Endocrinology - CM

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1. What stage of diabetic nephropathy after Mogensen is characterized by: GFR 60-90 ml/min, micro
albuminuria, mildly elevated blood pressure?
a. [X] 1
b. [ ] 2
c. [X] 3
d. [ ] 4
e. [ ] 5
2. What stage of diabetic nephropathy after Mogensen is characterized by: GFR < 60ml/min, macro
albuminuria, moderately elevated blood pressure?
a. [ ] 1
b. [ ] 2
c. [X] 3
d. [X] 4
e. [ ] 5
3. What hypotensive drugs are of election in the treatment of patients with diabetic nephropathy and
hypertension?
a. [X] Diuretics
b. [X] Ca canals blockers
c. [X] Renin-angiotensin-aldosterone system inhibitors (ICE, sartans)
d. [ ] Central acting drugs
e. [ ] Beta-blockers
4. Which of the following are normal blood glucose measurements?
a. [ ] 3,3 - 8 mmol/l
b. [X] 3,3 - 5,5 mmol/l in capillary blood
c. [ ] 4,4 - 7,0 mmol/l
d. [X] 3,3 - 6,1 mmol/l in venous blood
e. [ ] 3,3 - 7,8 mmol/l
5. Which of the contra-insulinic acting hormones responds first to low blood glucose?
a. [ ] cortisol
b. [ ] somatotrope
c. [X] catecholamine
d. [X] glucagon
e. [ ] thyroid hormones
6. Which of the following are insulin effects?
a. [ ] lipogenesis inhibition
b. [ ] lipolysis stimulation
c. [X] lipolysis inhibition
d. [X] lipogenesis stimulation
e. [ ] neutral effect on lipid metabolism
7. Which of the following cells are insulin-dependent?
a. [ ] Nerve cell
b. [X] Muscle cell
c. [X] Adipocyte
d. [ ] Crystalline lens
e. [ ] Endothelial cell
8. Which of the following modifications are involved in diabetes mellitus type 2 pathogeny?
a. [X] Insulin resistance
b. [ ] Autoimmune process against pancreatic beta-cells
c. [X] Inadequate insulin secretion
d. [ ] Absolute insulin deficiency
e. [ ] Beta-cells destruction
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9. Which environmental factors are involved in type 2 diabetes mellitus pathogenesis?
a. [X] sedentary lifestyle
b. [X] hyper caloric diet
c. [X] endocrinopathies
d. [ ] viral infections
e. [ ] pancreas pathology
10. Which of the following blood glucose measurements are normal?
a. [X] Fasting glucose up to 6,1 mmol/l
b. [ ] Fasting glucose up to 7,0 mmol/l
c. [ ] Postprandial glucose up to 11,1 mmol/l
d. [X] 2 hour blood glucose in OGTT up to 7,8 mmol/l
e. [ ] Fasting glucose between 6,1 - 7,0 mmol/l
11. Which of the following paraclinical criteria confirm the diagnosis of diabetes mellitus?
a. [X] Fasting glucose > 7mmol/l
b. [ ] Low C-peptide
c. [X] HbA1c > 6,5%
d. [ ] Blood glucose 2 hours after a meal < 7,8mmol/l
e. [ ] Persistent glycosuria
12. Which are the evolution stages of cubic foot Charcot?
a. [X] Acute phase - edema, signs of inflammation, elevated local temperature
b. [ ] Subclinical stage
c. [ ] Clinical manifestation stage
d. [X] Chronic phase - monstrous foot deformation
e. [ ] Stage with complications
13. What osteo-articular changes can be found in diabetes mellitus patients?
a. [X] Charcot foot
b. [ ] Gonarthrosis
c. [ ] primary deforming osteoarthrosis
d. [X] Dupuytren's contracture
e. [ ] sacroilitis
14. The following investigations are necessary in early diagnosis of diabetic nephropathy:
a. [ ] Nechiporenko urine test
b. [X] Glomerular filtration appreciation
c. [ ] Zimnitsky test
d. [X] Micro albuminuria/ macro albuminuria
e. [ ] Urinalysis
15. Which of the following changes are attributed to diabetic microangiopathy?
a. [ ] Major vessels damage in lower limbs
b. [X] Diabetic retinopathy
c. [ ] Brain vessels damage
d. [X] Diabetic nephropathy
e. [ ] Coronaries damage
16. Somogyi phenomenon is characterized by:
a. [X] it is determined by a hypersecretion of contra-insulinic hormones in the early morning
b. [ ] it is a matinal hyperglycemia in the absence of nocturnal hypoglycemia
c. [X] it is a matinal hyperglycemia caused by a nocturnal hypoglycemia
d. [ ] it is caused by an insufficient dose of prolonged action insulin in the evening
e. [X] for confirmation blood glucose must be measured at 3:00 AM
17. Which of the following conditions can initiate the development of lactacidotic coma?
a. [X] pathologies caused by tissue hypoxia
b. [ ] gastrointestinal pathologies
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18.

19.

20.

21.

22.

23.

24.

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c. [X] biguanides administration

d. [ ] insulin excess
e. [ ] sulfonylurea overdose
Hypoglycemia is:
a. [X] Plasma blood glucose < 2,8 mmol/l, together with clinical symptoms
b. [X] Plasma blood glucose < 3,5 mmol/l, together with clinical symptoms
c. [ ] Plasma blood glucose < 3,5 mmol/l, regardless the symptoms
d. [ ] Plasma blood glucose < 2,2 mmol/l, regardless the symptoms
e. [X] Plasma blood glucose < 3,3 mmol/l
Which of the following factors can determine hypoglycemia?
a. [X] physical effort
b. [X] uncontrolled intake of biguanides
c. [X] alcohol intake
d. [ ] smoking
e. [ ] insufficient doses of insulin
The following risk factors for chronic diabetic complications can be modified through treatment, EXCEPT:
a. [X] genetic predisposition
b. [ ] hyperglycemia
c. [ ] dyslipidemia
d. [ ] arterial hypertension
e. [X] diabetes duration
Which of the following clinical signs are characteristic for hypoglycemia?
a. [ ] Signs of dehydration
b. [X] Adrenergic signs
c. [X] Neuroglycopenic signs
d. [ ] Acidosis signs
e. [ ] Arterial hypotension
Hypoglycemic coma is characterized by:
a. [X] Rapid coma state onset
b. [X] Rise in body temperature
c. [X] Tachycardia
d. [ ] Slow coma onset
e. [ ] Lack of tonic and clonic seizures
Which is common for both ketoacidosis and hyperosmolar comas?
a. [ ] Increase of the level of lactic acid
b. [ ] low pH of the blood
c. [X] Hyperglycemia
d. [X] Increased osmolarity of the blood
e. [ ] Essential increase of the potassium and sodium
Which are the key factors in the pathogenesis of ketoacidosis?
a. [X] Sever insufficiency of insulin
b. [ ] Accumulation of lactic acid in the tissues
c. [X] Increased activity of contrainsulinic hormones
d. [ ] Glucagon deficiency
e. [ ] Low level of free fatty acids
Which is specific for breathing in ketoacidotic coma?
a. [X] deep, noisy breathing (Kussmaul breathing)
b. [ ] rare, quiet breathing
c. [X] smell of acetone in breath
d. [ ] shallow breathing
e. [ ] normal breathing
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26. Hypoglycemic coma in DM is caused by:
a. [X] Over dosage of insulin
b. [ ] Insufficient protein intake
c. [X] Insufficient intake of carbohydrates at a usual dose of insulin
d. [ ] Insufficient intake of fat
e. [ ] Worsening of cardiovascular system function
27. Which of the following complications are caused by acute hyperglycemia ?
a. [ ] Diabetic Retinopathy
b. [X] Ketoacidosis coma
c. [ ] Diabetic nephropathy
d. [X] Lactic acidosis coma
e. [X] Hyperosmolar coma
28. What are the emergency measures in case of hypoglycemic coma ?
a. [X] Glucagon administration 1.0 s / c
b. [ ] Administration of glucose 5% - 200.0 ml i / v in infusion slow
c. [X] Glucose 40 % i / v in bolus till recurrence (max 100.0 )
d. [ ] Glucose 10% - 100.0 ml i / v
e. [X] Prednisolone 30 mg i/ m
29. In hyperosmolar coma compared to ketoacidosis coma there is:
a. [X] More marked hyperglycemia
b. [ ] Higher total insulin doses in treatment
c. [X] Rehydration using 0.45 % Nacl
d. [ ] Lower amoun of liquid infused
e. [ ] Administration of trisamine
30. 76Which of the following insulines are part of insulin analogues
a. [X] Lantus, Levemir
b. [ ] Protafan
c. [X] Novorapid, Apidra
d. [ ] Humulin NPH
e. [ ] Actrapid
31. Wich Insulin is indicated for the management in metabolic emergencies i / v ?
a. [X] Actrapid
b. [ ] Lantus
c. [ ] Protafan
d. [X] Humulin R
e. [ ] Humulin NPH
32. Which of the following mechanisms are proper to alpha glucosidase inhibitors ?
a. [ ] Decreases insulin resistance
b. [X] Delaying the digestion and absorption of carbohydrates
c. [ ] Stimulate insulin secretion
d. [X] Reduce postprandial glycemia
e. [ ] Increase secretion of incretins
33. Which of the following hypoglycemic medications increase insulin secretion?
a. [X] Analogs of GLP -1
b. [ ] metformin
c. [ ] acarbose
d. [X] DPP4 inhibitors
e. [X] glimepiride
34. What statements characterize the effects of repaglinide?
a. [X] Increasing insulin secretion
b. [ ] Decreases insulin resistance
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35.

36.

37.

38.

39.

40.

41.

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c. [X] Reduces postprandial glycemia

d. [ ] Increases peripheral insulin sensitivity
e. [ ] Reduce basal and postprandial glycemia
Which of the following insulin remedies causes the fastest hypoglycemia?
a. [ ] Humulin R
b. [X] Humalog
c. [X] Novo -Rapid
d. [ ] Lantus
e. [ ] Levemir
Which of these effects are specific to insulin ?
a. [X] Stimulates liver glycogen synthesis
b. [X] Increases glucose utilization by muscle
c. [ ] Stimulates hepatic gluconeogenesis
d. [X] Increases protein synthesis
e. [ ] Increases lipolysis
Metabolic changes that occur in insulin deficiency are?
a. [X] Increases hepatic gluconeogenesis
b. [X] Decreases glycogenesis
c. [ ] Increases peripheral glucose utilization
d. [X] Increase glycogenolysis
e. [ ] Increase protein synthesis
Which of the following hormones have contra-insulin effect?
a. [X] Somatotrope
b. [ ] Somatostatin
c. [X] glucagon
d. [X] Catecholamines
e. [X] Thyroid stimulating hormone
Which of the following is insulin independent tissue
a. [X] the lens
b. [X] endothelial cells
c. [ ] muscle cell
d. [ ] adipocyte
e. [X] nerve cells
Which of the following is characteristic for Type 2 diabetes?
a. [X] Usually begins after 40 years
b. [X] In most cases people are obese
c. [X] Frequent diagnosis is occasionally
d. [ ] Begins usually with ketoacidosis
e. [ ] Onset is sudden
Which of these skin lesions are carcateristic for diabetes ?
a. [X] Necrobiosis lipoidica
b. [X] Diabetic bulllae
c. [X] Facial rubeosis
d. [ ] Psoriasis
e. [ ] Pityriasis versicolor
Which of the following skin lesions are predominant in people with type 2 diabetes?
a. [ ] Vitiligo
b. [ ] Facial rubeosis
c. [X] xanthelasma
d. [X] acantosis nigricans
e. [X] Papular xanthoma
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43. Which of the following is characteristic for type 1 diabetes?
a. [X] Debutes in young people
b. [X] Antibodies to pancreatic beta-cells are present
c. [ ] In people with obesity
d. [X] Predisposed to ketoacidosis
e. [ ] C-peptide values are increased
44. In which of the following situations we suspect Type 2 diabetes ?
a. [X] Obese persons with heredocolateral anamnesis for Diabetes
b. [X] Recurrent skin infections ( furunculosis )
c. [ ] Individuals with gastrointestinal diseases
d. [X] Cutaneous and genital pruritus with ineffective treatment
e. [ ] Normal-weight people with hepatitis
45. Secondary diabetes can be induced by :
a. [X] Administering of drugs with diabetogenic potenttial
b. [ ] Autoimmune pathology of the pancreas
c. [X] Endocrynopathies
d. [X] Pancreatopathy
e. [ ] Obesity
46. Which of the following categories of patients have increased risk for type 2 diabetes ?
a. [X] Obesity
b. [X] Hypertension
c. [X] Dyslipidemia
d. [ ] Up to 40 years
e. [ ] BMI less than 25 kg / m2
47. Which of the following groups of women have increased risk for type 2 diabetes ?
a. [ ] Women with twin pregnancy
b. [ ] Women with hypothyroidism
c. [X] Women with polycystic ovary syndrome
d. [X] Women with history of gestational diabetes
e. [X] Women wich born children weighing over 4000gr
48. The risk of type 2 diabetes installation is higher
a. [ ] people who frequently develop viral infections
b. [X] women who have had a baby weighing more than 4.5 kg
c. [ ] people who until the age of 1 year were fed with cow's milk
d. [X] persons with obesity
e. [ ] persons with hypercholesterolemia
49. Lipoid necrobiosis is characterized by the following :
a. [X] the appeareance on the skin of ovoid signboards
b. [X] purple color, round shape and endured
c. [X] depressed center area sometimes ulcerated
d. [ ] most frequent skin damage is to the head and neck
e. [ ] skin hypertrophy
50. Which of the following laboratory investigations are strictly necessary to diagnose diabetes?
a. [X] fasting blood glucose
b. [X] postprandial hyperglycemia
c. [ ] The presence of glucose in urine
d. [X] HbA1c
e. [ ] Ketones in the urine
51. Proliferative diabetic retinopathy is characterized by:
a. [X] the presence of neoformed vessels on the surface of the retina
b. [X] excessive growth of tissue in the retina conjuctiva
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52.

