Endocrinology & Diabetes Practice Questions

Question 1

A 42-year-old woman presents with fatigue, muscle aches, and widespread pain. She has multiple tender points but normal inflammatory markers. Sleep is poor. What is the most appropriate initial treatment?

Accepted Answer

Pregabalin

Answer

NSAIDs

Answer

Prednisolone

Answer

Methotrexate

Answer

Physiotherapy alone

Question 2

A 49-year-old man presents with progressive weakness in his arms and legs over 24 months. He has bulbar symptoms including dysphagia and dysarthria. EMG shows widespread denervation. What is the most important prognostic factor?

Accepted Answer

Bulbar involvement

Answer

Age at onset

Answer

Rate of progression

Answer

Site of onset

Answer

Family history

Question 3

A 28-year-old woman presents with sudden onset severe headache during exercise. She vomits and has neck stiffness. CT head shows subarachnoid hemorrhage. What is the most likely cause?

Accepted Answer

Berry aneurysm

Answer

Arteriovenous malformation

Answer

Carotid dissection

Answer

Hypertensive hemorrhage

Answer

Trauma

Question 4

A 46-year-old man presents with recurrent episodes of severe flushing and diarrhea. CT shows liver metastases and a pancreatic mass. Chromogranin A is markedly elevated. What is the most likely primary tumor?

Accepted Answer

Pancreatic neuroendocrine tumor

Answer

Pancreatic adenocarcinoma

Answer

Hepatocellular carcinoma

Answer

Cholangiocarcinoma

Answer

Gastrinoma

Question 5

A 43-year-old man presents with recurrent episodes of severe sweating, palpitations, and headache. His BP during episodes is 240/130 mmHg. What is the most appropriate preoperative management?

Accepted Answer

Alpha-blockers then beta-blockers

Answer

Beta-blockers only

Answer

Alpha-blockers only

Answer

ACE inhibitors

Answer

Calcium channel blockers

Question 6

A 44-year-old woman presents with fatigue, muscle weakness, and weight loss. She has hyperpigmentation of palmar creases. Blood tests show Na+ 128 mmol/L, K+ 5.6 mmol/L. What is the most appropriate diagnostic test?

Accepted Answer

Synacthen stimulation test

Answer

Dexamethasone suppression test

Answer

24-hour urine cortisol

Answer

Adrenal antibodies

Answer

ACTH levels

Question 7

A 64-year-old woman presents with bone pain and fatigue. Blood tests show calcium 3.1 mmol/L, phosphate 0.7 mmol/L, and suppressed PTH. She has a history of sarcoidosis. What is the most likely cause of hypercalcemia?

Accepted Answer

Granulomatous disease

Answer

Primary hyperparathyroidism

Answer

Malignancy

Answer

Vitamin D intoxication

Answer

Milk-alkali syndrome

Question 8

A 47-year-old woman presents with fatigue, muscle weakness, and depression. She has purple striae and central obesity. 24-hour urine cortisol is elevated. What is the next most appropriate test?

Accepted Answer

Dexamethasone suppression test

Answer

MRI pituitary

Answer

ACTH levels

Answer

Adrenal CT

Answer

CRH stimulation test

Question 9

A 29-year-old woman presents with episodes of severe anxiety, tremor, and palpitations. These occur mainly when fasting. Blood glucose during episodes is 2.1 mmol/L. Insulin and C-peptide are elevated. What is the most likely diagnosis?

Accepted Answer

Insulinoma

Answer

Panic disorder

Answer

Factitious hypoglycemia

Answer

Reactive hypoglycemia

Answer

Adrenal insufficiency

Question 10

A 67-year-old woman presents with bone pain and confusion. Serum calcium is 3.4 mmol/L, phosphate is low, and PTH is elevated. Parathyroid scan shows increased uptake. What is the most appropriate treatment?

Accepted Answer

Parathyroidectomy

Answer

IV fluids and bisphosphonates

Answer

Cinacalcet

Answer

High-dose vitamin D

Answer

Corticosteroids

Endocrinology & Diabetes

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