DHA Dubai · Medical Sciences & Healthcare

Endocrine, Renal and Gastrointestinal Pathology

53 practice questions, each with the answer and an explanation.

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Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 53 questions

  1. A 48-year-old female presents with profound polyuria, polydipsia, weight loss, and recurrent candidal vulvovaginitis. Fasting plasma glucose is 8.6 mmol/L (155 mg/dL) and HbA1c is 9.2%. According to t…
  2. A 32-year-old female presents with palpitations, heat intolerance, diaphoresis, and noticeable anterior neck fullness. Physical examination reveals resting tachycardia (114 bpm), bilateral proptosis…
  3. A 24-year-old female with Type 1 diabetes is brought to the emergency department with altered mental status, tachypnea with fruity breath odor, and severe diffuse abdominal pain. Point-of-care capilla…
  4. A 54-year-old male presents with facial rounding ('moon facies'), proximal muscle weakness, purple abdominal striae, and newly diagnosed hypertension. A 24-hour urinary free cortisol test confirms hyp…
  5. A 63-year-old male with long-standing poorly controlled diabetes and hypertension presents for evaluation. Laboratory results reveal serum creatinine 180 umol/L, eGFR 36 mL/min/1.73m2, and a spot urin…
  6. A 38-year-old male with a history of recurrent calcium oxalate nephrolithiasis undergoes metabolic workup. Laboratory results show hypercalcemia (serum calcium 2.85 mmol/L, normal 2.15-2.55), hypophos…
  7. A 50-year-old male with decompensated alcoholic cirrhosis presents with worsening abdominal distension, fever (38.4 C), and diffuse abdominal tenderness. Diagnostic paracentesis yields cloudy ascitic…
  8. A 28-year-old female presents with alternating episodes of crampy lower abdominal pain, bloating, and irregular bowel habits (diarrhea alternating with constipation) over the past 9 months. Her sympto…
  9. A 46-year-old female presents with recurrent upper abdominal burning pain that occurs 2 to 3 hours after meals and frequently awakens her at night. The pain is consistently relieved by food ingestion…
  10. A 66-year-old female presents with severe pain in her knees and hips. Examination reveals firm, non-tender bony enlargements over the distal interphalangeal (DIP) joints and proximal interphalangeal (…
  11. A 34-year-old male presents with profound muscle weakness and recurrent muscle spasms. Laboratory investigation reveals severe hypokalemia (serum potassium 2.4 mmol/L), metabolic alkalosis (bicarbonat…
  12. A 29-year-old female presents with chronic watery diarrhea, weight loss, and an intensely pruritic vesicular rash across her elbows and knees (dermatitis herpetiformis). Duodenal endoscopic biopsy dem…
  13. A 42-year-old male presents with sudden excruciating left flank pain radiating downward to the groin and scrotum. The pain is colicky, accompanied by nausea and macroscopic hematuria. Non-contrast hel…
  14. A 60-year-old male with a 20-year history of gastroesophageal reflux disease (GERD) undergoes surveillance upper gastrointestinal endoscopy. Biopsy of the distal esophagus reveals replacement of the n…
  15. A 45-year-old female presents with acute severe epigastric pain that radiates through to her mid-back, accompanied by persistent retching and vomiting. Serum amylase is 980 U/L and serum lipase is 1,4…
  16. A 72-year-old male presents with painless gross hematuria, a palpable right flank mass, and a newly discovered right-sided varicocele that fails to decompress when in the supine position. Contrast-enh…
  17. A 58-year-old male with chronic hepatitis C virus infection presents with painless jaundice, dark urine, and pale stools. Laboratory tests reveal total bilirubin 145 umol/L, direct bilirubin 115 umol/…
  18. A 68-year-old male with long-standing poorly controlled hypertension presents with painless progressive bilateral visual blurring and difficulty driving at night. Ophthalmoscopy reveals bilateral crys…
  19. A 27-year-old male is admitted with severe burns covering 30% of his total body surface area. On day 4, he develops severe upper gastrointestinal bleeding with melena and hematemesis. Upper endoscopy…
  20. A 52-year-old female presents with persistent pain, stiffness, and symmetric swelling of the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of both hands, lasting > 1 hour every m…
  21. A 70-year-old female presents with acute severe lower abdominal pain and fever (38.8 C). Examination shows guarding in the left lower quadrant. Abdominal CT confirms acute colonic diverticulitis with…
  22. A 33-year-old female presents with profound fatigue, hyperpigmentation of the palmar creases and buccal mucosa, postural dizziness (BP 88/54 mmHg sitting, 74/46 standing), and persistent salt craving.…
  23. A 64-year-old male with long-standing liver cirrhosis presents with sudden painless vomiting of bright red blood (massive hematemesis) and hypotension. After securing the airway and establishing volum…
  24. A 40-year-old male presents with persistent epigastric burning and chronic diarrhea. Endoscopy demonstrates multiple refractory peptic ulcers located in the second and third portions of the duodenum a…