53.

54.

55.

56.

57.

58.

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c. [X] may be complicated by retina decolation

d. [X] presence of microhaemorrhages and microaneurisma
e. [ ] it is a risk factor for the development of cataracts
What are the particuliarities of the atherosclerotic process in patients with diabetes?
a. [X] occurs more frequently and earlier compared to non diabetics
b. [X] femenin sex protection disappears
c. [ ] more common in men
d. [X] generalised and distal
e. [ ] is a specific complication for type 1 diabetes
What are the characteristics IMA to people with diabetes?
a. [X] silent heart attack
b. [X] Damage to tritroncular coronary
c. [X] Common complications after myocardial infarction
d. [ ] Reduced lethality
e. [ ] More common in women
Which of the following symptoms characterize Mauriac syndrome?
a. [X] Hipostature
b. [X] Hepatomegaly
c. [ ] Psychological deviation
d. [X] Hypogonadism
e. [ ] Hypothyroidy
Which 3 of the following parameters are characteristic for ketoacidosis?
a. [X] Increased blood glucose above 14 mmol / l
b. [ ] Metabolic alkalosis
c. [X] Ketones in the blood and urine
d. [ ] ph between 7,35 - 7.4
e. [X] Ph less than 7.35
Which of the following clinical syndromes are characteristic ketoacidosis?
a. [X] Hyperglycemia syndrome
b. [X] Dehydration syndrome
c. [ ] Convulsive syndrome
d. [ ] Malabsorbtion syndrome
e. [X] Metabolic acidosis
Which of the following changes can be present in lactic acidosis coma?
a. [X] increased lactic acid and pyruvic acid concentration
b. [ ] lowered concentration of pyruvic acid and lactic acid
c. [X] blood ph decreased
d. [ ] severely increased blood sugar
e. [X] moderately increased blood sugar
Trigger factors in the development of hypoglycemia are:
a. [X] excessive doses of insulin
b. [X] malabsorption
c. [ ] carbohydrate excess in food
d. [ ] exercise
e. [X] intercurrent infections
Which of these signs are caused by catecholamines in hypoglycemic coma?
a. [X] cold transpiration
b. [ ] apathy
c. [X] tremble
d. [ ] headache
e. [X] tachycardia
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60. Trigger factors in the development of diabetic ketoacidosis are:
a. [X] incorrect insulin treatment
b. [ ] malabsorption
c. [X] stopping insulin therapy
d. [X] intercurrent diseases, trauma and surgery
e. [ ] diet with low carbohydrate intake
61. Which of the following neuroglycopenic symptom occur in hypoglycemic coma?
a. [X] visual dereglation
b. [X] apathy
c. [X] behavioral disorders
d. [ ] hunger
e. [ ] nausea and vomiting
62. Which of the following factors may cause hyperosmolar coma, EXCEPT:
a. [ ] Uncontrolled administration of diuretics
b. [X] Biguanide administration
c. [ ] Combustion, vomiting, diarrhea
d. [X] High insulin doses administration
e. [X] Administration of GLP1 receptors agonist
63. Clinical signs that suggest hypoglycemic coma in unconscious patient ?
a. [X] pale, moist skin
b. [X] increased muscle tone
c. [ ] hypertension
d. [X] seizures
e. [ ] smell of acetone
64. What is required to establish the ketoacidosis triad?
a. [ ] leukocytosis
b. [X] ketones
c. [X] marked hyperglycemia
d. [ ] the presence of fever
e. [X] reduced blood pH
65. Hyperosmolar coma treatment includes the following:
a. [X] sol 0.45% NaCl
b. [X] potassium chloride
c. [X] insulin
d. [ ] hypertonic solutions
e. [ ] sodium bicarbonate
66. Lactic acidosis coma therapy is following the next objectives, EXCEPT:
a. [ ] correction of acidosis
b. [ ] combat shock and hypoxia
c. [X] prevent hypoglycaemia
d. [X] dehydration treatment
e. [X] diuretics
67. Optimal distribution of micronutrients in the diet of a diabetic is:
a. [ ] carbohydrates 30%
b. [X] proteins 12-15%
c. [ ] lipids 10%
d. [X] carbohydrates 50-60%
e. [X] fats 25-30%
68. Which treatment may be used in the case of Charcot arthropathy?
a. [X] limb immobilization in the acute phase
b. [X] bisphosphonate therapy
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69.

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c. [ ] analgesic therapy
d. [X] surgical treatment in the acute phase
e. [X] orthopedic correction in chronic stages
What are the principles of basal-bolus insulin therapy regime?
a. [X] administration of long acting insulin imitating basal insulin secretion
b. [ ] administration of rapid insulin after meals
c. [X] administration of rapid insulin to correct postprandial hyperglycaemia
d. [ ] administration of long acting insulin in the morning and fast insulin in evening
e. [X] coresponds to long acting insulin and to short acting
What are the indications for insulin treatment?
a. [X] type 1 diabetes
b. [X] type 2 diabetes with purulent processes
c. [X] type 2 diabetes during surgery
d. [ ] type 2 diabetes primarily found, with blood glucose lower than 9 mmol / l
e. [ ] type 2 diabetes in obese
What side effects are specific for inhibitors of alpha glucosidase?
a. [X] intestinal disorders (bloating, diarrhea)
b. [X] increase in transaminases
c. [X] decreases serum Fe
d. [ ] hypoglycemia
e. [ ] hypertension
What cases are absolute indications for insulin treatment?
a. [X] hyperosmolar coma at people with type 2 diabetes
b. [ ] mild form of type 2 diabetes
c. [X] ketoacidotic coma
d. [X] massive surgery in patients with type 2 diabetes
e. [ ] steroid diabetes
Mark the cells constituting the islets of Langerhans:
a. [X] cells - secrete glucagon
b. [X] cells - insulin secretion
c. [ ] chromaffin cells
d. [X] cells - secrete somatostatin
e. [X] PP cells - secrete pancreatic polypeptide
Which hormones are secreted by Langerhans islets?
a. [X] glucagon
b. [X] insulin
c. [ ] somatotrope
d. [X] somatostatin
e. [X] pancreatic polypeptide
Immunological markers involved in type 1 diabetes:
a. [X] Anti-ICA
b. [X] Anti - GAD
c. [X] Anti - IAA
d. [ ] Anti-insulin receptor
e. [X] Anti-IA2
Which of the following clinical signs are part of the major signs of diabetes:
a. [X] polyuria
b. [X] polydipsia
c. [ ] furunculosis
d. [X] polyfagia
e. [X] weight loss
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77. What are the main changes of the heart in diabetes?
a. [X] coronary microangiopathy
b. [X] microangiopathy
c. [X] autonomic cardiac neuropathy
d. [X] dysmetabolic cardiomyopathy
e. [ ] central neuropathy
78. What are the diagnostic criteria for diabetes?
a. [X] fasting blood glucose higher than 7,0 mmol / l
b. [X] blood glucose OGTT after 2 hours more than 11,1 mmol / l
c. [ ] fasting blood glucose higher than 6,1 mmol / l
d. [X] HbA1c highter than 6,5%
e. [X] hyperglycemia signs are present and random blood glucose is higher than 11,1 mmol/l
79. Which of these syndromes are present in hyperosmolar coma?
a. [X] sindrome of marked hyperglycemia above 30 mmol / l
b. [X] neurological syndrome
c. [X] dehydration syndrome
d. [X] hypercoagulation syndrome
e. [ ] hypertensive syndrome
80. Which of the following clinical manifestations may occur in lactic acidosis coma?
a. [X] muscle pain
b. [X] digestive disorders
c. [X] hypotension and collapse
d. [X] hyperventilation and acetone odor
e. [ ] oliguria
81. Wich laboratory indicators require monitoring in treatment of diabetic ketoacidosis coma?
a. [X] glycaemic
b. [X] acid-base balance
c. [X] ionogram: K, Na
d. [ ] cholesterol level
e. [X] ketone bodies in urine and blood
82. Which of the following symptoms are present in ketoacidotic coma?
a. [X] dry skin and mucous membranes
b. [X] acetone smelling breath
c. [X] tachycardia
d. [X] Kussmaul breathing
e. [ ] clammy skin
83. Which dietary recommendations are for people with diabetes?
a. [X] 50-60% carbohydrate, 12-15% protein, 25-30% fat
b. [X] dietary fiber 30-40gr/day
c. [X] hypocaloric diet for obese people
d. [ ] complete exclusion of salt
e. [X] reducing salt intake to 7 gr/day
84. What methods are used in the treatment of type 2 diabetes?
a. [X] monotherapy with diet
b. [X] diet + oral hypoglycaemic agents
c. [X] insulin + Diet
d. [ ] only insulin
e. [X] diet + oral hypoglycaemic agents + insulin
85. The basic components in the treatment of diabetic ketoacidosis are:
a. [X] fighting dehydration and restoring electrolyte balance
b. [X] curing insulin deficiency
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86.

87.

88.

89.

90.

