Endocrine system — UPSC CMS MCQs (Medicine)

Question 1

Which one of the following statements is NOT true regarding the thyroid function/disorder in pregnancy?

Accepted Answer

C. Levothyroxine replacement therapy dose should be decreased by 30–50% early in pregnancy

Answer

There is an increase in the metabolism of thyroxine by placenta

Answer

Hyperemesis gravidarum may be associated with thyrotoxicosis in pregnancy

Answer

Impaired cognitive impairment may be seen in the offspring of mother with subclinical hypothyroidism

Question 2

All the following can be seen in the case of thyrotoxicosis, EXCEPT:

Accepted Answer

C. Deafness

Answer

Atrial fibrillation

Answer

Periodic paralysis

Answer

Osteoporosis

Question 3

Which one of the following is NOT correct regarding MEN-1 syndrome?

Accepted Answer

D. It involves pineal gland

Answer

It involves parathyroid glands

Answer

It involves pancreas

Answer

It involves pituitary gland

Question 4

Hirsutism is seen in which of the following?
1. Polycystic ovarian syndrome
2. Congenital adrenal hyperplasia
3. Hypothyroidism
4. Ovarian tumour
Select the correct answer using the code below:

Accepted Answer

B. 1, 2 and 4

Answer

1 and 2 only

Answer

1, 3 and 4

Answer

2 and 4 only

Question 5

A 42-year-old lady presents with symptoms of tiredness, constipation, impaired hearing and weight gain in spite of poor appetite. Which of the following are relevant investigations in this case?
1. TSH level
2. Free T4 levels (unbound T4)
3. Anti-TPO antibodies
4. Radionuclide scan of the thyroid
Select the correct answer using the code below:

Accepted Answer

A. 1, 2 and 3

Answer

1, 2 and 4

Answer

1, 3 and 4

Answer

2 and 3 only

Question 6

A patient presents with circulatory shock, nausea, vomiting and diarrhea. A diagnosis of acute adrenal crisis is considered. A blood sample is stored for measurement of serum cortisol and treatment started without delay. Which of the following are appropriate interventions?
1. IV normal saline
2. IV hydrocortisone 100 mg stat
3. IV 10% glucose
4. IV KCl as infusion
Select the correct answer using the code below:

Accepted Answer

A. 1, 2 and 3

Answer

1 and 2 only

Answer

1, 3 and 4

Answer

2, 3 and 4

Question 7

Which of the following are the potentially reversible causes of weight gain?
1. Insulinoma
2. Cushing’s syndrome
3. Sulfonylureas
4. Beta-blockers
Select the correct answer using the code :

Accepted Answer

D. 1, 2, 3 and 4

Answer

1 and 2 only

Answer

3 and 4 only

Answer

2 and 3 only

Question 8

Which of the following statements are correct regarding short stature?
1.Linear bone growth rates are pituitary dependent
2.Normal bone age in a child with short stature suggests hormonal disorder
3.Final height in boys can be estimated by adding 6-5 cm to mid-parental height
4.Replacement therapy with recombinant GH restores growth velocity in GH-deficient children
Select the correct answer using the code below:

Accepted Answer

C. 1, 3 and 4 only

Answer

1 and 2 only

Answer

1 and 3 only

Answer

1, 2, and 4

Question 9

A Thyroid Function Test report shows the following results: TSH-Undetectable, T3-Raised, T4-Raised Which one of the following will be the most likely interpretation on the basis of the above report?

Accepted Answer

C. Primary thyrotoxicosis

Answer

Hypothyroidism secondary to pituitary disease

Answer

Transient thyroiditis in evolution

Answer

Overtreatment of hypothyroidism with Liothyronine

Question 10

Iodine has complex effects on thyroid function. Very high concentrations of iodine inhibit thyroid hormone synthesis and release. This effect is known as

Accepted Answer

A. Wolff-Chaikoff effect

Answer

Jod-Basedow effect

Answer

reverse Wolff-Chaikoff effect

Answer

reverse Jod-Basedow effect

Question 11

Functioning pituitary adenoma most commonly arises from which one of the following cells?

Accepted Answer

B. Lactotroph

Answer

Somatotroph

Answer

Corticotroph

Answer

Thyrotroph

Question 12

Which one of the following diseases is characterized by destructive lymphoid infiltration of the thyroid gland leading to fibrosis and enlargement of the thyroid gland with an increased risk of developing thyroid lymphoma ?

