1.

An elderly male present with polyuria, she developed hypotension during an operation
polydipsia and weight loss for 3 months. Which of for appendicitis.
the following parameter is diagnostic of diabetes Hct: 49% (37–48)
WBC: 11 × 103 mm (4.3–10.8)
mellitus in this patient? Plasma glucose: 160 mg/dL (75–115)
Plasma calcium: 11 mg/dL (9–10.5)
a. Fasting blood sugar 117 mg% The most likely diagnosis is
a. Pheochromocytoma
b. Fasting blood sugar 137 mg% b. Renal artery stenosis
c. Essential hypertension
c. 2 hours blood sugar after OGT 180 mg% d. Insulin-dependent diabetes mellitus
d. Urine dipstic +++

2. In the management of diabetic ketoacidosis: 6. Not associated with diabetes mellitus:

a. Intracellular water deficit is best restored using a. Cushing syndrome

half strength saline [0.45% saline]
b. Acromegaly
b. Potassium should be given even before
checking the serum potassium concentration c. Hypothyroidism

c. Bicarbonate infusion is often only necessary in d. Phaeochromocytoma

severe acidosis pH< 7.0
7. Most common oral infection in diabetes
d. 5% dextrose solution should be avoided unless mellitus?
hypoglycaemia supervenes
a. Candida b. Aspergillus c. Streptococcus d.
3. Which type diabetes is HLA associated: Staphylococcus

a. Type I diabetes 8. GTT post 1 hour sugar for gestational diabetes

is > mg%?
b. Type II diabetes
a. 140 b. 150 c. 180 d. 200
c. Malnutrition related type disease
9. A 65-year-old man presents with signs and
d. Pregnancy related type diabetes symptoms of thyrotoxicosis. His radioiodine scan
and 24-h uptake show a patchy pattern but normal
4. Which of the following test is useful to
amount of radioiodine uptake. This presentation is
distinguish between insulinoma and sulfonylurea
most consistent with
related hypoglycemia:
- Graves’ disease
a. Antibody to Insulin - Subacute thyroiditis
- Toxic multinodular goiter
b. Plasma - C- peptide level - Hashimoto’s thyroiditis
- Toxic adenoma
c. Plasma Insulin level

d. Insulin- Glucose ratio

10. Foot Ulcers in diabetes are due to all except?
5. A 25-year-old woman is admitted for
hypertensive crisis. In the hospital, blood pressure a. Decreased immunity b. Neuropathy c.
is labile and responds poorly to antihypertensive
therapy. Microangiopathy d. Macroangiopathy
The patient complains of palpitations and
apprehension. Her past medical history shows that
11. An obese lady with BMI =35. FBG is normal Her past medical history is significant for Graves
and PPBG isslightly elevat ed. Ideal management Disease, which was
is?
treated with radioactive iodine. Laboratory studies
a. Exercise b. Insulin c. Metformin d. Diet confirm that TSH is
control
elevated. Which of the following is the best
12. Cause of death in diabetic ketoacidosis in treatment for this patient?
children?
A. Propylthiouracil (PTU)
a. Cerebral edema b. Hypokalemia c. Infection
d. Acidosis B. β-blockers

13. The glucose lowering effect is least and C. Levothyroxine

delayed by several weeks with the following oral D. Thyroidectomy
hypoglycaemic agents a. Insulin secretogogues
b. DPP -IV inhibitors c. Biguanides d. Alpha- 17. Oral anti-diabetic drug of choice in renal
Glucosidase inhibitors failure is:

14. A diabetes mellitus patient presents with a. Glyburide b. Chlorporamide c. Glipizide

fungal infection of sinuses and peri -orbital region d. Metformin
with significant visual impairment. Best treatment
18. A patient with DM of 4 years duration
among following is?
presents with dizziness andHR 52/ min, Probable
a. Amphotericin B b. Itraconazole c. cause is:
Ketoconazole d. Broad spectrum antibiotics
a. Hypoglycaemia b. Inferior wall MI c. Sick-
15. A 28-year-old woman is noted to have had 10 sinus syndrome d. Autonomic dysunction
lb unintended weight
19. What is correct indiabetic ketoacidosis?
loss, nervousness, palpitations, and tremor. She is
a. Low serum potassium b. Increased anion gap
diagnosed with probable
c. Metabolic alkalosis d. Respiratory
hyperthyroidism. Which of the following acidosis
laboratory test results is
20. A 40-year-old patient with a recent viral
most consistent with hyperthyroidism? infection presents with a significantly tender
gland, low radioiodine uptake, and signs and
A. Normal TSH and elevated T4/T3 levels symptoms of thyrotoxicosis. This presentation is
most likely
B. Elevated TSH levels and low T4/T3 - Graves’ disease
- Subacute thyroiditis
C. Elevated TSH levels and normal T4/T3 - Toxic multinodular goiter
- Hashimoto’s thyroiditis
D. Low TSH and elevated T4/T3 levels

16. A 35-year-old woman presents with increasing

fatigue for several
21. Microalbuminuria refers to urinary albumin
months. She has also gained 10 lb, despite a excretion rate of:
decrease in her appetite.
a. 30-300 mg/ 24 hour b. 400-600 mg/24 hour
c. 700-900 mg/ 24 hour d. > 100 mg/ 24 hour
 22. A 28-year-old man presents to his physician b. the introduction of 1 mg of glucagon s / c or /
for a health maintenance m;
c. the introduction of 5% glucose 40-100 ml IV;
visit. He feels well and does not report changes in d. intake of 1-2XE easily digestible carbohydrates
his appetite, weight, orally.
energy, or bowel movements. A firm nodule is
palpated in the left lobe 27. The leading link in the pathogenesis of
of his thyroid. The nodule is confirmed on hyperosmolar hyperglycemic state is:
ultrasound and measures a. absolute insulin deficiency;
1.3 cm. Which of the following is the next step in b. dehydration;
the workup of this c. ketosis ;
d. metabolic acidosis.
nodule?

