1. Cortisol is secreted from where? (A) Adrenal Medulla (B) Adrenal Cortex: Zona Fasiculata (C) Adrenal Cortex: Zona Reticularis (D) Adrenal Cortex: Zona Glomerulus (E) Anterior Hypophysis
2. Which of these is not secreted from the Anterior Hypohysis? (A) Thyroid Stimulating Hormone (B) Adrenocorticotrophin Hormone (C) Oxytocin (D) Follicular Stimulating Hormone (E) Lutenising Hormone
3. Diabetes Insipidus is a deficiency of what hormone? (A) Atrial Natriuretic Peptide (B) Vasopressin (C) Aldosterone (D) Insulin (E) Progesterone
5. Which of the following signs strongly support a diagnosis of pituitary adenoma? (A) Carpopedal Spasm (B) Bitemporal Hemianopsia (C) Chvostek's Sign (D) Tremor (E) Clubbing
6. ADH is secreted by the (A) Hypothalamus (B) Posterior lobe of the pituitary (C) Intermediate Lobe of the pituitary (D) Anterior lobe of the pituitary
7. ADH has it greatest influence on the kidneys at (A) Cortex (B) Distal convoluted tubule (C) Medulla (D) Proximal convoluted tubule
8. TSH stimulation in the thyroid causes (A) Decreased blood flow (B) Decrease in gland size (C) Increased in follicular epithelium (D) Increase in colloid
9. A 16 year old female presents to HMC s/p boating accident and closed head injury with anterior table non-displaced frontal sinus fractur(E) Her urine output on day two is 10 liters a day. You tell the family (A) This is self limited and prognosis is good (B) This requires immediate surgery for decompression and fracture repair (C) This is idiopathic and has a high mortality (D) This is not my problem as trauma service
10. In relation to Calcium, phosphorus (A) Increases in serum concentration (B) Decreases in serum concentration (C) Linked to Magnesium (D) Linked to albumin
Ans: B
11. Long term management of hypercalcemia does not include (A) Bisphosphonates (B) Hydration (C) Calcitonin (D) Loop diuretics
12. A 37 year old females is s/p thyroidectomy POD #2 with heart rate of 155, temperature of 102 and altered mental status. Her TSH is 0.01 and T4 is found to be 12.3. First line treatment includes (A) Medication targeted at destroying follicular cells (B) Medication that decreases T4 output in the colloid cells (C) Medication that prevents conversion of T4 to T3 (D) Medication targeted centrally to prevent the release of TSH
13. Which medication should be avoided in a thyroid storm (A) B-blocker (B) Glucocorticosteriods (C) Insulin (D) ASA
14. A 45 year old man is s/p total thyroidectomy with numbness in cace and hands and a positve Chovstek sign. The serum calcium is 6.9 the appropiate step is (A) D/C with close follow up to home (B) Check a magnesium STAT (C) Calcium gluconate 3 gm IV (D) Oscal with D 4500mg per day
15. Severe hypothyroidism characterized by dry, puffy skin, somnolence, slow mentation, and hoarseness is known as (A) hypoparathryroidsim (B) myxedema (C) pheochromocytoma (D) rickets
16. Insulin shock is characterized by (A) severe hypoglycemia caused by an overdose of insulin (B) severe hyperglycemia (C) too little insulin in the bloodstream (D) an allergic reaction to insulin
17. Which of the following would be an appropriate medication for someone with hypothyroidism? (A) Cymbalta (B) Levoxyl (C) Zelnorm (D) Zithromax
18. Chronic excretion of large amounts of urine of low specific gravity is indicative of (A) diabetes innocens (B) diabetes insipidus (C) diabetes intermittens (D) diabetes mellitus
19. Potassium, sodium, and chloride are (A) catecholamines (B) electrolytes (C) enzymes (D) steroids
20. Enlargement of the bones of the hands, feet, and face due to overproduction of growth hormone is called (A) acromegaly (B) Cushing syndrome (C) polydactyly (D) Addison disease
21. Which of the following is a measure of blood sugar after 4 or more hours of no food? (A) fasting glucose (B) glucose tolerance test (C) microalbumin test (D) thyroid function test