Accepted Answer

D. Hashimoto’s thyroiditis

Answer

de Quervain’s Thyroiditis

Answer

Multinodular Goitre

Answer

Riedel’s thyroiditis

Question 13

With regards to treatment of thyrotoxicosis of Grave’s disease, consider the following statements
1. Propylthiouracil is suitable in breastfeeding patients.
2. Large goitre is an indication for thyroidectomy.
3. Radioiodine is recommended for management in pregnancy.
4. Agranulocytosis is a complication associated with carbimazole.
Which of the statements given above are correct ?

Accepted Answer

C. 1, 2 and 4

Answer

1, 2 and 3

Answer

2, 3 and 4

Answer

1, 3 and 4

Question 14

Under which one of the following conditions, the HPA axis suppression is likely to result in crisis due to adrenal insufficiency following withdrawal of glucocorticoids ?

Accepted Answer

C. If glucocorticoids have been prescribed repeatedly within the previous year

Answer

If glucocorticoids have been given by intravenous route for five days

Answer

If glucocorticoids have been administered orally for one week

Answer

If the dose is less than equivalent of 5 mg prednisolone per day

Question 15

Consider the following statements about erectile dysfunction in diabetic males:

Accepted Answer

C. It may be aggravated by beta-adrenergic agonist drugs

Answer

It affects 60 % of males

Answer

Its common cause is an underlying neuro-vascular pathology

Answer

Endocrine disorders like hyperprolactinemia may cause it Which of the statements given above are true?

Question 16

Consider the following statements with regard to Graves’ ophthalmopathy :
1. Proptosis is often asymmetric and can even appear to be unilateral
2. It is a clinical diagnosis
3. Worsening of symptoms upon glucocorticoid withdrawal is common
4. Radiation therapy is very effective in treatment
Which of the above statements are correct?

Accepted Answer

B. 1, 2 and 3

Answer

1 and 2 only

Answer

2, 3 and 4

Answer

1 and 4 only

Question 17

Which of the following are correct regarding Diabetes insipidus?
1. Polyuria and polydipsia are common symptoms.
2. Urine is of low osmolality and specific gravity.
3. Lithium is useful in treatment.
4. It is potentially lethal, if hypothalamic thirst centre is damaged.
Select the correct answer using the code below:

Accepted Answer

B. 1, 2 and 4

Answer

1, 2 and 3

Answer

1 and 4 only

Answer

2, 3 and 4

Question 18

Which of the following constitute differential diagnosis of hypocalcemia?
1.Hypomagnesemia
2.Chronic alcoholism
3.Pseudohypoparathyroidism
4.Paget’s disease
Select the correct answer using the code below:

Accepted Answer

A. 1, 2, and 3

Answer

1 and 2 only

Answer

3 and 4 only

Answer

2, 3, and 4

Question 19

Which of the following are useful for the treatment of Hirsutism?
1.Amiloride
2.Oestrogen
3.Finasteride
4.Spironolactone
Select the correct answer using the code below:

Accepted Answer

D. 2, 3, and 4

Answer

1, 2, and 3

Answer

1, 2, and 4

Answer

3 and 4 only

Question 20

GnRH deficiency with hyposmia is typically seen in

Accepted Answer

A. Kallmann syndrome

Answer

Bardet-Biedl syndrome

Answer

Prader-Willi syndrome

Answer

Wallenberg syndrome

Question 21

Consider the following pharmacological agents:
1. Propranolol
2. Sodium ipodate
3. Propylthiouracil
4. Liothyronine Which of the above can be used for the treatment of thyrotoxic crisis?

Accepted Answer

C. 1, 2 and 3

Answer

3 only

Answer

1 and 2 only

Answer

2, 3 and 4

Question 22

Consider the following pharmacological agents:
1. Liothyronine
2. Levothyroxine
3. Carbimazole
4. Sodium ipodate Which of the above may be included in the treatment of myxedema coma?

Accepted Answer

B. 1 and 2

Answer

1 only

Answer

2 and 3

Answer

3 and 4

Question 23

Low serum thyroglobulin levels are seen in

Accepted Answer

A. thyrotoxicosis factitial

Answer

subacute thyroiditis

Answer

Graves’ disease

Answer

toxic multinodular goitre

Question 24

Which one of the following is an example of hypogonadotropic hypogonadism?

