Endocrinology Practice Questions PDF

**1) Pituitary Disorders** **Acromegaly** **Q1.** Acromegaly is caused by excessive secretion of which hormone in adults? 1. Thyroxine (T4) 2. Growth Hormone (GH) 3. Insulin 4. Prolactin\ **Correct Answer: 2** **Q2.** The most common cause of acromegaly is: 1. Pituitary adenoma secr...

**1) Pituitary Disorders** **Acromegaly** **Q1.** Acromegaly is caused by excessive secretion of which hormone in adults? 1. Thyroxine (T4) 2. Growth Hormone (GH) 3. Insulin 4. Prolactin\ **Correct Answer: 2** **Q2.** The most common cause of acromegaly is: 1. Pituitary adenoma secreting GH 2. Autoimmune destruction of the thyroid 3. Adrenal gland tumour 4. Excess steroid medication\ **Correct Answer: 1** **Q3.** A key feature of acromegaly is: 1. Shortened fingers and toes 2. Enlarged hands, feet, and facial bones (jaw, brow) 3. Severe weight loss and emaciation 4. Eyeball protrusion only\ **Correct Answer: 2** **Q4.** The first-line treatment for acromegaly is often: 1. Radioactive iodine ablation 2. Surgical resection of the pituitary adenoma 3. Levothyroxine replacement 4. Insulin injections\ **Correct Answer: 2** **Q5.** Medical therapy used to reduce GH levels in acromegaly includes: 1. Somatostatin analogues (e.g., octreotide) 2. Beta-blockers 3. Thiazide diuretics 4. Oral contraceptives\ **Correct Answer: 1** **Hypopituitarism ± Panhypopituitarism** **Q6.** Hypopituitarism refers to: 1. Overproduction of all pituitary hormones 2. Deficient production of one or more pituitary hormones 3. Excessive steroid use 4. Irreversible hypothyroidism\ **Correct Answer: 2** **Q7.** A common cause of hypopituitarism is: 1. Pituitary tumour or post-pituitary surgery 2. Excess dietary calcium 3. Viral gastroenteritis 4. Chronic anxiety\ **Correct Answer: 1** **Q8.** Panhypopituitarism means deficiency of: 1. Only growth hormone (GH) 2. Only FSH and LH 3. Multiple or all anterior pituitary hormones 4. Cortisol alone\ **Correct Answer: 3** **Q9.** Treatment for hypopituitarism typically involves: 1. High-dose chemotherapy 2. Hormone replacement (cortisol, thyroxine, sex hormones, GH) 3. Simple observation with no medications 4. Antibiotics for 3 months\ **Correct Answer: 2** **Diabetes Insipidus** **Q10.** Diabetes insipidus is characterized by: 1. Hyperglycaemia and insulin deficiency 2. Excess parathyroid hormone 3. Inadequate ADH action leading to polyuria and polydipsia 4. High serum T3/T4\ **Correct Answer: 3** **Q11.** In cranial (central) diabetes insipidus, the primary defect is: 1. Lack of ADH secretion from the posterior pituitary 2. Kidney unresponsiveness to ADH 3. Excess insulin production 4. Overproduction of cortisol\ **Correct Answer: 1** **Q12.** Desmopressin (DDAVP) is used to treat which type of diabetes insipidus? 1. Nephrogenic DI 2. Cranial (central) DI 3. Type 1 diabetes mellitus 4. Type 2 diabetes mellitus\ **Correct Answer: 2** **Q13.** A common cause of nephrogenic diabetes insipidus is: 1. Pituitary adenoma 2. Lithium therapy or other nephrotoxic drugs 3. Autoimmune thyroiditis 4. Excess calcium intake\ **Correct Answer: 2** **2) Thyroid Disorders** **Hyperthyroidism (Thyrotoxicosis)** **Q14.** A key clinical feature of hyperthyroidism (thyrotoxicosis) is: 1. Weight gain despite poor appetite 2. Weight loss with increased appetite, tremor, and palpitations 3. Bradycardia and cold intolerance 4. Periorbital oedema\ **Correct Answer: 2** **Q15.** Common causes of hyperthyroidism include: 1. Graves' disease, toxic multinodular goitre, or toxic adenoma 2. Hypothalamic failure 3. Autoimmune adrenalitis 4. Steroid abuse\ **Correct Answer: 1** **Q16.** First-line antithyroid drug for hyperthyroidism is often: 1. Carbimazole 2. Levothyroxine 3. Bisphosphonates 4. Beta-2 agonists\ **Correct Answer: 1** **Q17.