22. Which of the following is transcribed correctly? (A) The patient was diagnosed with type 1 diabetes at 4 years of ag(E) (B) The patient was diagnosed with type I diabetes at 4 years of ag(E) (C) The patient was diagnosed with type I diabetes at 4-years of ag(E) (D) The patient was diagnosed with type one diabetes at 4 years of ag(E)
23. Elevated glucose levels, especially in obese persons, may be due to (A) diabetic acidosis (B) glucose intolerance (C) insulin resistance (D) insulin shock
24. Which gland secretes DHEA and cortisol? (A) pituitary (B) adrenal (C) parathyroid (D) pineal
25. Measurement of T3, T4 and TSH is collectively known as (A) TFTs (B) BMP (C) LFTs (D) CMP
26. Which of the following is a hypoglycemic medication? (A) Avandia (B) Ceftin (C) Lipitor (D) Prevacid
27. Overactivity of the thyroid gland is called (A) Addison disease (B) Cushing syndrome (C) hyperthyroidism (D) hypothyroidism
28. Which of the following is a complication of diabetes mellitus? (A) gastropharesis (B) exophthalmos (C) hirsutism (D) moon facies
29. Graves disease is also known as (A) hypothyroidism (B) parathymia (C) hyperinsulinism (D) toxic goiter
30. The "master gland" of the endocrine system, located at the base of the brain, is the (A) apical gland (B) Bartholin gland (C) pituitary gland (D) thyroid gland
31. The combining form gonad/o menas (A) adrenal glands (B) pancreas (C) sex organs (D) thyroid gland
32. Which type of gland secretes hormones directly into the bloodstream rather than into ducts leading to the exterior of the body? (A) endocrine gland (B) exocrine gland (C) serous gland (D) target gland
33. Which test is used to evaluate blood glucose levels over the previous 2 months? (A) methemoglobin (B) C-reactive protein (C) hemoglobin A1c (D) prolactin
34. Enlargement of the thyroid gland is called (A) bruit (B) goiter (C) moon facies (D) thyroiditis
35. What is a possible diagnosis for a middle-age woman with thinning hair, fatigue, irritability, and weight gain? (A) hyperthyroidism (B) hypochondria (C) hypoparathyroidism (D) hypothyroidism
36. Insulin is produced in the (A) gallbladder (B) kidney (C) liver (D) pancreas
37. Which hormone is secreted in the urine of pregnant women? (A) beta hCG (B) oxytocin (C) growth hormone (D) somatotropin
38. Which of the following is secreted by the posterior lobe of the pituitary gland and stimulates contraction of the uterus during labor? (A) estrogen (B) oxytocin (C) progesterone (D) prolactin
39. The class of drugs referred to as glitazones are used to treat (A) diabetes insipidus (B) non-insulin-dependent diabetes mellitus (C) infertility (D) hypothyroidism
40. Which of the following is used to treat diabetes mellitus? (A) Humalog (B) Lotrel (C) Lotensin (D) Neuronitn
41. Which of the following hormones stimulates egg production in the ovaries? (A) FSH (B) PSA (C) TSH (D) prolactin
42. Which of the following secrete estrogen and progesterone? (A) adrenal glands (B) pineal glands (C) ovaries (D) testes
43. What is the name of the gland that is composed of a right and left lobe on either side of the trachea? (A) adrenal gland (B) parathyroid gland (C) pituitary gland (D) thyroid gland
44. An excessive or abnormal hair growth, particularly male pattern hair growth on a woman, is called (A) Addison disease (B) cretinism (C) hirsutism (D) testoxicosis
45. Growth hormone (A) Directly stimulates growth of cartilage and bone (B) Levels are subnormal in acromegaly (C) Promotes lipolysis in adipose tissue (D) Enhance protein breakdown in non-vital organs (E) Enhance insulin-stimulated glucose uptake by tissue
46. What test is most useful for Killer? (A) TSH concentration (B) Skin biopsy (C) Total T4 or fT4
47. What was your diagnosis? (A) Hypothyroidism (primary, ie thyroid disease) (B) Hypothyroidism (secondary, ie pituitary disease) (C) Hyperthyroidism