Accepted Answer

A. Kallmann’s syndrome

Answer

Klinefelter’s syndrome

Answer

Turner’s syndrome

Answer

Cryptorchidism

Question 25

With regard to management of hypothyroidism, consider the following statements :
1. Treatment is with levothyroxine replacement.
2. It is taken as a single daily dose.
3. Average dose is 1-6 μg/kg/day.
4. Full dose per weight should be started in those with coronary artery disease.
Which of the statements given above are correct ?

Accepted Answer

A. 1, 2 and 3

Answer

2, 3 and 4

Answer

1, 2 and 4

Answer

1, 3 and 4

Question 26

Which one of the following is NOT true about Ghrelin?

Accepted Answer

B. It decreases gastric emptying

Answer

It stimulates appetite

Answer

It increases acid secretion

Answer

Fasting increases its secretion

Question 27

A young lady presents in outdoor clinic with complaints of menstrual irregularity, weight gain, hair loss, tiredness and weakness. What will be the investigation of choice?

Accepted Answer

D. Free T4 and TSH level

Answer

FSH & LH level

Answer

Estrogen level

Answer

Free T3 and free T4 level

Question 28

Which one of the following hormones acts via the receptor tyrosine kinase?

Accepted Answer

C. IGF-1

Answer

FSH

Answer

TSH

Answer

PTH

Question 29

Which of the following are correct regarding hypothyroidism?
1. It is more common in females.
2. Autoimmunity is a rare etiopathogenesis.
3. In pregnancy, increased dose of levothyroxine is required.
4. Suppressed TSH is a risk factor for osteoporosis.
Select the correct answer using the code below:

Accepted Answer

C. 1, 3 and 4

Answer

1, 2 and 3

Answer

1 and 4 only

Answer

2, 3 and 4

Question 30

Which of the following are correct regarding Cortisol?
1. Levels are highest in the morning on waking.
2. Cortisol falls dramatically during an illness.
3. More than 95% circulating cortisol is protein bound.
4. It is the major glucocorticoid in humans and can also activate mineralocorticoid receptors. Select the answer
using the code given below :

Accepted Answer

A. 1, 3 and 4

Answer

2, 3 and 4

Answer

1 and 3 only

Answer

1 and 2 only

Question 31

Which of the following findings are seen in Diabetic Retinopathy on fundus examination ?
1. Microaneurysm
2. Dot and blot hemorrhage
3. Retinal thickening
4. Neovascularization
Select the correct answer using the code below :

Accepted Answer

B. 1, 2 and 4

Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

2, 3 and 4

Question 32

Which of the following statements are correct with regard to glucose homeostasis?
1. Insulin level rises postprandially.
2. Major portion of postprandial glucose is used by skeletal muscle.
3. Brain uses glucose in an insulin-dependent manner.
4. Glucagon is secreted during exercise. Select the answer
using the code given below:

Accepted Answer

B. 1, 2 and 4

Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

2, 3 and 4

Question 33

Consider the following pancreatic hormones:
1. Insulin
2. Islet amyloid polypeptide or amylin
3. Glucagon
4. Somatostatin Which of the above is/are secreted by beta cells of the pancreatic islets?

Accepted Answer

C. 1 and 2

Answer

1 only

Answer

2 and 3

Answer

1 and 4

Question 34

Which one of the following conditions is caused by mutations in the gene that encodes the sodium-potassium-2-chloride cotransporter (NKCC2), and presents with sodium wasting, hypokalemia, hypomagnesaemia and hypercalciuria?

Accepted Answer

B. Bartter syndrome

Answer

Alport syndrome

Answer

Fanconi syndrome

Answer

Gitelman syndrome

Question 35

Which of the following biochemical abnormalities is seen in severe hypertriglyceridemia?

