2023-24 ENDOCRINE SYSTEM MODULE FINAL EXAM
1. What are the side effects of insulin
treatment?
a. Generalized lipoatrophy and
lipodistrophy
b. Hypoglycemia and weight gain
c. Genital infecSon and weight gain
d. Heart failure and oedema
e. Allergy and malignancy
2. Which one of the followings is a chronic
macrovascular complicaSon of diabetes
mellitus?
a. Peripheral artery disease
b. DiabeSc reSnopathy
c. DiabeSc sensorial neuropathy
d. DiabeSc kidney disease
e. DiabeSc autonomic neuropathy
3. A 44-year-old man has a 6 month
history of generalized headaches. On
physical examinaSon he is found to have a
blood pressure of 170/110 mm Hg.
Laboratory studies show a serum sodium
of 145 mmol/L, potassium 2.6 mmol/L,
glucose 92 mg/dL, and creaSnine 1.2
mg/dL. His plasma renin acSvity is 0.2
ng/mL/hr and his serum aldosterone 55
ng/mL. Which of the following is the most
likely cause for these findings?
a. Pituitary adenoma
b. 21-hydroxylase enzyme deficiency
c. Exogenous corScosteroid administraSon
d. Adrenal corScal adenoma
e. Renal cell carcinoma
4. Which of the following pituitary -target
organ hormone pairs are correct?
a. AnSdiureSc hormone- Arginin
Vasopressine
b. ProlacSn-ProlacSn inhibiSng hormone
c. Oxytocin- Myorelaxin
d. Growth hormone- Endorphins
e. Follicule SSmulaSng Hormone- Inhibin
5. Which of the following aspects of a
paSent's history is parScularly important
in evaluaSng potenSal adrenal gland
insufficiency?
a. History of hypertension
b. OccupaSonal history
C.History of unexplained weight loss
d. Smoking habits
e. Excessive hair growth
6. Which may not be the cause in a male
paSent with low serum testosterone and
high serum luteinizing hormone (LH)
and/or follicle- sSmulaSng hormone
(FSH)?
a. Chronic renal failure
b. InfecSons like mumps
c. LymphocySc hypophysiSs
d. HepaSc cirrhosis
e. Acquired Immune Deficiency Syndrome
7. A 47-year-old man comes to the
physician because of unintenSonal weight
loss of 4 kg over the past one month,
palpitaSons, pain during swallowing and
low grade fever. He describes of having an
upper respiratory tract infecSon about 2
months ago. His TSH level is supressed and
thyroid hormones are elevated. Which of
the following is not a characterisSc of this
condiSon?
a. Decreased uptake of radio-iodine in the
thyroid
b. Pathcy heterogenecity in sonography
c. Increased erythrocyte sedimentaSon
rate
d. Giant cells in fine needle aspiraSon
cytology
e. Low thyroglobulin levels
8. Which of the following is not an
endocrine disease that causes
gynecomasSa?
a. HyperprolacSnemia
b. Acromegaly
c. Klinefelter syndrome
d. Primary hypogonadism
e. Hyperthyroidism
 2023-24 ENDOCRINE SYSTEM MODULE FINAL EXAM
9. Which of the following diseases is not in
the spectrum of iodine deficiency
disorders(IDD)
a. Miscarriage and sSllbirths
b. Decreased suscepSbility of the thyroid
gland to nuclear radiaSon
c. Endemic creSnism
d. Neonatal hypothyroidism
e. Retarded physical development
10. When conducSng a physical
examinaSon of a paSent suspected for
hyperthyroidism, which of the following
signs would be the most likely observed?
a. Lid retracSon
b. Bradycardia
c. Cool and dry skin
d. Pihng edema in the upper extremiSes
e. Redness and sSffness on the feet
11. Which of the followings is not a
symptom/sign of panhypopituitarism?
a. Increased perspiraSon
b. InferSlity
c. Bradycardia
d. Fine skin wrinkles
e. FaSgue
12. A 28-year-old woman, notes that she
has had no menstrual periods for the past
6 months, but she is not pregnant and
takes no medicaSons. Within the past
week, she has noted some milk leakage
from her breasts. She has had headaches
for the past 2 months and noSced a
decline in her vision. On physical
examinaSon loss of lateral vision and
galactorrhea was detected. Which of the
following findings is most likely to be
present in this woman?
a. HyperprolacSnemia
b. Increased serum corSsol
c. Lack of growth hormone suppression
d. Abnormal glucose tolerance
e. Decreased serum TSH
13. When gathering a paSent's history to
assess … potenSal parathyroid disorders,
which of the following aspects is most
relevant?
a. Family history of kidney stones
b. Preference for hot or cold beverages
c. Family history of respiratory illnesses
d. Personal history of bone fractures
e. Increased frequency of bowel
movements
14. Which of the following
symptoms/signs is not a characterisSc of
hyperglycemic hyperosmolar state?
a. Fruity mouth odor
b. Hypotension
c. Dry mucous membranes
d. Tachycardia
e. Altered consciousness
15. Which of the following is not
characterisSc of Klinefelter syndrome?
a. Chromosomal anomaly 47XXY
b. GynecomasSa
c. Female external genitalia
d. Mental retardaSon, personality and
behavioral disorders
e. InferSlity
16. A 32-year-old pregnant woman
admijed to hospital with marked vaginal
bleeding aker the onset of labor at 39
weeks of gestaSon. Cesarean secSon was
performed and she remained hypotensive
for 4 hours and required transfusion of 8
packed erythrocyte suspension. Aker
delivery there was no lactaSon and normal
menstrual cycles did not start. She became
sluggish and Sred. Laboratory findings
include hyponatremia, hyperkalemia, and
hypoglycemia. Which of the following is
most likely diagnosis for this paSent?
a. Postpartum thyroidiSs
b. Sheehan Syndrome
c. Nelson Syndrome
d. Bilateral adrenal hemorrhage
e. GestaSonal diabetes mellitus
 2023-24 ENDOCRINE SYSTEM MODULE FINAL EXAM