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c. [X] curing acidosis

d. [X] treatment of concomitant conditions and pathologies
e. [ ] hypotensive therapy
What statements correspond to the effects of metformin?
a. [X] inhibits hepatic gluconeogenesis
b. [X] reduces glucose absorption in the gastrointestinal tract
c. [X] increases anaerobic glycolysis
d. [ ] stimulates insulin secretion
e. [X] determines weight loss
What are the effects of sulfonylureas?
a. [X] stimulate insulin secretion
b. [ ] decrease glucose uptake in the intestine
c. [X] inhibit pancreatic alpha cells
d. [ ] posses trophic action on beta cells
e. [X] increase beta cell sensitivity to hyperglycaemia
Which are the situations when Metformin is NOT indicated?
a. [X] pregnancy and lactation
b. [X] severe hepatopathy
c. [X] severe renal pathology
d. [X] body mass deficit
e. [ ] obese type 2 diabetes
What are the contraindications for administration of sulfonylureas?
a. [X] ketoacidosis
b. [X] type 1 Diabetes
c. [X] pregnancy
d. [X] liver disease
e. [ ] type 2 diabetes, medium form with deficient insulin secretion
What are the side effects of sulfonylureas?
a. [X] hypoglycaemia
b. [ ] lactic acidosis
c. [X] weight gain
d. [ ] liver injury
e. [X] antabuse reaction
What are the effects of antithyroid drugs:
a. [X] Inhibition of thyroglobulin synthesis
b. [X] Inhibition of iodine organification
c. [X] Inhibition of iodine tyrosine coupling
d. [ ] Blocking of tissue receptors
e. [X] Blocking of thyroid hormone secretion
Excessive thyroid hormones secretion in Grave's disease causes:
a. [X] Glycolysis
b. [ ] Protein anabolism
c. [X] Lipolysis
d. [ ] Decreased thermogenesis
e. [ ] Reduced transformation of carotene to vitamin A
The skin in Grave's disease is:
a. [ ] Pale, with hyperkeratosis
b. [ ] Delicate, cold
c. [ ] Dry, with desquamation
d. [X] Warm, velvet like
e. [X] Warm, moist
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94. Grave's disease is associated with the following:
a. [ ] Positive Chvostek sign
b. [ ] Positive Herthoge sign
c. [X] Pretibial myxoedema
d. [X] Endocrine ophthalmopathy
e. [ ] "Fool moon"facies
95. Which of the following statements about Grave's disease are true?
a. [X] It is an autoimmune disorder
b. [ ] Is a thyroid functional autonomy
c. [X] It is a pathology with hereditary predisposition
d. [ ] It is determined by a marked increase in TSH
e. [ ] It is frequently associated with type 2 diabetes
96. Which of the following are present in Grave's disease ?
a. [X] Low TSH
b. [ ] Low radioiodine uptake
c. [ ] Hard, painful goitre
d. [X] Raised T3 and T4
e. [ ] Presence of TSH receptor blocking antibodies
97. For mild (grade I) thyrotoxicosis are characteristic:
a. [ ] The thyroid gland is of grade I - II enlargement
b. [ ] Pulse 70-80 beats / minute
c. [ ] The thyroid gland is of grade III-IV enlargement
d. [X] Pulse 90-100 beats / minute
e. [X] Clinical picture with subtle symptoms
98. For grade II of thyrotoxicosis are characteristic:
a. [X] Suggestive clinical signs
b. [X] Pulse 100-120 beats / minute
c. [X] Proptosis + 5 mm
d. [ ] The thyroid gland is of grade II-III enlargement
e. [ ] Weight gain of 5%
99. For severe (grade III) thyrotoxicosis are characteristic:
a. [X] Heart rate over 120 beats / minute
b. [X] Atrial fibrillation
c. [ ] Grade IV-V thyroid gland enlargement
d. [ ] Other organs are not affected
e. [ ] Painful thyroid at palpation
100. The medical treatment of Grave's disease consists of the following drugs:
a. [ ] Biguanides
b. [X] Imidazole derivatives
c. [ ] Sulfonylureas
d. [X] Beta-blockers
e. [ ] Amiodarone
101. The following statements about antithyroid therapy in Grave's disease are true:
a. [ ] It is administered in high doses for a 6 months period
b. [X] Treatment is started with high doses
c. [ ] It is contraindicated in children and adolescents
d. [ ] The therapy is discontinued after a euthyroid state is achieved
e. [X] Long-term low dose therapy is administered for 1.5 - 2 years
102. Contraindications for radioiodine therapy in Grave's disease are:
a. [ ] Relapsed hyperthyroidism after partial thyroidectomy
b. [X] Children, adolescents, reproductive age
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c. [ ] Inefficiency of medical treatment
d. [X] Pregnancy, lactation
e. [ ] Hyperthyroidism with progressive endocrine ophthalmopathy
103. The following statements about the treatment of Grave's disease with radioiodine are true:
a. [X] Partial destruction of the thyroid tissue occurs
b. [ ] It is contraindicated in the elderly
c. [ ] It is indicated for the retrosternal goitre treatment
d. [X] It is is indicated in the hyperthyroidism with progressive ophthalmopathy
e. [ ] It is indicated for the treament of the mild form of diffuse toxic goitre
104. Which statements are true regarding thyroid toxic adenoma:
a. [ ] It is a "cold" thyroid nodule
b. [ ] It is the hyperplasia of a thyroid lobe
c. [X] It is a "hot" thyroid nodule
d. [ ] It is a TSH secreting adenoma
e. [X] It is a hyperfunctional autonomous thyroid adenoma
105. Differential diagnosis criteria of tireotoxic adenoma with Grave's disease are:
a. [ ] Serum level of T3 and T4
b. [ ] Serum level of TSH
c. [X] Thyroid scintigraphy
d. [ ] Radioiodine uptake
e. [X] Presence of ophthalmopathy and pretibial myxoedema
106. Treatment of endocrine ophthalmopathy includes the following:
a. [ ] NSAIDs
b. [X] Glucocorticoids
c. [ ] Beta-blockers
d. [ ] Potassium iodide
e. [X] Radiotherapy of the orbits
107. The side effects of the antithyroid drugs (Mercazolil) are:
a. [ ] Hyperthyroidism
b. [X] Gastrointestinal symptoms
c. [ ] Haemorrhage
d. [X] Leukopenia
e. [ ] Aphonia
108. Thyrotoxic syndrome occurs in the following conditions:
a. [X] Diffuse toxic goitre
b. [ ] Atrophic form of autoimmune thyroiditis
c. [X] Toxic multinodular goitre
d. [ ] Central Hypothyroidism
e. [ ] Riedel Thyroiditis
109. Antithyroid drugs are used to treat the following conditions:
a. [ ] Subacute thyroiditis
b. [ ] Acute thyroiditis
c. [ ] Endemic goiter
d. [X] Grave's disease
e. [X] Thyreotoxic adenoma
110. Contraindications for surgical treatment of Grave's disease are:
a. [ ] Thyroid larger than grade III
b. [ ] Suspicion of malignancy
c. [ ] Inefficient antithyroid drugs
d. [X] Decompensated severe thyrotoxicosis
e. [X] Progressive endocrine ophthalmopathy
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111. The 'hot' thyroid nodule at scintigraphy is detected in the following conditions:
a. [X] Toxic thyroid adenoma
b. [ ] Grave's disease
c. [ ] Autoimmune thyroiditis
d. [X] Multinodular goitre
e. [ ] Subacute thyroiditis
112. The clinical picture of the thyrotoxic crisis is dominated by the following symptoms:
a. [ ] Diffuse or local bone pain
b. [X] Exacerbation of neuropsychiatric disorders
c. [X] Increased cardiovascular events
d. [ ] Hypothermia
e. [ ] Painful muscle contractures
113. The following statements regarding endocrine ophthalmopathy are true:
a. [ ] At the basis of pathogenesis is increased secretion of T3 and T4
b. [X] It is an independent autoimmune disease
c. [ ] It is treated with imidazole derivatives
d. [X] May be associated with, anticipate or appear after Grave's disease has developped
e. [ ] It is often associated with a "hot"nodulein the thyroid gland
114. Graves-Basedow disease is characterized by:
a. [X] Thyrotoxic syndrome +goitre + endocrine ophthalmopathy
b. [ ] Goitre + excess TSH + thyrotoxic syndrome
c. [X] Thyroid-stimulating antibodies + endocrine ophthalmopathy+ goitre
d. [X] goitre + pretibial myxoedema + thyreotoxic syndrome+ endocrine ophthalmopathy
e. [ ] Thyreotoxic syndrome + goitre + lipoid necrobiosis
115. The following cardiovascular disorders are characteristic for Grave's disease:
a. [X] Atrial fibrillation
b. [X] Sinus tachycardia
c. [ ] Increased pulsatile pressure
d. [X] Decreased systolic pressure
e. [ ] Atrioventricular block
116. In Grave's disease:
a. [X] Heart sounds are loud, increased pulsatile pressure
b. [ ] Heart sounds are faint, increased systolic pressure
c. [ ] Increased systolic and diastolic pressure
d. [X] Decreased diastolic pressure, loud heart sounds
e. [X] Accelerated heart sounds, increased systolic pressure
117. The following endocrine disorders are seen in Grave's disease:
a. [ ] Hypoglycemia
b. [X] Adrenal insufficiency
c. [ ] Metrorrhagia
d. [X] Hyperglycemia
e. [X] Amenorrhea
118. Unlike Grave's disease in neurocirculatory dystonia we have:
a. [ ] Subfebrility
b. [ ] Fine, uniform tremor of fingers
c. [X] Cold, dry skin
d. [X] Intermitent tachycardia if nervous
e. [X] Local Sweating
119. The adverse effects of antithyroid drugs are:
a. [X] Leukopenia, agranulocytosis, thrombocytopenic purpura
b. [ ] Weight Loss
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c. [X] Digestive symptoms
d. [X] Rash
e. [ ] Cardiotoxicity
120. Preparation for surgery in Grave's disease includes the following:
a. [X] Achieving euthyroidism
b. [ ] Administration of I131
c. [X] Decreasing the volume of goitre
d. [X] Administration of corticosteroids in severe cases
e. [ ] Administration of antithyroid drugs
121. Unlike Grave's disease, tuberculosis records:
a. [ ] Normal pulmonary radiological picture
b. [X] Evening rise of temperature
c. [X] Mantoux positive reaction
d. [ ] Positive Marie sign
e. [X] Normal T3, T4, TSH
122. Treatment of endocrine ophthalmopathy includes the following:
a. [ ] Starting doses of prednisolone of 5-10 mg / day
b. [X] Radiation of orbits
c. [X] Starting doses of corticosteroids of 60-100 mg / day
d. [ ] Partial thyroidectomy
e. [X] Diuretics
123. Which of the following factors trigger the thyrotoxic crisis?
a. [ ] Surgery without achieving a euthyroid state
b. [X] Late diagnosis of the disease
c. [ ] Uncontrolled calcium antagonists therapy
d. [X] Intercurrentinfections
e. [X] Exposure to cold
124. Treatment of thyrotoxic adenoma includes the following:
a. [X] Enucleation of the nodule
b. [X] Radioiodine therapy
c. [X] Achievement of a euthyroid state using antithyroid drugs and beta-blockers
d. [ ] Chemotherapy
e. [ ] Cervical irradiation
125. In what situations will occur low TSH level and increased level of T3 and T4:
a. [X] Grave's disease
b. [X] Thyreotoxic adenoma
c. [X] Thyreotoxic phase of subacute thyroiditis
d. [ ] Primary hypothyroidism
e. [ ] Fibrous thyroiditis
126. Treatment of thyrotoxic crisis includes the following remedies:
a. [X] High dose antithyroid drugs
b. [X] Lugol solution
c. [ ] Thyroidectomy
d. [ ] Low dose I 131 administration
e. [X] Glucocorticoids
127. Endocrine ophthalmopathy treatment includes the following:
a. [ ] Partial thyroidectomy
b. [X] Treatment for dehydration with diuretics
c. [X] Glucocorticoids
d. [ ] Treatment with I131
e. [X] Radiation of orbits
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128. Which statements concerning toxic thyroid adenoma are true?
a. [ ] It is often associated with endocrine ophthalmopathy
b. [X] Severe impairment of the cardiovascular system
c. [ ] It is associated with pretibial myxoedema
d. [X] Thyroid scintigraphy reveals a hot nodule
e. [X] The lab exam shows low TSH
129. For toxic thyroid adenoma are characteristic:
a. [X] Clinical manifestations of thyrotoxicosis
b. [ ] Secondary hypothyroidism
c. [ ] At palpation - painful, fluctuating thyroid nodule
d. [X] Thyroid hormone secretion is independent of TSH
e. [X] The treatment is usually surgical
130. TSH is decreased in the following thyroid diseases:
a) [X] Grave's disease
b) [X] Secondary hypothyroidism
c) [ ] Endemic goitre
d) [X] Toxic thyroid adenoma
e) [ ] Hypothyroid phase of subacute thyroiditis
131. Which of the following mechanisms are involved in the pathogenesis of thyrotoxic crisis?
a. [X] An important increase in thyroid hormones
b. [ ] Decreased serum calcium with neuromuscular hyperexcitability
c. [ ] Overexcited simpato-adrenal system
d. [X] Relative corticoadrenal insufficiency
e. [X] Insufficiency of adrenal medulla
132. Which of the following thyroid diseases evolves with thyrotoxicosis?
a. [X] Toxic thyroid adenoma
b. [X] Grave's disease
c. [X] Subacute thyroiditis
d. [ ] Autoimmune thyroiditis
e. [ ] Fibrous thyroiditis
133. The following eye signs are known:
a. [X] Deficit of convergence
b. [X] Rare blinking
c. [X] Exaggerated eye gloss
d. [X] Tremor of closed eyelids
e. [ ] Exophthalmia
134. Which of the following changes occur in the immune system in Grave's disease?
a. [ ] Lack of T-helper lymphocytes
b. [X] Lack of T-suppressor lymphocytes
c. [X] Stimulation of B lymphocytes with production of specific antibodies
d. [X] Presence of thyroid stimulating immunoglobulins
e. [X] Presence of TSH receptor stimulating antibodies
135. Which of the following clinical manifestations are characteristic for Grave's disease?
a. [X] Fine tremor of extremities
b. [X] Subfebrility
c. [ ] Cold intolerance
d. [X] Weight loss
e. [X] Fatigue
136. Which of the following clinical manifestations are characteristic for Grave's disease?
a. [X] Tachycardia
b. [X] Irritability
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c. [ ] Constipation
d. [X] Increased appetite
e. [ ] Termophobia
137. Which of the following metabolic modifications are characteristic for Grave's disease?
a. [X] Increased protein catabolism
b. [ ] Decreased lipolysis
c. [X] Increased glycolysis
d. [X] Increased glycogenolysis
e. [ ] Intensification of thermogenesis
138. Which of these bone and muscle changes are characteristic for Grave's disease?
a. [ ] Osteoporosis
b. [ ] Tetany crisis
c. [X] Periodic paralysis
d. [ ] Increase of bone resorbtion
e. [X] Muscle weakness and wasting
139. Which of the following statements on endocrine ophthalmopathy are correct?
a. [X] It is determined by the action of antibodies towards the retrobulbar tissue
b. [X] It is an autoimmune disorder
c. [X] It is a clinical manifestation of thyrotoxicosis
d. [X] The severe form occurs more frequently in men
e. [ ] It is characterized by proptosis
140. Which of the following cardiovascular effects are characteristic for thyrotoxicosis?
a. [X] Increased cardiac output
b. [X] Increased systolic blood pressure
c. [X] Tachyarrhythmias
d. [X] Increased pulsatile blood pressure
e. [ ] Increased diastolic blood pressure
141. Which statements regarding antithyroid drugs are true?
a. [X] Inhibit thyroid hormones synthesis
b. [X] Treatment duration is prolonged (18-24 months)
c. [X] May cause leukopenia, agranulocytosis
d. [X] Treatment is started at high doses
e. [ ] Are contraindicated in children and adolescents
142. What are the complications of radioiodine therapy?
a. [ ] Thyreotoxic crisis
b. [ ] Transient hypothyroidism
c. [ ] Radiation thyroiditis
d. [ ] Aphonia
e. [X] Permanent hypothyroidism
143. What are the indications for surgical treatment of Grave's disease?
a. [X] Third degree and more of thyroid enlargement
b. [X] Suspicion of malignancy
c. [X] Poor compliance to medical treatment
d. [X] Pregnancy in 2nd-3d trimester
e. [ ] Late diagnosis of Grave's disease
144. Which of the following criteria are informative for the differential diagnosis of Grave's disease and
thyreotoxic adenoma?
a. [ ] Syndrome of thyrotoxicosis
b. [X] Presence of thyroid stimulating immunoglobulins
c. [X] Presence of ophthalmopathy
d. [X] Presence of pretibial myxoedema
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e. [X] "Hot"nodule at thyroid scintigraphy
145. Which of the following clinical signs are characteristic for the thyrotoxic crisis?
a. [X] Alteration in mental status
b. [X] High fever (41-42)
c. [X] Digestive disorders
d. [ ] Bronchospasm
e. [X] Tachycardia, atrial fibrillation
146. What are the indications for surgical treatment of Grave's disease?
a. [X] Patients with poor compliance to medical treatment
b. [X] Inefficiency of medication
c. [X] Adverse reactions to antithyroid drugs
d. [X] Women who are breastfeeding
e. [ ] Hyperthyroidism with progressive endocrine ophthalmopathy
147. The following drugs are used in the treatment of subacute thyroiditis:
a. [ ] Antithyroid drugs
b. [ ] Radioiodine
c. [X] NSAIDs
d. [ ] Dopamine agonists
e. [X] Glucocorticoids
148. The clinical signs that characterize subacute thyroiditis are:
a. [ ] Dysphonia
b. [X] Low-grade fever or fever
c. [ ] Ophthalmopathy
d. [X] Local pain with irradiation
e. [ ] Dyspnea
149. Laboratory tests show the following changes in subacute thyroiditis:
a. [X] Accelerated ESR
b. [ ] Anemia
c. [ ] Monocytosis
d. [X] Leucocytosis
e. [ ] Eosinophilia
150. The following investigations are important for the diagnosis of autoimmune thyroiditis:
a. [ ] Thyroid scintigraphy
b. [X] Determination of T3, T4, TSH
c. [ ] Test with TSH
d. [ ] Determination of urinary iodine
e. [X] Determination of antithyroid antibodies (antithyroperoxidase, anti-thyroglobulin)
151. Goitre in fibrous thyroiditis (Riedel) has the following characteristics:
a. [ ] It is diffusely enlarged, painful
b. [X] Extensive fibrosis of the thyroid
c. [ ] Has an elastic consistency
d. [X] Has a hard, woody consistency
e. [ ] The thyroid gland is not palpable
152. Clinical features of subacute thyroiditis are:
a. [ ] Fluctuation at palpation of the thyroid
b. [X] Low-grade fever or fever
c. [X] Local pain or with irradiation
d. [ ] Galactorrhoea
e. [X] Compression phenomena
153. The following statements regarding acute thyroiditis are true:
a. [X] It is caused by microbial flora
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b. [ ] Follows several viral infections
c. [X] Routine haematology indicates leukocytosis and accelerated ESR
d. [ ] The thyroid gland has a woody consistency
e. [ ] It is characterized by hypothermia
154. The following statements regarding the treatment of severe forms of subacute thyroiditis are true:
a. [ ] Are treated only with NSAIDs
b. [X] Are treated with glucocorticoids
c. [ ] Are treated surgically
d. [X] Duration of treatment is 1 - 1.5 months
e. [ ] Are treated with antithyroid drugs
155. The following statements regarding subacute thyroiditis are true:
a. [X] T3 and T4 increase at the onset of the disease
b. [ ] It is not treated with antibiotics
c. [X] Routine haematology indicates accelerated ESR
d. [ ] It is a disease caused by microbial flora
e. [ ] Increased radioiodine uptake
156. The treatment of subacute thyroiditis includes the following:
a. [ ] Thyroid irradiation
b. [X] Glucocorticoids
c. [ ] Treatment with radioactive iodine I131
d. [X] NSAIDs
e. [ ] Antithyroid drugs
157. Group prophylaxis of endemic goitre consists of:
a. [X] Administration of iodine to pregnant women
b. [ ] Use of iodized salt
c. [ ] Iodination of bakery products
d. [X] Administration of iodine preparations in schools
e. [ ] Administration of L-thyroxine
158. Endemic goitre prophylaxis includes the following:
a. [X] Mass prophylaxis withpotassium iodine
b. [X] Mass prophylaxis with iodized salt
c. [ ] Administration of low-dose I131
d. [ ] Administration of potassium perchlorate
e. [X] Iodination of bakery products
159. In excesive concentrations, thyroid hormones have the following effects:
a. [X] Intensify lipolysis
b. [X] Intensify protein catabolism
c. [X] Increase calorygenesis
d. [ ] Reduce glycogenolysis
e. [ ] Reduce energy formation
160. In excessive concentrations, thyroid hormones have the following effects with a few EXCEPTIONS:
a. [ ] Intensify lipolysis
b. [X] Decrease glycolysis
c. [ ] Increase the processes of oxidation, oxidative phosphorylation and accumulation of energy
d. [X] Decrease calorigenesis
e. [ ] Lower cholesterol
161. The following statements on thyroid hormones are true:
a. [X] T3 is 4 times more active than T4
b. [ ] T4 is the activehormone
c. [X] of T3 comes from peripheral conversion of T4
d. [ ] T4 plasma concentration is lower than T3
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e. [X] T4 half-life is 7-8 days
162. In which of the following situations there will be low TSH level and increased levels of T3 and T4:
a. [X] Grave's disease
b. [X] Toxic thyroid adenoma
c. [ ] Thyreotoxic phase of subacute thyroiditis
d. [ ] Primary hypothyroidism
e. [ ] Fibrous thyroiditis
163. Which of these effects are specific for thyroid hormones?
a. [X] Growth, development and maturation of nerve tissue
b. [X] Stimulation of protein synthesis
c. [X] Favor conversion of carotene to vitamin A
d. [X] Calorigenic effect
e. [ ] Increase of circulating cholesterol
164. Central hypothyroidism is characterized by the following:
a. [X] Absent or slightly pronounced oedema
b. [ ] Increased T3, T4
c. [ ] Intense uptake at thyroid scintigraphy
d. [ ] TSH test - negative
e. [X] Low TSH
165. The medication used in the treatment of hypothyroidism:
a. [X] L-thyroxine
b. [ ] Mercazolil
c. [X] Combination T4 - T3 therapy
d. [ ] NSAIDs
e. [ ] Antibiotics
166. Cardiovascular changes in hypothyroidism are:
a. [ ] Tachycardia
b. [ ] Atrial fibrillation
c. [ ] Increased pulsatilepressure
d. [X] Bradycardia
e. [X] Enlarged heart
167. The clinical picture of mixoedema coma is manifested by:
a. [ ] Psychomotor agitation
b. [X] Progressive asthenia, hypothermia
c. [X] Stupor, hypoventilation
d. [ ] Painful muscle contractures
e. [ ] Systolic hypertension
168. The causes of central hypothyroidism are:
a. [ ] Thyroidectomy
b. [ ] Thyroid agenesis
c. [X] Pituitary tumors
d. [ ] Iodine deficiency
e. [X] Neuroinfections
169. The causes of primary hypothyroidism are:
a. [X] Treatment with antithyroid drugs
b. [ ] Traumatic head injury
c. [ ] Neuroinfections
d. [X] Thyroiditis
e. [ ] Hypothalamic and pituitary tumors
170. The following symptoms are characteristic for hypothyroidism:
a. [X] Thickened, dry skin
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b. [ ] Tachycardia
c. [X] Weight gain
d. [ ] Low cholesterol
e. [ ] Diarrhea
171. Treatment of mixoedema coma includes the following drugs:
a. [X] Thyroid hormones
b. [ ] Mercazolil
c. [X] Hydrocortisone succinate
d. [ ] Beta-blockers
e. [ ] Calcium medication
172. Primary hypothyroidism is characterized by the following symptoms:
a. [X] Weight gain
b. [ ] Tachycardia
c. [ ] Diarrhea
d. [X] Thickened, dry skin
e. [X] Hoarse voice
173. The following clinical signs are characteristic for hypothyroidism:
a. [X] Pale skin, swollen eyelids
b. [ ] Pretibial myxoedema
c. [X] Constipation
d. [ ] Hyperpigmentation of the skin
e. [X] Dry, rough, fragile hair
174. Which of these skin changes are present in primary hypothyroidism?
a. [X] Pale-yellow color
b. [ ] Thin
c. [X] Thickened
d. [X] Dry
e. [X] Hyperkeratosis
175. Which of the following cardiovascular disorders are characteristic for hypothyroidism?
a. [X] Enlarged heart
b. [X] Bradycardia
c. [X] Decreased contractility of the myocardium
d. [X] Decreased blood circulation velocity
e. [ ] Tachycardia
176. Which of the following clinical manifestations are characteristic for hypothyroidism?
a. [X] Constipation
b. [ ] Loud heart sounds
c. [X] Decreased glomerular filtration
d. [X] Macroglossia