Accepted Answer

A. Pseudohyponatremia

Answer

Metabolic alkalosis

Answer

Hyperuricemia

Answer

Hyperkalemia

Question 36

Which of the following is an inhibitor of the intestinal mucosal transporter NPC1L1, responsible for the absorption of dietary and biliary cholesterol

Accepted Answer

D. Ezetimibe

Answer

Atorvastatin

Answer

Fenofibrate

Answer

Metformin

Question 37

Which of the following statements are correct in respect of vitamin D?
Skin exposure to sunlight is the main source
Deficiency of vitamin D causes distal muscle weakness
Vitamin D synthesis decreases in winter, as one moves away from the equator
Body store accumulated during summer is consumed during winter
Select the correct answer using the code below:

Accepted Answer

C. 1, 3, and 4

Answer

1, 2, and 3

Answer

1, 2, and 4

Answer

2, 3, and 4

Question 38

Which of the following abnormalities occur from vitamin D deficiency in children?
1. Craniotabes
2. Bossing of frontal and parietal bones
3. Muscle hypotonia
4. Shrinking of epiphysis at the lower end of radius
Select the correct answer using the code below.

Accepted Answer

A. 1, 2 and 3

Answer

1, 2 and 4

Answer

1, 3 and 4

Answer

2, 3 and 4

Question 39

Consider the following statements with regard to Vitamin D deficiency:
1. Vitamin D deficiency is common in northern latitudes.
2. Vitamin D deficiency is more likely to develop in people with dark skin.
3. Exposure to UV light is advisable in patients with Vitamin D deficiency.
Which of the statements given above are correct?

Accepted Answer

D. 1, 2 and 3

Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 3 only

Question 40

Consider the following statements with regard to vitamin C:
It is heat stable.
Normal platelets are poor in ascorbate.
Perifollicular hyperkeratosis is a clinical sign of scurvy.
Infants fed exclusively on boiled milk are vitamin C deficient.
Which of the above statements are correct?

Accepted Answer

D. 3 and 4

Answer

1 and 2

Answer

2 and 3

Answer

1 and 4

Question 41

An elderly alcoholic man who mainly eats a diet of maize and maize products presents with complaints of chronic diarrhea, severe sunburn-like lesions, tension on exposed parts, and acute delirium. He is admitted. What is the likely diagnosis and its treatment?

Accepted Answer

C. Pellagra, Niacin therapy

Answer

Celiac disease, Gluten-free diet

Answer

Vitamin B12 deficiency, Parenteral B12 therapy

Answer

Whipple’s disease, Doxycycline + Trimethoprim

Question 42

A 36 year old man presents with decreased appetite, mouth soreness, diarrhoea and irritability. On examination he has a bright red tongue with a pigmented scaly rash around the neck. Which one of the following food items in his diet has a bearing on his disease ?

Accepted Answer

C. Corn

Answer

Rice

Answer

Wheat

Answer

Fish

Question 43

Consider the following statements with regard to the treatment of vitamin A deficiency :
I. Repeated high doses of retinol can cause liver damage and teratogenicity
II. Acute overdose of vitamin A may lead to increased intracranial pressure and skin desquamation
III. Regular vitamin A supplementation is also recommended for pregnant women even in countries where vitamin A deficiency is not endemic
IV. Excessive intake of carotene may cause harmless orange pigmentation of the skin
Which of the statements given above are correct ?

Accepted Answer

B. I, II and IV

Answer

I, II and III

Answer

I, III and IV

Answer

II, III and IV

Question 44

Carotenoderma, due to ingestion of excessive amounts of carotene-containing fruits and vegetables, can be distinguished from jaundice by sparing of which of the following?

Accepted Answer

D. Sclerae

Answer

Palms

Answer

Soles

Answer

Nasolabial folds

Question 45

Consider the following statements with regard to “Anorexia of Aging”:
1. Declining chemosensory function (smell and taste)
2. Reduced efficiency of chewing
3. Slowed gastric emptying
4. Alterations in the neuro-endocrine axis
Which of the above statements are associated with early satiety and weight loss in elderly?

Accepted Answer

C. 1, 2, 3 and 4

Answer

3 and 4 only

Answer

1, 2 and 4 only

Answer

1, 2 and 3 only

Q1. Which one of the following statements is NOT true regarding the thyroid function/disorder in pregnancy?

Q2. All the following can be seen in the case of thyrotoxicosis, EXCEPT:

Q3. Which one of the following is NOT correct regarding MEN-1 syndrome?

Q4. Hirsutism is seen in which of the following? 1. Polycystic ovarian syndrome 2. Congenital adrenal hyperplasia 3. Hypothyroidism 4. Ovarian tumour Select the correct answer using the code below:

Q7. Which of the following are the potentially reversible causes of weight gain? 1. Insulinoma 2. Cushing’s syndrome 3. Sulfonylureas 4. Beta-blockers Select the correct answer using the code :

Q9. A Thyroid Function Test report shows the following results: TSH-Undetectable, T3-Raised, T4-Raised Which one of the following will be the most likely interpretation on the basis of the above report?