** Beta-blockers (e.g., propranolol) in hyperthyroidism primarily help with: 1. Directly reducing T3/T4 levels 2. Symptomatic control of palpitations, tremor, anxiety 3. Increasing metabolic rate 4. Eradication of any tumour\ **Correct Answer: 2** **Q18.** In refractory hyperthyroidism, definitive treatments can include: 1. Radioactive iodine ablation or surgical thyroidectomy 2. Long-term alpha-blockers 3. Exclusive bed rest 4. Strictly high-carbohydrate diet\ **Correct Answer: 1** **Hypothyroidism (Myxoedema)** **Q19.** Key symptoms of hypothyroidism include: 1. Tremor, insomnia, heat intolerance 2. Fatigue, cold intolerance, weight gain 3. Tachycardia and anxiety 4. Rapid weight loss with normal appetite\ **Correct Answer: 2** **Q20.** A common cause of primary hypothyroidism is: 1. Autoimmune thyroiditis (Hashimoto's) 2. Pituitary adenoma secreting TSH 3. Excess GH release 4. Adrenal hyperplasia\ **Correct Answer: 1** **Q21.** The mainstay of treatment for hypothyroidism is: 1. Levothyroxine (synthetic T4) 2. High-dose insulin 3. Beta-blockers only 4. Proton pump inhibitors\ **Correct Answer: 1** **Q22.** In regions where iodine deficiency is prevalent, hypothyroidism prevention includes: 1. Iodised salt or adequate dietary iodine 2. Avoiding all types of seafood 3. Excess steroid use 4. Fasting for a week\ **Correct Answer: 1** **Thyroid Issues in Children** **Q23.** In children, untreated hypothyroidism can lead to: 1. Excessive growth of long bones 2. Delayed tooth eruption, stunted growth, and developmental delay (cretinism) 3. Premature puberty in all cases 4. Reduced risk of dental caries\ **Correct Answer: 2** **Q24.** Neonatal screening for congenital hypothyroidism helps to: 1. Enhance bone resorption 2. Ensure early detection and treatment to prevent growth and developmental issues 3. Identify adult-onset diabetes mellitus 4. Prevent mouth ulcers\ **Correct Answer: 2** **3) Parathyroid Disorders** **Hyperparathyroidism** **Q25.** Hyperparathyroidism commonly presents with: 1. Hypocalcaemia and muscle spasms 2. Hypercalcaemia, kidney stones, bone pain (high PTH) 3. Hyperglycaemia 4. Autoimmune adrenal insufficiency\ **Correct Answer: 2** **Q26.** The most frequent cause of primary hyperparathyroidism is: 1. Parathyroid adenoma 2. Chronic renal failure 3. Vitamin D deficiency 4. Overuse of desmopressin\ **Correct Answer: 1** **Q27.** Surgical removal of the adenoma is definitive treatment for: 1. Primary hyperparathyroidism 2. Secondary hyperparathyroidism 3. Diabetes insipidus 4. Grave's ophthalmopathy\ **Correct Answer: 1** **Q28.** Bisphosphonates can be used in hyperparathyroidism to: 1. Increase PTH secretion 2. Reduce bone resorption and serum calcium temporarily 3. Raise T3 and T4 levels 4. Stimulate the release of insulin\ **Correct Answer: 2** **Hypoparathyroidism** **Q29.** Hypoparathyroidism leads to: 1. High serum calcium 2. Low serum calcium (hypocalcaemia) 3. Hyperglycaemia 4. Hyponatraemia only\ **Correct Answer: 2** **Q30.** A common cause of hypoparathyroidism is: 1. Accidental removal or damage to the parathyroids during thyroid surgery 2. Excess GH secretion 3. Excess vitamin D supplementation 4. Pituitary tumour\ **Correct Answer: 1** **Q31.** The mainstay of treatment in hypoparathyroidism is: 1. High-dose insulin 2. Calcium and vitamin D supplementation 3. Beta-blockers 4. Carbimazole\ **Correct Answer: 2** **4) Adrenal Disorders** **Cushing's Disease (Hypercortisolism)** **Q32.** Cushing's disease (hypercortisolism) typically presents with: 1. Low blood sugar, weight loss, and low blood pressure 2. Central obesity, moon face, buffalo hump, striae 3. Exophthalmos and goitre 4. Chronic diarrhoea and malabsorption\ **Correct Answer: 2** **Q33.** A common iatrogenic cause of Cushing's syndrome is: 1. Chronic high-dose corticosteroid therapy 2. Extended antibiotic use 3. Untreated hypothyroidism 4. Overuse of insulin in type 2 diabetes\ **Correct Answer: 1** **Q34.