A. Radioactive iodine uptake study 28. The risk group for developing diabetic
neuroosteoarthropathy includes patients:
B. Fine needle aspiration
a. with arterial hypertension;
C. Repeat ultrasound in 6 months b. with a violation of the heart rhythm;
D. Referral to surgeon for open biopsy c. with peripheral neuropathy ;
d. with thyrotoxicosis.
23. A 30-year-old woman with thyrotoxicosis has
a diffusely enlarged gland on palpation of the
neck. Her thyroid scan and 24-h uptake show 29. Diabetic macroangiopathies include:
uniformity of uptake and an increased percentage
uptake. This patient has a. diabetic nephropathy;
- Graves’ disease b. diabetic retinopathy ;
- Subacute thyroiditis c. diabetic retinopathy ;
- Toxic multinodular goiter
- Hashimoto’s thyroiditis d. ischemic heart disease.
30. Diabetic microangiopathies include

24. Which type diabetes is HLA associated: a. coronary artery disease;

b. diabetic neuroosteoarthropathy ;
a. Type I diabetes b. Type II diabetes c. c. diabetic neuropathy ;
Malnutrition related type disease d. Pregnancy d. diabetic nephropathy;
related type diabetes

25. Which of the following is not a test for 31. A patient with chronic autoimmune
diabetes mellitus (Hashimoto’s) thyroiditis develops a rapidly
enlarging thyroid mass. Most likely this is
a. Fasting blood glucose b. Random blood - Thyroid lymphoma
glucose c. D-Xylose test d. Oral Glucose - Medullary thyroid carcinoma
tolerance test - Papillary thyroid carcinoma
- Anaplastic thyroid carcinoma
26. An alternative way to relieve symptoms of
severe hypoglycemia in an adult patient is:
32. What kidney structure is affected in diabetic
a. the introduction of 0.5 mg of glucagon s / c or / nephropathy?
m;
a. the medulla of the kidney;
 b. loop of Henle ; levels of TSH, and decreased free T4 levels.
c. renal glomerulus; Which of the following is also likely to be
d. collecting duct. associated with her hypothyroid state
- Decreased body mass index
33. Which vessels are affected in diabetic - Heat intolerance
macroangiopathy ? - Increased metabolic rate
- Sleepiness
a. arteries;
b. veins;
c. capillaries; 39. Localization of pain in diabetic
d. lymphatic vessels. polyneuropathy
34. A patient with a low TSH and high T3 most
likely has a. knee and/or ankle joints;
- Hyperthyroidism b. muscles;
- Nonthyroidal illness (sick euthyroidism) c. there is no clear localization;
- Estrogen therapy d. feet.
- Subclinical hypothyroidism 40. A 55 years old male patient underwent
- Familial (euthyroid) dysalbuminenic cholecystectomy for gall stone calculus. During
hyperthyroxinemia surgery the patient' s pulse was irregularly
irregular, 160/ min, BP =80/ 50 mm of Hg, temp,
40°c. On examination a swelling in the neck was
found. Most likely diagnosis is:
35. What indicator is the most reliable criterion - Thyroid storm
for the degree of diabetes compensation during - Myocardial infarction
dynamic examination? - Pancreatitis
- SVT
a.C-peptide;
b.glycated hemoglobin;
c.average daily glycemia; 41. The main clinical signs of the acute stage of
d.fructosamine . diabetic neuroosteoarthropathy
36. Clinical manifestation of critical lower limb a..hyperemia;
ischemia in a patient with DM is: b. hyperthermia;
a. acral necrosis; c. foot deformity;
b. bullae on the lower leg; d. unilateral swelling.
c. finger hematoma due to injury; 42. A 65-year-old man presents with signs and
symptoms of thyrotoxicosis. His radioiodine scan
d. the wound of the sole of the foot, and 24-h uptake show a patchy pattern but normal
surrounded by hyperkeratosis; amount of radioiodine uptake. This presentation is
most consistent with
- Graves’ disease
37. Which of the following antibodies is involved - Subacute thyroiditis
in the tissue destructive process associated with - Toxic multinodular goiter
hypothyroidism in Hashimoto' s and atrophic - Hashimoto’s thyroiditis
thyroiditis? - Toxic adenoma
- Thyroperoxidase antibody
- Thyroglobulin antibody
- TSH receptor antibody 43. The most common variety of thyroid cancer is
- Thyroid stimulating antibody - Thyroid lymphoma
- Medullary thyroid carcinoma
- Papillary thyroid carcinoma
38. A 46-year-old woman on lithium therapy for - Anaplastic thyroid carcinoma
her bipolar disorder presents with complaints of - Follicular thyroid carcinoma
weakness, arthralgia, and constipation. Blood
work reveals hypercholesterolemia, increased
44. Elevated plasma calcitonin is seen with a. immediately after diagnosis;
- Thyroid lymphoma b. 1 year after diagnosis;
- Medullary thyroid carcinoma c. 3 years after diagnosis;
- Papillary thyroid carcinoma
- Anaplastic thyroid carcinoma d. 5 years after diagnosis.
50. A specific deformity of the foot in diabetes
mellitus is
45. In what acute complication of diabetes
mellitus is the development of symptoms a. Hallux valgus ;
associated with absolute insulin deficiency? b. Charcot's foot ;
c. Taylor's deformation;
a. hyperosmolar hyperglycemic d. transverse flat top ;
state; 51. Tactics for the treatment of symptoms of
b. hypoglycemic coma; severe hypoglycemia is to
c. diabetic ketoacidosis ;
d. lactic acidosis . a. the introduction of 40-100 ml of a
46. When relieving symptoms of mild 40% glucose solution until
hypoglycemia, it is advisable to control glucose consciousness is restored;
after taking easily digestible carbohydrates b. the introduction of 40-100 ml of
through 5% glucose solution until
consciousness is restored;
a. 10 minutes; c. taking 1-2XE easily digestible
b. 15 minutes; carbohydrates orally.
c. 30 minutes; d. longitudinal flat feet.
d. 45 minutes;
52. A patient without symptoms and without a
47. Diabetic foot syndrome is recent illness is found to have a normal free T4
and elevated TSH which are confirmed on
a. shin wound against the repeated measurements. The most likely
background of necrobiosis explanation is
lipoidis; - Hyperthyroidism
- Nonthyroidal illness (sick euthyroidism)
b. foot wound against the - Estrogen therapy
background of impaired venous - Subclinical hypothyroidism
outflow in a patient with DM;
c. a foot wound associated with a
neurological disorder in a patient 53. High levels of thyroidal peroxidase antibody
are found with
with DM; - Iodine deficiency
d. traumatic fracture of the toe. - Lithium
48. A 58-year-old woman presents as an - Hashimoto’s thyroiditis
outpatient with lethargy, fatigue, and cold - Propylthiouracil
intolerance. Thyroid function testing reveals a free
T4 of 0.5 (0.7 to 2.0) and a TSH of 0.1 (0.5 to 5).
The best next diagnostic test is 54. Endemic goiter results from
- Thyroid scan and uptake - Iodine deficiency
- MRI of the pituitary - Lithium
- Prolactin - Hashimoto’s thyroiditis
- Thyroid autoantibodies - Propylthiouracil

49. Screening for diabetic polyneuropathy is 55. What is most significant in terms of the risk of
performed in patients with type 2 diabetes. developing painful distal diabetic neuropathy in
patients with type 1 diabetes?
 a. hypertriglyceridemia ; 61.Which of the following complications of type 2
b. diabetic ketoacidosis ; diabetes mellitus would be most likely to occur in
c. duration of diabetes; the first year of disease?
d. poor glycemic control.
56. Infiltration of orbital soft tissue and a. Chronic nausea and vomiting
extraocular muscles with lymphocytes, b. Coronary artery disease
mucopolysaccharides, and fluid is seen with c. Neuropathy
- Graves’ disease d. Orthostatic hypotension
- Jod-Basedow phenomenon 62.Which of the following is most likely to occur
- Choriocarcinoma
- Struma ovarii after the administration of insulin therapy in a
patient with diabetic ketoacidosis?

