PRELIMS 3 KEY

SET -A
A-1) Identify the marked area

ANSWER: degenerating part of fetal cortex

REF: inderbir Singh 11th edition 316

A-2) Lymphatics of adrenal gland drain into lymph nodes:

1)internal iliac
2)para aortic
3)superficial inguinal
4)coeliac
ANSWER: 2
REF: Gray's anatomy, 41st edition, pg no:1197
A-3)

Remark the physiological importance of this neurohemal part of pituitary

ANSWER: It is median eminence and only here hypothalamic releasing and
inhibitory hormones are secreted from nerve endings and taken through blood
to anterior pituitary
REF: Guyton and hall textbook of physiology ,13th edition, pg no: 941,942

A-4) A child with kwashiorkar is identified and given high calorie diet with
more than adequate quantities of carbohydrates. Growth hormone levels are
now measured. How would u expect it to be?
A. Low
B. high
C. Remains same
D. Significantly low
ANSWER: C
REF : Guyton and Hall textbook of physiology, 13th edition, pg no:945

A-5) Effect of GH on growth of bone are all of the following except:

1) Increased production of osteoblast.
2) Strong stimulation of osteoblast
3) Chondrocytes are converted to osteoblasts
4) Thickens enchondral bones throughout life due to increased rate of
deposition
5) Increases growth at epiphyseal cartilages
ANSWER: 4
REF: Guyton and Hall textbook of medical physiology, 13th edition, pg no:944

A-6) Which of the following decrease insulin secretion

A) .alpha adnergic activity
B) aminoacids --arginine and lysine
C) parasympathetic stimulation-Ach
D) increased GH and cortisol levels
E) beta adrenergic activity
ANSWER: A
REF :Guyton and hall textbook of medical physiology 13 the edition pg no 946

A-7) Which of the following cytokines produced by adipocytes is not increased

in obesity
A) leptin
B) plasminogen activator inhibitor - 1
C) adiponectin
D) resistin
ANSWER: C
REF: Harrison 19th edition 2393

A-8) A young man with a blood pressure of 175 / 110mm hg . He is found to

have a high circulating aldosterone but a low circulating cortisol .
Glucocorticoid treatment lowers his circulating aldosterone and lowers his
blood pressure to 140 / 85 mm hg . He probably has abnormal
A. 17 alpha hydroxylase
B. 21 beta hydroxylase
C. Aldosterone synthase
D. Cholesterol desmolase
ANSWER :C
REF: Ganong 374

A-9) A)type 1 deiodinase- i)regulate intracellular 1)inner and outer ring

T3 level- Deiodination.

B) B)Type 2 deiodinase- ii)major source of 2)found in placenta and fetal

circulating T3- tissues and inner ring
deiodination.
C) C)Type 3 deiodinase - iii)local production of 3) outer ring deiodination
T3 in tissues -

ANSWER: a . (ii) - 1
b. (iii) - 3
c. (i) – 2
REF: Soumen manna review of physiology page 520

A-10) In pontine reticular formation the activity of acetyl choline containning

neurons _________ and in locus ceruleus and raphe nuclei the activity of
Norepinephrine and serotonin containning neurons is ________ in awaken
state and its reverse causes _____ sleep .
1. Reduced , reduced , NREM
2. Increased , reduced , REM
3. Reduced , increased , REM
4. Reduced , increased , NREM
ANSWER: 3
REF:Ganong 25th edition 278

SET-B
B-1) Pit-1 is a tissue specific transcription factor for which of the following?!
1)corticotrope
2)lactotrope
3)thyrotrope
4)somatotrope
5)gonadotrope
( Multiple answers)
ANSWER: 2 3 4
REF: Harrison 19th edition 401e-1

B-2)
A) A middle aged man had a severe viral infection and was admitted in the
intensive care unit for a long time.. Lab says his T4 and TSH are normal.. RT3
increased and T3 levels decreased. What is the scenario?!

B) A 24 Yr old woman returns after followup after routine laboratory tests

show markedly elevated total T4 and normal TSH level.. The patient was
asymptomatic and the physical examination is unremarkable.. Diagnosis?!

ANSWER:
A.euthyroid sick syndrome
B.Familial euthyroid hyperthyroxinemia/ Familial dysalbuminemic
hyperthyroxinemia (FDH)
REF: greenspan's basic and clinical endocrinology 160 and 179
B-3)

ANSWER: A. Spironolactone bodies

B. Pseudo inclusion Bodies
REF: robbins basic pathology 9th edition Pg 755 and 732

B-4)

ANSWER: A. armanni ebstein lesion in DKA

B.charcot bottcher filaments
B-5) Name the amyloid proteins deposited in
1)Medullary carcinoma of thyroid
2)Type 2 diabetes mellitus
3)Iatrogenic insulin induced amyloidosis
4)Pituitary (age associated)
ANSWER:
A cal-calcitonin amyloid
AIAPP-islet amyloid polypeptide amyloidosis
AIns-insulin amyloid
Apro -prolactin amyloid
REF: rubin's Pathology , 7th edition ,567