48. For most dogs, what is the main hormone that is deficient? (A) Thyroxine (T4) (B) Diiodotyrosine (T2) (C) Triiodothyronine (T3)
49. Where is it produced? (A) Thyroid (B) Cellular conversion (C) Brain
50. What is the active form of thyroid hormone? (A) Triiodothyronine T3 (B) Diiodotyrosine (T2) (C) Thyroxine (T4)
51. Where is T3 produced? (A) Equally from thyroid and tissue conversion of T4 (B) Small amount from thyroid, and mostly from tissue conversion of T4 (C) Mostly from thyroid and small amount from tissue conversion of T4
52. What other form of thyroid hormone is produced in the cells? (A) Diiodotyrosine T2 (B) Thyroxine T4 (C) Reverse T3
53. What is its function? (A) Negative feedback to thyroid (B) Same function as T3 (C) Inactive
54. What is the mechanism for deficiency of thyroid hormones in majority of cases? (A) Bilateral thyroid gland destruction (B) Insufficient precursors for production (C) Insufficient pituitary production of TSH
55. How is the gland destroyed? (A) Infection (B) Traumatic injury (C) Immune mediated
56. What are the most common clinical signs? (A) Lethargy and alopecia (B) Weight gain and PU/PD (C) Alopecia and weight gain
57. Where is the alopecia typically seen? (A) Trunk and belly (B) Base or tip of tail, base of ears, lateral lumbar region (C) Tips of pinnae, base of tail and under chin
58. Other hair coat or skin changes include? (A) Dry hair, Short guard hairs, Fading coat colour (B) Dry hair, Long guard hairs, Fading coat colour (C) Hyperpigmentation, Seborrhea (D) A and C (E) B and C
59. Other common clinical signs includ(E).. (A) Weight gain, Hyperthermia, Bradycardia, Infertility, constipation (B) Weight loss, Bradycardia, Constipation (C) Weight gain, Bradycardia, Infertility, Constipation (D) Weight loss, Bradycardia, Infertility, Diarrhoea
60. What non-specific tests are often abnormal on a haematology and biochemistry profile? (A) Anaemia of chronic disease, increased cholesterol, triglycerides, CK (B) Anaemia of chronic disease, increased urea, creatinine and CK (C) Anaemia of chronic disease, decreased cholesterol and CK, increased liver enzymes
61. What was the first specific diagnostic test you did? (A) Free T4 (B) TSH concentration (C) TSH stimulation (D) Total T4 (E) A & D
62. Why not measure T3= active form? (A) Too expensive (B) Often below normal in hypothyroid dogs (C) Often below normal in euthyroid sick dogs (D) B & C
63. What does 'euthyroid sick' mean? (A) Any form of thyroid abnormality (B) Synonymous with hypothyroid (C) Decreased TT3, +/- TT3 and +/- fT4 in sick (non-hypothyroid) dog
64. Which of the following may affect the measurement of T4 & T3? (A) Phenobarbital (B) Metacam, carprofen (C) Prednisolone (D) General anaesthetic (E) Clomipramine (F) All of the above
65. What did you use as hormone replacement therapy? (A) Triiodothyroine T3 (B) Thyroxine T4 (C) Reverse T3
66. Which of the following are signs of overdosing? (A) Clinical signs of overdosing do not occur with T4 therapy (B) Nervousness, restlessness, panting, tachycardia, PU/PD (C) Lethargy, dullness, inappetance
67. How common is secondary (pituitary dependent. or tertiary (hypothalami(C) hypothyroidism in dogs? (A) Common (B) Rare (C) Never occurs
68. How would you distinguish between primary, secondary and tertiary hypothyroidism? (A) Measure TSH (B) Biopsy gland (C) Give TRH and measure T4 (D) All of the above
69. How common is hypothyroidism in dogs? (A) Rare (B) Relatively common (C) Similar occurrence to other endocrinopathies
70. How common is hypothyroidism in cats? (A) Rare (B) Most common endocrinopathy (C) Similar occurrence to other endocrinopathies
71. What are the most likely diseases for PU/PD & alopecia? (A) Diabetes mellitus, Hyperadrenocorticism, GH responsive alopecia (B) Hyperadrenocorticism, Diabetes mellitus (C) Chronic renal failure, hypoadrenocorticism, hepatic neoplasia