a. Magnesium moves out of cells

b. Phosphate moves out of cells
57. Pretibial myxedema is associated with c. Potassium moves into cells
- Graves’ disease d. Potassium moves out of cells
- Jod-Basedow phenomenon
- Choriocarcinoma 63. A patient with type 1 diabetes mellitus
- Struma ovarii presents to the clinic with muscle cramping,
fatigue, abdominal pain, nausea, and deep
respirations. The blood pH is 7.25. Which of the
following hormones is most likely increased in
58. A 7-year-old child is brought to the doctor by this patient?
his parents, who complain that he is still wetting
the bed. They have tried restricting fluid intake a. Glucagon
before bed and using a bedwetting alarm, but b. Insulin
nothing has helped. Which medication would be c. Prolactin
most helpful for this child? d. Secretin
- Amiloride 64. A patient has poorly controlled type 2 diabetes
- Amitriptyline
- Desmopressin mellitus and presents to the emergency
- Teriparatide department with polyuria, polydipsia, blurred
vision, and a serum glucose concentration of 780
mg/dL. Which of the following findings is most
59.Which test results would best confirm a likely to be found on further evaluation?
diagnosis of type 2 diabetes mellitus in a
symptomatic patient? a. Decreased skin turgor
b. Deep (Kussmaul) respirations
a. Overnight monitoring of glucose levels at c. Elevated jugular venous pressure
an accredited center d. Fruity breath odor
b. Random blood glucose test showing a 65.Why are ketones typically present in the urine
value of >200 mg/dL of patients with diabetic ketoacidosis but absent in
c. Serial glucose blood tests for a week the urine of patients with a hyperosmolar
d. Two fasting blood glucose test results hyperglycemic state?
>110 mg/dL
a. Patients with diabetic ketoacidosis have
increased renal clearance of ketones.
60. Consider the following statements about b. Patients with diabetic ketoacidosis have
acromegaly
- Impaired glucose tolerance increased serum insulin levels, leading to
- Galactorrhoea ketogenesis.
- Hypertension
- Suppression of growth hormone with glucose
 c. Patients with a hyperosmolar a. Blood pH of 7.55
hyperglycemic state have decreased renal b. Coma
function, so they do not excrete ketones in c. Deep and rapid breaths
the urine. d. Normal to elevated insulin levels
d. Patients with a hyperosmolar 71. Which of the following would be lower in
hyperglycemic state produce insulin, patients with type 1 diabetes mellitus (DM) than
which suppresses ketogenesis. in those with type 2 DM?

a. Autoantibodies against islet cells

66. Acromegaly is characterized by all except: b. Cardiovascular complications
- Diabetes c. C-peptide levels
- Muscular hypertrophy d. Renal complications
- Enlarged nasal sinuses
- Increased heel pad thickness
72. A 45-year-old male presents to the clinic for
his annual physical. He was diagnosed with
Riedel thyroiditis last year. His exam shows a
67. A 67-year-old male with type 2 diabetes firm, painless thyroid gland. Which of the
mellitus comes to the emergency department with following is the best indication for surgical
fever and confusion. His blood glucose is 1200 thyroidectomy in this patient?
mg/dL and serum potassium level is 3.9 mEq/L.
Blood ketones are negative. The
electrocardiogram is normal. Which of the
a. HLA-DR5 haplotype
following is the best management plan for
b. Hürthle cells on fine-needle aspirate
intravenous treatment?
c. Stridor
a. Insulin d. Uncontrolled hyperthyroidism
b. Insulin, then normal saline, then 73. A 55-year-old female presents for her
potassium annual physical exam. She has intermittent pain
c. Normal saline, then dextrose solution while twisting her neck. During the thyroid
d. Normal saline, then insulin and potassium exam, she flinches in pain resulting from
tenderness in her mildly enlarged thyroid gland.
Which of the following is believed to trigger the
68.Which of the following populations has the most likely cause of this patient’s symptoms?
highest incidence of new type 1 diabetes mellitus?
a. Autoimmune injury
a. Older adult patients b. Bacterial infection
b. Immunocompromised patients c. Radiation exposure
c. Patients younger than age 19 years d. Viral infection
d. Pregnant women
69. All of the following are associated with
gigantism/ acromegaly, except: 74. A newborn baby with suspected thyroid
- Mental Retardation dysgenesis might also have which of the
- Hyperhydrosis following?
- Visceromegly
- Impaired glucose tolerance a. Atrial fibrillation
b. Diarrhea
70. Which of the following clinical findings is c. Hyperactivity
most likely to be present in a patient presenting d. Protruding tongue
with diabetic ketoacidosis?
 d. Propylthiouracil

80. A 65-year-old female with a history of

75.Neuropsychiatric symptoms of hypertension, myocardial infarction, and heart
hypothyroidism can be most often mistaken for failure presents to a clinic with symptoms of
what other illness? jitteriness, dyspnea, insomnia, and heat
a. Anxiety intolerance. Her pulse is 110 beats/min. Her
b. Depression serum thyroid-stimulating hormone level is low,
c. Insomnia and her triiodothyronine/thyroxine (T3/T4) levels
d. Psychosis are high. She is given propranolol, her pulse rate
76. Which of the following disorders would declines, and she feels a little better. Which of the
present with a low thyroid-stimulating hormone following is the best management strategy for this
level? patient?

a. Atrophic thyroiditis a. Iodine

b. Hashimoto's thyroiditis b. Methimazole, then radioiodine
c. Iodine deficiency c. Observation
d. Pituitary insufficiency d. Propylthiouracil

77. The syndrome of inappropriate Antidiuretic

hormone (ADH) secretion is characterized by the
following:
- Hyponatremia and urine sodium excretion > 20
mEq/L
- Hypernatremia and urine sodium excretion > 20
mEq/ L
- Hyponatremia and hyperkalemia
- Hypernatremia and hyperkalemia

78. Pituitary diabetes insipidus is improved by:

- Water restriction
- Lithium
- Chlorpropamide
- Chlorthiazide

79. A female who is 8 weeks pregnant presents to

her physician for a routine prenatal visit. She
complains of anxiety, heart palpitations, and
hyperdefecation. On lab evaluation, she is found
to have low serum thyroid-stimulating hormone
and high thyroxine. Which of the following is the
most appropriate initial treatment for this patient?

