Endocrinology Extra Questions

1. A 16-year-old girl is seen in the gynaecology outpatient department with primary amenorrhoea and excessive facial hair growth. Examination reveals normal genitalia, apart from an apparently large clitoris. Differential diagnosis includes congenital adrenal hyperplasia (CAH).
CAH (21α-hydoxylase deficiency) is characterised by which of the following?

2. A 27-year-old woman is seen in the antenatal clinic. She suffered from hyperemesis gravidarum in the first trimester and routine thyroid function tests have revealed abnormalities.
Which of the following is a recognised change in regulation of thyroid function in pregnancy?

3. During her pregnancy a 38-year-old woman is diagnosed with gestational diabetes requiring insulin treatment at 28 weeks of gestation.
Which of the following statements bests describes the function of human placental lactogen?

4. A 34-year-old woman is admitted to labour ward at 31 weeks’ gestation with threatened preterm labour. She is given two doses of steroids as a precaution. Which of the following describes the first step in the synthesis of steroids?

5. Which of the following is an action of cortisol?

6. A 28-year-old woman is referred to the gynaecology clinic with primary infertility. On examination, she has a round face, prominent stretch marks on her abdomen and hirsutism.
Which of the following is not a feature of Cushing’s syndrome?

7. A 26-year-old woman is referred to the gynaecology clinic with abdominal pain and amenorrhoea. You suspect she may have Cushing’s syndrome and decide to send her for further tests.
Which of the following tests would be suitable for confirmation of the diagnosis?

8. A 52-year-old woman with Cushing’s syndrome is referred to the preassessment clinic prior to a vaginal hysterectomy.
Which of the following is a feature of Cushing’s syndrome?

9. An 18-year-old woman is seen in the gynaecology clinic for investigation of amenorrhoea. You notice that she is overweight with hirsutism, a round face and acne. Although looking up recent blood tests, you notice that her plasma cortisol is high and her adrenocorticotrophic hormone (ACTH) is undetectable.
What is the most likely cause of these results?

10. What is a site of action of antidiuretic hormone?

11. A 72-year-old woman is seen in preassessment clinic prior to undergoing a routine vaginal hysterectomy for prolapse. Her blood pressure is found to be high and electrolytes deranged.
Which of the following is a secondary cause of hyperaldosteronism?

12. A 60-year-old woman with a chronic disease is admitted to hospital acutely unwell.She has severe diarrhoea and vomiting. She is hypotensive with a blood pressure of 85/45 mmHg. You suspect, she has Addison’s disease.
Which of the following is a recognised cause of Addison’s disease?

13. A 24-year-old woman is admitted with vomiting and diarrhoea at 26 weeks’ gestation. Her electrolytes are deranged and fail to resolve after the acute event and she requires admission to the high-dependency unit. Addison’s disease is suspected.
Which of the following is the most appropriate initial specific test for Addison’s disease?

14. Which is the first catecholamine to be produced in the synthesis of catecholamines?

15. A 48-year-old woman is found to have persistent hypertension during a work-up for gynaecology operation. Further investigation reveals a phaeochromocytoma.
Which of the following biochemical changes is associated with phaeochromocytoma?

16. Which of the following actions is related to glucagon?

17. A 32-year-old Asian woman is diagnosed at 28 weeks’ gestation with gestational diabetes. Treatment with metformin is commenced.
Which of the following is an insulin antagonist?

18. A 51-year-old woman is started on hormonal replacement therapy (HRT). You consider the properties of oestrogen when discussing the contraindications to HRT treatment.
Which of the following is a property of oestrogen?

19. A 21-year-old woman is started on the mini pill. She asks you about the possible side effects of progesterone.
Which of the following is a property of progesterone?

20. A 32-year-old woman is referred to the gynaecology clinic with secondary amenorrhoea. Day 21 progesterone levels indicate that she is not ovulating.
Which of the following statements best describes the events occurring at the midluteal phase of the menstrual cycle?

21. A 34-year-old woman undergoes regular ultrasound scans for follicle tracking having been started on clomiphene treatment.
Which of the following statements most appropriately describes the mature ovarian follicle?

22. A 23-year-old woman is seen in the gynaecology clinic after an ultrasound scan reveals multiple cysts on both ovaries. She also complains of irregular menstrual cycles and has been trying to conceive for over 1 year.
Which of the following lead to clinical manifestations of polycystic ovarian syndrome?

23. Which of the following increases sex hormone binding globulin?