McqMate
1. |
Which is not a potential etiology of hypoglycemia in adults? |
A. | alcohol |
B. | salbutamol |
C. | insulinoma |
D. | salicylates |
E. | adrenal insufficiency |
Answer» B. salbutamol |
2. |
Which is the major precipitant of DKA? |
A. | infection |
B. | missed doses of insulin |
C. | AMI |
D. | Pancreatitis |
E. | PE |
Answer» A. infection |
3. |
Which is not usually a feature of DKA? |
A. | seen type 1 diabetics mainly |
B. | serum osmalality 275-295mmol/l |
C. | fluid deficit usually less than that in HHNS |
D. | glucose usually lower than that in HHNS |
E. | acidosis |
Answer» B. serum osmalality 275-295mmol/l |
4. |
Which is not true regarding the management of DKA? |
A. | the administration of IV fluid immediately on arrival is the life saving event |
B. | fluid replacement should be 3-4 litres over the first four hours in a pt who is not shocked |
C. | even if the K+ is >5.5 poatssium replacemnt should be commenced |
D. | the insulin bolus should be about 0.1 units/kg, with subsequent infusion at 0.1units/kg/hr |
E. | cerebral oedema responds to mannitol |
Answer» C. even if the K+ is >5.5 poatssium replacemnt should be commenced |
5. |
Which is not a feature of Hyperosmolar, hyperglycemic non ketotic states? |
A. | very high glucose, often greater than 40 mmol/l |
B. | ph>7.3 |
C. | serum osmalality often greater than 350 mmol/L |
D. | low bicarbonate |
E. | lack of ketones in the urine |
Answer» D. low bicarbonate |
6. |
Which statement is false about the fluid deficit in HHNS? |
A. | it is usually 5L |
B. | if not shocked then 0.45% saline should be given |
C. | fluid replacement should always precede insulin therapy in the non shocked pt |
D. | fluid replacement should be done over a longer period of time than in DKA |
E. | normal saline should be given to the shocked patient |
Answer» A. it is usually 5L |
7. |
Which is not true about non ketotic hyperosmolar states? |
A. | these patients usually present with a GCS >8 |
B. | total body potassium is not reduced as in DKA as there is no acidosis |
C. | focal neurological deficits are sometimes seen |
D. | they are prone to arterial and vascular thrombosis |
E. | insulin administration should be at the same rate as in DKA |
Answer» B. total body potassium is not reduced as in DKA as there is no acidosis |
8. |
Which is not true regarding drug therapy in diabetes? |
A. | the use of ACEI even in normotensive patients, delays the onset of diabetic nephropathy |
B. | the use of simvistatin in pts with CHD significantly reduces the risk of future CHD |
C. | sulphonylureas stimulate the pancreatic secretion of insulin |
D. | Acorbase(Glucobay) interferes with GIT absorption of carbohydrate |
E. | Metformin is an oral insulin analogue |
Answer» E. Metformin is an oral insulin analogue |
9. |
The nitroprusside dipstick test of the urine measures? |
A. | acetoacetate |
B. | beta hydroxybuterate |
C. | acetone |
D. | A and C |
E. | All of the above |
Answer» D. A and C |
10. |
Which is not a feature of alcoholic ketoacidosis? |
A. | Dehydration |
B. | Positive dipstick for ketones |
C. | ABG = acidosis, alkalsos or normal |
D. | Increased anion gap, regardless of pH |
E. | hyperglycemia |
Answer» E. hyperglycemia |
11. |
Which is false regarding alcoholic ketoacidosis? |
A. | it is usually seen in chronic alcoholics |
B. | usually there has been a recent cessation in drinking with several days of vomiting and poor oral intake |
C. | Thiamine should be given |
D. | Mainstay of treatment is IV fluids, including dextrose |
E. | Low dose insulin given judiciously hastens recovery |
Answer» E. Low dose insulin given judiciously hastens recovery |
12. |
Which is the most common precipitant of alcoholic ketoacidosis? |
