Endocrine System

1. In a patient following total parathyroidectomy., all of the following will

happen except:
A. Patient will die if no treatment is given
B. Patient will develop renal stones
C. Patient will improve by I/V calcium gluconate
D. Patient will benefit from vitamin D therapy
E. Patient will develop muscle spasm
Key: B

2. A patient develops symtpms & signs of growth hrmone excess. The

type of cells most likely to be increased in pituitary are:
A. Basophils
B. Eosinophils
C. Chromophobes
D. Oxyntic cells
E. Chief cells
Key: C

3. Which one of the following fasting blood sugar levels require further
evaluation:
A. 2 mmol/l
B. 4.5 mmol/l
C. 6.5 mmol/l
D. 8 mmol/l
E. 10 mmol/l
key: C
4. A male, age 35, comes to casualty department of a tertiary care hospital,
with the complains of episodes of hypoglycemia occurring
frequently. The best and appropriate investigation will be:
A. Glucose tolerance test and curve study
B. Fasting blood sugar only
C. Fasting blood sugar and C-peptide measurement
D. Insulin assay
E. Fasting blood sugar and insulin assay
Key: C
5. A woman in first trimester of pregnancy was found to have blood levels
at 300 mg%. what would be the most appropriate treatment for her:
A. Sulfonylurea
B. Acarbose
C. Insulin
D. Biguanide
E. Insulin & sulfonylurea
Key: C

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6. A 16 year-old girl fractures her right wrist while playing ping-pong with a
friend. She is short & thin, her bones appear small & fragile, & her
growth & development have been delayed. While her blood pressure
is being taken, the patient develops tetany of the right obtained:
serum calcium l=6.8 mg/dL, urinary calcium = 50 mg/day, serum
phosphate =16 mg/dL, & urinary phosphate = 600 mg/day (N = 300-
600). Which of the following is the most likely diagnosis?
A. Osteoporosis
B. Paget’s disease
C. Primary hypoparathyroidism
D. Secondary hypoparathyroidism
E. Vitamin D deficiency
Key: E

7. Parathormone:
A. Increases calcium excretion
B. Increase serum phosphate
C. Is produced by P cells of thyroid
D. Is a steroid hormone
E. Can lead to renal stones
Key: E

8. A 55-year-old man is brought to ER in semicomatose state;

hypoglycemia is diagnosed with blood glucose blevel of 40 mg/dl.
The treatment should be:
A. 10 % dextrose. IV
B. glucagons. IV
C. 50% dextrose, IV
D. Oral glucose
E. 5 % dextrose + potassium, IV
key; C
9. In an untreated adrenalectomized subject, a physician would likely find:
A. Increased daily excretion of 17- hydroxysteroids
B. Increased daily exctetion of 17- ketosteroids
C. Increased skin pigmentation
D. Increased volume of exteacellular fluid
Key: C
10. A pregnant woman comes to you with raised total T3 & T4; the cause is:
A. Increased TRH
B. Increased TSH
C. Increased TBG
D. Toxic adenoma
E. Grav’s disease
Key: C

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11. A 6-year-old boy with short stature & delayed bone age is started on
recombinant growth hormone therapy. Which of the following
laboratory findings in serum is most likely after 3 months of therapy:
A. Decreased insulin-like growth factor I concentration
B. Increased alkaline phosphatase activity
C. Increased calcium concentration
D. Increased phosphorus concentration
E. Increased urea nitrogen (BUN) concentration
Key; B
12. A 23-year-old student has severe diarrhea resulting from an intestinal
parasite that the he acquired on a trip to Quetta. He loses 4.0 liters
of intestinal fluid over a 6-hour period, but fells to sick to drink any
fluids. His urine output during the 6-hour ordeal is only 0.1 liters.
Which of the following best be scribes his status at the end of the 6-
hours period as compared to the hour before the onset of diarrhea? :
A. Decreased plasma angiotensin II levels
B. Decreased urine osmolarity
C. Increased extracellular fluid volume
D. Increased glomerular filration rate
E. Increased plasma aldosterone levels
Key; E
13. Secondary hyperaldosteronism can be produced by one of the following
:
A. Increased angiotensin II
B. Salt excess
C. Increased rennin
D. Increased ACTH
E. Increased cortisol
Key: C
14. A 70-kg (154-lb) man on a fixed NaCl intake (200 mmol/day) is given
daily injections of a potent imeralocorticoid hormone for 4 days. He
has free access to water & consumes his usual caloric intake.
Excretion of NaCl is as follows?