21. A 35-year-old male paSent is admijed

17. Which one is not included in Fracture with the complaint of weight gain. Which
Risk Assessment Tool (FRAX) calculaSon ? drug he is taking can cause weight gain?
a. GlucocorScoid usage a. Amitriptyline
b. Rheumatoid ArthriSs b. Valsartan
c. Smoking c. FamoSdine
d. Family history of hip fracture d. Sildenafil
e. Non-steroidal anS-inflammatory drug e. Acetyl salicylic acid
usage
22. Which one is an indicaSon for oral
18. Late diagnosed primary glucose tolerance test?
hyperparathyroidism could be associated a. Obesity
with the following symptoms and findings b. Feeling thirsty
except; c. Presence of polycysSc kidney disease
a. Chronic Renal Failure d. Women with a history of giving birth to
b. Nephrocalcinosis and/or nephrolithiasis a baby with small for gestaSonal age
c. ConjuncSval calcificaSons and cataracts e. PaSent using glucocorScoid
d. CalcificaSon of the basal ganglias
e. Psycological problems like depression, 23. Which of the following is not a clinical
psychosis, demenSa symptom or finding for overt
hypothyroidism?
19. Which of the following tests are a. FaSgue, lethargy, consSpaSon
necessary for a 40 years b. Slowing intellectual and motor acSviSes
old woman with hirsuSsm and c. Fast reacSve deep tendon reflexes
oligomenorrhea? d. Weight gain despite decreasing appeSte
I. Serum total testosteron e. Hair loss, cold intolerance, muscle
II. Hydroxyprogesterone sSffness, cramps
III. FasSng insulin
IV. Gonadotrophin releasing 24. A 32-year-old woman presented with
hormone headache. On physical examinaSon, he
V. Luteinizing hormone had elevated blood pressure of 160/98
VI. Estradiol mmHg with potassium levels 3.1 mEq/L
a. I, II, III, V (reference range 3.6-5.4 mEq/L). Her renin
b. I, II, IV, V level was low and aldosterone level was
c. I, II, V, VI high. Based on her clinical presentaSon
d. I, III, V, VI which one of the following diagnosis is not
e. I, IV, V, VI likely for this paSent?
a. GlucocorScoid-remediable
20. Which of the followings is a feature of aldosteronism
primary adrenocorScal deficiency? b. Conn's syndrome
a. Hypocalcemia c. Bilateral adrenal hyperplasia
b. Hyperglycemia d. Idiopathic adrenal hyperplasia
c. Low serum creaSnin levels e. Licorice ingesSon
d. Hyperkalemia
e. Lymphopenia 25. A 22-year-old woman presented with
recurrent episodes of palpitaSons,
headache, and increased sweaSng which
 2023-24 ENDOCRINE SYSTEM MODULE FINAL EXAM
last for 30 minutes. On physical
examinaSon, she had elevated blood
pressure of 160/94 mmHg with the rest
being unremarkable. Based on her clinical
which one of the following test is the most
sensiSve for the diagnosis?
a. 24-hour urinary adrenaline and
noradrenaline
b. 24-hour urinary fracSonated
metanephrine, normetanephrine
c. 24-hour urinary dopamine
d. Serum adrenaline and noradrenaline
e. 24-hour urinary total metanephrine,
normetanephrine
26. Which one of the following is not
among the roles of ultrasound for nodular
thyroid disease and malignancy?
a. PreoperaSvely, define the operaSon
strategy for the cancer paSents.
b. Early detecSon of surgical complicaSons
like hypoparathyroidism
c. Guide fine needle aspiraSon for the high
risk nodules
d. Picking up the high risk cases amon a
large paSent group
e. PostoperaSve management and follow-
up of thyroid cancer paSents.
27. A 25-year-old woman palpates a lek
breast "lump" on self-examinaSon. Her
physician palpates a 2 cm, well
circumscribed, mobile rubbery mass.
There is no pain or tenderness. No axillary
lymphadenopathy is noted. Which of the
following is the most likely diagnosis?
a. Fibroadenoma
b. Intraductal papilloma
c. Breast cyst
d. FibrocysSc changes
e. Breast cancer
28. Which of the following is the most
common cause of primary
hyperparathyroidism?
a. Diffuse hyperplasia (MEN I and II)
b. MulSple adenoma
c. Carcinoma
d. Single Adenoma
e. Thyroid surgery