Q10. Iodine has complex effects on thyroid function. Very high concentrations of iodine inhibit thyroid hormone synthesis and release. This effect is known as

Q11. Functioning pituitary adenoma most commonly arises from which one of the following cells?

Q12. Which one of the following diseases is characterized by destructive lymphoid infiltration of the thyroid gland leading to fibrosis and enlargement of the thyroid gland with an increased risk of developing thyroid lymphoma ?

Q14. Under which one of the following conditions, the HPA axis suppression is likely to result in crisis due to adrenal insufficiency following withdrawal of glucocorticoids ?

Q15. Consider the following statements about erectile dysfunction in diabetic males:

Q18. Which of the following constitute differential diagnosis of hypocalcemia? 1.Hypomagnesemia 2.Chronic alcoholism 3.Pseudohypoparathyroidism 4.Paget’s disease Select the correct answer using the code below:

Q19. Which of the following are useful for the treatment of Hirsutism? 1.Amiloride 2.Oestrogen 3.Finasteride 4.Spironolactone Select the correct answer using the code below:

Q20. GnRH deficiency with hyposmia is typically seen in

Q21. Consider the following pharmacological agents: 1. Propranolol 2. Sodium ipodate 3. Propylthiouracil 4. Liothyronine Which of the above can be used for the treatment of thyrotoxic crisis?

Q22. Consider the following pharmacological agents: 1. Liothyronine 2. Levothyroxine 3. Carbimazole 4. Sodium ipodate Which of the above may be included in the treatment of myxedema coma?

Q23. Low serum thyroglobulin levels are seen in

Q24. Which one of the following is an example of hypogonadotropic hypogonadism?

Q26. Which one of the following is NOT true about Ghrelin?

Q27. A young lady presents in outdoor clinic with complaints of menstrual irregularity, weight gain, hair loss, tiredness and weakness. What will be the investigation of choice?

Q28. Which one of the following hormones acts via the receptor tyrosine kinase?

Q31. Which of the following findings are seen in Diabetic Retinopathy on fundus examination ? 1. Microaneurysm 2. Dot and blot hemorrhage 3. Retinal thickening 4. Neovascularization Select the correct answer using the code below :

Q33. Consider the following pancreatic hormones: 1. Insulin 2. Islet amyloid polypeptide or amylin 3. Glucagon 4. Somatostatin Which of the above is/are secreted by beta cells of the pancreatic islets?

Q34. Which one of the following conditions is caused by mutations in the gene that encodes the sodium-potassium-2-chloride cotransporter (NKCC2), and presents with sodium wasting, hypokalemia, hypomagnesaemia and hypercalciuria?

Q35. Which of the following biochemical abnormalities is seen in severe hypertriglyceridemia?

Q36. Which of the following is an inhibitor of the intestinal mucosal transporter NPC1L1, responsible for the absorption of dietary and biliary cholesterol

Q38. Which of the following abnormalities occur from vitamin D deficiency in children? 1. Craniotabes 2. Bossing of frontal and parietal bones 3. Muscle hypotonia 4. Shrinking of epiphysis at the lower end of radius Select the correct answer using the code below.

Q40. Consider the following statements with regard to vitamin C: It is heat stable. Normal platelets are poor in ascorbate. Perifollicular hyperkeratosis is a clinical sign of scurvy. Infants fed exclusively on boiled milk are vitamin C deficient. Which of the above statements are correct?

Q41. An elderly alcoholic man who mainly eats a diet of maize and maize products presents with complaints of chronic diarrhea, severe sunburn-like lesions, tension on exposed parts, and acute delirium. He is admitted. What is the likely diagnosis and its treatment?

Q42. A 36 year old man presents with decreased appetite, mouth soreness, diarrhoea and irritability. On examination he has a bright red tongue with a pigmented scaly rash around the neck. Which one of the following food items in his diet has a bearing on his disease ?

Q44. Carotenoderma, due to ingestion of excessive amounts of carotene-containing fruits and vegetables, can be distinguished from jaundice by sparing of which of the following?