NIDDM (564/1700)

A 45yo man with colon cancer now develops increased thirst, increased frequency in urination and weight loss. His fasting blood glucose=9mmol/L. what is the most appropriate management?
a. Oral hypoglycemic
b. Insulin long acting
c. Short acting insulin before meal
d. IV insulin
e. Subcutaneous insulin

Cushing's disease (1657/1700)

You suspect Cushing's disease in a 50yo woman who has attended clinic with glycosuria, HTN and a suggestive body habitus. Initial inv point you towards a dx of Cushing's disease. Which of the following findings would be against this dx?

a. A normal 8am cortisol
b. Failure to suppress morning cortisol with dexamethasone
c. HTN requiring >2 antihypertensive agents
d. Impaired growth hormone response to glucose loading
e. Unilateral adrenal enlargement

Diabetes and nephropathy (913/1700)

A 68yo woman dx with T2DM and BMI=33. Lab: GFR=29, urea=13, creatinine=390mmol/L. Whats the next appropriate management?
a. Biguanide
b. Sulfonylurea
c. Insulin
d. Glitazone
e. Sulfonylurea receptor binder

Renal transplant, Obese, Bullied (506/1700)

A 10yo boy is clinically obese and the shortest in his class. He had a renal transplant last year
and his mother is worried that he is being bullied. What is the most probable dx?
a. Cushing’s syndrome
b. Congenital hypothyroidism
c. Pseudocushing’s syndrome
d. Lawrence moon biedel syndrome
e. Down’s syndrome

Jaundice and hypothyroidism (476/1700)

A 28yo female presents with 1 wk hx of jaundice and 2d hx of altered sleep pattern and moods.
She was dx with hypothyroidism for which she is receiving thyroxine. TFT showed increased TSH.
PT=70s. What is the most probable dx?
a. Acute on chronic liver failure
b. Hyper-acute liver failure
c. Autoimmune hepatitis
d. Acute liver failure
e. Drug induced hepatitis

Thirst, Urinary Frequency, Deep Painless Ulcer (415/1700)

A 60yo man with a 4y hx of thirst, urinary freq and weight loss presents with a deep painless
ulcer on the heel. What is the most appropriate inv?
a. Ateriography
b. Venography
c. Blood sugar
d. Biopsy for malignant melanoma
e. Biopsy for pyoderma

Palpitations, Irregular tachycardic pulse (409/1700)

A 29yo lady came to the ED with complaints of palpitations that have been there for the past 4
days and also feeling warmer than usual. Exam: HR=154bpm, irregular rhythm. What is the tx for
her condition?

a. Amiodarone
b. Beta blockers
c. Adenosine
d. Verapamil
e. Flecainide

Polyuria and Nocturia (407/1700)

A 67yo male presents with polyuria and nocturia. His BMI=33, urine culture = negative for
nitrates. What is the next dx inv?
a. PSA
b. Urea, creat and electrolytes
c. MSU culture and sensitivity
d. Acid fast urine test
e. Blood sugar

Thyrotoxicosis in pregnancy (369/1700)

A 34yo woman is referred to the endocrine clinic with a hx of thyrotoxicosis. At her 1st
appointment she is found to have a smooth goiter, lid lag and bilateral exophthalmos with puffy
eyelids and conjunctival injection. She wants to discuss the tx of her thyroid prb as she is keen to become pregnant. What is the most likely tx you would advise?
a. 18m of carbimazole alone
b. 18m of PTU alone
c. A combo of anti-thyroid drug and thyroxine
d. Radioactive iodine
e. Thyroidectomy

SIADH (1521/1700)

A pt is dx with SIADH. Choose the appropriate biochemical change.
a. Plasma Na+ decrease and urine osmolarity increase
b. Plasma Na+ decrease and urine osmolarity decrease
c. Plasma Na+ increase and urine osmolarity decrease
d. Plasma Na+ increase and urine osmolarity increase

Diabetic, drowsy and confused (354/1700)

An elderly pt who is known to have DM presents to the hospital with drowsiness, tremors and
confusion. What inv should be done to help in further management?

a. Blood sugar
b. ECG
c. Standing and lying BP
d. Fasting blood sugar
e. CT

Addisons (341/1700)

A 54yo woman has presented with episodes of abdominal ache, vomiting and postural
hypotension. She also has a dark pigmentation of her skin. A dx of Addison’s disease was made.
What is the most likely electrolyte abnormality expected in this pt?

a. High Na+, Low K+
b. Low Na+, High K+
c. Low Na+, Low K+
d. High Na+, High K+
e. Low Na+, Normal K+

Small testicles and Gynecomastia (69/1700)

A 30yo man and wife present to the reproductive endocrine clinic because of infertility. The man
is tall, has bilateral gynecomastia. Examination of the testes reveals bilateral small, firm testes.
Which of the following inv is most helpful in dx?

a. CT of pituitary
b. Chromosomal analysis
c. Measure of serum gonadotropins
d. Measure of serum testosterone

SIADH (42/1700)

A 74yo man who has been a smoker since he was 20 has recently been dx with SCLC. What
serum electrolyte picture will confirm the presence of SIADH?

a. High serum Na, low serum osmolarity, high urine osmolarity
b. Low serum Na, low serum osmolarity, high urine osmolarity
c. Low serum Na, high serum osmolarity, high urine osmolarity
d. High serum Na, low serum osmolarity, low urine osmolarity
e. High serum Na, high serum osmolarity, low urine osmolarity

Brain metastasis and polyuria, polydipsia (33/1700)

A pt with cerebral mets has polyuria and polydipsia. What part of the brain would be affected?
a. Cerebral cortex
b. Cerebellum
c. Diencephalon
d. Pons
e. Medulla

Weight loss, palpitations (3/1700)

A 44yo woman has lost weight over 12 months. She has also noticed episodes where
her heart beats rapidly and strongly. She has a regular pulse rate of 90bpm. Her ECG
shows sinus rhythm. What is the most appropriate inv to be done?

a. Thyroid antibodies
b. TFT
c. ECG
d. Echocardiogram
e. Plasma glucose

Smoker with pigmentation, DM and hypokalemia (2/1700)

 A 74yo smoker presented to his GP with cough and SOB. Exam revealed pigmentation of the oral mucosa and also over the palms and soles. Tests show that he is diabetic and hypokalemic. What is the most probable dx?

a. Pseudocushing syndrome
b. Conns disease
c. Ectopic ACTH
d. Cushings disease
e. Hypothyroidism