** The first-line definitive treatment for pituitary-based Cushing's disease is: 1. Transsphenoidal surgical resection of the pituitary adenoma 2. Total thyroidectomy 3. Adrenalectomy 4. High-dose beta-blockers\ **Correct Answer: 1** **Q35.** A recommended preventive measure for iatrogenic Cushing's is: 1. Avoid unnecessary long-term high-dose steroids or use the lowest effective dose 2. Take high-dose vitamin D continuously 3. Increase dietary sugar 4. Restrict water intake\ **Correct Answer: 1** **Addison's Disease (Adrenal Insufficiency)** **Q36.** Addison's disease is characterized by: 1. Overproduction of cortisol 2. Deficiency of cortisol ± aldosterone 3. Overproduction of thyroid hormones 4. Excess ADH release\ **Correct Answer: 2** **Q37.** Common causes of Addison's disease include: 1. Autoimmune destruction of the adrenal cortex 2. Excess growth hormone tumour 3. Lithium-induced adrenal changes 4. Pituitary hyperplasia\ **Correct Answer: 1** **Q38.** A classic sign of Addison's disease is: 1. Hyperpigmentation of the skin and mucosa 2. Pale, waxy complexion 3. Prominent moon face 4. High blood pressure\ **Correct Answer: 1** **Q39.** Treatment for Addison's disease involves: 1. Life-long steroid replacement (hydrocortisone ± fludrocortisone) 2. High-dose carbimazole 3. Beta-blockers 4. Antibiotics\ **Correct Answer: 1** **Q40.** Addisonian crisis can be prevented in known adrenal insufficiency by: 1. Stopping steroid medication abruptly 2. Doubling the steroid dose during infection, trauma, or surgery 3. Avoiding water intake 4. Never adjusting the steroid dose\ **Correct Answer: 2** **5) Gonadal/Reproductive Disorders** **Amenorrhea, PCOS, Precocious Puberty, Premature Ovarian Failure, Hypogonadism** **Q41.** Polycystic ovary syndrome (PCOS) can present with: 1. Hyperandrogenism (hirsutism), irregular menses, obesity 2. Hypothyroidism and hair loss 3. High parathyroid hormone and hypercalcaemia 4. Adrenal insufficiency\ **Correct Answer: 1** **Q42.** A potential treatment for PCOS with insulin resistance is: 1. Metformin (insulin-sensitizing agent) 2. Bisphosphonates 3. High-dose steroids 4. Radioactive iodine\ **Correct Answer: 1** **Q43.** Precocious puberty is defined as: 1. Puberty occurring at a normal age 2. Early pubertal changes before age 8 in girls or 9 in boys 3. Irreversible short stature 4. Delayed puberty beyond 16 years\ **Correct Answer: 2** **Q44.** Hypogonadism in males might present as: 1. Early closure of epiphyseal plates 2. Low testosterone, reduced secondary sexual characteristics 3. Rapid deepening of voice 4. High fertility\ **Correct Answer: 2** **6) Multiple Endocrine Neoplasia (MEN) Syndromes** **Q45.** MEN syndromes are characterized by: 1. Multiple endocrine gland tumours 2. Viral infections of multiple glands 3. Simple hypothyroidism 4. Single tumour in the lung\ **Correct Answer: 1** **Q46.** A well-known genetic cause of MEN2 is a mutation in which gene? 1. RET proto-oncogene 2. CFTR gene 3. Insulin receptor gene 4. ACTH receptor gene\ **Correct Answer: 1** **Q47.** A prophylactic measure in MEN2 (to prevent medullary thyroid cancer) can be: 1. Prophylactic thyroidectomy in early life 2. High-dose insulin 3. Immediate gallbladder removal 4. High-fibre diet only\ **Correct Answer: 1** **7) Polyglandular Deficiency Syndromes (PDS)** **Q48.** Polyglandular deficiency syndromes typically involve: 1. Multiple autoimmune endocrine gland failures (e.g., Addison's + thyroiditis + T1 diabetes) 2. Single parathyroid gland tumour 3. Excess GH and TSH 4. Low blood sugar only\ **Correct Answer: 1** **Q49.** Treatment for polyglandular deficiency syndrome primarily: 1. Replacement of each deficient hormone (adrenal, thyroid, insulin) 2. Single antibiotic for 1 week 3. High-dose chemotherapy 4. Resection of the pituitary\ **Correct Answer: 1** **8) Osteoporosis** **Q50.** Osteoporosis is characterized by: 1. Increased bone density 2. Reduced bone mineral density and higher fracture risk 3. Excess parathyroid hormone only 4. Hyperthyroidism in all patients\ **Correct Answer: 2** **Q51.