72. What are the steps needed to diagnose hyperA? (A) Look for adrenal tumour, if negative look for pituitary tumour (B) Confirm hyperA but it is not possible to determine whether aetiology is pituitary or adrenal (C) Confirm hyperA then differentiate between pituitary and adrenal dependent
73. What test/s can be used to confirm/ deny hyperA? (A) Low dose dexamethasone suppression test (B) High dose dexamethasone suppression test (C) ACTH concentration (D) ACTH stimulation test (E) Both A and D
74. What are the causes of HyperA (A) Neoplasia + iatrogenic (exogenous steroids) (B) Neoplasia + iatrogenic + immune mediated (C) Neoplaia + iatrogenic + diet
75. What is the primary hormone in excess in a pituitary tumour? (A) ACTH (B) Cortisol (C) TSH
76. What is the primary hormone in excess in an adrenal tumour (A) ACTH (B) Cortisol (C) TSH
77. What are the major effects of excess cortisol? (A) Catbolic + immunosuppression (B) Catabolic + anabolic (C) Catabolic + immune stimulation
78. Which of the following could be used to determine PDH vs AT? (A) 4 hour sample in the LDD (B) High dose dexamethasone suppression test (C) Ultrasound &/ or x-ray of adrenals (D) ACTH concentration (E) All of the above
79. What is the rationale for using radiography? (A) Different adrenal size (B) Identify other abdominal problems (C) Mineralisation of the adrenals
80. What are the implications of a pituitary tumour? (A) Most are large tumours that will kill the dog due to space occupation in the brain (B) Most are small tumours, but dog is likely to die from metastasis. (C) Most are small tumours; tumour invasion and metastasis rarely cause death
81. How would you test for iatrogenic hyperA? (A) ACTH stimulation (B) Low dose dexamethasone suppression test (C) High dose dexamethasone suppression test (D) ACTH concentration
82. What was your final diagnosis for Sheena? (A) Pituitary dependent hyperadrenocorticism + bacterial cystitis (B) Adrenal dependent hyperadrenocorticism + renal failure (C) Adrenal dependent hyperadrenocorticism + cystitis
83. What treatment would you recommend? (A) Surgery (B) Euthanasia (C) No treatment is necessary
84. What test/s should be performed prior to surgery? (A) Chest radiograph and abdominal ultrasound (B) Chest radiograph and brain MRI or CT scan (C) Chest radiograph and cardiac ultrasound
85. If surgery was not an option? (A) Euthanasia (B) Drug therapy (C) No treatment necessary
86. What drugs? (A) Mitotane +/- prednisolone or trilostane (B) Mitotane +/- prednisolone or selegiline/ L-deprenyl (C) Ketoconazole +/- prednisolone or selegiline/ L-deprenyl
87. How do you assess the response to treatment? (A) Feed and water intake (B) ACTH stimulation test (C) Both of the above
89. The main mechanism of _____ is to block TH iodination; also prevent peripheral conversion of T4 -->T3. (A) Propylthiouracil (B) Methimazole (C) Triiodothyronine (D) Iodine
90. The main indication for _____ is intravenous calcium replacement for hypocalcemi(A) (A) Calcium gluconate (B) Calcium carbonate (C) Calcium citrate (D) Raloxifene
91. Monoclonal antibody that binds to Her2/neu receptor on breast cancer cells (A) Estrogen replacement (B) Gonadotropins (C) Tamoxifen (D) Anastrozole (E) Trastuzumab
92. Glipizide has the following main side-effects: (A) Hypoglycemia (B) Lactic acidosis (C) Weight gain (D) Hepatotoxicity
93. Partial estrogen agonist (SERM) in breast tissue - used to treat and prevent ER-positive breast cancer (A) Estrogen replacement (B) Gonadotropins (C) Tamoxifen (D) Anastrozole
94. The main mechanism of _____ is to block TH iodination; contraindicated in pregnancy due to possibly teratogenicity. (A) Propylthiouracil (B) Methimazole (C) Triiodothyronine (D) Iodine
95. The main mechanism of _____ is symptomatic relief of hyperthyroidism. (A) Propylthiouracil (B) Methimazole (C) Triiodothyronine (D) Iodine (E) Potassium thiocyanate (F) Beta-blockers
