaired fasting glucose and impaired glucose tolerance
C. Diabetes mellitus
D. Impaired glucose tolerance
E. Impaired fasting glucose
5. A 33-year-old female is referred to endocrinology with thyrotoxicosis. Following a discussion of
management options she elects to have radioiodine therapy. Which one of the following is the most
likely adverse effect?
A. Hypothyroidism
B. Thyroid malignancy
C. Agranulocytosis
D. Oesophagitis
E. Precipitation of thyroid eye disease
6. 44-year-old woman presents with feeling 'hot all the time' and is consequently worried she is going
through an early menopause. Her husband has also noticed a 'fullness' of her neck which has become
apparent over the past few weeks. On examination her pulse is 90/minute and she has a small, non-
tender goitre. Blood tests are arranged:
TSH: < 0.05 mu/l Free T4: 24 pmol/l (9–22pmol/L)
Anti-thyroid peroxidase antibodies: 102 IU/mL (< 35 IU/mL) ESR: 23 mm/hr
What is the most likely diagnosis?
A. Hashimoto's thyroiditis
B. Toxic multinodular goitre
C. Thyroid cancer
D. De Quervain's thyroiditis
E. Graves' disease
7. 50-year-old woman presents with polyuria and polydipsia. She has recently been started on citalopram
for depression but is otherwise fit and well. She has complained of constipation recently but has put
this down to her new medication.
-Calcium 2.8mmol/l- (1 . 0–1 . 25mmol/L ) Phosphate 0.7mmol/l
-Parathyroid hormone5.0pmol/l (1.2-5.8pmol/l)- Renal function and full blood count are normal.
What is the most likely cause for these blood results?
A. Parathyroid adenoma
B. Myeloma
C. Metastatic cancer
D. Drug induced
E. Parathyroid hyperplasia
8. A 43-year-old woman is referred to the endocrine clinic with symptoms of weight gain, fatigue and
headache. She was also recently diagnosed with type two diabetes. On examination, you note
truncal obesity with proximal wasting of the arms and legs. Hirsutisms present, and the skin appears
thin with multiple striae and bruises. You suspect Cushing's syndrome and perform routine blood
tests as part of your investigations.
What biochemical abnormality would you expect to find in this condition?
A. Hypercalcaemia
B. Hyperkalaemic metabolic acidosis
C. Hyperkalaemic metabolic alkalosis
D. Hypokalaemic metabolic acidosis
E. Hypokalaemic metabolic alkalosis
9. 45-year-old woman is investigated for weight gain. She had had been unwell for around four months
and described a combination of symptoms including depression, facial male-pattern hair growth and
reduced libido. During the work-up she was found to be hypertensive with a blood pressure of
170/100 mmHg. Which one of the following tests is most likely to be diagnostic?
A. Renin: aldosterone levels
B. High-dose dexamethasone suppression test
C. Pelvic ultrasound
D. Overnight dexamethasone suppression test
E. 24 hr urinary free cortisol
10. A 37-year-old lady presents with weight gain and bruising. On examination, she is hypertensive and
has proximal myopathy. A low dose dexamethasone suppression test showed a lack of appropriate
suppression of plasma cortisol. However, cortisol was suppressed during a high dose dexamethasone
suppression test. Plasma ACTH was elevated. A pituitary MRI was normal.
What is the most likely diagnosis?
A. Cushing's disease
B. Exogenous steroid use
C. Small cell lung cancer
D. Conn's syndrome
E. Adrenal hyperplasia
11. 35-year-old female has recently been diagnosed with Addison's disease due to autoimmune adrenal
failure after presenting with a 3-month history of lethargy, nausea, weight loss and fainting.
Which of the following physical signs may you find in this patient?
A. Stretch marks on her abdomen
B. Multiple bruises on her limbs
C. Frontal balding
D. Thinning of the axillary hair
E. Cafe au laitspots
12. A 28-year-old woman presented to endocrine clinic with secondary amenorrhoea and galactorrhoea
for the last 6 months. Her general physical and systemic examination was normal. She was quite
keen to start a family in the near future and sought advice regarding further management. Which
one of the following is the most appropriate therapeutic option in her case?
A. Bromocriptine
B. Elective trans-sphenoidal surgery
C. Octreotide
D. Quinagolide
E. Radiotherapy

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How should these results be interpreted?

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