** A major risk factor for osteoporosis in older women is: 1. Normal estrogen levels 2. Postmenopausal low estrogen status 3. Overactive parathyroid hormone only 4. High testosterone\ **Correct Answer: 2** **Q52.** One standard medical therapy to strengthen bones in osteoporosis is: 1. Bisphosphonates (e.g., alendronate) 2. Growth hormone injections 3. Antithyroid drugs 4. Beta-blockers\ **Correct Answer: 1** **Q53.** Prevention of osteoporosis includes: 1. Adequate calcium and vitamin D intake, weight-bearing exercise 2. Zero physical activity 3. High-dose steroid use 4. Strict fluid restriction\ **Correct Answer: 1** **9) Key Drugs/Therapies** **Carbimazole** **Q54.** Carbimazole is primarily used to treat: 1. Hyperthyroidism (Graves' disease) 2. Hypothyroidism 3. Addison's disease 4. Diabetes insipidus\ **Correct Answer: 1** **Q55.** Carbimazole's mechanism of action is: 1. Increasing T3 and T4 production 2. Blocking thyroid peroxidase to inhibit hormone synthesis 3. Stimulating GH release 4. Acting as an insulin secretagogue\ **Correct Answer: 2** **Propylthiouracil (PTU)** **Q56.** Propylthiouracil is an alternative antithyroid medication that also: 1. Blocks peripheral conversion of T4 to T3 2. Increases serum cortisol 3. Replaces parathyroid hormone 4. Stimulates aldosterone\ **Correct Answer: 1** **Levothyroxine (Thyroxine)** **Q57.** Levothyroxine is used for: 1. Treating hypothyroidism by providing synthetic T4 2. Treating hyperthyroidism 3. Raising serum cortisol 4. Replacing PTH in hypoparathyroidism\ **Correct Answer: 1** **Q58.** An important monitoring parameter in levothyroxine therapy is: 1. Liver function tests only 2. TSH and T4 levels 3. Blood glucose only 4. Potassium levels\ **Correct Answer: 2** **Bisphosphonates** **Q59.** Bisphosphonates (e.g., alendronate) reduce: 1. Osteoclastic bone resorption 2. Insulin secretion 3. Serum sodium exclusively 4. Pituitary hormone secretion\ **Correct Answer: 1** **Q60.** Bisphosphonates are commonly indicated for: 1. Addison's disease 2. Osteoporosis and hypercalcaemia of malignancy or hyperparathyroidism 3. Diabetes insipidus 4. Myxoedema coma\ **Correct Answer: 2** **Vitamin D Supplements** **Q61.** Vitamin D supplementation is useful for: 1. Increasing intestinal calcium absorption 2. Causing hyperthyroidism 3. Lowering cortisol levels 4. Inhibiting insulin release\ **Correct Answer: 1** **Q62.** In secondary hyperparathyroidism due to chronic renal failure, vitamin D therapy: 1. Is irrelevant 2. Helps reduce PTH by improving calcium absorption 3. Promotes Addison's disease 4. Depletes serum calcium\ **Correct Answer: 2** **Calcium Supplements** **Q63.** Calcium supplementation is indicated in: 1. Hypoparathyroidism-related hypocalcaemia 2. Hypercalcaemia of primary hyperparathyroidism 3. Addison's disease 4. Overactive thyroid disease only\ **Correct Answer: 1** **Steroids (Hydrocortisone, Fludrocortisone)** **Q64.** Hydrocortisone is primarily used as: 1. Replacement therapy in adrenal insufficiency (Addison's) 2. First-line treatment for hyperthyroidism 3. Treatment for diabetes insipidus 4. Hypoglycaemic agent\ **Correct Answer: 1** **Q65.** Fludrocortisone replaces which hormone function? 1. Thyroxine 2. Aldosterone (mineralocorticoid) 3. Insulin 4. Parathyroid hormone\ **Correct Answer: 2** **Oral Contraceptive Hormones** **Q66.** Combined oral contraceptives (estrogen + progestogen) primarily: 1. Stimulate TSH secretion 2. Suppress ovulation 3. Treat Addison's disease 4. Cure hyperthyroidism\ **Correct Answer: 2** **HRT (Hormone Replacement Therapy)** **Q67.** Postmenopausal HRT typically replaces: 1. Estrogen ± progesterone to reduce menopausal symptoms and protect bone density 2. Insulin for glucose control 3. GH for muscle mass 4. Aldosterone to treat Addison's\ **Correct Answer: 1** **Insulin** **Q68.