| Post Name | Assistant Professor in Endocrinology |
|---|---|
| Department | Medical Education |
| Question Paper Code | 085/2026/OL |
| Category Code | 684/2025 |
| Date of Test | 9 May 2026 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
Which of the following statements regarding the synthesis of thyroid hormones is incorrect?
Answer
C. Sodium iodide symporter present at the apical surface of thyrocyte actively transports iodide from the circulation
2
Which of the following statements best describes the anatomy of the adrenal gland?
Answer
A. Inferior adrenal artery is a branch of renal artery
3
All are true about corticotrophs except:
Answer
D. Corticotrophs secrete ACTH, a 29-amino acid peptide
4
Which investigation is typically performed to rule out exogenous Cushingās syndrome?
Answer
C. 8 am fasting serum cortisol
5
The 72-hour fasting test used in the evaluation of hypoglycaemia is characterized by all of the following except:
Answer
A. The patient should not be ambulatory during the test
6
Growth hormone (GH) stimulation testing in the evaluation of a child with short stature is characterized by all of the following except:
Answer
C. GH stimulation testing should be performed in the evaluation of all the children with short stature
7
The dynamic test used to diagnose simple virilizing congenital adrenal hyperplasia due to 21-hydroxylase deļ¬ciency in an adult is characterized by all of the following except:
Answer
B. Serum 17-OH progesterone is measured at 0 and 30 minutes
8
The age standardized prevalence of diabetes in India based on IDF 2024 data is approximately:
Answer
A. 10%
9
The prevalence of overweight/obesity among Indian adults based on National Family Health Survey (NFHS 4 & 5) is approximately:
Answer
D. 40%
10
Which of the following statements is not true regarding the epidemiology of thyroid disorders?
Answer
D. Multi nodular goitre is less common in iodine deļ¬cient area
11
More than 95% cases of acromegaly caused by?
Answer
A. GH secreting pituitary adenoma
12
Which of the following statement is/are correct about clinical features of acromegaly? (i) Headache is often mild. (ii) Raynaud's phenomenon is reported in less than 1% of patients. (iii) Neural enlargement but not the wrist tissue swelling lead to carpal tunnel syndrome.
Answer
D. None of above (i), (ii) & (iii)
13
Which of the following statement is / are correct about diagnosis of acromegaly?
Answer
D. High IGF1 level correlates with clinical indices of disease activity in acromegaly
14
Which of the following statement is/are correct about surgical treatment of acromegaly? (i) Patients with macroadenomas have less improvement in symptoms. (ii) Within 2 hours of successful resection, metabolic dysfunction starts improving. (iii) Overall, 85% to 95% of patients achieve normalized IGF1 levels.
Answer
B. Only (i) and (ii)
15
Which of the following statement is / are correct about dopamine agonists in acromegaly? (i) It is indicated in patient with mild IFG-1 elevation. (ii) Eļ¬cacy is dependent of prolactin concentration. (iii) Therapeutics escape occurs with dopamine agonist therapy.
Answer
C. Only (i) and (iii)
16
Which are signiļ¬cant predictors of postoperative biochemical remission of Acromegaly? (i) Younger age (ii) Small tumor size (iii) Low preoperative GH level
Answer
A. Only (ii) and (iii)
17
Which of the following hormones is Least Likely to be expressed by a plurihormonal pituitary adenoma in a patient with acromegaly?
Answer
A. Antidiuretic hormone (ADH)
18
Which of the following statement is / are correct about panhypopituitarism? (I) Most common cause is neoplastic adenoma. (ii) Less common with hormone producing adenoma. (iii) Never associated with diabetes insipidus.
Answer
A. Only (ii) and (iii)
19
Which of the following statement is / are correct about diagnosis of secondary adrenal insuļ¬ciency? (i) ACTH in patients with secondary adrenal insuļ¬ciency is usually low. (ii) Secondary adrenal insuļ¬ciency conļ¬rms if serum cortisol is less than 100 nmoLāL. (iii) Measure serum cortisol at 8:00 am.
Answer
A. Only (ii) and (iii)
20
Which of the following statement is / are correct about treatment of panhypopituitarism?
Answer
D. Women of postmenopausal age with hypogonadotropic hypogonadism do not require hormonal replacement therapy
21
Which of the following statement is/are correct about mortality in panhypopituitarism? (i) Young age has a higher standardized mortality ratio. (ii) Patients with craniopharyngioma have an increased mortality. (iii) Pituitary radiotherapy is associated with high mortality.
Answer
B. All of above (i, ii & iii)
22
Which speciļ¬c drug is noted for causing hypophysitis in up to 10% of patients treated for malignant melanoma?