29. Which of the below is wrong about
debridment in diabeSc foot ulcers (DFUs)?
a. RevascularizaSon is a must before
aggressive debridement if possible.
b. Both devitalized Sssue and a porSon of
vitalized Sssue should be removed from
wound bed.
c. Any fibrin Sssue should be removed
from wound bed.
d. Any clinical/macroscopic Sssue should
be removed preferably sharply from
wound bed.
e. Both infecSous control medically and
surgical debridement should be performed
during the treatment of DFUS
30. Which of the below is correct about
the management of diabeSc foot ulcers
(DFUS)?
a. Swab culture should be the first opSon
to determine the infecSous agent.
b. Sharp debridement can be performed
only with general anesthesia.
c. Urgent amputaSon may be the first
opSon in some paSents with the findings
of sepsis.
d. If there are clinical and laboratory
findings of sepsis, revascularizaSon should
be the first opSon.
e. ExudaSve status of a wound is not
crucial in paSents with DFUS.
31. Which of the following is the most
common restricSve surgery performed
both in our country and in the USA?
a. VerScal banding
b. Roux-n-Y gastric bypass
c. Mini-gastric bypass
d. Sleeve gastrectomy e. Duodenal switch
32. What is the BMI score of the paSent
with 124 kg and 163 cm ?
a. 46,6
 2023-24 ENDOCRINE SYSTEM MODULE FINAL EXAM
b. 42,6
c. 45,9
d. 41,8
e. 47,6
33. Which of the following opSons is not
an indicaSon for surgery in a paSent with
incidentaloma?
a. Elevated plasma free metanephrines
and 24- hour urine metanephrines and
catecholamines
b. Serum aldosterone/Plasma renin
acSvity raSo >30 in a hypertensive paSent
c. 2cm tumor with negaSve screening tests
d. Delay in contrast medium washout on
computed tomography (CT)
e. Increased ajenuaSon on unenhanced
CT (>20 HU)
34. Which of the following is an exact
indicaSon for surgery in Graves' disease?
a. ContraindicaSons to anSthyroid drugs
b. Moderate to severe ophthalmopathy
c. Failure to achieve euthyroidism during
treatment with AnSthyroid drugs
d. Previously operated or externally
irradiated neck
e. Large goiters causing dysphagia
35. A 53 years old lady presented with a
suspicous 2 cm solid mass. Which biopsy
method is appropriate for this paSent?
a. Excisional biopsy
b. FNAB
c. Incisional biopsy
d. Core biopsy
e. SterotacSc biopsy
36. Which one of the following is incorrect
about the geneScs of obesity?
a. Monogenic obesity, also called common
obesity, is inherited in a Mendelian pajern
b. Prader-Willi Syndrome is a geneSc
disorder in which there are other features
that accompany obesity
c. The heritability of adiposity can be
esSmated from twin and adoptee studies
d. FTO (fat mass- and obesity-associated)
gene has the strongest geneSc associaSon
with obesity, among the genes idenSfied
by genome wide associaSon studies
e. Specific treatments are available only
for specific types of monogenic obesity,
such as lepSn deficiency
37. Which one is incorrect about the
geneScs of mulSple endocrine neoplasia
type 2 (MEN2)?
a. The RET protein is a receptor tyrosine
kinase
b. ProphylacSc thyroidectomy should be
performed for paSents with pathogenic
germline RET variant
c. RET is an oncogene
d. The germline RET mutaSons in MEN2
result in a gain of funcSon
e. Familial medullary thyroid carcinoma is
not considered as a subtype of MEN2
38. Which one of the following is correct
about the geneScs of obesity?
a. HLA gene has the strongest geneSc
associaSon with obesity, among the genes
idenSfied by genome wide associaSon
studies
b. Monogenic obesity, also called common
obesity, is inherited in a Mendelian pajern
c. Prader Willi syndrome is a monogenic
form of obesity in which obesity is an
isolated feature
d. ReSnal dystrophy, polydactyly and renal
malformaSons are accompanied to obesity
in Cohen Syndrome
e. MelanocorSn 4 receptor agonist is used
for the treatment of geneSc obesity
caused by a rare single-gene mutaSon