Day NaCl (mmol)

1 30
2 90
3 180
4 200
Assuming that 1 L of isotonic saline contains 150 mmol of NaCl & weight 1
kg, how much will he weigh (in kg) at the end of day 4?
A. 66
B. 68
C. 70
D. 72
E. 74

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 key: D

15. A women comes in ER semiconscious,k with a history of PPH 10 year

back; her labs shows Na 110 mmol/L. what is the diagnosis :
A. Hypothyroidism
B. SIADH
C. Sheehan’s syndrome
D. Addison’s disease
E. Cushing’s syndrome
Key: C

16. Anitibodies in Graves’ diseases are actually :

A. Antibody to thyroid tissue colloid and its carbohydrate content
B. Antibody to the TSh receptors
C. Antibody to thyroglobulin
D. A & C
E. A & B
Key; B

17. A 28 years old female patient with toxic goiter, wants to treat her
exophthalamus for cosmetic reasons; the best way is:
A. Partial thyroidectomy with T4 suppplementation
B. Total thyroidectomy withreplacement
C. Radio tive iodine
D. Antithyroid drugs only
E. Prednisolone
Key: E

18. A patient dies of chronic renal failure; which of the following structures
will be hypertrophied if autopsy is done:
A. Adrenal cortex
B. Adrenal medulla
C. Adrenal gland
D. Thyroid gland
E. Parathyroid gland
Key: E

19. The intracellular domain of the insulin receptors has which of the
following enzyme activities:
A. Adenylyl cyclase
B. Phosphodiesterase
C. Phospholipase C
D. Phosphoprotien phophatas
E. Tyrosin kinase
Key: E

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20. Preoperative management pheochromocytoma include :
A. β – receptor blockade alone
B. α – receptor blockade alone
C. both a & β receptor blockade
D. blood transfusion
E. anti-coagulants
key; C

21. Secretion of growth hormone is increased with:

A. Cortisol
B. Exercise
C. REM sleep
D. Glucose
E. FFA
Key: B

22. Which substance maintains plasma Ca level:

A. 1,25 dihydroxy cholecalciferol
B. protactin
C. calcitonin
D. growth hormone
E. phosphate ions
key: A

23. which one is not the effect of Cushing’s syndrome:

A. buffalo hump
B. hypotension
C. osteoporosis
D. moon face
E. purplish striae
key: B
24. Steroid hormone acts via;:
A. Formation of CAMP
B. Formation of DAG+lP 3
C. Gene transcription
D. Tyrosine kinas activity
E. Altering ion channels
Key: C
25. The following is true regarding aldosterone:
A. Production is stimulated by a fall in renal blood flow
B. Secretion is stimulated by a fall in potassium ion concentration
C. Causes sodium loss & potassium retention in sweat & saliva
D. Production is increased by a fall in plasma rennin conc.
E. When secreted in excess leads to muscle weakness & hypotension
Key: A

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26. A 2-year-old baby girl, on her regular checkup by a doctor, noticed to
have an enlarged clitoris, the most likely diagnosis would be:
A. Klienfelter syndrome
B. Turner syndrome
C. Down’s syndrome
D. Mosacism
E. Adrenogenital syndrome
Key; E