** Insulin therapy is critical for managing: 1. Diabetes mellitus (type 1, sometimes type 2) 2. Hyperthyroidism 3. Hypoparathyroidism 4. Addison's disease\ **Correct Answer: 1** **Vasopressin / Desmopressin (DDAVP)** **Q69.** Desmopressin (DDAVP) is used to: 1. Increase water reabsorption in the kidneys for cranial diabetes insipidus 2. Lower blood sugar 3. Block GH release 4. Suppress cortisol production\ **Correct Answer: 1** **Surgery (Endocrine Tumours)** **Q70.** Surgical resection is a key treatment for: 1. Pituitary adenomas (e.g., in acromegaly or Cushing's) 2. Hypothyroidism 3. Nephrogenic diabetes insipidus 4. Mild PCOS\ **Correct Answer: 1** **10) Investigations** **Q71.** A typical blood test finding in primary hyperthyroidism (Graves') is: 1. Elevated T3/T4 with suppressed TSH 2. Low T3/T4 with suppressed TSH 3. High TSH with high T3/T4 4. Low cortisol only\ **Correct Answer: 1** **Q72.** In Cushing's disease, which hormone is often elevated? 1. TSH 2. Cortisol 3. PTH 4. GH\ **Correct Answer: 2** **Q73.** Imaging modality commonly used to detect pituitary adenomas is: 1. MRI of the sella turcica 2. Chest X-ray 3. Mammogram 4. Abdominal ultrasound\ **Correct Answer: 1** **Q74.** In primary hyperparathyroidism, you'd expect blood tests to show: 1. Low calcium, high PTH 2. High calcium, high PTH 3. High cortisol, low ACTH 4. Low sodium, low potassium\ **Correct Answer: 2** **Q75.** For suspected Addison's disease, one confirmatory test is: 1. Short Synacthen (ACTH stimulation) test 2. Oral glucose tolerance test 3. Dexamethasone suppression test 4. TRH stimulation test\ **Correct Answer: 1** **Q76.** If a thyroid nodule is discovered, a common imaging or functional test is: 1. Thyroid ultrasound or scintigraphy (radioisotope uptake scan) 2. Plain chest X-ray 3. Colonoscopy 4. Bone densitometry\ **Correct Answer: 1** **11) General / Miscellaneous** **Q77.** In patients on long-term high-dose steroids (e.g., prednisolone), there is increased risk of: 1. Osteoporosis, hyperglycaemia, and infection risk 2. Hypocalcaemia 3. Hypotension 4. Hypothyroidism\ **Correct Answer: 1** **Q78.** A diabetic patient with poor control and high blood glucose might also show: 1. Low risk of infections 2. Increased susceptibility to oral infections and poor wound healing 3. Enhanced bone density 4. Hypopigmentation\ **Correct Answer: 2** **Q79.** In Addison's disease, patients sometimes require steroid cover for: 1. Routine daily tasks 2. Stressful procedures (surgery, dental extractions) to prevent adrenal crisis 3. When TSH is elevated 4. To treat migraines\ **Correct Answer: 2** **Q80.** Osteoporosis risk can be reduced by: 1. Weight-bearing exercise, adequate calcium & vitamin D, and limiting steroid use 2. Strict bed rest for months 3. Consuming zero dairy 4. Only prescribing analgesics\ **Correct Answer: 1** **Q81.** If a patient has a known pituitary tumour, a primary concern for the dentist or physician might be: 1. Visual field defects (compression of optic chiasm) and possible hormonal deficiencies/excesses 2. Excess hair growth on the scalp 3. Obesity resistant to any therapy 4. Abnormally high RBC count\ **Correct Answer: 1** **Q82.** In hyperthyroid patients, one caution for dental procedures is: 1. Potential sensitivity to adrenaline (risk of tachycardia/palpitations) 2. Immediate syncope from bradycardia 3. Inability to produce any sweat 4. Hypotension with sedation\ **Correct Answer: 1** **Q83.** A T1 diabetic on insulin might need what consideration before a lengthy dental procedure? 1. No difference from a healthy patient 2. Adjusting insulin dose/timing to avoid hypoglycaemia 3. Doubling the dose of insulin 4. Skipping all meals\ **Correct Answer: 2** **Q84.** Menopause is associated with: 1. Decreased estrogen levels leading to potential bone loss (osteoporosis) 2. High testosterone levels 3. Overproduction of PTH 4. Chronic hyperthyroidism\ **Correct Answer: 1**