a. Levothyroxine
b. Lugol solution (iodine)
c. Methimazole
81. Central diabetes insipidusis characterized by: a. Red striae
- High plasma and high urine osmolality
- Low plasma and low urine osmolality b. Increased adrenaline
- Low plasma and high urine osmolality c. Proximal muscle weakness
- * Low urine and high plasma osmolality
d. Edema
88. Obesity is seen in all except:
82. A chronic smoker presented with mild a. Cushing syndrome
haemoptysis. He also gave a history of
hypertension and obesity. Lab data showed raised b. Pickwinian syndrome
ACTH levels, which were not suppressed by high
dose dexamethasone. The cause for the Cushing' s c. Prader willi syndrome
syndrome in the patient is: d. Sipple syndrome
- MEN I
- Pituitary adenoma 89. Cushing syndrome is commonly caused by:
- Adrenal cortical adenoma
- Ectopic ACTH secreting tumor a. Adrenal adenoma
b. Adrenal hyperplasia
83. Ideal investigation for adrenal insufficiency is: c. Ectopic adrenal hormone production
a. ACTH stimulation d. Adrenal carcinoma
b. Cortisol level estimation 90. Most common cause of Cushing's syndrome is:
c. Dexamethasone test a. Pituitary adenoma
d. Urinary steroid estimation b. Adrenal adenoma
84. The most common cause of malignant adrenal c. Ectopic ACTH
mass is:
d. Iatrogenic steroids
a. Adrenocortical carcinoma
91. Not seen in Cushing's syndrome:
b. Malignant Phaeochromocytoma
a. Hypoglycemia
c. Lymphoma
b. Hypertension
d. Metastasis from another solid tissue tumor
c. Frank psychosis
85. Adrenal reserve is best tested by means of
infusion with: d. Hypokalemia

a. Glucocorticoids 92. A 28-year-old lady has put on weight [10 kg

over a period of 3 years] and has oligomenorrhoea
b. ACTH followed by amenorrhoea for 8 months. The blood
c. Hypothyroidism pressure is 160/ 100 mm of Hg. Which of the
following isthe most appropriate investigation?
d. Metyrapone
a. Serum electrolytes
86. Mainstay of treatment of nephrogenic diabetes
insipidus is: b. Plasma cortisol
- Desmopressin
- Thiazide/ Amiloride diureties and salt restriction c. Plasma testosterone and ultrasound
- Desmopressin and salt restriction d. T3,T4 and TSH
- Vasopressin and salt restriction
93. A patient presents with hemoptysis and
Cushingoid features with a lack of dexamethasone
87. All of the following are true about Cushing's suppression, the likely reason could be:
syndrome, except:
a. Adrenal hyperplasia b. Pituitary adenoma
b. Adrenal adenoma c. Adrenal cortical adenoma
c. CA lung d. Ectopic ACTH secreting tumor
d. Ectopic ACTH production 100. Nelson' s syndrome is most likely seen after:
94. True about Cushing' s syndrome is all except: a. Hypophysectomy
a. Association with the MEN 1 syndrome b. Adrenalectomy
b. Bronchial carcinoid causes cushing syndrome c. Thyroidectomy
c. Hypokalemia d. Orchidectomy
d. Associated with coronary accidents 101. 40 year Male presents with primary infertility.
Testis is present with azoospermia and absent vas
95. Pseudo- Cushing syndrome is seen in:
deferens
a. Chronic alcoholism
a. CFTR mutation
b. Incidentaloma
b. A.I.S
c. Adrenal carcinoma
c. Mullerian dysgenesis
d. Nelson syndrome
d. Congenital adrenal hyperplasia
96. A common cause of Cushing' s syndrome is:
102. A 28-year-old lady has put on weight [10 kg
a. Cancer producing ectopic ACTH over a period of 3 years] and has oligomenorrhoea
followed by amenorrhoea for 8 months. The blood
b. Pituitary adenoma pressure is 160/ 100 mm of Hg. Which of the
following isthe most appropriate investigation?
c. Adrenal tuberculosis - Serum electrolytes
d. None of the above - Plasma cortisol
- Plasma testosterone and ultrasound
97. All of the following are true about Cushing’s - T3,T4 and TSHT3,T4 and TSH
syndrome, except
a. Red striae 103. A child presents with ambiguous genitalia
without hyperpigmentation and normal blood
b. Increased adrenaline pressure, 2.5 cm phallus with no opening at its tip,
c. Proximal muscle weakness labia develop ed. Gonads are not seen in inguinal
region and Mullerian structures are present on
d. Edema USG. The most probable diagnosis is:
98. A common cause of Cushing' s syndrome is: a. AIS
- Cancer producing ectopic ACTH
- Pituitary adenoma b. Maternal virilising tumor
- Adrenal tuberculosis
c. CAH
- None of the above
d. 5-alpha-reductase deficiency
99. A chronic smoker presented with mild 104. Ideal investigation for adrenal insufficiency
haemoptysis. He also gave a history of is:
hypertension and obesity. Lab data showed raised - ACTH stimulation
ACTH levels, which were not suppressed by high - Cortisol level estimation
dose dexamethasone. The cause for the Cushing' s - Dexamethasone test
syndrome in the patient is: - Urinary steroid estimation