27. A 15-year-old girl is brought to the physician because of irritability,

restlessness, difficulty concentrating & deteriorating academic
performance over the past 2 moths. She has had occasional
palpitations & a 1-kg (2-lb) weight loss during this period despite an
increased appetite. Menarche was at the age of 12 year & her menses
occur at regular intervals. Examination shows no abnormalities.
Serum triiodothyronine (T3) & thyroxine (T4) levels are increased.
Which of the following is the most likely diagnosis:
A. Attention-deficit/hyperactivity disorder
B. Diabetes mellitus
C. Hyperthyroidism
D. Pituitary adenoma
E. Thyroid cancer
Key: C

28. Among the various findings of patient of hypothyroidism, the most

particular finding is:
A. Cold intolerance
B. Somnolence
C. Bradycardia
D. Increased relaxation phase of ankle jerk
E. Sluggish activity
Key: D

29. A 15-year-old lady without any signs & symptoms neither had any
significant medial history was found to be hyoponatremic. The most
likely cause is:
A. Excessive diuretic use
B. SIADH
C. Psychogenic polydipsia
D. Decreased salt intake
E. Use of hormones
Key: B

30. After thyroidectomy which one of the following after effects you would
expect:

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 A. Elevated T4
B. Elevated free T4
C. Elevated T3
D. Elevated TSH
E. Elevated calcium level
Key: D

31. Tumors of the adrenal edulla that are actively producing catecholamines
are called pheochromocytomas. Patients with these tumors
experience sudden peridodic increased in catecholamine blood
levels. During such an episode patients may experience:
A. Decreased heart rate
B. Decreased blood pressure
C. Decreased blood glucose
D. Decreased sweat secretion
E. Cardiac ischemia
Key: E

32. Secondary hyperaldosteronism is due to:

A. ACTH increase
B. Cortisol increase
C. Rennin increase
D. Rennin decrease
E. None of the above
Key: C

33. During strenuous exercise:

A. Insulin will rise & glucagons will fall
B. Insulin will fall & glucagons will rise
C. Plasma glucose becomes very low
D. Glycogenolysis decreases
E. Gluconeogeneis decreases
Key: B

34. Following is true regarding release of the catecholamines adrenaline &

noradrenaline from the adrenal medulla:
A. Increases blood level of glucose by favoring glycogenolysis in liver &
muscle cells
B. Decrease blood levels of free fatty acids & ketone bodies
C. Increase muscle & splanchnic blood flow
D. Increases even when the parasympathetic nerves to the adrenal
glands are cut
E. Decreases plasma acid level
Key: A

35. Regarding growth hormone all of the following are true except:

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 A. Secretion increases during sleep
B. Increases insulin secretion
C. Is secreted by basophilic cells of anterior pituitary gland
D. Causes Na+ & K retention
E. Secretion increases in wasting diseases
Key: C

36. Dietary deficiency of iodine causes all of the following except:

A. Inhibits T3 & T4 production
B. Inhibits synthesis of thyroglobulin
C. Stimulates TSH
D. Causes goiter in pregnancy
E. Causes colloid goiter
Key; B

37. Adrenocorticotropic hormone (ACTH) promotes the production of

cortisol by stimulating which of the following reactions :
A. 11-deoxycortisol to cortisol
B. 17-hydroxyprogesterone to 11-deoxycortisol
C. progesterone to 17-hydroxyprogesterone
D. pregnenolone to progesterone
E. cholesterol to pregnenolone
key: E

38. After a severe postpartum hemorrhage a patient apparently recovered

well. However she was unable to breast feed & gradually noted
breast atrophy & no resumption of menses. Later she developed
constipation slurred speech & moderate nonpitting edema. The likely
diagnosis is:
A. Acute tubular necrosis
B. Amenorrhea galactorrhea syndrome
C. Asherman’s syndrome
D. Sheehan’s syndrome
E. Forbes Albright syndrome
Key: D

39. Regarding transport & metabolism of adrenal cortex hormones all of the
following are true except:
A. Cortisol is bound to transcortin
B. Total plasma cortisol level is about 13.5 ug/dl.
C. Transcortin is increased in multiple myeloma
D. Transcortin is also increased in pregnancy
E. Transcortin is decreased in nephrosis
Key: C

40. the least appropriate statement for growth hormone is:

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 A. it is polypeptide
B. secreted by anterior pituitary
C. exerts is anabolic action by somatomedins
D. half life in 6-7 hours
E. effects CHO metabolism
key: D

41. Cortisol increases all of following except:

A. Neutrophils
B. RBCs
C. Platelets
D. Monocytes
E. Lymphocytes
Key: E

42. Following is least likely to be true about cortisol :

A. It’s a gluco-corticoid
B. Increased in stress reaction
C. Increases blood sugar
D. Is catabolic hormone
E. Causes increased Na excretion
Key: E

43. The effect of insulin on glucose transport is to:

A. Permit transport against a conc. gradient
B. Enhance transport across the cell membrane
C. Enhance transport across the tubular epithelium of the kidney
D. Enhance transport into the brain
E. Enhance transport thru the intestinal mucosa
Key: B

44. A patient with T3 value of 3 (lower cut limit) T4 value of 8 (lower cut
limit) & TSH 200 (high); what is the diagnosis
A. Hyperpituitarism
B. Hyperthyroidism
C. Hypothyroidism
D. Hyperparathyroidism
E. Goiter
Key: C

45. Which of the following hormone is not a tyrosine derivative?

A. Epinephrine

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 B. Norepinephrine
C. Prolactin
D. Thyroxine
E. Triiodothyronine
Key; C

46. Which hormone lowers cholesterol level:

A. Progestogen
B. Insulin
C. Growth hormone
D. Cortisol
E. Thyroxin
Key: E
47. Which of the following is not the action of the glucagons?:
A. Increased gluconeogenesis
B. Increased ketone body formation
C. Decreased lipolytic activity
D. Increased blood glucose level
E. Increased glycogenolysis
Key: C
48. Regarding glucagons all of the following are true except:
A. Is non-ketogenic
B. Can casue hyperglycemia
C. Is lipolytic
D. Is gluconeogenic
E. Is glycogenolytic
Key: A
49. The receptors for growth factors is located:
A. Inside cytoplasm
B. Inside nucleus
C. On nuclear membrane
D. On cell membrane
E. None
Key; D
50. The following is true regarding thyrotoxicosis:
A. Propylthiouracil lowers serum T3 level mainly by blocking peripheral
conversion from T4
B. Symptoms of sympathetic overactivity are due to raised catecholamine
levels
C. Carbimazole blocks hormone synthesis at more than one sites in the
biosynthetic pathways
D. One drop of lugol’s iodine solution daily will lower the BMR
E. Lodine is used alone in the preoperative preparation of the patient
Key; C

51. Intermediary in the synthesis of cortisol & androgen:

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 A. Pregnenolone
B. Estrogen
C. Progesterone
D. Aldosterone
E. Corticosterone
Key; A

52. Following is true regarding thyroxine & triiodothyronine:

A. Circulate in equal concentration
B. Concentration increased in pregnancy
C. Concentration increased by methimazole
D. Acts normally by uncoupling oxidative phosphorylation
E. Increase the duration of tendon reflexes
Key: B

53. A young woman has puffy eyes & hoarse voice, & her plasma TSH conc.
is ow but increases markedly when she is given TRH she probably
has:
A. Hyperthyroidism due to a thyroid tumor
B. Hypothyroidism due to a primary abnormality in thyroid gland
C. Hypothyroidism due to a primary abnormality in pituitary bland
D. Hyperthyroidism due to a primary abnormality due to a primary
abnormality in the hypothalamus
Key: D

54. Amount of ionized calcium in blood fall by all of the following except:
A. If sodium cirtrate is added to it
B. If the thyroid glands is perfused with a calcium rich solution
C. In hyperventilation
D. When the blood phosphate levels falls
E. At high altitude
Key; D

55. Plasma half life of insulin is:

A. 5 minutes
B. 10 minutes
C. 15 minutes
D. 20 minutes
E. 25 minutes
key; A

56. The likelihood of developing tetany is increased when:

A. Plasma bicarbonate level decreases

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 B. Plasma magnesium level rises
C. The anterior pituitary is removed
D. Respiratory failure develops
E. One is exposed to high altitude without prior acclimatization
Key: E