B-6) State the effect of different OHA on weight (neutral or weight gain or
weight loss )
1.Biguanides -
2.Sulfonyl urea -
3.Bolus insulin -
4.Gliptins -
5.Exenatide -
ANSWER:
1. neutral
2. weight gain
3. Weight gain
4. Neutral
5. Weight loss
REF: Williams textbook of endocrinology 11th edition 1417
B-7) Name the sulfonyl ureas that has low risk of hypoglycemia , weight gain .
A. Glipizide , glimepiride
B. Glibenclamide , glipizide
C. Gliclazide, glimepiride
D. Glyburide , glipizide
ANSWER: A
REF: williams textbook of endocrinology 11th edition1413

B-8) Dose of dexamethasone given to mother in anticipated preterm delivery

A. 12 mg 12 hourly 2 doses
B. 12 mg 24 hourly 4 doses
C. 6 mg 24 hourly 2 doses
D. 6 mg 12 hourly 4 doses
ANSWER :D
Ref : Nelson 20 th edition 852

B-9) Prednisolone intake of more than __ per day for more than ___ months
increases the risk of osteoporosis ,
A. 5 mg , 5months
B.10 mg , 5 months
C. 5mg , 3 months
D. 10 mg , 3 months
ANSWER : C
REF: Goodman and Gilman 12th edition 1227

B-10) Prednisolone intake of more than __ mg per day causes __ cataract

A. 5 - 10 mg , anterior subcapsular cataract
B.10 to 15 mg , posterior subcapsular cataract
C.5 to 10 mg ,posterior subcapsular cataract
D. 10 to 15 mg , anterior subcapsular cataract
ANSWER: B
REF: good man gillman 12th edition 1227

B-11)

This lady suddenly developed swelling of all the soft tissues . Anti allergic
treatment gave a poor response. Similiar family history was present. Name the
androgen and C1 esterase inhibitor used to treat this condition .
ANSWER: 1.Stanozolol / danazol
2. Cinryze
REF : goodman and gilman 12th edition 1209

SET-C
C-1) Arrange the ectopic parathyroid glands from the most common to the
least common site
1.High cervical
2.Intrathymic
3.Paraesophageal
4.Intrathyroidal
5.Mediastinal
6.Carotid sheath
ANSWER: 3 5 2 4 6 1
REF: Schwartz surgery 12th edition 1571

C-2)
The screening test for mineralocorticoid excess is
A. Saline infusion test
B. Salt loading test
C. Aldosterone renin ratio
D. Cosyntropin test
ANSWER: C
Ref : page no: 2728 , 20 th edition

C-3)
Connect it and identify the personality and the named sign
ANSWER: neurofibromatosis 1
1.von recklinghausen
2.patrick yesudian sign
3.bare orbit sign
4.crowe's sign
REF: rooks book of dermatology 4.17

C-4) A mother of one and half year old child gave the history of white reflex in
2 eyes for the past 1 month. On ct there were calcifications within the eye ball.
The histopath findings showed rosttes . Whats the tumor related to endocrine
is likely to be present in this child ?

ANSWER: pinealoblastoma
REF : parson 349

C-5)

Name this. State the endocrine association !

ANSWER: band keratopathy
Hyperparathyroidism/ vitamin d toxicity
REF : parson 189
C-6) If 100 couple hav used a contraceptive method for a period of 2 years and
have resulted in 20 pregnancies, calculate the pearl index .
A.20
B.10
C.12
D.15
ANSWER: B
REF : dutta book of gynecology 495

C-7) Upper segment : lower segment ratio is increased in the following

diseases , except
A. Hypothyroidism
B. Turner
C. Achondroplasia
D.morquio syndrome

ANSWER: D
REF : GHAI 9th edition506

C-8) Choose the false statements regarding the CT features of adrenal masses
A. Adrenal adenomas are lipid rich
B. Benign masses round and homogenous
C. Pheochromocytoma shows lobulated and inhomogenous mass
D. Malignant masses have low attenuating values
ANSWER: D
REF: Harrison 19th edition 2321
C-9) Choose the false statement regarding adrenocortical carcinoma

A. ki 67 proliferations >5% has poor prognosis

B. Mitotane is recommended for high risk recurrence cases
C. Neurotoxic complications of mitotane are expected when mitotane levels
are more than 20 mg per dl
D. 18 FDG PET scan is highlu sensitive , even diffrentiates metastsais and
adrenocortical carcinoma
E. Weiss scoring gives the histopathological classification
(Multiple answers)
ANSWER: A ,D
REF : Harrison 19th edition
2322

C-10)

name the surgery and complicated expected

ANSWER: roux en y gastric bypass

Complication: Stromal stenosis
REF : C 10)greenspans basic and clinical endocrinology 10th edition Pg 740