A. | pancreatitis |
B. | GI bleed |
C. | Alcohol withdrawl without precipitating illness |
D. | Infection |
E. | hepatitis |
Answer» A. pancreatitis |
13. |
Which may not cause an adrenal crisis? |
A. | Waterhouse Freidrichson syndrome |
B. | Sheehans syndrome |
C. | Acute discontinuation of steroids therapy |
D. | Anticoagulant use |
E. | Fulminant septicemia |
Answer» B. Sheehans syndrome |
14. |
What biochemical abnormality is possible in an addisonian crisis? |
A. | hyponatremia |
B. | hypokalemia |
C. | hypoglycemia |
D. | normokalemia and normonatremia |
E. | all of the above |
Answer» E. all of the above |
15. |
Which statement is incorrect with regards to treatment of an addisonian crisis? |
A. | i.v. normal saline should be given to treat shock |
B. | i.v.dextrose will also be required |
C. | i.v. fludrocortisone is required |
D. | i.v. dexamethase or hydrocortisone should be given |
E. | fluoxymesterone (androgen replacement) does not need to be given |
Answer» C. i.v. fludrocortisone is required |
16. |
Which is false about chronic steroid administration and illness? |
A. | no suppression of the pituatry-adrenal axis occurs if the dose is <10mg regardless of the duration of administration |
B. | no suppression of the axis occurs regardless of the dose as long axis is taken for less than 3 weeks |
C. | in a time of physical stress the glucocorticoid dose should be increased 2-3 times for a few days |
D. | in a time of physical stress the mineralocorticoid dose should be increased 2-3 times for a few days |
E. | there is no need for glucose supplementation when physical stress occurs |
Answer» D. in a time of physical stress the mineralocorticoid dose should be increased 2-3 times for a few days |
17. |
Which statement is false about pheochromocytomas? |
A. | clinically they may present with attacks of pallor, palpitations, sweating, headache and anxiety |
B. | clinicaaly they present with hypertension alone, or sometime abdominal pain and vomiting |
C. | investigations include urinary VMA and catecholamines |
D. | beta blockade is the temporary treatment of choice and possibly long term |
E. | the treatment of choice is surgical resection |
Answer» D. beta blockade is the temporary treatment of choice and possibly long term |
18. |
Which is the most common cause of hyperthroidism in Australia? |
A. | Graves disease |
B. | Toxic multinodular goiter |
C. | Toxic adenoma |
D. | Pituatry aetiology |
E. | Excess iodine |
Answer» A. Graves disease |
19. |
Which is not a feature of hyperthroidism? |
A. | lid lag |
B. | lid retraction |
C. | amenorrhea |
D. | peripheral neuropathy |
E. | hyperreflexia |
Answer» D. peripheral neuropathy |
20. |
Which agent should not be used in the treatment of a thyroid storm? |
A. | propranolol |
B. | propylthiouracil |
C. | steroids |
D. | salicylates |
E. | panadol |
Answer» D. salicylates |
21. |
Which is false regarding the treatment of a myxoedema coma? |
A. | thyroxine should be given i.v. initially |
B. | thyroxine should be given in full dosage prior to blood results |
C. | steroids should be given |
D. | hyponatremia should be treated with fluid restriction |
E. | dextrose may be required |
Answer» B. thyroxine should be given in full dosage prior to blood results |
22. |
Which is not a feature of hypothyroidism? |
A. | loss of outer third of the eyebrow |
B. | bradycardia |
C. | opthalmopathy |
D. | weight gain |
E. | constipation |
Answer» C. opthalmopathy |
23. |
Which drug is not a possible precipitant of myxoedema coma? |
A. | lithium |
B. | amioderone |
C. | benzodiazepines |
D. | phenytoin |
E. | ranitidine |
Answer» E. ranitidine |
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