57. A high plasma calcium level causes:

A. Bone demineralization
B. Increased formation of 1,25 dihydroxycholecalciferol.
C. Decreased secretion of calcitonin
D. Decreased blood coagulability
E. Increased formation of 24,25 dihydroxycholecalciferol
Key: E

58. In diabetic ketoacidosis all of the following are likely to occur except:
A. Serum osmolality may exceed 320 mOsm per kg.
B. The fluid deprivation is 5-6 L.
C. The most common occurrence is in patient with juvenile onset diabetes
mellitus
D. The pH of the blood is usually below 7.0
E. Hypoventilation
Key: E

59. Metabolic rate may be estimated:

A. By measuring respiratory quotient
B. From carbon dioxide production
C. By measuring a person’s total heat production at room temperature
D. Form oxygen consumption
E. By increasing thyroxine levels in blood
Key; D

60. During exercise following will be observed:

A. Increased insulin, decreased glucagons
B. Decreased insulin, decreased glucagons
C. Increased insulin, increased glucagons
D. Decreased insulin, increased glucagons
E. None of the above
Key: D

61. One of your diabetic patients has a blood glucose level of 200 mg/dl.
Surprisingly a dipstick test is negative for urinary glucose how could
this finding be explained:

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 A. Patient is in a state of antidiuresis
B. Patient has diabetes insipidus
C. Patient has significantly reduced GFR
D. Patient has defective tubular glucose itransporters
E. Dipstick test are more sensitive for reducing sugar other than glucose
Key: C

62. The following is true regarding insulin:

A. Stimulates glycogen phosphorylase in liver & muscles
B. Inhibits glycogen phosphrylase in liver
C. Stimulates hormone sensitive lipase (HSL) in adipose tissue
D. Inhibits pyruvate kinase in all tissues
E. Inhibits pyruvate dehydrogenase in liver & muscle
Key: B

63. A young man brought to the emergency dept with delirium & severe
abdominal pain. The investigation of choice is:
A. Blood sugar level
B. Serum amylase
C. Serum lipase
D. Abdominal ultrasound
E. GT scan
Key: A

64. cortisol deficiency is often characterized by:

A. fall in eosinophils count
B. rise in platelets count
C. ise in erythrocytes count
D. rise in lymphocytes count
E. rise in neutrophils counts
key: D

65. The following is true regarding calcitonin:

A. Increases the blood calcium ion conc.
B. Is secreted by parafollicular cells of thyroid glands
C. Is a steroid hormones
D. Increases are the formation of new osteoclasts
E. Increases osteolytic of osteo-cytic membrane
Key :B

66. Following will be observed as a result of aldosterone on salivary

secretion:
A. Secretion of Na+
B. Reabsorption of Na+

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 C. Reabsorption of K+
D. Secretion of Cl
E. Reabsorption of HCO3
key: B

67. The following is true regarding adrenocorticotropic hormone:

A. Secretion mainly increases the aldosterone secretion
B. Is regulated by a factor from posterior pituitary gland
C. Secretion is directly proportional to the cortisol level in blood
D. Is produced by neurons whose cell bodies lie in hypothalamus
E. Production is controlled by a hormone form hypothalamus
Key; E

68. The following is true regarding parathyroid hormone:

A. Has no effect on absorption of calcium form kidney
B. Causes postmenopausal osteoporosis
C. Increases phosphate absorption form kidney
D. Is secreted by oxyphill cells
E. Enhances Ca2 &PO4 absorption in intestine by inc. renal formation of
1,25- dihydeoxycholecalciferol
Key; E

69. Regarding calcium all of the following are true except:

A. Concentration fo the serum is normally 8.5-10 mg/100 ml (2.1-2.6
mmol/l)
B. Is present in the body in larger amounts than any other cation
C. Is 70% ionized
D. Becomes less ionized when blood pH rises
E. In the serum is characteristically raised in hyperthyroidism
Key: C