e. [X] Hypoacidity
177. Which of the following nervous system disorders are characteristic for hypothyroidism?
a. [ ] Accentuated reflexes
b. [X] Slowing of intellectual and motor activities
c. [X] Apathy
d. [X] Decreased memory
e. [X] Somnolence
178. Which of the following signs are characteristic for congenital hypothyroidism?
a. [X] Intellectual deficit up to cretinism
b. [X] Dismorfic dwarfism
c. [X] Yellow skin
d. [ ] Low body weight
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e. [X] Delay of sexual maturation
179. Which of the following hormones are secreted predominantly by eosinophils of pituitary gland?
a. [X] STH
b. [ ] ACTH
c. [X] Prolactin
d. [ ] FSH, LH
e. [ ] TSH
180. What are the places of vazopresine and oxytocin synthesis?
a. [X] supraoptic nucleus
b. [ ] neurohipophysis
c. [ ] intermediate lobe of the pituitary
d. [X] paraventricular nucleus
e. [ ] ventrolateral nucleus
181. Which of the following factors participate in the regulation of vasopressin secretion?
a. [ ] concentration of Na
b. [ ] simpato-adrenal activity
c. [ ] the blood volume circulation
d. [X] osmotic pressure
e. [X] glomerular filtration
182. Which of the following characterisctics are specific for nephrogenic diabetes insipidus?
a. [X] sudden onset
b. [ ] primary deficit of K
c. [ ] low renal response to ADH
d. [X] low DHA
e. [ ] hypocalcemia
183. Which of the following pathologies can differentiated with vasopressin test?
a. [X] psychogenic polydipsia and central diabetes insipidus
b. [ ] renal insuficiency (Phase polyuria) and nephrogenic diabetes insipidus
c. [X] central diabetes insipidus and nephrogenic diabetes insipidus
d. [ ] nephrogenic diabetes insipidus and polyuria of hyperparathyroidism
e. [ ] polyuria of nephrogenic diabetes insipidus and primary aldosteronism
184. Which of the following effects of excess STH are dependent on somatomedin?
a. [X] Increase in cartilage and bone
b. [ ] Increased insulin resistance of tissues
c. [X] Increase in muscle mass
d. [ ] Lipolysis is increased
e. [ ] Hyperglycemia
185. Which of the following simptoms are specific for acromegaly?
a. [ ] teguments thin, dry
b. [X] thick hair
c. [ ] hypotension, tachycardia
d. [ ] narrow chest
e. [X] proeminance of eyebrow arches
186. Which of the following simptoms are specific for gigantism?
a. [ ] early puberty
b. [ ] visceromegalia
c. [X] external genitalia hypertrophy
d. [ ] mandibular retrognatism
e. [X] increases skeleton proportionally
187. Which of the following statements are true about pure pituitary dwarfism?
a. [X] the child is born with small weight and size
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b. [ ] associated with many serious somatic malformations
c. [ ] growth slowing is remarkable, usually after the age of 2-3 years
d. [ ] early closure of growth cartilage
e. [X] mandible remains undeveloped
188. Which of the following characters are specific for hypothyroidian dwarfism?
a. [X] " disharmonic dwarf "
b. [ ] normal intellectual development
c. [ ] teguments thin, fine
d. [X] newborns overweight, hypothermic
e. [ ] bone age equals chronological age
189. Which of the following symptoms are specific for empty Turkish saddle syndrome?
a. [ ] cachexia
b. [ ] hirsutism
c. [X] vision problems, runny nose
d. [ ] exophthalmia
e. [X] diaphragmatic defect of saddle
190. Which of the following signs may appear in Nelson syndrome?
a. [X] hyperpigmentation
b. [X] hypertensive crisis
c. [X] pituitary tumor syndrome
d. [ ] low levels of ACTH
e. [ ] elevated urinary 17 ketosteroids
191. Which of these effects are stimulated by ACTH?
a. [ ] morphogenesis of glomerular area
b. [X] skin pigmentation
c. [ ] hypertrophy and hyperplasia of the adrenal medulla
d. [X] hypertrophy, hyperplasia and hyperfunction of fascicular and reticular area
e. [ ] entire adrenal hypertrophy and hyperplasia
192. Which of these effects are directly stimulated by ACTH?
a. [ ] secretion of catecholamines
b. [ ] liposynthesis
c. [X] skin pigmentation
d. [ ] muscular atrophy
e. [X] lipolysis
193. Which of these effects are stimulated by FSH?
a. [X] spermatogenesis
b. [ ] corpus luteum formation
c. [ ] testosterone synthesis
d. [X] Sertoli cells
e. [ ] progesterone synthesis
194. Which of the following pituitary tumors are mostly non-secretory?
a. [ ] basophilic
b. [X] chromophobe
c. [X] craniopharyngioma
d. [ ] acidophilic
e. [ ] mixed
195. Which of the following effects can be caused by a pituitary adenoma with suprasellar expansion?
a. [X] Diabetes insipidus
b. [ ] nasal liquorrhea
c. [ ] epistaxis
d. [ ] unilateral protrusion
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e. [X] bitemporal hemianopsia
196. In which of the following situations can galactorrhea appear?
a. [X] primary hypothyroidism
b. [ ] hypertension
c. [ ] hyperglycemia
d. [X] eosinophilic pituitary adenoma
e. [ ] Sheehan syndrome
197. Which of the following medicines may cause galactorrhea?
a. [ ] Bromocriptine
b. [ ] Pyridoxine
c. [X] Metoclorpramide
d. [ ] Cabergoline
e. [X] Oral contraceptives
198. Which of the following clinical signs may be present in hyperprolactinemic syndrome?
a. [ ] centripetal obesity
b. [ ] bilateral protrusion
c. [X] amenorrhea
d. [ ] subsidence of the vertebrae
e. [X] hirsutism, acne
199. Which of the following clinical signs may be present in Sheehan's syndrome?
a. [X] axilo-pubic hair loss
b. [ ] persistent galactorrhea
c. [X] amenorrhea with phenomenae of desexualization
d. [ ] melasma
e. [ ] muscle hypertrophy
200. Which of the following associations may be used to treat Sheehan syndrome for a 25 years old woman?
a. [ ] Clomiphene citrate, progestin
b. [X] estrogen - progestin
c. [ ] Adiuretine, bromocriptine
d. [ ] Gonadoliberines given in pulses, aldosterone
e. [X] thyroid hormones, glucocorticoids
201. Which of the following will be used in hormone replacement therapy in panhypopituitarism for a 55
years old woman?
a. [ ] Gonadotropin
b. [ ] Mineralocorticoids
c. [X] Glucocorticoids
d. [X] Thyroid hormones
e. [ ] Estrogen-progestin
202. Which of the following results of fluid restriction test confirm the diagnosis diabetes insipidus?
a. [X] increased hematocrit
b. [ ] decreased plasma osmolarity
c. [ ] increased osmolarity of the urine
d. [X] low density of the urine
e. [ ] lean body mass changes
203. Which of the following are synonyms for adiposo-genital syndrome?
a. [ ] adreno-genital syndrome
b. [X] Frohlich-Babinschi syndrome
c. [ ] Parhon syndrome
d. [X] adiposo-genital dystrophy
e. [ ] Simmonds syndrome
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204. Which of the following are specific for adiposo-genital dystrophy?
a. [ ] sindactily, polydactyly
b. [ ] primary hypogonadism
c. [X] obesity, pseudoginecomastia
d. [ ] retinitis pigmentosa
e. [X] central hypogonadism, cryptorchidism
205. Which of the following statements are true for Cushing's disease?
a. [X] is the clinical manifestation of excessive secretion of ACTH
b. [ ] is the clinical manifestation of eosinophilic pituitary adenoma
c. [ ] ethiopathology is adrenocortical adenoma
d. [X] a pathology of hypothalamic pituitary system
e. [ ] is the clinical manifestation of adrenal adenoma
206. Which of the following are characteristic for obesity in Cushing?
a. [ ] uniform on the trunk and limbs
b. [ ] mainly in upper limbs
c. [X] Facio - truncular, centripetal
d. [ ] mostly buttocks and legs
e. [X] "buffalo hump"
207. Which of these syndromes may be present in Cushing's disease?
a. [ ] hypoglycemia
b. [X] secondary immunodeficiency
c. [ ] adreno - genital syndrome
d. [X] virile syndrome
e. [ ] hypotension
208. Which of the following conditions may be present in craniopharyngioma?
a. [ ] hyperhidropexic syndrome
b. [ ] early puberty
c. [X] bilateral hemianopsia
d. [ ] diabetes
e. [X] sexual retardation
209. According to tinctorial properties, in the adenohypophysis there are the following cells:
a. [X] acidophil
b. [ ] chromaffin
c. [X] basophils
d. [X] chromophobe
e. [ ] C -cells
210. What are the mechanisms of regulation in the endocrine system?
a. [ ] limphogen
b. [X] the "feed back"
c. [X] the biorhythm
d. [ ] myogenic
e. [X] neurogenic
211. Which of the following liberins are produced in the hypothalamus?
a. [X] Gonadoliberine
b. [ ] Vasoliberine
c. [X] Tiroliberine
d. [X] Somatoliberine
e. [ ] Oxitocin liberine
212. The following inhibitors of hypothalamic hormones are known:
a. [ ] Gonadostatine
b. [X] Prolactostatine
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c. [X] Somatostatin
d. [ ] Corticostatine
e. [X] Melanostatine
213. Which of these effects are stimulated by luteinizing hormone?
a. [X] ovulation, formation of corpus luteum
b. [ ] follicle growth and maturation
c. [X] testosterone synthesis
d. [X] progesterone synthesis
e. [ ] spermatogenesis
214. Which of the following are developmental stages of a pituitary tumor?
a. [ ] Transsphenoidal
b. [ ] Retrochiasmal
c. [X] Intrahypophiseal
d. [X] Intrasellar
e. [X] Invasive
215. Which of the following signs are characteristic of acromegaly?
a. [X] thick, wet skin
b. [ ] disappearance of skin creases
c. [X] thick, coarse hair
d. [ ] facies of full moon
e. [X] proemination of zygomatic arches
216. Which of the following endocrine disorders may be present in acromegaly?
a. [X] galactorrhea
b. [X] diabetes
c. [ ] thyroid gland atrophy
d. [X] amenorrhea
e. [ ] frequent ketoacidotic coma
217. Which of the following means can be used in the treatment of acromegaly?
a. [X] transsphenoidal adenomectomy
b. [ ] radioiodtherapy
c. [X] transfrontal adenomectomy
d. [X] radiotherapy
e. [ ] adrenalectomy
218. Which of the following remedies can cause galactorrhea?
a. [ ] Thyroid hormones
b. [X] Estrogens
c. [ ] Bromocriptine
d. [X] Psychotropic
e. [X] Opioids
219. Which of the following changes occur in prolactinoma?
a. [X] hypothalamic pulsative secretion of gonadoliberine is altered
b. [ ] increased hypothalamic synthesis of prolactostatin
c. [X] decreased pituitary secretion of gonadotropins
d. [ ] inhibited adrenal steroidogenesis with pubio-axillary hair reduction
e. [X] inhibited gonadal steroidogenesis
220. Which of these means may be used in the treatment of prolactinoma?
a. [ ] sulfonylurea derivatives
b. [X] dopamine agonists
c. [X] transsphenoidal adenomectomy
d. [ ] oral contraceptives
e. [X] vitamin B6
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221. Which of the following clinical manifestations are characteristic for pituitary dwarfism?
a. [X] sexual retard
b. [X] acromicry, splanhnomicry
c. [ ] thyreotoxicosis
d. [X] juvenile skeletal characterstics
e. [ ] thick, wet teguments
222. Which of the following changes can be present in Sheehan's syndrome?
a. [X] postpartum agalactia
b. [X] secondary adrenocortical insufficiency
c. [ ] primary gonadal insufficiency
d. [X] secondary thyroid insufficiency
e. [ ] bitemporal hemianopsia
223. Which of the following remedies are used to treat adenohypophyseal insufficiency:
a. [ ] Bromocriptine
b. [X] Androgens
c. [X] Corticosteroids
d. [ ] Ketoconazole
e. [X] Estrogen - progestin
224. Which of the following are specific to diabetes insipidus?
a. [X] failure to issue, transport of ADH
b. [ ] impaired glucose tolerance
c. [X] polyuria, hypoizostenuria
d. [ ] hyperhydration
e. [X] polydipsia, aglycosuria
225. Adiposo-genital dystrophy can be determined by:
a. [ ] gonadal dysgenesis
b. [ ] cryptorchidism
c. [X] neuroinfections
d. [X] craniocerebral trauma
e. [X] intrauterine infections