  25. A 52-year-old male presents with hematemesis. Emergency endoscopy reveals an active bleeding peptic ulcer. Following endoscopic hemostasis, what high-dose medication is standard?
  26. A 58-year-old cirrhotic patient with ascites presents with low-grade fever and diffuse abdominal pain. What absolute ascitic neutrophil count confirms Spontaneous Bacterial Peritonitis?
  27. A 60-year-old female with decompensated cirrhosis exhibits confusion, asterixis, and lethargy. What is the first-line pharmacologic agent for hepatic encephalopathy?
  28. According to the revised Atlanta classification, how many of the three diagnostic criteria are required to establish the diagnosis of acute pancreatitis?
  29. Which clinical constellation adds hypotension and altered mental status to Charcot triad, defining Reynolds pentad in acute ascending cholangitis?
  30. Which serologic biomarker demonstrates highest sensitivity and specificity as the initial screening test for celiac disease in an IgA-competent patient?
  31. A 26-year-old male presents with recurrent crampy right lower quadrant pain, chronic diarrhea, perianal fistulas, and skip lesions on colonoscopy. What is the most likely diagnosis?
  32. A 30-year-old male presents with bloody diarrhea and tenesmus. Sigmoidoscopy reveals continuous circumferential mucosal inflammation extending proximally from the rectum. What is the diagnosis?
  33. A 48-year-old male with bronze skin pigmentation, hepatomegaly, and new diabetes mellitus has a transferrin saturation of 65%. What initial genetic testing is indicated?
  34. A 19-year-old male presents with tremor, dysarthria, elevated hepatic transaminases, and brown rings on the peripheral cornea. What is the underlying disease?
  35. Under the KDIGO guidelines, which serum creatinine change within 48 hours defines Stage 1 Acute Kidney Injury (AKI)?
  36. A 4-year-old child presents with generalized edema, heavy proteinuria of 4.5 g/24h, and hypoalbuminemia. Electron microscopy reveals diffuse effacement of podocyte foot processes. What is the diagnosi…
  37. A 10-year-old boy develops facial puffiness, dark tea-colored urine, and hypertension 2 weeks after streptococcal pharyngitis. What renal biopsy finding on electron microscopy is expected?
  38. A patient with severe hyperkalemia of 7.2 mEq/L exhibits widening of the QRS complex on ECG. What is the very first intravenous medication that must be administered?
  39. In managing severe chronic symptomatic hyponatremia, what is the maximum recommended rise in serum sodium over 24 hours to prevent osmotic demyelination syndrome?
  40. Which formula correctly calculates the serum anion gap from standard serum electrolyte measurements?
  41. In a patient with metabolic acidosis and a serum bicarbonate of 12 mEq/L, what is the expected respiratory compensation PaCO2 predicted by Winter's formula?
  42. Which type of renal tubular acidosis is characterized by impaired distal alpha-intercalated cell hydrogen ion secretion, resulting in an inability to acidify urine below pH 5.5?
  43. A 42-year-old female presents with bilateral flank masses, microscopic hematuria, and hypertension. Ultrasound reveals extensive cysts in both kidneys. What extrarenal complication carries highest mor…
  44. In a patient presenting with diabetic ketoacidosis, what serum potassium concentration mandates withholding intravenous insulin until potassium is replenished?
  45. A 70-year-old male with type 2 diabetes presents with altered mental status, severe dehydration, blood glucose of 850 mg/dL, and serum osmolality of 345 mOsm/kg without significant ketosis. What is th…
  46. A 35-year-old female with Graves disease develops high fever, marked tachycardia of 160 bpm, agitation, and delirium. What is the immediate multi-drug therapy sequence?
  47. An 80-year-old female presents in winter with hypothermia, bradycardia, periorbital edema, and obtundation. TSH is 85 mIU/L with undetectable free T4. What is the initial treatment?
  48. Which initial screening test is recommended to establish hypercortisolemia in a patient with central obesity, moon facies, and purple abdominal striae?
  49. A 38-year-old male with resistant hypertension and unprovoked hypokalemia has a plasma aldosterone to plasma renin activity ratio of 35. What is the most likely diagnosis?
  50. A 34-year-old female presents with hyperpigmentation, postural hypotension, fatigue, hyponatremia, and hyperkalemia. What test confirms primary adrenal insufficiency?
  51. A 45-year-old male with paroxysmal palpitations, headache, and diaphoresis has elevated plasma fractionated metanephrines. What medical preparation is required prior to surgical resection?
  52. A 56-year-old female presents with recurrent nephrolithiasis. Serum calcium is 11.2 mg/dL with an elevated intact parathyroid hormone level of 110 pg/mL. What is the most common cause?
  53. A 60-year-old male with small cell lung cancer develops confusion. Serum sodium is 120 mEq/L, serum osmolality is 250 mOsm/kg, and urine osmolality is 420 mOsm/kg with normal volume status. What is th…

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