70. For diagnosis of diabetes the most important test is:

A. Fasting blood glucose
B. Random blood glucose
C. Glycosylated Hb
D. Glucose tolerance test
E. Urine sugar
Key: D

71. Regarding 50 gm glucose tolerance test all of the following are true
except:
A. Blood glucose curve becomes flat by thyroid removal
B. Slow rise & fall of blood glucose curve occur in normal then in diabetes
mellitus

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 C. It does not cause glucose in urine in normal persons
D. Slow rise of blood glucose occur in celiac disease
E. It may be effected by drungs eg, steroids
Key; B

72. A 40 year-old woman is diagnosed as a case of adrenal insufficiency.

The following is likely to found in this patient:
A. Hyponatremi
B. Hyperphosphatemia
C. Hypopligmentat on
D. Lowered blood urea nitrogen
E. Dehydration
Key: A

73. In ketoacidosis, the basic pathophysiology is:

A. Insulin deficiency
B. Decreased enzyme production by liver
C. Action of glucagons
D. Inceased ketone bodies formation
E. Decreased deacylase
Key: A

74. The hormonal analysis of a 40-year-oldman shows an elevated level of

parathyroid hormone in serum. Following is likely to be true in this
patient:
A. Secretion is increased by a high plasma level of ionized calcium
B. Decreased calcium reabsorption in the kidney tubules
C. Bone cysts can develop
D. Plasma con. Is usually lowered in osteoporosis
E. Increases the reabsorption of phosphate by the kidney tubules
Key: C

75. Regarding thyroxine all of the following are true except:

A. Increases glycolysis & gluconeogenesis
B. Deficiency in infants causes defective myelination & abnormal
development of synapses
C. Is carried in the blood stream mostly by albumin
D. Is less active than triiodothyronine
E. Has a calorigenic action
Key: C

76. The receptors for thyroid hormone are located:

A. In cytoplasm
B. On nuclear membrane
C. Inside nucleus
D. On plasma membrane

15
 E. On mitochondria
Key: B

77. adrenaline differs from noradrenaline in all of the following except:

A. Is a more potent dilator of the bronchi
B. Causes tachycardia when injected intravenouisly
C. Is the catecholamine secreted in greatest amount by the adreanal
medulla
D. Inceases the strength of myocardial contraction
E. Causes vasodilation in skeletal muscle & liver
Key: D

78. Regarding a patient who develops sudden parathyroid deficiency all of

the following are true except:
A. Is likely to develop skeletal muscle spasms
B. Is likely to die if no treatment is given
C. Is likely to be improved by a slow intravenous injection of calcium ions,
eg calcium gluconate
D. Is likely to be improved in the long term by regular doses of vitamin D
E. Is likely to develop renal calculi
Key; E

79. A patient with a secreting tumor of the adrenal medulla

(pheochromocytoma) typically has all of the following except:
A. A raised blood pressure which may be transient or constant
B. A fine tremor of the extended had
C. A lowering of blood pressure when an alpha adrenoceptor atagonist is
given
D. An increase in the basal metabolic rate
E. Decreased VMA and metanephrines in urine
Key: E

80. The characteristics of hyperparathyroidism include all of the following

except:
A. Demineralization of bone
B. Formation of kidney stoned
C. Hypercalcemia
D. Hypercalciuria
E. Hyperphosphatemia
Key: E

81. A 34-year-old woman has undergone total thyroidectomy for

multinodiular goiter. During a postoperative follow-up 2 months
later, following is likely to be found:
A. A low blood cholesterol level
B. Exaggerated stretch reflexes

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 C. A fine tremor of the fingers
D. Flattening of the oral glucose tolerance curve
E. Exophthalmos
Key; D

82. The biochemical changes associated with inadequately controlled IDDM

include :
A. Abnormally rapid fall of blood glucose following a meal
B. Abnormally low conc. of fatty acids in blood
C. High level of ketones in blood
D. High rate of glycogen synthesis in liver
E. Low plasma lipoprotein level
Key: C