226. Frohlih-Babinski Syndrome (adiposo-genital dystrophy) requires differential diagnosis with:
a. [ ] Sheehan Syndrome
b. [X] Prader-Willi Syndrome
c. [ ] Klinefelter's syndrome
d. [X] pubertal, juvenile basophilism
e. [X] constitutional, eating obesity
227. Which of the following remedies can be used to treat adiposo- genital syndrome?
a. [X] Testosterone after age 16 years
b. [ ] Estrogen-progestin after age 14 years
c. [X] Estrogens, progestins from age 10 years
d. [X] Chorionic gonadotropin
e. [ ] Testosterone at age 6 years
228. In Cushing's disease may be present the following metabolic disorders:
a. [X] retaining of Na and water
b. [ ] general lipogenesis
c. [X] protein catabolism
d. [ ] hypoglycemia
e. [X] hypokalemia
229. Which of the following symptoms may be present in Cushing's disease?
a. [ ] anacide gastritis
b. [X] nephrolithiasis
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c. [X] menstrual cycle disorders
d. [ ] pulsatile increased blood pressure
e. [X] gastrointestinal ulceration
230. Which of the following indices support the diagnosis of Cushing's disease?
a. [ ] phosphorus, kalium increased
b. [X] sodium, chlorine elevated
c. [ ] low cortisol
d. [X] 17 OH 17KS increased
e. [X] ACTH increased
231. Which of the following are specific to Nelson syndrome?
a. [X] primary adrenal insufficiency
b. [X] ACTH-secreting pituitary adenoma
c. [ ] skin depigmentation
d. [ ] adiposo-genital dystrophy
e. [X] occurs after bilateral adrenalectomy
232. Which of the following hormones are secreted by the pituitary basophil cells?
a. [X] LH
b. [ ] Prolactin
c. [X] FSH
d. [X] ACTH
e. [X] TSH
233. Which of the following factors stimulate the secretion of STH?
a. [X] Sleep, stress
b. [X] Exercise
c. [X] Hypoglycemia
d. [ ] Hyperglycemia
e. [X] Somatoliberin
234. Which of the following are specific to prolactin?
a. [X] Mamotropic
b. [X] Luteotrophic
c. [X] Lactotropic
d. [ ] Reduces glycaemia
e. [X] Decreases gonadotropins
235. Which of the following processes are inhibited by hyperprolactinemia?
a. [X] Spermatogenesis
b. [X] Synthesis of FSH
c. [X] Ovulation
d. [X] Synthesis of LH
e. [ ] Lactation
236. Which of the following factors stimulate the release of prolactin?
a. [ ] Hyperglycemia
b. [X] Exercise
c. [X] Sleep, nipple irritation
d. [X] Stress, intercostal neuralgia
e. [X] Intercourse, thoracic "herpes zoster"
237. Which of the following causes may be presented in acromegaly?
a. [X] vision changes
b. [X] menstrual cycle disorder
c. [ ] hyperpigmentation, hypoglycemia
d. [X] headache, osteo-articular pain
e. [X] changes in the exterior
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238. In an advanced stage of acromegaly may be present:
a. [X] insulin resistant diabetes
b. [X] galactorrhea, hypothyroidism
c. [X] diffuse or nodular goiter
d. [X] amenorrhea, impotence
e. [ ] thyrotoxicosis, hypercorticism
239. Which of these investigations are informative in the diagnosis of acromegaly?
a. [X] basic level of STH
b. [ ] ACTH test
c. [X] field of view
d. [X] oral glucose load test
e. [X] radiography, CT, MRI of Turkish saddle
240. Which of the following remedies are used in the treatment of acromegaly?
a) [X] Octreotide
b) [X] Bromergon
c) [X] Parlodel
d) [ ] Somatomedin C
e) [X] Bromocriptine
241. Which of the following are synonyms of hiperprolactinic syndrome?
a. [ ] Adiposo-genital syndrome
b. [X] Syndrome Chiari-Frommel
c. [X] Syndrome galactorrhea - amenorrhea
d. [X] Syndrome of persistent lactation and amenorrhea
e. [X] Prolactinoma
242. Which statements are true about Sheehan's syndrome?
a. [X] is caused by ischemic necrosis of pituitary
b. [X] is a complication of collapse in pregnancy
c. [X] early postpartum agalactiae
d. [X] fertility can be restored with drugs
e. [ ] gonadoliberine is indicated therapy
243. Which of the following symptoms are characteristic for the Simmonds disease?
a. [ ] galactorrhea
b. [X] amenorrhea
c. [X] axilo-pubian hair loss
d. [X] anorexia
e. [X] hypothermia
244. Which of the following therapeutic means are used to treat Simmonds syndrome?
a. [X] added salt in food
b. [ ] diet rich in K
c. [X] levothyroxine
d. [X] Retabolil
e. [X] Prednisolone
245. In which of the following situations may develop diabetes insipidus?
a. [X] Paraventricular nuclei damage
b. [X] Primary aldosteronism
c. [X] Primary Hyperparathyroidism
d. [ ] DHA surplus
e. [X] Surgery in the hypothalamic-pituitary region
246. Which of the following indices have diagnostic value in diabetes insipidus?
a. [X] Urine volume
b. [X] The osmolarity of the plasma
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c. [ ] ACTH test
d. [X] urine density
e. [X] Urinary osmolality
247. Testing with fluid restriction in diabetes insipidus generates:
a. [ ] Increased urinary density
b. [X] Increase in hematocrit
c. [X] Weight loss
d. [X] Weakness, collapse
e. [X] Increased plasma osmolality
248. Which of the following signs may be present in adiposo-genital syndrome?
a. [X] Secondary hypogonadism
b. [X] Gynoid obesity
c. [X] Deficient hairiness
d. [X] Hypertension
e. [ ] Gynecomastia
249. Adiposo-genital syndrome should be differentiated with:
a. [X] Prader - Willi
b. [X] Syndrome Barraker - Simmonds
c. [ ] Simmonds syndrome, Sheehan
d. [X] Morganii-Stuart-Morel syndrome
e. [X] Syndrome Lawrence-Moon- Bardel
250. Which statements are true regarding Cushing's disease?
a. [X] primary damage is at the hypothalamic-pituitary level
b. [X] is the clinical manifestation of ACTH hypersecretion
c. [X] adrenal hyperplasia
d. [ ] the adrenal medulla hyperplasia
e. [X] secretion of glucocorticoids is exaggerated
251. Which of the following are present in Cushing's disease?
a. [X] 'buffalo hump'
b. [ ] thick, wet teguments
c. [X] osteoporosis
d. [X] muscle hypotrophy
e. [X] frequent bone fractures
252. Skin in Cushing's disease is:
a. [X] ribbed, purpuric
b. [X] acne, furunculosis
c. [X] marbled
d. [ ] thick
e. [X] hyperpigmentated
253. Which of the following are characteristic paraclinical indices for Cushing's disease?
a. [X] Increased serum cholesterol
b. [X] Increased fibrinogen
c. [ ] Erithropenia, leucopenia
d. [X] Hypernatremia, hypokalemia
e. [X] Lymphocytopenia and eosinopenia
254. Which statements are true about craniopharyngioma?
a. [X] supraselar and / or intraselar placement
b. [X] radiologic - supra- or intrasellar calcification
c. [X] CT shows cystic or solid structure
d. [ ] pituitary trope hormones are often grown
e. [X] clinic is equivalent to the non-secreting hypothalamic-pituitary tumors
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255. The following statements are true about craniopharyngioma:
a. [ ] frequency is increased in adults
b. [X] predominantly a suprasellar tumor
c. [X] dysembryoplastic tumor
d. [X] frequently compresses the optical chiasma
e. [X] are present signs of hydrocephalus
256. In what diseases the growth cartilage plates close late?
a. [X] prepubertal hypogonadism
b. [X] congenital hypothyroidism
c. [ ] adrenogenital syndrome
d. [X] pituitary dwarfism
e. [X] Klinfelter syndrome
257. In which of the following diseases may be present polyuric- polydipsic syndrome?
a. [X] Diabetes
b. [ ] Recklinghausen disease
c. [ ] Addison
d. [X] Conn Syndrome
e. [X] pituitary stem sections
258. In the medulla of adrenal glands is synthesized:
a. [ ] Androstendiol
b. [ ] Cortisol
c. [X] Noradrenalin
d. [ ] Aldosterone
e. [X] Adrenalin
259. Adrenalin induces:
a. [X] Increased systolic blood pressure
b. [ ] Increased diastolic blood pressure
c. [X] Increased pulsatile blood pressure
d. [ ] Relaxation of the uterus
e. [ ] Bronchospasm
260. Androgen deficiency in Addison disease determines:
a. [ ] Increase of gluconeogenesis
b. [ ] Breast and ovary enlargement
c. [X] Decrease of protein anabolism
d. [X] Loss of axillo-pubic hair
e. [ ] Stimulation of lipogenesis
261. Evolution of Addison disease can be:
a. [ ] Transitory
b. [ ] Latent
c. [X] Typical
d. [ ] Benign
e. [X] Atypical
262. Addison disease is characterized by:
a. [ ] Muscles hypertonia and hyperkinesia
b. [X] Asthenia, weight loss
c. [ ] Increased appetite, hyperacid gastritis
d. [X] Low glomerular filtration, oliguria
e. [ ] Cardiomegaly, edemas
263. Addison disease is confirmed by:
a. [X] Low amplitude of QRT, elongated T
b. [ ] Increased aldosterone
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c. [X] Low cortisol, high ACTH
d. [ ] 17 - OHCS and 17 KS increased in urine
e. [ ] High 17-OHCS and 17KS in ACTH test
264. Secondary adrenal deficiency includes:
a. [ ] Hypertension
b. [ ] High cortisol
c. [X] Depigmentation
d. [ ] Increased ACTH
e. [X] Positive ACTH test
265. What laboratory tests decrease in Addisonian crisis?
a. [X] Cortisol
b. [X] Aldosterone
c. [ ] Testosterone
d. [ ] Catecholamine
e. [ ] Potassium
266. Acute adrenal insufficiency is confirmed by:
a. [ ] Low urea, alkalosis
b. [X] Hyponatremia, hyperkalemia
c. [ ] Na/K rapport above 30
d. [ ] Hyperglycemia, eosinopenia, lymphopenia
e. [X] Low urinary cortisol and 17-OHCS
267. Which of the following diseases are accompanied by hypertension?
a. [ ] Addison disease
b. [X] Cushing syndrome
c. [ ] Nelson syndrome
d. [ ] Acute adrenal insufficiency
e. [X] Conn syndrome
268. Hypercortisolism can determine:
a. [X] Osteoporosis
b. [ ] Gynoid obesity
c. [X] Vascular fragility
d. [ ] Thickening of the skin
e. [ ] Muscle hypertrophy
269. In Cushing syndrome can be present the following changes:
a. [ ] Hypotension
b. [ ] Pale stretch marks
c. [X] Hirsutism, acne
d. [ ] Hyperpigmentation
e. [X] Psychosis, depression, suicide
270. Which of the clinical and paraclinical signs are characteristic for an androsteroma:
a. [ ] Male pseudohermaphroditism
b. [X] Female virile syndrome
c. [ ] Loss of muscular mass
d. [X] High urinary 7-KS
e. [ ] Increased adipose tissue mass
271. Conn syndrome is characterized by:
a. [X] A tumor of the glomerular zone
b. [ ] Tumor of medulla
c. [X] Primary hyperaldosteronism
d. [ ] Marked retention of potassium
e. [ ] Secondary hyperaldosteronism
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272. Pheochromocytoma is:
a. [ ] A tumor of adrenal cortex
b. [X] A tumor of adrenal medulla
c. [ ] Induces hypercorticism
d. [X] Induces hypersecretion of catecholamines
e. [ ] Characterized by hypotension
273. Another definition of pheochromocytoma:
a. [X] Pheochromocytoblastoma
b. [ ] Androsteroma
c. [ ] Corticoestroma
d. [ ] Glucosteroma
e. [X] Cromafinoma
274. Skin in pheochromocytoma can be:
a. [ ] Thick, with jaundice
b. [X] Cold with piloerection
c. [ ] Pale, dry
d. [X] Marbled with acrocyanosis
e. [ ] Thick with purple stretch marks
275. Which of the following dynamic tests confirm the diagnosis of pheochromocytoma?
a. [X] With histamine
b. [ ] With dexamethasone
c. [ ] With ACTH
d. [ ] With thyroliberin
e. [X] With tropaphen
276. Which zones are present in the cortex of the adrenal gland?
a) [X] Fasciculate
b) [ ] Medulla
c) [X] Reticular
d) [ ] Cortical
e) [X] Glomerular
277. The glomerular zone of the adrenal cortex synthetizes:
a. [X] Androstendione
b. [X] Corticosterone
c. [ ] Deoxycorticosteron
d. [X] Testosterone
e. [ ] Aldosterone
278. Androgens produced by the adrenal cortex stimulate:
a. [ ] Ovarian follicle maturation
b. [ ] Sertoly cells
c. [X] Boys puberty
d. [X] Girls puberty
e. [X] Axilo-pubian pilosity, libido in women
279. Catecholamines can stimulate:
a. [X] Vasoconstriction
b. [X] Hypertension
c. [ ] Low glycaemia
d. [X] Sweating
e. [ ] Liposinthesis