a. MEN I
105. The most common cause of malignant adrenal dl. Which of the following is the most probable
mass is: diagnosis in his case?
- Adrenocortical carcinoma
- Malignant Phaeochromocytoma a. Nutritional rickets
- Lymphoma
b. Renal rickets
- Metastasis from another solid tissue tumor
c. Hyperparathyroidism
106. A 30-year-old male complains of loss of d. Skeletal dysplasia
erection; he has low testosterone and high prolactin
level in blood; What is the likely diagnosis: 111. A 75 year old lady with fracture neck of
femur presents with two days history of altered
a. Pituitary adenoma sensorium and decreased urinary output. Serum
b. Testicular failure calcium is 15.5 mg/ dL, Urea is 140 mg/ dL,
Creatinine is 2 mg/ dL. All of the following are
c. Craniopharyngioma usefulf or immediate management of
hypercalcemia, except:
d. Cushing' s syndrome
a. Normal saline
107. A female who is 8 weeks pregnant presents to
her physician for a routine prenatal visit. She b. Furosemide
complains of anxiety, heart palpitations, and
hyperdefecation. On lab evaluation, she is found to c. Dialysis
have low serum thyroid-stimulating hormone and
d. Bisphosphonates
high thyroxine. Which of the following is the most
appropriate initial treatment for this patient? 112. Which of the following statements is not true?
- * Propylthiouracil
- Levothyroxine a. Parathyroid hormone-related protein is
- Lugol solution (iodine) responsible for causing hypercalcemia in cancer
- Methimazole patients.
b. The unionized fraction of calcium in the plasma
108. Patients with hypothyroidism and which of is an important determinant of PTH secretion.
the following diseases should have their thyroid
hormone replaced most slowly? c. Mg 2+ln influences PTH secretion in the same
- Atherosclerotic heart disease direction as Ca 2+ , but is a less potent secret-
- Chronic kidney disease agogue. d. Ca 2+ influences PTH secretion by
- Diabetes mellitus acting on a calcium sensor G-protein coupled
- Hyperparathyroidism receptor located in the parathyroid gland.
113. A 33 year old lady presents with polydipsia
109. A 17-year old girl who was evaluated for and polyuria. Her symptoms started soon after a
short height wasfound to have an enlarged pituitary road trafic accident 6 months ago. The blood
gland. Her T4 waslow and TSH was increas ed. pressure is 120/ 80 mm Hg with no postural drop.
Which of the following is the most likely The daily urinary output is 6-8 liters. Investigation
diagnosis? showed, Na 130 mEq/L, K. 3.5 mEq/ L, urea 15
a. Pituitary adenoma mg/dL, sugar-65 mg/ dL. The plasma osmolality is
268 mosmol/ L and urine osmolality 45 mosmol/L.
b. TSH-secreting pituitary tumour The most likely diagnosisis:
c. Thyroid target receptor insensivity a. Central diabetes insipidus.
d. Primary hypothyroidism b. Nephrogenic diabetes insipidus.
110. A 10-year-old boy has a fracture of femur. c. Resolving acute tubular necrosis.
Biochemical evaluation revealed Hb 11. 5 gm/ dl
and ESR 18 mm 1 hour, serum calcium 12.8 Mg/ d. Psychogenic polydipsia.
dl, serum phosphorus 2.3 mg/ dl, alkaline
phosphatase 28 KA units and blood urea 321mg/
114. A patient following head injury was admitted c. Chlorpropamide
in intensive care ward with signs of raised
d. Chlorthiazide
intracranial pressure. He was put on ventilator and
started on intravenous fluids and diuretics. Twenty 119. Drugs used in thyroid crisis are A/E:
four hours later his urine output was 3.5 litres, - Propranolol
serum sodium 156mEq/ L and urine osmolality of - Carbimazole
316 mOsm/ kg. The most likely diagnosis based on - Iodine
these parameters is: - Corticosteroids

a. High output due to diuretics

120. The lab investigation of patient shows low T3,
b. Diabetes insipidus low T4, and low TSH. It cannot be:
- Primary hypothyroidism
c. Too much infusion of normal saline
- Pan-hypopituitarism
d. Cerebral salt retaining syndrome - Liver disease
- None of the above
115. Mainstay of treatment of nephrogenic diabetes
insipidus is:
121. The syndrome of inappropriate ADH
a. Desmopressin secretion is characterized by the following:
b. Thiazide/ Amiloride diureties and salt restriction a. Hyponatremia and urine sodium excretion > 20
mEq/L
c. Desmopressin and salt restriction
b. Hypernatremia and urine sodium excretion > 20
d. Vasopressin and salt restriction
mEq/ L
116. Why are ketones typically present in the urine
c. Hyponatremia and hyperkalemia
of patients with diabetic ketoacidosis but absent in
the urine of patients with a hyperosmolar d. Hypernatremia and hyperkalemia
hyperglycemic state?
- Patients with diabetic ketoacidosis have increased 122. All of the following are associated with
renal clearance of ketones. gigantism/ acromegaly, except:
- Patients with diabetic ketoacidosis have increased
serum insulin levels, leading to ketogenesis. a. Mental Retardation
- Patients with a hyperosmolar hyperglycemic state b. Hyperhydrosis
have decreased renal function, so they do not
excrete ketones in the urine. c. Visceromegly
- Patients with a hyperosmolar hyperglycemic
state produce insulin, which suppresses d. Impaired glucose tolerance
ketogenesis.
123. Confirmatory investigation for Acromegaly is:
a. Insulin induced GH suppression
b. Glucose induced GH suppression
117. Central diabetes insipidusis characterized by:
c. Random GH assay
a. Low plasma and low urine osmolality
d. IGF -I level
b. High plasma and high urine osmolality
124. Laron dwarfism is due to? a. GH deficiency
c. Low plasma and high urine osmolality b. GHRH deficiency c. GH receptor resistance d.
d. Low urine and high plasma osmolality IGF-1deficiency

118. Pituitary diabetes insipidus is improved by: 125. Conn's syndrome is associated with all,
except:
a. Water restriction - Hypertension
- Muscle weakness
b. Lithium - Hypokalemia
- Edema
 - Polyuria
- Polydypsia
126. Acromegaly is characterized by all except: - Weakness
a. Diabetes - Anasarca

b. Muscular hypertrophy
133. Which of the following is the most common
c. Enlarged nasal sinuses cause of Addison's disease in India?
- Post-partum pituitary insufficiency
d. Increased heel pad thickness - Tuberculosis
- HIV
127. Consider the following statements about - Autoimmune adrenal insufficiency
acromegaly
a.. Impaired glucose tolerance 134. A 7-year-old child is brought to the doctor by
his parents, who complain that he is still wetting
b. Galactorrhoea the bed. They have tried restricting fluid intake
before bed and using a bedwetting alarm, but
c. Hypertension
nothing has helped. Which medication would be
d. Suppression of growth hormone with glucose most helpful for this child?
128. In Addison’s disease, most diagnostic test is a. Amiloride
- Serum Na+,K+,rennin b. Amitriptyline
- Serum Na+,K+,saline suppression
c. Desmopressin
- Serum creatinine/ urea ratio
- ACTH stimulation test d. Teriparatide
135. A 21-year-old patient is started on intravenous
vasopressin for septic shock. What is a potential
129. All of the following are features of adverse effect of this medication?
acromegaly except?
a. Decreased appetite
a. Glucose intolerance
b. Drowsiness
b. Non-suppression of growth hormone by glucose c. Hypernatremia
ingestion d. Limb ischemia
c. Raised level of plasma somatomedin C
136. All of the following causes
d. Low serum phosphate
hyperprolactinemia except:
130. Paradoxical growth hormone response to TRH
a. Methyldopa b. Phenothiazines
isseen in all except?
c. Bromocriptine d.
a. Malnutrition Metoclopramide

