McqMate
These multiple-choice questions (MCQs) are designed to enhance your knowledge and understanding in the following areas: Biology .
| 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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