1.	Parathyroid adenomas:

A.	Are more common in women than in men.
B.	Are usually multiple.
C.	Produce calcitonin.
D.	Are most frequently situated in the superior glands.
E.	Cause resorption of bone tissue.

2.	Cushing’s syndrome:

A.	Is not associated with signs of virilism.
B.	May be due to an adrenal cortical adenoma.
C.	May be associated with oat-cell carcinoma of the lung.
D.	Causes decreased breakdown of body protein.
E.	Is characterized by raised levels of cortisol. 

3.	Causes of hypopituitarism:

A.	Prolactinaemia.
B.	Disseminated intravascular coagulation.
C.	Sickle cell anemia.
D.	Raised intracranial pressure.
E.	Surgery.

4.	Hashimoto’s disease of the thyroid:

A.	Shows a massive lymphoid infiltrate when examined microscopically.
B.	Is considered to be an autoimmune disease.
C.	Is not associated with autoimmune gastritis.
D.	Is associated with Addison’s disease.
E.	May show Askanazy cells (Hurthle cells) when examined microscopically.

1.	Parathyroid adenomas:

A.	True. Parathyroid adenomas are three times as common in females as in males.
B.	False: Usually solitary lesions.
C.	False.
D.	False: Some 75% of parathyroid adenomas arise in one of the inferior glands.
E.	True.

2.	Cushing’s syndrome:

A.	False. Cushing’s syndrome in females is usually accompanied by some signs of virilism such as masculine distribution of hair, acne and deepening of voice.
B.	True.
C.	True.
D.	False. There is increased catabolism of body protein.
E.	True.

3.	Causes of hypopituitarism:

A.	True.
B.	True.
C.	True.
D.	True.
E.	True.

4.	Hashimoto’s disease of the thyroid:

A.	True.
B.	True.
C.	False.
D.	True. In both conditions there is evidence of cell-mediated autoimmunity to mitochondrial antigens which are not entirely organ-specific.
E.	True. 

5.	Type I diabetes mellitus:

A.	Tends to occur at an older age than does type II diabetes.
B.	Is associated with increased production of glucagon.
C.	Is usually treated with oral hypoglycaemic agents.
D.	May be complicated by a retinopathy.
E.	Is caused by destruction of alpha cells in the pancreatic islets.

6.	Addison’s disease:

A.	In the last century was commonly due to tuberculosis.
B.	May result in hypovolaemia and hypotension.
C.	If primary, is associated with reduced levels of ACTH.
D.	Results in hypernatraemia.
E.	Is associated with hypopigmentation of the skin.

7.	Pituitary adenoma:

A.	Growth hormone adenomas are the most common type.
B.	Usually functioning.
C.	May cause hypopituitarism.
D.	Tumor is removed by a transphenoidal approach.
E.	Accounts for 50% of intracranial tumors.

8.	In the pituitary gland:

A.	Somatotroph cells produce growth hormone.
B.	Functional adenomas are most commonly composed of corticotroph cells.
C.	Non-functional adenomas are the commonest cause of hypopituitarism.
D.	Growth-hormone producing adenomas cause acromegaly if they occur before puberty.
E.	Post-partum hemorrhage may cause pituitary necrosis.

5.	Type I diabetes mellitus:

A.	False.
B.	False.
C.	False.
D.	True.
E.	False.

6.	Addison’s disease:

A.	True.
B.	True. Mineralocorticoid deficiency results in loss of salt and water with consequent hypovolaemia and hypotension.
C.	False. ACTH levels are raised.
D.	False. Hyponatraemia results due to failure of reabsorption of salt in the renal tubules.
E.	False. Hyperpigmentation of the skin occurs in Addison’s disease due to raised ACTH levels.

7.	Pituitary adenoma:

A.	False. Prolactinomas are most common.
B.	False. May be non-functioning.
C.	True.
D.	True.
E.	False. Accounts for 10%.

8.	In the pituitary gland:

A.	True. These cells are acidophilic.
B.	False.
C.	True. The other two common causes are Sheehan’s syndrome and empty sella syndrome.
D.	False. They cause gigantism if they occur before puberty and acromegaly after puberty.
E.	True. Failure of lactation may be the presenting syndrome.

9.	Symptoms of acromegaly:

A.	Coarse, oily skin.
B.	Prognathism.
C.	Large tongue.
D.	Large spade-like hands.
E.	Paraesthesia.

10.	The following are complications of diabetes mellitus:

A.	Amyloid deposition.
B.	Glomerulosclerosis.
C.	Peripheral vascular disease.
D.	Pyelonephritis.
E.	Blindness.

11.	Phaeochromocytoma:

A.	Are derived from adrenocortical cells.
B.	Are classified as paragangliomas.
C.	Cause hypertension by excessive production of aldosterone.
D.	May cause sweating and nervousness.
E.	May be familial.

