AMC MCQ Renal and Endocrine Disorders 5

Question 1

A 45-year-old man with a family history of renal failure has flank pain, hypertension, haematuria and bilateral enlarged kidneys with multiple cysts. What is the most likely diagnosis?

Accepted Answer

Autosomal dominant polycystic kidney disease

Answer

Bilaterally enlarged cystic kidneys with a positive family history indicate autosomal dominant polycystic kidney disease.

Question 2

A 19-year-old woman is found to have a TSH of 8 mU/L with a normal free T4 and is asymptomatic. What is the appropriate management of this subclinical hypothyroidism?

Accepted Answer

Repeat thyroid function in 2-3 months

Answer

Mildly raised TSH with normal T4 and no symptoms should be rechecked before deciding on treatment.

Question 3

A 68-year-old man on metformin undergoes a contrast CT and develops oliguric acute kidney injury 48 hours later. What is the most likely cause?

Accepted Answer

Contrast-induced nephropathy

Answer

Iodinated contrast can cause an acute tubular injury within 48-72 hours, especially in those with pre-existing renal impairment.

Question 4

A 30-year-old man with type 1 diabetes reports early morning sweating and headaches, with a fasting hyperglycaemia. Overnight readings show hypoglycaemia at 3am. What does this pattern describe?

Accepted Answer

Somogyi phenomenon

Answer

Nocturnal hypoglycaemia triggering counter-regulatory rebound morning hyperglycaemia describes the Somogyi effect.

Question 5

A 52-year-old woman is found to have an asymptomatic serum calcium of 2.85 mmol/L with an inappropriately normal PTH. What is the most likely diagnosis?

Accepted Answer

Primary hyperparathyroidism

Answer

A non-suppressed PTH in the face of hypercalcaemia indicates primary hyperparathyroidism.

AMC MCQ Practice Test

AMC MCQ Practice Test

AMC MCQ Renal and Endocrine Disorders 5