39. Which one of the following is not a
tesSng criterion for high-penetrance
breast cancer suscepSbility genes?
a. >= 1 close blood relaSve with ovarian
cancer
b. Ashkenazi Jewish ancestry
c. Triple negaSve breast cancer at any age
 2023-24 ENDOCRINE SYSTEM MODULE FINAL EXAM
d. Breast cancer diagnosed at an age >50
years
e. Male breast cancer at any age
40. Which of the following is incorrect
about Li- Fraumeni syndrome (LFS)?
a. LFS should be excluded in cases of
adrenocorScal carcinoma
b. AdrenocorScal carcinoma develops in
approximately 10% of individuals with LFS
c. AcSvaSon mutaSon in oncogene TP53
leads to LFS
d. This syndrome is associated with high
risks for a diverse spectrum of childhood-
and adult-onset malignancies
e. LFS is inherited in an autosomal
dominant manner
41. Which one of following is not an
absolute or relaSve contraindicaSon for
radioiodine treatment for differenSated
thyroid cancers?
a. Considerable reducSon of pulmonary
funcSon in paSents with lung metastases
and high radioiodine uptake
b. Elevated serum TSH levels
c. Considerable xerostomia due to proven
impairment of salivary gland funcSon
d. High-grade bone marrow depression in
cases of treatment with high acSviSes of
radioiodine
e. Pregnancy
42. Which one of the following
radiopharmaceuScals is used for
parathyroid scinSgraphy?
a. 99mTc-MDP
b. 99mTc-DTPA
c. 99mTc-Sestamibi*
d. 99mTc-DMSA
e. 99mTc-Pertecnetate
43. In which one of the following
condiSons radioacSve iodine uptake is
decreased?
a. MulSnodular toxic goiter
b. Graves' Disease
c. Subacute thyroidiSs
d. Autonomous toxic nodule
e. Hashitoxicosis
44. Which of the following statement is
false about adrenal imaging?
a. CT is the first-level imaging modality for
the but evaluaSon of adrenal lesions
b. An adrenal mass with an unenhanced
CT ajenuaSon value less than 10 HU
requires
an MRI
c. Cysts demonstrate <20 HU on
unenhanced CT scans
d. Adrenal corScal carcinomas may contain
calcificaSons
e. Myelolipoma demonstrate variable
areas of high T1 signal, signal loss on fat
saturated images due to macroscopic fat
45. Which of the following is not
considered among the indicatons for
breast MRI?
a. DifferenSaSon of tumor recurrence and
fibrous Sssue in postoperaSve paSents
b. Surgical planning of mulSfocal lesions
c. EvaluaSon of lesions adjacent to the
chest wall
d. Follow-up of simple uncomplicated cysts
e. Follow-up of integrity of implants
46. Which of the following statements
listed below is not an indicaSon for
adrenal venous sampling?
a. Adrenal cushing disease
b. IdenSfy aldosterone-secreSng
adenomas
c. Biochemically proved
pheochromocytoma that is not visible at
CT or MRI
d. DifferenSate adenomas from bilateral
adrenal hyperplasia
e. NontraumaSc adrenal hemorrhage
47. Which is the most common seen
pathology of sella turcica?
A.Dermoid tumors
 2023-24 ENDOCRINE SYSTEM MODULE FINAL EXAM

b. Pituitary adenoma
c.Craniopharyngioma
d. Meningioma
e. Metastasis

48. Which is the most common type of

pituitary adenomas?
a. TSHoma
b. Cushing Disease
c. Acromegaly
d. FSH Oma Non-funcSoning pituitary
adenoma
e. ProlacSnoma

49. Which one of the following drugs is not

a standard opSon in treaSng a
postmenopausal paSent with breast
cancer?
a. Estrogen receptor inhibitors
b. Aromatase inhibitors
c. Doxorubicin
d. LHRH agonisSc drugs
e. Ant.-HER-2 monoclonal anSbodies

50. Which statement is incorrect for

pheochromocytoma?
a. It is a tumor of chromaffin cells and is a
cause of hypertension that can be
corrected surgically.
b. Immunohistochemically, chromogranin
and tyrosine hydroxylase are posiSve, and
keraSn is negaSve.
c. Disappearance of the reSculin
framework predicts a high risk of
metastasis.
d. Some show germ-line mutaSons, and
nearly 50% of the cases with germ-line
mutaSons are bilateral.
e. All paSents carry a lifeSme risk of
metastasis and all are considered
'malignant'.