83. Regarding somatostatin all of the following are true except:

A. Is secreted by the D cells of the pancreatic islets.
B. Has a plasma life of 3 minutes
C. Is the substance thru which growth hormone exerts much of its effect
D. May exerts its effects in close proximity to site of release
E. Inhibits secretion of growth hormone & glucagons
Key: C

84. After removal of ACTH producing cells of anterior pituitary, all of the
following will be observed except:
A. Atrophy of zona fasciculate
B. Atrophy of zona glomerulosa
C. Atrophy of zona reticularis
D. Los of cortisol production
E. Loss of androgen production
Key; B

85. After infusion of small amount of TRH, TSH is raised but level of T3 & T4
remain unaffected; which of the following explain this condition:
A. Primary thyroid disease
B. Secondary thyroid disease
C. Tertiary thyroid disease
D. THS receptor antibodies
E. Hashimoto’s disease
Key: A

86. Muscles are not contributors to blood glucose level between of the
absence of:
A. Glucokinase
B. Hexokinaase
C. G6PO4-DHG
D. Glucose -6-phosphatase

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 E. Glucose -1-phosphatase
Key: D

87. The following is true regarding somatostain:

A. Is secreted by alpha cells of pancreas
B. Is a mucopolysaccharide
C. Has extremely long half-life
D. Secretion is inhibited by increased blood glucose level
E. Secretion is stimulated by increased blood amino acids level
Key: E

88. Regarding growth hormone all of the following are true except
A. Bovine growth hormone if injected in humans, produce no effect on
growth
B. Growth hormone from monkeys has diabetogenic effect, as well as
stimulates growth in humans
C. Humans growth hormone has intrinsic latogenic activity
D. Basal growth hormone level in humans less than 3 mg/ml of plasma
E. It is metabolized partly in liver
Key: D

89. Regarding effects of growth hormone all of the following are true except
A. It causes decrease in Na & K excretion from kidneys
B. It synergises with androgens, to inc. size of accessory reproductive
organs
C. It decreases fat contents of body
D. It causes rise in plasm a phosphorus levels
E. It causes rise in plasma phosphorus levels
F. It stimulates erythropoiesis
Key: E
90. A 56-year-old male is noted to have episodic hypertension , a mass in
his adrenal gland & elevated catecholamines. The most likely
diagnosis is:
A. Pheochromocytoma
B. Ganglioneuroma
C. Neuroblastoma
D. Adrenal cortical carcinoma
E. Adrenal cortical hyperplasia
key: A

91. Regarding adrenal glands all of the following are true except:
A. Blood supply is form phrenic artery also
B. After hypophyscetomy all three layers of adrenal cortex degenerate
C. Human adrenal gland is larger in size in fetal life as compared after
birth
D. Extra adrenal sites are found along aorta apart form its usual site

18
 E. Aldosterone is secreted by zona glomerulaosa, & is partly under
control of ACTH
Key; B

92. Regarding hormones of adrenal medulla all of the following are true
except:
A. After hypophysectomy epinephrine synthesis falls
B. 50% of catecholamines are excreted in urine as metanephrine &
normetanephrine
C. 50% is exreted in urine as VMA
D. dopamine is recommended in cardiogenci shock
E. dopamine acts as vasodilator of mesenteric vessels
key: C
93. impaired glucose tolerance is associated with all of the following
except:
A. cushing syndrome
B. pheochromocytoma
C. acidophilic adenoma
D. grav’s disease
E. chronic panreatitis
key: B
94. Regarding anterior pituitary gland the following is true:
A. Whole β-MSH is identical to a part of ACTH
B. Gamma MSH is present in sufficient con. In intermediate & anterior
lobes, and is adrenal insufficiency
C. POMC (pro-opimelanocortin) forms a no of hormones
D. POMC is synthesized in anterior pituitary only
E. POMC is hydrolyzed into alpha and beta MSH in adults
Key: A
95. Regarding pigment abnormalities the following is true:
A. Black pigmentation is a feature of adrenal insufficiency due to any
cause
B. Hypopituitarism manifest as hyperpigmentation
C. Albinos have a congenital inability to synthesize melanin
D. Piebaldism is characterized by patches of skn, that are
hyperpigmented. And is a congenital defect
E. Vitiligo show patchy loss of pigmentation and is a hereditary condition
present at birth
Key: C