12.	Grave’s thyroiditis:

A.	Usually occurs with a thyroid of normal size.
B.	Is caused by excess of TSH.
C.	Has a positive association with pretibial myxoedema.
D.	Has a histological picture of hypoplastic acinar epithelium.
E.	Has a positive association with exophthalmos.

9.	Symptoms of acromegaly:

A.	True.
B.	True.
C.	True.
D.	True.
E.	True.

10.	The following are complications of diabetes mellitus:

A.	False.
B.	True. Glomerulosclerosis occurs secondarily to the microangiopathy in the renal vasculature.
C.	True.
D.	True.
E.	True.

11.	Phaeochromocytoma:

A.	False. They are derived from the cells of the adrenal medulla.
B.	True. Other abdominal paragangliomas include those arising from the organs of Zuckerkandi.
C.	False. They caused hypertension due to excessive production of catecholamines.
D.	True.
E.	True. They may be part of the multiple endocrine neoplasia (MEN) syndrome.

12.	Grave’s thyroiditis:

A.	False. Usually produces a diffuse goitre.
B.	False. Grave’s disease is caused by an auto-antibody which binds to thyroid epithelial cells and mimics the action of TSH.
C.	True. Due to accumulation of mucopolysaccharides in the dermis.
D.	False. The acinar epithelium is hyperplastic.
E.	True.

13.	Thyroid adenoma:

A.	Caused by somatic mutations in some components of TSH signaling pathway.
B.	Appears ‘cold’ on thyroid scan.
C.	Hemorrhage into it may cause severe neck pain.
D.	Presents as diffusely enlarged mass.
E.	10% becomes malignant.

14.	Papillary carcinoma of the thyroid:

A.	Occurs most frequently in the elderly.
B.	Is the least common type of thyroid carcinoma.
C.	Has a prognosis worse than that of follicular thyroid carcinoma.
D.	May contain psammona bodies.
E.	Metastases most commonly by the hematogenous route.

15.	Hypoparathyroidism:

A.	Occurs in the di George syndrome.
B.	Is accompanied by decreased plasma phosphate levels.
C.	May occur after thyroidectomy.
D.	May produce tetany.
E.	May be due to organ-specific autoimmunity.

16.	Electrolyte disturbances of hyperaldosteronism:

A.	Hyponatraemia.
B.	Hypokalaemia.
C.	Metabolic alkalosis.
D.	Hypocalcemia.
E.	Hypovolaemia.

13.	Thyroid adenoma:

A.	True.
B.	True.
C.	True.
D.	False. Discrete, solitary masses.
E.	True.

14.	Papillary carcinoma of the thyroid:

A.	False. Usually occurs before 45 years of age.
B.	False. Most common malignant tumor of thyroid.
C.	False.
D.	True.
E.	False. Rarely metastasize by blood; lymphatic metastases to cervical lymph nodes may occur. 

15.	Hypoparathyroidism:

A.	True. 
B.	False.
C.	True.
D.	True.
E.	True.

16.	Electrolyte disturbances of hyperaldosteronism:

A.	False.
B.	True.
C.	True.
D.	True.
E.	False.

17.	Adrenogenital syndromes:

A.	21-hydroxylase deficiency is a common cause.
B.	Leads to salt-wasting.
C.	Causes virilization in female.
D.	Usually autosomal dominant.
E.	Bilateral adrenal enlargement.

18.	Insulin:

A.	Promotes glycogen breakdown in the liver.
B.	Promotes glucose entry into cells.
C.	Is produced by the alpha cells in the islets of Langerhans.
D.	Promotes lipolysis.
E.	Promotes gluconeogenesis.

19.	The following are complications of diabetes mellitus:

A.	Kimmelstiel-Wilson lesions in the kidneys.
B.	Retinopathy.
C.	Pre-eclamptic toxaemia.
D.	Accelerated atheroma.
E.	Peripheral neuropathy.

20.	Thyroid cancers:

A.	Higher risk in solitary nodules.
B.	May be due to irradiation when young.
C.	Anaplastic type is common in young girls.
D.	Medullary carcinoma is part of MEN syndrome.
E.	Follicular carcinoma spread hematogenously.

17.	Adrenogenital syndromes:

A.	True.
B.	True.
C.	True.
D.	False.
E.	True.

18.	Insulin:

A.	False.
B.	True.
C.	False.
D.	False.
E.	False.

19.	The following are complications of diabetes mellitus:

A.	True.
B.	True.
C.	True.
D.	True.
E.	True. This may be due to occlusion of small vessels supplying nerves.

20.	Thyroid cancers:

A.	True.
B.	True.
C.	False.
D.	True.
E.	True.