Endocrinology

1.    Diabetes Mellitus (DM).

***) Concerning diabetes mellitus in children all of the following are true, except:

A.    Polydipsia

B.     Polyphagia

C.     Ketoacidosis

D.    Does not always require injectable insulin

E.     Usually is rapid in onset, often presenting as diabetic coma

Answer: D* Does not always require injectable insulin

***) A 3 years old child lost appetite over the last few days, ingested a lot of water, frequent urination, and developed acute abdominal pain, vomiting and hyperventilation. Most probably he has:

A.    Tumor in the forth ventricle

B.     Acute renal failure

C.     Acute appendicitis

D.    Diabetic ketoacidosis

E.     Diabetes insipidus

Answer: 4* Diabetic ketoacidosis

2.    Hypothyroidism.

***) The most valuable test in the diagnosis of congenital hypothyroidism is:

A.    T3

B.     T4

C.     Cholesterol level

D.    TSH

E.     Bone age by X-ray

Answer: D* TSH

***) Early manifestations of congenital hypothyroidism include all of the following, except:

A.    Prolonged physiologic jaundice

B.     Apneic spells

C.     Constipation

D.    Delayed osseous development

E.     Increased appetite

Answer: E* Increased appetite

***) Clinical features of hypothyroidism may include all of the following, except:

A.    Mental retardation

B.     Goitre

C.     Short stature

D.    Advanced bone age

E.     Constipation

Answer: D* Advanced bone age

***) All of the following are features of congenital hypothyroidism, except:

A.    Lethargy

B.     Prolonged jaundice

C.     Persistent diarrhea

D.    Hoarse cry

E.     Feeding difficulties

Answer: C* Persistent diarrhea

***) Signs of congenital hypothyroidism include all the following except:

A.    Prolonged neonatal jaundice

B.     Lethargy and poor feeding

C.     Constipation

D.    Early closure of anterior fontanel

E.     Umbilical hernia

Answer: D* Early closure of anterior fontanel

***) A 25 days old baby complains of prolonged jaundice, constipation, dry skin and umbilical hernia. The most likely appropriate diagnosis is:

A.    Breast milk jaundice

B.     G6PD

C.     Thalassemia major

D.    Hypothyroidism

E.     Crigler Najar disease

Answer: D* Hypothyroidism

***) A 9 month old female was seen because of inability to sit or stand. Examination showed neck mass anteriorly. The tongue was broad and thick; no erupted teeth, liver and spleen not palpable. One of the following tests will establish the most likely suspected diagnosis:

A.    Routine urine analysis

B.     Serum calcium and phosphorus

C.     Karyotyping

D.    Urine for mucopolysaccharides

E.     T4 and TSH

Answer: E* T4 and TSH

***) Congenital goiter in the newborn is least likely to be due to which of the following:

A.    Maternal ingestion of large amount of iodine during pregnancy

B.     Defect in the synthesis of thyroid hormones

C.     Maternal iodine deficiency

D.    Hashimoto's disease in the newborn

E.     Maternal ingestion of antithyroid drugs

Answer: A* Maternal ingestion of large amount of iodine during pregnancy

***) Regarding Hashimoto's thyroiditis, all are true except:

A.    Most common cause of juvenile hypothyroidism

B.     The etiology is autoimmune

C.     Thyroid antiperoxidase antibodies are positive in 90%

D.    Is 7 times more common in boys

E.     Lead to growth retardation

Answer: D* Is 7 times more common in boys

3.    Congenital Adrenal Hyperplasia (CAH).

***) 1 month old infant is seen with vomiting and severe dehydration. Physical examination reveals ambiguous genitalia, laboratory test show hyponatremia. The best likely diagnosis is:

A.    Gastroenteritis

B.     Congenital hypothyroidism

C.     Pseudohermaphroditism

D.    Congenital adrenal hyperplasia

E.     Congenital diaphragmatic hernia

Answer: D* Congenital adrenal hyperplasia

4.    Short Stature.

***) The short stature is associated with all of the following, except:

A.    Chronic renal disease

B.     Hypothyroidism

C.     Down's syndrome

D.    Low birth weight

E.     Breast fed babies

Answer: E* Breast fed babies

***) Causes of short stature can be due to all of the following, except:

A.    Emotional deprivation

B.     Turner's syndrome

C.     Kleinfelter’s syndrome

D.    Primary hypothyroidism

E.     Gluten enteropathy

Answer: C* Kleinfelter’s syndrome

***) All of the following can cause short stature, except:

A.    Achondroplasia

B.     Familial

C.     Kleinfelter’s syndrome

D.    Hypothyroidism

E.     Corticosteroid therapy

Answer: C* Kleinfelter’s syndrome

***) Short stature may be associated with the following conditions, except:

A.    Chronic kidney disease

B.     Hypothyroidism

C.     Down syndrome

D.    Achondroplasia

E.     Marfan syndrome

Answer: E* Marfan syndrome