Question 1

Which is not a potential etiology of hypoglycemia in adults?

Accepted Answer

Salbutamol, a beta-2 agonist used primarily for treating asthma, does not cause hypoglycemia. Instead, it can potentially cause hyperglycemia by increasing glycogenolysis and gluconeogenesis. Other options listed are known causes of hypoglycemia.

Question 2

Which is the major precipitant of DKA?

Accepted Answer

Infection is the most common precipitant of diabetic ketoacidosis (DKA), as it leads to increased levels of counter-regulatory hormones such as cortisol, glucagon, and adrenaline, which in turn increase blood glucose levels and can precipitate DKA in susceptible individuals.

Question 3

Which is not usually a feature of DKA?

Accepted Answer

Serum osmolality in DKA is typically higher than the normal range (275-295 mmol/l), often due to the high glucose levels and ketones present in the blood.

Question 4

Which is not true regarding the management of DKA?

Accepted Answer

Potassium replacement in the management of diabetic ketoacidosis (DKA) is typically initiated when serum potassium levels are below 5.5 mEq/L. If the potassium level is above 5.5 mEq/L, it is generally not recommended to start potassium replacement because the risk of hyperkalemia increases, which can be dangerous.

Question 5

Which is not a feature of Hyperosmolar, hyperglycemic non ketotic states?

Accepted Answer

Hyperosmolar, hyperglycemic nonketotic state (HHNS) typically features very high blood glucose levels, high serum osmolality, and a lack of significant ketosis, including the absence of ketones in the urine. The pH in HHNS is usually greater than 7.3, indicating that it is not an acidotic state, and bicarbonate levels are not typically low as they would be in diabetic ketoacidosis (DKA), making option D incorrect for HHNS.

Question 6

Which statement is false about the fluid deficit in HHNS?

Accepted Answer

The fluid deficit in Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS) is typically much greater than 5 liters, often ranging from 8 to 12 liters or more, depending on the severity of dehydration.

Question 7

Which is not true about non ketotic hyperosmolar states?

Accepted Answer

The answer of Which is not true about non ketotic...

Question 8

Which is not true regarding drug therapy in diabetes?

Accepted Answer

Metformin is not an oral insulin analogue; it is a biguanide that works by decreasing glucose production in the liver and improving insulin sensitivity, but it does not mimic insulin itself.

Question 9

The nitroprusside dipstick test of the urine measures?

Accepted Answer

The nitroprusside dipstick test of urine is sensitive to acetoacetate and acetone, but not to beta-hydroxybutyrate.

Question 10

Which is not a feature of alcoholic ketoacidosis?

Accepted Answer

Alcoholic ketoacidosis is characterized by dehydration, a positive dipstick for ketones, an ABG that can show acidosis, alkalosis, or be normal, and an increased anion gap, regardless of pH. Hyperglycemia is not a feature of alcoholic ketoacidosis; instead, patients often have normal or low blood sugar levels.

Question 11

Which is false regarding alcoholic ketoacidosis?

Accepted Answer

Low dose insulin is not typically a part of the treatment regimen for alcoholic ketoacidosis. The mainstay of treatment involves hydration, correcting electrolyte imbalances, and providing thiamine and glucose to halt ketogenesis and promote metabolism of ketone bodies. Insulin is generally not required because the condition is not primarily due to insulin deficiency but rather to an increased ratio of NADH/NAD+ from alcohol metabolism, leading to impaired gluconeogenesis and increased ketogenesis.

Question 12

Which is the most common precipitant of alcoholic ketoacidosis?

Accepted Answer

The answer of Which is the most common precipitant of...

Question 13

Which may not cause an adrenal crisis?

Accepted Answer

Sheehan's syndrome primarily affects the pituitary gland, not the adrenal glands, and is less likely to directly cause an adrenal crisis compared to the other options.

Question 14

What biochemical abnormality is possible in an addisonian crisis?

Accepted Answer

Addisonian crisis is characterized by severe adrenal insufficiency, which leads to a number of biochemical abnormalities, including hyponatremia, hypokalemia, and hypoglycemia.

Question 15

Which statement is incorrect with regards to treatment of an addisonian crisis?

Accepted Answer

Fludrocortisone is not typically used in the acute management of an Addisonian crisis. The immediate treatment focuses on intravenous fluids (normal saline), glucose (dextrose), and corticosteroids (such as hydrocortisone or dexamethasone), not on mineralocorticoids or androgen replacement.

Question 16

Which is false about chronic steroid administration and illness?

Accepted Answer

The answer of Which is false about chronic steroid administration...

Question 17

Which statement is false about pheochromocytomas?

Accepted Answer

Beta-blockers should not be used as the initial treatment for pheochromocytoma because they can lead to unopposed alpha-adrenergic receptor stimulation, potentially causing a hypertensive crisis. Alpha-blockade is typically initiated before beta-blockers to prevent this.

Question 18

Which is the most common cause of hyperthroidism in Australia?

Accepted Answer

Graves' disease is the most common cause of hyperthyroidism in Australia and many other parts of the world. It is an autoimmune disorder where the body's immune system attacks the thyroid gland, causing it to produce too much thyroid hormone.

Question 19

Which is not a feature of hyperthroidism?

Accepted Answer

Peripheral neuropathy is not a feature of hyperthyroidism; it is more commonly associated with hypothyroidism. Hyperthyroidism typically presents with symptoms like lid lag, lid retraction, amenorrhea, and hyperreflexia due to the increased metabolism and sympathetic nervous system activity.

Question 20

Which agent should not be used in the treatment of a thyroid storm?

Accepted Answer

Salicylates should not be used in the treatment of a thyroid storm because they can displace thyroid hormones from their binding proteins, potentially worsening the condition.

Quiz 1: Endocrine Disorders