b. Anorexia nervosa 137. The following are recognized features of

panhypopituitarism except:
c. Prolactinoma
a. Increased insulin sensitivity
d. Acromegaly
b. Pigmentation of the mucous membranes
131. Heel pad thicknessis useful in:
c. Low serum thyroxine and TSH levels
a. Hypothyroidism
d. Loss of secondary sex characters
b. Acromegaly
138. A 32-year-old female patient did not visit the
c. PEM physician for the last 6 year when she had given
d. All of the above birth to her last daughter, which was her third
child. She has currently come with complaints of
132. Conn's syndrome is characterized by all vaginal pruritus. She also has history of cold
except: intolerance and repeated skin infections. On
examination, the skin is dry and coarse. The pubic 144.The most common cause of goiter in
and axillary hair is absent. All the following can be developing nations is
given for her treatment except:
a. Iodine deficiency
a. Prednisolone b. Thyroid hormone c.
b. Lithium
Ethinyl estradiol d. Insulin
c. Hashimoto’s thyroiditis
139. A patient has amenorrhea with hypothalamic
lesion. The diagnosisis most likely to be? d. Propylthiouraci
a. Kallman's syndrome 145.
b. Asherman’s syndrome 146. High levels of thyroidal peroxidase antibody
are found with
c. Stein Leventhal syndrome
a. Iodine deficiency
d. Sheehans syndrome
b. Lithium
140. In a patient with iodine-deficiency goiter who
moves from an iodinedeficient area to an iodine- c. Hashimoto’s thyroiditis
replete area, the occurrence of hyperthyroidism
most likely represents d. Propylthiouracil

a. Graves’ disease 147. A patient without symptoms and without a

b. Jod-Basedow phenomenon recent illness is found to have a normal free T4 and
c. Choriocarcinoma elevated TSH which are confirmed on repeated
d. Struma ovarii measurements. The most likely explanation is
141. Thyrotoxicosis and uniformly increased a. Hyperthyroidism
radioactive iodine uptake in the thyroid can occur
without any thyrotropin receptor antibodies or any b. Nonthyroidal illness (sick euthyroidism)
thyroid autoimmunity in
c. Estrogen therapy
a. Graves’ disease
d. Subclinical hypothyroidism
b. Jod-Basedow phenomenon 148. A low TSH, high T4, and high T3 suggests

c. Choriocarcinoma a. Hyperthyroidism

d. Struma ovarii b. Nonthyroidal illness (sick euthyroidism)

142 .Pretibial myxedema is associated with c. Estrogen therapy
a. Graves’ disease d. Subclinical hypothyroidism
b. Jod-Basedow phenomenon e. Familial (euthyroid) dysalbuminenic
c. Choriocarcinoma hyperthyroxinemia

d. Struma ovarii 149. A patient with a low TSH and high T3 most
likely has
143. Infiltration of orbital soft tissue and
extraocular muscles with lymphocytes, a. Hyperthyroidism
mucopolysaccharides, and fluid is seen with b. Nonthyroidal illness (sick euthyroidism)
a. Graves’ disease c. Estrogen therapy
b. Jod-Basedow phenomenon d. Subclinical hypothyroidism
c. Choriocarcinoma e. Familial (euthyroid) dysalbuminenic
d. Struma ovarii hyperthyroxinemia
150. The most common variety of thyroid cancer is
a. Thyroid lymphoma b. Bradycardia
b. Medullary thyroid carcinoma c. Decreased sweating
c. Papillary thyroid carcinoma d. Increased basal metabolic rate
d. Anaplastic thyroid carcinoma e. Increased weight gain
e. Follicular thyroid carcinoma 155. A 46-year-old woman on lithium therapy for
her bipolar disorder presents with complaints of
weakness, arthralgia, and constipation. Blood work
151. Elevated plasma calcitonin is seen with reveals hypercholesterolemia, increased levels of
TSH, and decreased free T4 levels. Which of the
a. Thyroid lymphoma following is also likely to be associated with her
b. Medullary thyroid carcinoma hypothyroid state?

c. Papillary thyroid carcinoma a. Decreased body mass index

d. Anaplastic thyroid carcinoma b. Heat intolerance

e. Follicular thyroid carcinoma c. Increased metabolic rate

152. A 65-year-old man presents with signs and d. Sleepiness

symptoms of thyrotoxicosis. His radioiodine scan e. Tachycardia
and 24-h uptake show a patchy pattern but normal
amount of radioiodine uptake. This presentation is 156. Anti-TSH receptor antibodies are most
most consistent with specific to which disease?
- Graves disease
a. Graves’ disease - Hashimotos thyroiditis
- Postviral thyroiditis
b. Subacute thyroiditis - Atrothic thyroiditis
c. Toxic multinodular goiter
d. Hashimoto’s thyroiditis 157. A patient with thyroid cancer is told that he
has a life expectancy of less than 6 months from
e. Toxic adenoma diagnosis. The variety of thyroid cancer with this
prognosis is
153. A 30-year-old woman with thyrotoxicosis has
a diffusely enlarged gland on palpation of the neck. a. Thyroid lymphoma
Her thyroid scan and 24-h uptake show uniformity
of uptake and an increased percentage uptake. This b. Medullary thyroid carcinoma
patient has c. Papillary thyroid carcinoma
a. Graves’ disease d. Anaplastic thyroid carcinoma
b. Subacute thyroiditis e. Follicular thyroid carcinoma
c. Toxic multinodular goiter 158. A patient with chronic autoimmune
d. Hashimoto’s thyroiditis (Hashimoto’s) thyroiditis develops a rapidly
enlarging thyroid mass. Most likely this is
e. Toxic adenoma
a. Thyroid lymphoma
154. A 37-year-old woman presents with
exophthalmus and an enlarged thyroid gland. The b. Medullary thyroid carcinoma
levels of free thyroxine in her blood are elevated. c. Papillary thyroid carcinoma
Other clinical findings of Graves’ disease include
which of the following? d. Anaplastic thyroid carcinoma