96. The following is true regarding thyroglobulin:

A. Is found in RBC
B. Level in blood is decreased in hyperthyroidism
C. Level in blood is increased in some types of thyroid
D. Contain lipids
E. Is very active component acting on tissues

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 Key: C

97. all of the following hormones act by negative feedback mechanism

except :
A. cortisol – ACTH
B. thyroxine – TSH
C. calcium – PTH
D. testosterone – LU & FSH
E. suckling – Proiactin
key: E

98. Regarding the islets of langerhans all of the following are true except:
A. Contain beta cells whose granules fix anti- insulin antibodies
B. Contain alpha cells which secrete glucagons
C. Have a high zina content relative to other tissues
D. Contains granular gamma cells which are thought to secrete a
hormone which controls the blood glucose level
E. Contain F cells that secrete pancreatic polypeptide
Key :D

99. The following is true regarding hypoglycemia:

A. Is associated with acinar cell tumors of the pancrease
B. Occurs when a normal person fasts for 48 hours
C. Characteristically occur 2 hours after meals in untreated
hyperthyroidism
D. Is a charachteristic feature of induced hypothermia
E. Is associated with a fall in catecholamines
Key: C

100. Regarding parathyroid hormone all of the following are true except:
A. Increases the plasma phosphate level
B. Secretion is regulated by serum calcium level
C. Enhances resorption of calcium form bone
D. Is a polypeptide
E. Increases the urinary output of phosphates
Key; B

101. Administration of glucocorticoids in high doses for prolonged

periods results in:
A. Loss of hair
B. Increased dlugconeogenesis
C. Mineralization of bone
D. Thickening of skin
E. Virilizing effects in women
Key: B

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102. Which of the following areas of the adrenal gland would be expected
to increase in activity in a patient subjected to salt restriction:
A. Adrenal medulla
B. Zona fasciculate of the adrenal cortex
C. Zona reticularis of the adrenal cortex
D. Zona glomerulosa of the adrenal cortex
Key; D

103. Cortisol is produced:

A. During sleep
B. In trauma
C. In addision’s disease
D. In evening
E. In hypopituitarisim
Key: B

104. Following help to investigate a patient suffering from grave’s

disease:
A. T3 level
B. T4 level
C. TSH level
D. TRH level
E. TSH receptor antibodies
Key: C

105. The presence of 3+ urinary ketones in a patient is due to:

A. Starvation
B. Insulin deficiency
C. Diabetes insipidus
D. Hyperglyeemia
E. Impaired metabolism of ketones
Key: B

106. A series of photographs taken of a middle aged man over a period of

two decades demonstrates gradual coarsening of facial features and
progressive protrusion of the brows. Upon questioning the patient
reports having to wear larger shoes than he did as a young man
which of the following pair of hormones normally regulates the
hormone responsible for these changes
A. TSH & ACTH
B. LH & HCG

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 C. Prolactin & FSH
D. Somatostatin & GHRH
E. Dopamine & norepinephrine
Key; D

107. A 46-year-old man with weakness and a 10-lb increase in weight has
a blood pressure of 160/100 mmHg. His lab data shows Na- 155
mmol/L, K+ 2.3 mmol/L & low plasma rennin the diagnosis is:
A. Cushing’s syndrome
B. Diabetes mellitus
C. Primary hyperaldosteronism
D. Secondary hyperaldosteronism
E. Pheochromocytoma
Key: C

108. Immediately postpartum there may be a decrease in insulin

requirements of diabetic patients. This can be partly explained by:
A. Increased food intake
B. Decreased activity
C. Decrease in plasma estrogen
D. Decrease in plasma progesterone
E. Decrease in plasma chorionic somatomammotropin
Key: E

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