280. Frequently, in Addison's disease with autoimmune etiology can be:
a. [ ] Big adrenal glands with calcifications
b. [X] Small or normal adrenal glands
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c. [ ] Hirsutism, purplish mucosa
d. [X] Vitiligo, asthma
e. [X] Hypoparatiroidism, hypothyroidism
281. Deficiency of mineralocorticoids in Addison disease can determine:
a. [X] Decrease of Na, Cl reabsorption
b. [ ] Anasarca, cerebral edema
c. [X] Decrease of K elimination
d. [ ] Extracellular hyperhidration
e. [X] Extracellular dehydration
282. Medium gravity of Addison's disease is characterized by:
a. [X] Hyperpigmentation
b. [ ] Addison's crisis
c. [ ] Therapeutic effect: diet + mineralocorticoid
d. [X] Diarrhea, rarely constipation
e. [X] Therapeutic effect: diet + glucocorticoids
283. In Addison's disease may be present:
a. [ ] cholelithiasis, nephrolithiasis
b. [X] gastrointestinal ulcers
c. [X] ttraction for salty food, nausea, vomiting
d. [ ] hyperacidity gastritis
e. [X] often filiform pulse
284. Acute adrenal insufficiency can be characterized by:
a. [X] teguments are cold, sweaty
b. [X] cyanosis, hyperpigmentation
c. [ ] accentuated heart contractions
d. [X] nausea, vomiting, diarrhea
e. [ ] hypertension
285. Variants of the clinical manifestation of acute adrenal insufficiency are:
a. [X] Neuro - psychic
b. [ ] Pulmonary
c. [X] Cardiovascular
d. [ ] Nephrotic
e. [X] Abdominal
286. The treatment of acute adrenal insufficiency includes:
a. [X] Sol. Hydrocortisone i/ v
b. [X] Sol. DOCA i / m
c. [ ] Sol. Magnesium sulphate
d. [X] Sol. 5% glucose i / v
e. [ ] Sol. Kcl i / v
287. Addison's disease is characterized by:
a. [ ] Hypertension
b. [X] Hyperpigmentation
c. [X] Hair color is darkening
d. [ ] Mucous depigmentation
e. [X] "Drop -like" heart
288. The following statements are true for Cushing's syndrome:
a. [X] there is an adrenocortical adenoma or adenocarcinoma
b. [ ] it is the consequence of ACTH hypersecretion
c. [X] it is an autonomous hypercortisolism
d. [X] usually there is a solitary unilateral glucosteroma
e. [ ] it is the consequence of 3-beta - dehydrogenase deficiency
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289. Increased level of cortisol in plasma may occur in the following cases:
a. [X] Alcoholism, cirrhosis, cancer
b. [X] Cushing's disease and syndrome
c. [ ] Adreno-genital syndrome
d. [ ] Conn's Syndrome
e. [X] Ectopic ACTH secretion
290. Androsteroma evolves with the following signs:
a. [ ] Gynecomastia
b. [X] Virilization
c. [X] Muscles mass increases
d. [X] Clitoral hypertrophy
e. [ ] Eunucoidism
291. The treatment of adrenal tumors may include:
a. [X] Adenoma or adrenalectomy
b. [ ] Radiotherapy of hypothalamic-pituitary area
c. [X] Hloditan, ketoconazole
d. [ ] Parlodel, bromocriptine
e. [X] Hydrocortisone after operation
292. Conn's syndrome can be confirmed by:
a. [ ] Dexamethasone test
b. [X] Salt loading test
c. [ ] Test with Histamine
d. [X] Test with Captopril
e. [X] Test with Spironolactone
293. Pheochromocytoma can be:
a. [X] Sporadic, familial
b. [ ] Neuropsychiatric, autoimmune
c. [ ] Cardiovascular, Peripheral
d. [X] Benign, malignant, abdominal
e. [X] Paroxysmal, permanent, asymptomatic
294. Pheochromocytoma with hypersecretion of adrenaline may be characterized by:
a. [ ] Hypertension with bradycardia
b. [X] Hypertension leading to collapse
c. [ ] Normotensive
d. [X] Orthostatic Hypotension
e. [X] Tachycardia
295. Pheochromocytoma can cause the following complications:
a. [X] Pulmonary edema with hemoptysis
b. [X] Arrhythmias, heart attack, stroke
c. [ ] Nephrolithiasis
d. [ ] Asthma
e. [X] Brain hemorrhage
296. Adrenocortical hormones are derived from:
a. [X] Cholesterol
b. [X] pregnenolone
c. [X] 17-OH pregnenolone
d. [X] Dehydroepiandrosterone
e. [ ] Gammaglobulin
297. Cortisol secretion is stimulated by:
a. [X] feedback mechanism
b. [X] stress, pain
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c. [ ] glucose level
d. [X] circadian rhythm
e. [X] ACTH
298. The following statements are true for Addison's disease:
a. [X] there is a destructive process in both adrenals
b. [ ] it is the consequence of ACTH deficiency
c. [X] there is a deficiency of adreno- cortical hormones
d. [X] it is a primary, chronic adrenal insufficiency
e. [X] determines excess of ACTH
299. Lack of cortisol in Addison's disease determines:
a. [ ] Increased protein anabolism
b. [X] Gastric anacidity
c. [X] Decreased immunity
d. [X] Hypoglycemia
e. [X] Decreased glomerular filtration
300. The skin in case of Addison's disease is:
a. [X] Cold
b. [X] Dry
c. [ ] Elastic
d. [X] Dehydrated
e. [X] Thin
301. In Addison's disease the following statements are frequently true:
a. [X] Delay of puberty, decreased libido
b. [X] Genital hypoplasia
c. [X] Bronchitis, pneumonia
d. [ ] Increased pilosity
e. [X] Tuberculosis, pleurisy
302. The differential diagnosis of Addison's disease is made with:
a) [X] Nelson's Syndrome
b) [X] Porphyria
c) [X] Hemochromatosis
d) [ ] Parhon's syndrome
e) [X] Biliary cirrhosis
303. The treatment of Addison's disease may include the following:
a. [X] rich diet in Na, proteins, vitamins
b. [X] Limiting K in diet
c. [ ] a-adreno blocker, b-adreno blocker, insulin
d. [X] Sol. Glucose, DOCA
e. [X] hydrocortisone, prednisolone
304. Acute adrenal insufficiency can be characterized by:
a. [X] Abdominal Pain
b. [ ] Cardiomegaly, pulmonary edema
c. [X] Oliguria without thirst
d. [X] Frequent, filiform pulse
e. [X] Hypotension
305. In the following cases ACTH level may be increased:
a. [X] Nelson's Syndrome
b. [X] Cushing's disease
c. [ ] Cushing's syndrome
d. [X] Addison's disease
e. [X] adrenocorticotropic adenoma
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306. Adreno-genital syndromes are characterized by:
a. [X] adrenal hyperplasia
b. [X] autosomal recessive enzyme deficiency
c. [X] defect in the synthesis of steroids
d. [ ] ACTH deficiency
e. [X] disorders in sexualization
307. The treatment of adreno-genital syndrome may include:
a. [X] DOCA, Sol. Glucose
b. [X] Prednisolone, dexamethasone
c. [ ] Parlodel, bromocriptine
d. [X] Estrogen or androgen
e. [X] Masking clitoris, vagina plastic surgery
308. Metabolic effects of hypercortisolism are the following:
a. [X] Increased neoglucogenesis, hyperglycaemia
b. [ ] Protein anabolism
c. [X] Lipolysis, fat redistribution
d. [X] Insulin resistance
e. [X] Obesity - cushingoid type
309. In Cushing's syndrome in contrast to Cushing's disease are present:
a. [X] Brutal onset
b. [X] Faster evolution
c. [X] Marked virilization
d. [X] Low serum ACTH
e. [ ] Test with dexamethasone is positive
310. Intrebarea
a. [X] Adrenal tumor
b. [X] Bilateral ginecomastia
c. [ ] Estrogen deficiency
d. [X] Female phenotype
e. [X] Testicular hypotrophy
311. Conn's syndrome is characterized by:
a. [X] Chvostek and Trousso signs are positive
b. [X] Polydipsia, polyuria, nocturia
c. [X] Low density urine
d. [ ] Neuro-muscular hypoexcitability
e. [X] Tetanus, muscle spasms
312. Conn's Syndrome should be differentiated with:
a. [ ] Addison's disease
b. [X] Adreno-genital syndromes
c. [X] Cushing's Syndrome
d. [X] Essential hypertension
e. [X] Secondary aldosteronism
313. The paroxysm of catecholamines may be caused by:
a. [X] Tumor palpation, smells
b. [X] Stress, mental and physical efort
c. [X] Birth, surgery
d. [ ] Alpha-adrenoblockers and tranquilizers administration
e. [X] Intubation, anesthesia, alcohol
314. Effective treatment of pheochromocytoma includes:
a. [X] Adrenalectomy
b. [ ] Dibazol, clofelin
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c. [X] Calcium antagonists
d. [X] Initially, alpha-adrenoblockers
e. [X] Beta-adrenoblockers after administration of alpha-adrenoblockers
315. The following statements characterize the medulosuprarenal gland:
a. [X] Synthesizes catecholamines
b. [X] Is located under the reticular area
c. [ ] Is stimulated by ACTH
d. [X] Contains chromaffin cells
e. [X] Synthesizes epinephrine
316. Which of the following are NOT typical effects of glucocorticoids?
a. [X] Glucose uptake by tissues
b. [X] Intestinal absorption of Ca
c. [X] Production of collagen
d. [ ] Hepatic gluconeogenesis
e. [X] Macrophage migration
317. Testosterone has the following physiological effects:
a. [X] Accelerates growth in puberty
b. [ ] Maintains open growth cartilage after puberty
c. [X] Develops the skeleton of the shoulder girdle(belt)
d. [ ] Inhibits erythropoiesis
e. [ ] Blocks development of the shoulder and pectoral muscles
318. When is the maximal secretion of testosterone?
a. [ ] Between the hours of 24.00 - 04.00
b. [X] In May
c. [ ] In September
d. [X] Between 5:00 - 9:00
e. [ ] In January
319. Estrogens stimulate the following processes:
a. [X] Myometrium growth
b. [ ] Blocks the xitocin receptors
c. [X] Tubes peristaltics
d. [ ] Blocks cervical mucus secretion
e. [ ] Inhibits bone growth and closes the cartilage growth plates
320. What statements are characteristic for the ovarian follicle?
a. [X] It is stimulated by FSH and less by LH
b. [ ] It is formed during the postovulatory period
c. [X] Produces estrogens
d. [ ] At the beginning of the cycle the follicle becomes the corpus luteum
e. [ ] Produces progesterone
321. In girls puberty includes the following:
a. [X] Telarha from 11 years
b. [X] Pubarha from 13 years
c. [ ] Menarche at 11 - 13 years
d. [ ] The maximum growth at about 10 years
e. [ ] Female phenotype from 12 years
322. What causes precocious izosexual false puberty in girls?
a. [X] Estrogen-secreting ovarian cysts
b. [ ] Pituitary tumors
c. [ ] Nelson syndrome
d. [X] Ovarian, adrenal tumors
e. [ ] Turner Syndrome
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323. What are the characteristics of delayed puberty?
a. [X] Absence of secondary sexual characteristics until age 16
b. [ ] Rarely accompanies physical retardation
c. [ ] Caused by dietary protein abuse
d. [ ] More common in girls
e. [X] It is often caused by organic and family causes
324. What causes primary hypogonadism?
a. [ ] Hypothalamic-pituitary tumors
b. [ ] Cushing's disease
c. [X] Gonadal dysgenesis
d. [X] Veneric diseases
e. [ ] Cranial irradiation
325. What signs can be present in cases of primary postpubertar hypogonadism?
a. [X] Proportional constitution
b. [ ] Open growth areas
c. [ ] Incurable infertility
d. [X] Involution of sexual signs
e. [ ] Possible pseudohermaphroditism
326. In primary hypogonadism the following hormonal deviations are found:
a. [ ] FSH, LH high in prepubertal boys
b. [X] Increased FSH, LH postpuberty in girls
c. [X] FSH, LH low in prepubertal girls
d. [ ] FSH, LH decreased postpuberty in boys
e. [ ] Postpuberty, androgens and estrogens are normalized
327. Klinefelter's syndrome includes:
a. [ ] Most common karyotype is 45 XO
b. [X] One or more extra X chromosomes
c. [ ] Rare digenesis
d. [X] During embryonic period, normal development of testes and genitals
e. [ ] Normal psycho-intellectual development
328. Turner's syndrome can be characterized by the following :
a. [X] Is determined by a loss of X chromosome during embryonic development
b. [X] Often includes karyotype 45XO
c. [ ] Sexual chromatin is positive
d. [ ] More often evolves as male
e. [ ] Rarely are present mosaicisms like 45XO / 46XX, 45XO / 47XXX
329. What anomalies are present in Turner's syndrome?
a. [X] " Fish mouth"
b. [ ] Exophthalmia
c. [ ] Low set palate
d. [ ] Up - set ears
e. [X] Low hair insertion on the neck
330. Gonadal dysgenesis 46XY includes the following features:
a. [X] Female phenotype
b. [ ] Normal testicles
c. [X] Low sex hormones
d. [ ] Low gonadotropins
e. [ ] Education and treatment like in primary male hypogonadism
331. False cryptorchidism is characterized by the following:
a. [ ] Present in 20 % of cases
b. [X] Appears when cold and emotions
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c. [ ] Disappears at physical effort
d. [ ] It can be abdominal,or femoral
e. [X] It disappears when relaxing, warm
332. What are the theories in ethiopathology of POS?
a. [ ] Deacrease of androgens aromatization nto estrogens
b. [ ] Hypoinsulinemia increases insulin sensitivity
c. [X] Frequent, major jumps of Gn-RH
d. [ ] Deficiency of LH
e. [X] It increases the accumulation of cholesterol and androgens
333. POS treatment may include the following :
a. [ ] Corticosteroids
b. [X] Diane B 35
c. [ ] Lysine - vasopresine
d. [ ] Tubal ligation
e. [X] Laparoscopic electrocautersation of cysts
334. Treatment of menopause may include the following:
a. [ ] In premenopausal period - estrogens
b. [X] Estrogen - progestine at the onset of menopause
c. [X] Tranquilizers, calcium
d. [ ] Progestives in postmenopause
e. [ ] Clomiphene citrate
335. Which are the products of Sertoli cell?
a. [ ] Estrogen
b. [X] Mullerian Inhibition Hormone (MIH)
c. [X] Sperm
d. [X] Inhibins A and B
e. [ ] Aldosterone
336. Which are the products of Leydig cells?
a. [X] Dihydrotestosterone
b. [ ] Cortisol
c. [X] Testosteron
d. [ ] Estrogen in large quantities
e. [X] Small quantities of progestagen
337. Which tests may be recommended for testicular function assessment:
a. [X] With LH-RH
b. [X] With chorionic gonadotropin
c. [ ] With dexamethasone
d. [X] With clomiphene
e. [ ] With ACTH
338. Ovaries are characterized by?
a. [X] Dimensions 2,5x2x1 cm
b. [X] Estrogen and progesteron producing
c. [X] Synthesize small quantities of androgens
d. [ ] Inhibit the production of relaxin, inhibin, activin
e. [ ] Dimension over 3,5x2,5x2 cm
339. Which of following tests are not informative for ovarian exploration?
a. [ ] With progesterone
b. [X] With Captopril
c. [X] With Spironolactone
d. [ ] With Estroprogestative
e. [ ] With Gn-RH
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340. Precocious puberty is characterized by the following:
a. [ ] Starts in girls under 10 years
b. [ ] Starts in boys under 11 years
c. [X] True Gn-RH dependent form
d. [X] Precocious izosexual puberty
e. [X] Precocious heterosexual puberty
341. Which are thecauses of precocious izosexual false puberty in boys?
a. [X] Adrenogenital syndrome
b. [X] Chorionic gonadotropin secreting tumor
c. [ ] Estrogen-secreting suprarenalian tumor
d. [X] Testicular tumors
e. [ ] Isolated saddle syndrome
342. Secondary hypogonadism includes the following forms
a. [ ] Testicular
b. [X] Hypogonadotrop
c. [X] Pituitary
d. [ ] Ovarian
e. [X] Hipothalamic
343. Primary congenital hypogonadism is characterized by the following:
a. [X] Intersexuality in boys
b. [ ] Hiperstenic constitutional type
c. [X] Puberty absence or atenuation
d. [ ] Intersexuality in girls
e. [X] Eunucoid constitutional type
344. Primary male hypogonadism treatmentincludes the following:
a. [X] Androgens with slow resorption are preferred from 16 years
b. [X] Omnadren can be administered every 2-4 weeks
c. [ ] Testosterone is recommended once per 2-4 weeks
d. [X] Sustenon is administered two times a month
e. [ ] Chorionic gonadotropin is administrated
345. Klinefelter syndrome includes the following:
a. [X] Eunucoid constitutional type
b. [X] Feminine fat distribution
c. [ ] Low stature
d. [X] Frequently bilateral gynecomastia
e. [ ] Small penis
346. Which of following characterize Turner's syndrome?
a. [X] Lack of prepubertal growth spurt
b. [ ] Intense pubic hair growth
c. [X] Hypoplastic genitals
d. [ ] Developed mammary glands
e. [X] Primary amenorrhea
347. The male version of the Turner's syndrome is characterized by the following:
a. [X] Intersexuality
b. [ ] Imperfect spermatogenesis
c. [X] Mosaicism 45XO / 46XY
d. [X] Treatment according to the feminine variant
e. [ ] Fertility sometimes preserved
348. Which of the following are characteristic for triple-X syndrome
a) [X] More common in deliveries after 45 years
b) [X] Female phenotype
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c) [ ] Low FSH, LH
d) [ ] Increased estrogen
e) [X] Functional gonads
349. Causes of cryptorchidism may be:
a. [X] Genetic, toxic
b. [ ] Nelson Syndrome
c. [X] Physical, infectious
d. [ ] Occurs in type II diabetes
e. [X] Inguinal canals dysgenesis
350. Which of thefollowing characterize andromastia?
a. [X] Physiologically occurs in puberty, temporary
b. [ ] Is painful, often at 30 - 40 years
c. [X] Physiologically - common after andropause
d. [ ] Increases the androgen / estrogen ratio
e. [X] It may be true or false
351. Which of the following laboratory changes confirm POS?
a. [X] Serum LH / FSH increases 2 times
b. [X] Increased serum androgen level
c. [X] Estrogen deficiency
d. [ ] Over 10 cysts of 3-9 mm, arranged in a crown
e. [ ] Big cysts during ovulation
352. Which of the following clinical manifestations are often noted in menopause?
a. [X] Hot flashes, insomnia
b. [X] Atrophic vaginitis, cystitis
c. [ ] Increased axilo-pubic hair growth
d. [X] Digestive and joint disorders
e. [ ] Fibrocystic mastitis
353. Which of the following characterize the testicles?
a. [X] Start production of hormones after 8 weeks of gestation
b. [X] Contain Sertoli cells
c. [ ] Are blocked by FSH and LH
d. [X] Produce hormones from cholesterol
e. [X] Contain Leydig cells
354. Which are the actions of androgens?
a. [X] Condition sexual behavior
b. [X] Determine the differentiation of male genitals line
c. [X] Libido and potency stimulation
d. [ ] Decrease virility and pilosity
e. [X] Inhibit cyclical gonadoliberin secretion
355. Which of thefollowing characterize the normal genitals:
a. [X] 3 cm penis at birth
b. [X] In adults testicles are over 3.5 x 2 cm, rigid, elastic
c. [X] In adults the penis is 8-10 cm
d. [ ] Testicles in adult are over 4.5 x 3 cm, rigid
e. [X] The penis at 11 - 12 years is 5-6 cm
356. Which are the effects of estrogen metabolism?
a. [X] It stimulates enzyme and protein synthesis
b. [ ] Reduces carbohydrate tolerance
c. [X] Antiatherogenic effect
d. [X] Liquid and Na retention
e. [ ] Reduces basal temperature
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357. Which are the tests exploring the ovaries?
a. [X] Basal temperature
b. [X] Cervical Mucus
c. [ ] Sexual chromatin, karyotype
d. [X] Vaginal smears
e. [X] Myometrium biopsy
358. Intrebarea Puberty in boys includes the following:
a. [X] Starts at the age of 12 years
b. [ ] Closing of the growth areas at 18 years
c. [X] At 12 years testicles areabout 2 cm
d. [X] Pubic pilosity appears at 10 years
e. [ ] Spermatogenesis starts from 16 to 18 years
359. Which are the causes of precocious false heterosexual puberty?
a. [ ] Pituitary tumors
b. [X] Congenital adrenogenital syndrome
c. [X] Ovarian tumors with androgen secretion
d. [X] Adrenal tumors
e. [X] Testicular tumors with estrogen secretion
360. Which ofthe following characterizethe eunucoid constitutional type?
a. [X] High stature, small head
b. [X] Long, thin neck
c. [ ] Wide and long chest
d. [ ] Short extremities
e. [X] Narrow shoulders
361. The treatment of female primary hypogonadism has the following purposes:
a. [X] Triggering puberty
b. [X] Preventing constitutional asthenia
c. [ ] Restoring fertility
d. [X] Female phenotype development
e. [X] Closing the growth areas at statural maturation
362. Which of the following syndromes present hypergonadotrop hypogonadism?
a. [X] Klinefelter's syndrome
b. [X] Turner's syndrome
c. [X] Morris's and Reifeinstein's syndromes
d. [ ] Simmonds's and Sheehan's syndromes
e. [X] "Triple-X"', "double male"syndromes
363. Klinefelter syndrome is characterized by the following:
a. [X] Usually infertility
b. [X] Often associated with autoimmune thyroiditis
c. [X] Glucose intolerance
d. [ ] Effective treatment with corticosteroids
e. [X] Often varicose veins
364. The female version of Turner's syndrome includes the following:
a. [X] High FSH and LH
b. [X] Low estrogens
c. [ ] Sexual chromatin often is positive
d. [X] Treatment order: STH-anabolics-estrogens
e. [X] Sexual chromatin in mosaicism is sometimes positive
365. Which of thefollowing characterize pseudohermaphroditism?
a. [X] Unisexual gonadal cells present in the same body
b. [ ] Ovotestis presence
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c. [X] Male - female phenotype
d. [X] Peniform clitoris
e. [X] Sometimes urogenital sinus
366. Which are the criteria for Pasqwalini's syndrome?
a. [X] LH deficiency
b. [X] Testosterone insufficiency
c. [ ] Low FSH
d. [X] Eunucoid habitus
e. [X] Gynecomastia, preserved spermatogenesis
367. Which of the following characterizes cryptorchidism?
a. [X] Absence of testicles in the scrotum
b. [X] May be true, false, unilateral, bilateral
c. [X] Abdominal and inguinal retention
d. [ ] Primary, secondary, tertiary
e. [X] With perineal, pubian and femoral ectopia
368. The treatment of cryptorchidism includes the following:
a. [X] Chorionic gonadotropin at age of 1 - 2 years
b. [ ] Testosterone at 2 - 15 years
c. [X] Gonadotropin when FSH and LH are low
d. [X] Gonadotropin in hypothalamic-pituitary involvement
e. [X] Surgery is optimal at the age of about 2 years
369. What complications are caused by PCOS?
a. [ ] Androgen-dependent neoplasms
b. [X] Depression or aggression
c. [X] Risk of breast cancer
d. [X] Uterine fibromatosis
e. [X] Endometrial carcinoma
370. Which of the followingcharacterize the andropause?
a. [X] Male gonads morphophisiologic involution
b. [X] Start over the age of 70 years
c. [X] Heatwaves, insomnia
d. [ ] Bradycardia, permanent hypotension
e. [X] Blood pressure oscillation, sweating, headache
371. Which of the following disorders do not characterize obesity?
a. [ ] Hypercholesterolemia
b. [X] Hipernatriemia
c. [X] Hipocalciemia
d. [ ] Low fibrinolysis
e. [ ] Hypocortisolemia
372. Which hypothalamic dysfunctions are involved in obesity onset:
a. [ ] Low parasympathetic tonus
b. [X] Ventro-medial nuclei hypotonia
c. [ ] Increased activity of ventro-medial nuclei
d. [ ] Simpato-adrenal system activation
e. [X] Ventro- lateral nuclei hypertonus
373. Obesity can be characterized by the following disorders:
a. [ ] Increased level of thyroid hormones
b. [ ] Low aldosterone
c. [X] Hyperprolactinemia
d. [ ] Hyperinsulinism
e. [X] Increased levels of catecholamines
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374. Obesity classification includes the following forms:
a. [ ] Tertiary
b. [X] Secondary
c. [X] Constitutional
d. [X] Cerebral
e. [ ] Medulosuprarenal
375. Which of the following factors may be predisposing to obesity:
a. [ ] Hyperestrogenemia
b. [X] Sedentarism
c. [ ] Sweetening agents abuse
d. [X] Hypothalamus disorders
e. [X] Hypercortisolemia
376. Hormonal disorders in obesity include:
a. [X] Increased corticotrope activity
b. [X] Decreased thyreotrope activity
c. [X] Increased antidiuretic (ADH) hormone secretion
d. [ ] Increased somatotrope activity
e. [X] Insulin resistance
377. Obesity increases the risk for the following diseases:
a. [ ] Primary hypocorticism
b. [X] Osteoporosis
c. [X] Deforming spondylosis
d. [X] Secondary aldosteronism
e. [X] Nephrolithiasis

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