The Quizzes about Endocrinology disease – Part 4 (20 test)

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The Quizzes about Endocrinology disease – Part 4 (20 test)
5 (100%) 1 vote

Select the ONE answer that is BEST in each case.

Which of the following is the most appropriate management for phenylketonuria?

In phenylketonuria, a low phenylalanine diet with relentless attention to details of diet is required for a good outcome. The diet should be started by 3 weeks of age. Children of mothers with phenylketonuria can be affected if exposed to phenylalanine in utero. Therefore, women with the disorder should stay on a restricted diet until they complete childbearing. In phenylalanine hydroxylase deficiency, tyrosine becomes an essential amino acid and dietary supplements must be provided.

 

See all quizzes of  the Endocrinology disease at here:

Part 1Part 2 | Part 3 | Part 4| Part 5 |

 

61. Which of the following is the most appropriate management for phenylketonuria?

(A) a gluten-free diet from age 6 months to 12 years

(B) supplemental insulin

(C) enteral feeding

(D) tyrosine supplements

(E) a low carbohydrate diet

62. A 21-year-old woman on no medications develops rigidity, tremor, and incoordination. She has a history of unexplained hepatitis 2 years ago and depression 1 year ago. Her examination is pertinent for increased tone, normal muscle strength, and coarse tremor of the hands. An ophthalmologic examination is positive for a brownish pigmented ring at the corneal margin. Which of the following findings is most likely to be present in this patient? (See Fig. 3–6.)

(A) renal failure

(B) cirrhosis of the liver

(C) elevated ceruloplasmin

(D) sensory loss

(E) increased plasma copper

63. A 57-year-old man complains of increased thirst and urination. His examination is normal except for obesity (BMI>30). Which of the following is the most appropriate initial diagnostic test?

(A) a urine osmolality

(B) hemoglobin A1C level

(C) a fasting blood sugar (FBS)

(D) a glucose tolerance test (GTT)

(E) random glucose

64. Which of the following is the most likely effect of insulin at the cellular receptor level?

(A) stimulating tyrosine kinase

(B) binding to ion channels

(C) binding to intracellular erb A receptors

(D) stimulating guanylate cyclase

(E) activating G-proteins

65. Which of the following is the most likely metabolic effect of insulin on adipose tissue?

(A) decrease of glucose transport

(B) decrease in glucose phosphorylation

(C) decrease in lipolysis

(D) decrease in lipoprotein lipase

(E) enhancement of glucagon effect

66. A 32-year-old woman presents with heat intolerance, palpitations, diarrhea, weakness, and weight loss. Her blood pressure is 90/60 mm Hg, pulse 110/min, and she has a fine tremor in her hands. The TSH level is suppressed and T3 and T4 are elevated. Which of the following is most likely to precipitate this condition?

(A) propylthiouracil administration

(B) high-dose prednisone therapy

(C) beta-adrenergic blockade

(D) pneumonia

(E) salicylate administration

67. A 15-year-old youth has not gone through puberty. Which of the following is the most likely diagnosis?

(A) inadequate diet

(B) normal variation

(C) pituitary tumor

(D) Leydig cell dysfunction

(E) drug side effects

68. A 44-year-old woman is recently diagnosed with breast cancer and undergoes a mastectomy. Which of the following features is most likely to be important in determining response to tamoxifen therapy?

(A) metastases confined to liver

(B) patient more than 5 years premenopausal

(C) androgen receptors on the tumor cell membrane

(D) tumor has progesterone receptors (PR)

(E) metastases confined to brain

69. Which of the following increases a woman’s risk of breast cancer?

(A) castration before age 40 years

(B) late first pregnancy

(C) long-term nursing

(D) history of breast cancer in an aunt

(E) multiparity

70. Which of the following statements is correct?

(A) resting metabolic rate (RMR) is identical in men and women when corrected for weight and height

(B) virtually all nitrogen loss is through urine in the form of urea

(C) increasing the proportion of protein in the diet increases the efficiency of protein production in the body

(D) generally, physical activity accounts for only 15% of total energy expenditure over most conditions

(E) recommended levels of adult protein ingestion should be decreased by 30% for the very elderly

71. A 35-year-old woman, on hemodialysis for chronic renal disease, complains of pain in the hands. On examination, the joints are normal with no inflammation or tenderness on palpation. Lab values reveal a low calcium, high phosphate, and high PTH level. What is the most likely diagnosis? (See Fig. 3–7.)

(A) scleroderma

(B) gout

(C) secondary hyperparathyroidism

(D) pseudogout

(E) Paget’s disease

72. A 35-year-old woman presents with fatigue, weakness, and weight gain. Her blood pressure is 155/90 mm Hg, pulse 80/min, and there is central obesity with skin striae. Investigations are shown in Table 3–1. Which of the following is the most likely diagnosis?

(A) adrenal hyperplasia secondary to hypothalamic dysfunction

(B) adrenal adenoma with complete autonomy

(C) exogenous steroids, iatrogenic

(D) pituitary tumor

(E) carcinoma of the adrenal

73. A 55-year-old obese woman complains of vulvar pruritus, recent weight loss in spite of a large appetite, and waking up frequently at night to urinate. Which of the following is the most likely diagnosis?

(A) DM

(B) DI

(C) vaginitis and cystitis

(D) myxedema

(E) pheochromocytoma

74. A 72-year-old man with Type II diabetes notices painless skin lesions on his legs. They have an irregular raised border with a flat depressed center that is hyperpigmented brown in color. (SELECT ONE)

(A) microaneurysms

(B) vitreal hemorrhage

(C) dilated veins

(D) retinal detachment

(E) hemorrhage (dot and blot)

(F) open-angle glaucoma

(G) erythema multiforme

(H) pyoderma gangrenosum

(I) necrobiosis lipoidica

(J) candidiasis

77. Can be caused by high prolactin level (SELECT ONE)

(A) loss of sexual desire

(B) failure of erection with absent nocturnal penile tumescence (NPT)

(C) absence of emission

(D) absence of orgasm with normal libido and erectile function

(E) failure of detumescence

78. Rarely indicates organic disease (SELECT ONE)

(A) loss of sexual desire

(B) failure of erection with absent nocturnal penile tumescence (NPT)

(C) absence of emission

(D) absence of orgasm with normal libido and erectile function

(E) failure of detumescence

79. Can be caused by hematologic disease (SELECT ONE)

(A) loss of sexual desire

(B) failure of erection with absent nocturnal penile tumescence (NPT)

(C) absence of emission

(D) absence of orgasm with normal libido and erectile function

(E) failure of detumescence

80. Can be caused by vascular disease (SELECT ONE)

(A) loss of sexual desire

(B) failure of erection with absent nocturnal penile tumescence (NPT)

(C) absence of emission

(D) absence of orgasm with normal libido and erectile function

(E) failure of detumescence

81. Slight elevation of plasma testosterone and androstenedione (SELECT ONE)

(A) drugs

(B) adrenal tumor

(C) polycystic ovarian disease (PCOD)

(D) adrenal hyperplasia

(E) idiopathic hirsutism

(F) ovarian tumor

82. Can be associated with anovulation, obesity, and amenorrhea (SELECT ONE)

(A) drugs

(B) adrenal tumor

(C) polycystic ovarian disease (PCOD)

(D) adrenal hyperplasia

(E) idiopathic hirsutism

(F) ovarian tumor

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