96. The main indication for _____ is dietary calcium supplementation; need to take with a meal and can take less. (A) Calcium gluconate (B) Calcium carbonate (C) Calcium citrate (D) Raloxifene
98. The main mechanism of _____ is to replace thyroxine (T4). (A) Propylthiouracil (B) Methimazole (C) Triiodothyronine (D) Iodine
99. The main mechanism of _____ is closing K+ membrane channels on beta cells which triggers inulin releas(E) (A) Glizipide (B) Metformin (C) Sitagliptin (D) Exenatide
101. GnRH analog that can suppress fertiltiy if given continuously (A) Estrogen replacement (B) Gonadotropins (C) Tamoxifen (D) Anastrozole
102. The main mechanism of _____ is to block secretion of preformed thyroid hormon(E) (A) Propylthiouracil (B) Methimazole (C) Triiodothyronine (D) Iodine
103. Metformin has the following main side-effects: (A) Hypoglycemia (B) Lactic acidosis (C) Weight gain (D) Hepatotoxicity
104. _____ is indicated for use in emergent hypercalcemia to quickly reduce serum calcium; given in combnation with bisphosphonates which take ~48 hours to reduce serum calcium. (A) Calcium gluconate (B) Calcium carbonate (C) Calcium citrate (D) Raloxifene (E) Bisphosphonates ("-dronate") (F) Calcitonin
105. This main mechanism of _____ is to act as an analog of incretin (GLP-1) which increases glucose dependent insulin secretion and reduces glucagon releas(E) (A) Glizipide (B) Metformin (C) Sitagliptin (D) Exenatide
106. The main mechanism of _____ is to inhibit DPP-4. (A) Glizipide (B) Metformin (C) Sitagliptin (D) Exenatide
107. The main mechanism of _____ is killing thyroid cells. (A) Propylthiouracil (B) Methimazole (C) Triiodothyronine (D) Radioactive iodine (I131)
108. The main mechanism of _____ is inhibition of gluconeogenesis in the liver. (A) Glizipide (B) Metformin (C) Sitagliptin (D) Exenatide
109. The main indication for _____ is vitamin D replacement. (A) Calcium gluconate (B) Calcium carbonate (C) Calcium citrate (D) Raloxifene (E) Bisphosphonates ("-dronate") (F) Calcitonin (G) Denosumab (H) Teriparatide (I) Calcitriol
110. The main mechanism of _____ is to increase insulin sensitivity in peripheral tissu(E) (A) Glizipide (B) Metformin (C) Sitagliptin (D) Exenatide (E) Pioglitazone/Rosiglitazone
111. The main mechanism of _____ is to inhibit iodide transport. (A) Propylthiouracil (B) Methimazole (C) Triiodothyronine (D) Iodine (E) Potassium thiocyanate
112. Aromatase inhibitor used in postmenopausal women with breast cancer to block peripheral estrogen production. (A) Estrogen replacement (B) Gonadotropins (C) Tamoxifen (D) Anastrozole
113. _____ is used to treat hypogonadism or ovarian failure, menstrual abnormalities; risk of endometrial cancer, bleeding, vaginal clear cell adenocarcinoma, thrombi formation (A) Estrogen replacement (B) Gonadotropins (C) Tamoxifen (D) Anastrozole
114. _____ is a selective estrogen receptor modulator and is indicated for treatment of osteoporosis and prevents breast cancer. (A) Calcium gluconate (B) Calcium carbonate (C) Calcium citrate (D) Raloxifene
115. The main indication for _____ is dietary calcium supplementation; don't need to take with a meal but have to take mor(E) (A) Calcium gluconate (B) Calcium carbonate (C) Calcium citrate (D) Raloxifene (E) Bisphosphonates ("-dronate") (F) Calcitonin (G) Denosumab (H) Teriparatide (I) Calcitriol
116. _____ is a monoclonal antibody that binds RANKL and inhibits osteoclast differentiation. (A) Calcium gluconate (B) Calcium carbonate (C) Calcium citrate (D) Raloxifene (E) Bisphosphonates ("-dronate") (F) Calcitonin (G) Denosumab
117. T4 is converted to T3 by _____. (A) TBG (B) thyroglobulin (C) peripheral tissue
118. Adrenal hemorrhage and insufficiency due to Neisseria meningitidis is called _____. (A) Addison's (B) Cushing's (C) Conn's (D) Waterhouse-Friderichsen syndrome