a. Anorexia e. Follicular thyroid carcinoma

159. A 40-year-old patient with a recent viral 165. The occurence of hyperthyroidism following
infection presents with a significantly tender gland, administration of supplemental iodine to subjects
low radioiodine uptake, and signs and symptoms of with endemic iodine deficiency goiter is known as:
thyrotoxicosis. This presentation is most likely
a. Jod-Basdow effect
a. Graves’ disease
b. Wolff-Chaikoff effect
b. Subacute thyroiditis
c. Thyrotoxicosis factitia
c. Toxic multinodular goiter
d. De quervain' sthyroiditis
d. Hashimoto’s thyroiditis
166. Which of the following antibodies is involved
e. Toxic adenoma in the tissue destructive process associated with
hypothyroidism in Hashimoto' s and atrophic
160. A 30-year-old woman with thyrotoxicosis has thyroiditis?
a diffusely enlarged gland on palpation of the neck.
Her thyroid scan and 24-h uptake show uniformity a. Thyroperoxidase antibody
of uptake and an increased percentage uptake. This
b. Thyroglobulin antibody
patient has
c. TSH receptor antibody
a. Graves’ disease
d. Thyroid stimulating antibody
b. Subacute thyroiditis
167. All of the following are true about amiadaro
c. Toxic multinodular goiter
induced thyroid dysfunction except?
d. Hashimoto’s thyroiditis
a. Hyperthyroidism is common in iodine defici
e. Toxic adenoma areas cnt
161. A 58-year-old woman presents as an b. Hypothyroidism is more common in men
outpatient with lethargy, fatigue, and cold
c. Amiodarone inhibits deiodinase activity
intolerance. Thyroid function testing reveals a free
T4 of 0.5 (0.7 to 2.0) and a TSH of 0.1 (0.5 to 5). d. Amiodaraone therapy is associated with initial
The best next diagnostic test is reduction of serum T4 levels
a. Thyroid scan and uptake 168. Decreased radio iodine uptake is/ are seen in [
select two options]:
b. MRI of the pituitary
a. Toxic multinodular goite
c. Prolactin
b. Grave's disease
d. Thyroid autoantibodies
c. Subacute thyroiditis
e. T3
d. Factitious thyroiditis
162.
169. Which of the following is a clinical sign of
163. Treatment for childhood hypothyroidism is
hypothyroidism?
with:
- Warm skin
a. T4 - Hyperreflexia
- Palmar erythema
b. T3 - Hyporeflexia
c. Levothyroxine
170. Clinical manifestations of diabetic
d. TSH ketoacidosis are
164. The bestmarker to diagnose thyroid related - gastrointestinal pain;
- increased appetite;
disorders is: [Manipal] a a. T3 b. T4 c. TSH d.
- polydipsia, polyuria;
Thyroglobulin
- loss of appetite, nausea, vomiting
 177. Grave’s disease or Basedow’s disease is due
to
171. The drug used in the management of
medullary carcinoma thyroid is: a. Hyperactivity of adrenal cortex

a. Cabozantinib b. Hypoactivity of the thyroid gland

c. Hyperactivity of thyroid gland
b. Rituximab
d. Hypoactivity of islets of Langerhans
c. Tenofovir
178. Sometimes, the thyroid symptoms are
d. Anakinra mistaken for which condition?
172. The lab investigation of patient shows|T3, a. Menopause
J.T4, and [TSH. It cannot be :
b. Posttraumatic stress
a. Primary hypothyroidism
c. Pregnancy
b. Pan-hypopituitarism
d. Crohn’s disease
c. Liver disease 179. Medications for hypothyroidism include
d. None of the above treatment that:
a. Replaces insulin
173. Which of the following is not associated with
hypothyroidism: b. Replaces ADH
a. Low T3 c. Replaces TH

b. High TSH d. Replaces surfactant

c. High Triglycerides 180. Which of these diseases is not related to

thyroid glands?
d. Low cholesterol
a.Cretinism
174. Proptosis is notseen in?
b. Myxoedema
a. Grave's disease c. Goitre
b. Sarcoidosis d. Acromegaly
c. Pituitary adenoma 181. In chronically deficient patients, this
abnormality is directly related to the enlargement
d. Myxoedema of the thyroid gland
175. The glucose lowering effect is least and a. Impaired conversion of T3 and T4
delayed by several weeks with the following oral
hypoglycaemic agents b. Reduced activity of thyroperoxidase
- Insulin secretogogues
c. Elevated levels of TSH
- DPP -IV inhibitors
- Biguanides d. An antibody that binds to the TSH receptor in
- Alpha-Glucosidase inhibitors the thyroid gland
182. This condition of chronic inflammation of the
thyroid leading to under-activity is
176.Iodine deficiency can cause a. Thyroiditis
a. Goiter b. Goitre
b. Thyroid cancer c. Hypothyroidism
c. Solitary thyroid nodules d. Hyperthyroidism
d. Thyroiditis 183. Which of the following proteins is the
precursor for the thyroid hormone, and also a
marker of thyroidal cancer? c. Increased Lipolysis
a. Thyroalbumin d. Protein Anabolism
b. Thyroglobulin
c. Thyroid binding globulin 191. A 50 years old man with hyperthyroidism is
d. All of the above treated with propylthiouracil. The drug reduces the
synthesis of thyroid hormones because it inhibits
184. The majority of the thyroid hormones in the the oxidation of
blood are bound to proteins. a. Triiodothyronine
Which of the following are not the thyroid b. Thyroxine
hormone-binding proteins in the plasma? c. Diiodotyrosine
a. Albumin d. Iodide
b. Thyroglobulin
c. Thyroid binding globulin 192.What is the role of thyroglobulin?
d. None of the above a. Assists with thyroid hormone production
185. In addition to inhibiting thyroid hormone
synthesis, which of the following chemical drug b. Transports thyroid hormones
also reduces the uptake of iodine into the thyroid
c. Storage of thyroid hormones
cells?
a. Carbimazole d. Assistance with thyroid hormone uptake
b. Methimazole
c. Thiourea
d. All of the above 193. Which of the following is a clinical sign of
186. Which of the following cellular processes hypothyroidism?
increase in response to thyroid-stimulating a.Warm skin
hormones? b.Hyperreflexia
a. Uptake of iodide into the follicular cells c.Palmar erythema
b. Synthesis of thyroglobulin proteins d.Hyporeflexia
c. Incorporation of iodide ions into tyrosine
molecules of thyroglobulin
d. All of the above 194. Which antibodies are pathognomonic of
Grave's disease?
187. In pregnancy, TBG levels increase, leading to
an increase in total thyroid hormone, but the a. Anti-TPO
normal levels of free hormone. This is known as b. Anti-TSH receptor
a. Euthyroid state c. Anti-thyroglobulin
b. Hyperthyroid state d .Anti-TRH receptor
c. Hypothyroid state 195. Which of the following is NOT a cause of
d. Subclinical hypothyroid state primary hyperthyroidism?
188. The hypothalamic-pituitary and thyroid axis a.TSH-secreting tumour
regulates the synthesis and release of thyroid b.Toxic nodule
hormones. Which of the following receptors are c.Congenital hyperthyroidism
down-regulated by excess T3 d.Graves disease
a. TSH receptor in the thyroid gland
b. T3 receptor in hypothalamus
c. TRH receptor in the anterior pituitary
d. All of the above 196. Which of the following is a symptom of
189. Which of the following is not the metabolic hyperthyroidism?
function of thyroid hormones?
a. Glycogenolysis a.Weight again
b. Gluconeogenesis b.Cold intolerance
c. Glucose oxidation c.Heart intolerance
d. Glycogenesis d.Constipation

