Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 3: Clinical Medicine
20 Endocrinology MCQs
Davidson's Medicine - Part 3: Clinical Medicine · Davidson's Principles of Medicine · 8 practice questions
- Adrenal disease
- Pituitary disease
- Thyrotoxicosis
- Thyroid disease
- Amenorrhoea
- Reproductive endocrinology and calcium
- Thyroid treatment
1. A woman after pituitary radiotherapy has lost hormones, and another child has polyuria over 3 L per day with thirst and a calcified suprasellar cystic mass with hyperphagic obesity. Which statements are correct?
- ATSH is lost first, and prolactinoma
- BProlactin is lost first, and meningioma
- CACTH is lost first with pigmentation, and nephrogenic diabetes insipidus
- DGrowth hormone is lost first with pallor and preserved aldosterone, and cranial diabetes insipidus and craniopharyngioma fit the second
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D. Growth hormone is lost first with pallor and preserved aldosterone, and cranial diabetes insipidus and craniopharyngioma fit the second The usual sequence is GH, gonadotrophins, ACTH then TSH with angiotensin-dependent aldosterone preserved; craniopharyngiomas arise from Rathke's pouch remnants and cause hypothalamic obesity.
2. A patient with Graves' disease and active ophthalmopathy needs definitive treatment. Which statements about radio-iodine and thyroid cancer follow-up are correct?
- ARadio-iodine is avoided over 40, and thyroglobulin is irrelevant
- BRadio-iodine is safe in pregnancy, and calcitonin follows papillary cancer
- CRadio-iodine is contraindicated in active ophthalmopathy and pregnancy, and rising detectable thyroglobulin after ablation suggests recurrence
- DRadio-iodine is preferred in ophthalmopathy, and thyroglobulin should be raised
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C. Radio-iodine is contraindicated in active ophthalmopathy and pregnancy, and rising detectable thyroglobulin after ablation suggests recurrence Radio-iodine causes hypothyroidism in about 40% in the first year and may exacerbate ophthalmopathy; thyroglobulin should be undetectable after ablation.
3. A patient with thyrotoxicosis has negligible thyroid isotope uptake after a viral illness, and another with Graves' disease is offered antithyroid drugs. Which statements are correct?
- AThe first is toxic adenoma, and carbimazole destroys tissue
- BThe first is Graves', and carbimazole is safe without monitoring
- CThe first is multinodular goitre, and relapse is rare
- DThe first is low-uptake thyroiditis, and carbimazole inhibits iodination of tyrosine with agranulocytosis in about 0.2% and relapse over 50%
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D. The first is low-uptake thyroiditis, and carbimazole inhibits iodination of tyrosine with agranulocytosis in about 0.2% and relapse over 50% Low uptake thyrotoxicosis is transient thyroiditis; Graves' has diffuse uptake; antithyroid drugs reduce synthesis by inhibiting iodination.
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