190. The metabolic function of thyroid hormones

include
a. Decreased oxygen consumption 197. Anti-TSH receptor antibodies are most
b. Increased lipogenesis specific to which disease?
 c. HIV
a.Graves disease d. Autoimmune adrenal insufficiency
b.Hashimotos thyroiditis
c.Postviral thyroiditis 203.Conn's syndrome is characterized by all
d.Atrothic thyroiditis except:

a. Polyuria
198. A condition of a chronic inflammation of the
thyroid, which lead to under activity? b. Polydypsia
a. Goitre
b. Thyroiditis c. Weakness
c. Hypothyroidism
d. Hyperthyroidism d. Anasarca
199. Which of the following are the functions of
204. In Addison’s disease, most diagnostic test is:
the thyroid gland inside the body?
a. Serum Na+,K+,rennin
a. Maintain Internal Homeostasis
b. Controls Metabolism b. Serum Na+,K+,saline suppression

c. Controls Heart Rate and Breathing c. Serum creatinine/ urea ratio

d.All of the above d. ACTH stimulation test

205. Incorrect about Addison’s disease is?

200. The 4 small glands in thyroid gland are a. Hypoglycemia

considered as
b. Hypokalemia
a. Pineal Gland c. Loss of axillary and pubic hair
b. Adrenal Gland d. Salt craving
c. Exocrine and Endocrine Gland 206. Conn's syndrome is associated with all, except
d. Parathyroid Gland :

201. A patient with a low TSH and high T3 most a. Hypertension

likely has
b. Muscle weakness
a. Hyperthyroidism
c. Hypokalemia
b. Nonthyroidal illness (sick euthyroidism)
c. Estrogen therapy d. Edema

d. Subclinical hypothyroidism 207. Dose of clonidine in suppression test done in

e. Familial (euthyroid) dysalbuminenic pheochromocytoma is:

hyperthyroxinemia
a. 0.3 mg

c. 100 mg suppression
202.Which of the following is the most common
cause of Addison's disease in india? b. 10 mg
a. Post-partum pituitary insufficiency d. 200 mg
b. Tuberculosis
208. Drug for management of hypertension in a. Diarrhoea
Phaeochromocytoma?
b. Orthostatic hypotension
a. Phenoxybenzamine
c. Episodic hypertension
b. Phentolamine
d. Weight gain
c. Labetalol
214. The residual form of phaeochromocytoma is
d. Esmolol treated by:

209. In the management of diabetic ketoacidosis: a. Strontium

- Intracellular water deficit is best restored using
half strength saline [0.45% saline] b. Phosphorus
- Potassium should be given even before checking
the serum potassium concentration c. Cobalt-60
- Bicarbonate infusion is often only necessary in
severe acidosis pH< 7.0 d. MIBG
- 5% dextrose solution should be avoided unless
hypoglycaemia supervenes 215. All the following drugs are used in
pheochromocytoma except:

210. Which of the following is not found in a. Prazosin

pheochromocytoma?
b. Atenolol
a. Episodic hypertension
c. Nitroprusside
b. Postural hypotension
d. Metyrosine
c. Increased hematocrit
216. All are clinical features of
d. Hypocalcemia pheochromocytoma, except:

211. A patient with pheochromocytoma would a. Increased hematocrit

secrete which of the following in a higher
b. Orthostatic hypotension
concentration?
c. Low cortisol level
a. Norepinephrine
d. Impaired glucose tolerance
b. Epinephrine
217. The occurence of hyperthyroidism following
c. Dopamine
administration of supplemental iodine to subjects
d. VMA with endemic iodine deficiency goiter is known as:

212. Pheochromocytoma is associated with: a. Jod-Basdow effect

a. Vitiligo b. Wolff-Chaikoff effect

b. Cafe-au-laitspots c. Thyrotoxicosis factitia

c. Ash leaf amelanotic macusles d. De quervain' sthyroiditis

d. Acanthosis Nigricans 218. The best marker to diagnose thyroid related

disorders is:
213. In a patient with pheochromocytoma, all the
following are seen except: a. T3
b. T4 c. Anaplastic carcinoma of the thyroid

c. TSH d. Follicular carcinoma of the thyroid

d. Thyroglobulin 224. Proptosis is not seen in?

219. Hypothyroidism may be caused by: a. Grave's disease

a. Lithium b. Sarcoidosis

b. Hematochromatosis c. Pituitary adenoma

c. Scleroderma d. Myxoedema

d. All of the above 225. Hypothyroidism is associated with the

following clinical problems, except:
220. Which of the following is not associated with
hypothyroidism: a. Menorrhagia

a. Low T3 b. Early abortions

b. High TSH c. Galactorrhoea

c. High Triglycerides d. Thromboembolism

d. Low cholesterol

221. The lab investigation of patient shows low T3, 226.TSH cannot be used for monitoring response
low T4, and low TSH. It cannot be : to treatment in:

a. Primary hypothyroidism a. Primary hypothyroidism

b. Pan-hypopituitarism b. Secondary hypothyroidism

c. Liver disease c. Thyroprivic hypothyroidism

d. None of the above d. Iodine deficiency

222. All of the following are true about amiadarone 227. Drugs used in thyroid crisis are A/E:
induced thyroid dysfunction except?
a. Propranolol
a. Hyperthyroidism is common in iodine deficient
areas b. Carbimazole

b. Hypothyroidism is more common in men c. Iodine

c. Amiodarone inhibits deiodinase activity d. Corticosteroids

d. Amiodaraone therapy is associated with initial 228. Which one of the following features may not
reduction of serum T4 levels be seen in hypothyroidism?

223. Pancreatitis, pituitary tumor and a. Cold intolerance

pheochromocytoma may be associated with: b. Deafness
a. Medullary carcinoma of the thyroid c. Pericardial effusion
b. Papillary carcinoma of the thyroid d. Pretibial myxoedema
229. Goitrous hypothyroidism commonly occurs in b. Osteomalacia
all of the following except?
c. Osteoporosis
a. Hashimoto's thyroiditis
d. Renal failure
b. Dyshormonogenesis [Pendred syndrome]

c. Thyroprivic hypothyroidism

d. iodine deficiency
235. A 10-year-old boy has a fracture of femur.
230. Presentation of hypothyroidism is? Biochemical evaluation revealed Hb 11. 5 gm/ dl
and ESR 18 mm 1 hour, serum calcium 12.8 Mg/
a. Pretibial myxedema dl, serum phosphorus 2.3 mg/ dl, alkaline
phosphatase 28 KA units and blood urea 321mg/
b. Hirusutism
dl. Which of the following is the most probable
c. Easily brusiable skin diagnosis in his case?

d. Galactorrhoea a. Nutritional rickets

231.The laboratory screening test which suggests b. Renal rickets

normal thyroid function is:
c. Hyperparathyroidism
a. TSH
d. Skeletal dysplasia
b. Free T4

c. T3

d Free T3

232. Subtle presentation of hyperparathyroidism is:

a. Psychiatric manifestation

b. Nephrocalcinosis

c. Abdominal pain

d. Asymptomatic hypercalcemia

233. Which of the following conditions is

associated with Hypothyroidism:

a. Hoshimoto' s Thyroiditis

b. Grave' s Disease

c. Toxic Multinodular Goiter

d. Struma ovary

234. Secondary hyperparathyroidism is seen in all

of the following, except:

a. Rickets