Answer
A. Ipilimumab
23
Which of the following statement is / are correct about lymphocytic hypophysitis in post-partum? (i) It occurs in last month of pregnancy. (ii) Patients commonly present with headache. (iii) Patient typically have a pre-pregnancy history of viral infection.
Answer
B. Only (i) and (ii)
24
Which of the following statement is / are correct about Sheehan syndrome? (i) Lactation failure is the commonest presentation. (ii) Initially all patient has adrenal insuļ¬ciency. (iii) Pituitary function is recovered after 5-7 years.
Answer
A. Only (i)
25
Which of the following statement is / are correct about pituitary apoplexy? (i) It occurs in setting of pituitary adenoma. (ii) Diplopia is a presenting feature. (iii) Surgery is indicated in all cases
Answer
C. Only (i) and (ii)
26
A patient with long-term amiodarone use develops thyrotoxicosis. USG Colour Doppler shows reduced vascularity of the thyroid gland. Which of the following is the most likely mechanism?
Answer
B. Destructive thyroiditis
27
A postmenopausal lady with untreated thyrotoxicosis presents with fragility fracture. Which of the following best explains the skeletal eļ¬ects?
Answer
B. Increased RANKL expression leading to enhanced osteoclastogenesis
28
A 68 years old man has persistent TSH value below 0.1 mIU/L with normal free T4 and total T3. He is asymptomatic otherwise. Which of the following is the most clinically signiļ¬cant long-term risk requiring consideration of treatment?
Answer
D. Increased risk of Atrial Fibrillation
29
Which of the following cellular mechanisms is most accurate reļ¬ecting the development of Orbitopathy in Gravesā Disease?
Answer
B. TSH receptor activation on orbital ļ¬broblasts leading to glycosaminoglycan deposition
30
A 34 years old lady presents with Thryotoxicosis. Labs show ā suppressed TSH, high Free T4, low thyroglobulin, low radioactive iodine uptake. Which is the most likely Diagnosis?
Answer
C. Factitious thyrotoxicosis
31
A neonate has congenital hypothyroidism with goiter. Labs show elevated TSH, low T4. Radioiodine uptake is increased. Perchlorate discharge test is positive. Which defect is most likely?
Answer
B. Thyroid peroxidase (TPO) deļ¬ciency
32
An infant presents with severe neurodevelopmental delay, hypotonia, high serum T3, low T4 and normal TSH. Which is the most likely defect?
Answer
A. MCT8 transporter mutation
33
A 32 years old lady has TSH 7 mIU/L, normal Free T4 level and Anti TPO positive. Which factor strongly predicts progression to overt hypothyroidism?
Answer
C. Presence of anti TPO antibodies
34
A 7 years old girl presents in the OPD with complaint of menstrual bleeding without commensurate breast development. Her bone age was found to be delayed. On USG, large multicystic ovaries were detected. Which of the following patterns is likely to be expected?
Answer
A. Increased TSH, Reduced free T4
35
An elderly patient with known coronary artery disease is diagnosed with TSH 18 mIU/L Which is the most appropriate initial management?
Answer
A. Start low dose and titrate slowly
36
Routine measurement of Calcitonin in patients with Thyroid Nodule is used to detect which of the following?
Answer
D. Medullary Carcinoma of Thyroid
37
A 42-year-old patient presents with a solitary thyroid nodule along with raised free T4 and suppressed TSH value. What will be the most appropriate next step?
Answer
A. Radionuclide Thyroid Scan
38
Which of the following features is suggestive of malignancy in a thyroid nodule?
Answer
B. Presence of Microcalciļ¬cation
39
Why FNAC of thyroid is unable to diļ¬erentiate Follicular Adenoma from Carcinoma of Thyroid?
Answer
C. Inability to detect capsular & vascular invasion
40
Which of the following genes is characteristically associated with Medullary Carcinoma of the Thyroid?
Answer
C. RET
41
Which one of the following synthetic steroids has maximum hypothalamic- pituitary-adrenal axis suppression?
Answer
D. Dexamethasone
42
Which one of the following clinical features is least common in Cushing syndrome in a male due to Carney complex?
Answer
B. Gastric schwannomas
43
Eļ¬ective non teratogenic drug to control hypercortisolism in pregnancy with Cushing Syndrome
Answer
B. Metyrapone
44
Which one of the following is not true regarding Cushing syndrome due to macronodular hyperplasia?
Answer
A. The nodules are pigmented
45
All the following clinical signs are less discriminatory for the diagnosis of Cushing syndrome except
Answer
D. Facial plethora
46
Lorenzo oil is useful as a monounsaturated fatty acid, which blocks the synthesis of desaturated very long-chain fatty acids in Adrenoleukodvstrophy. This Lorenz oil is a combination of
Answer
C. Oleic acid and erucic acid
47
All the following are true, except one regarding the DAX1 (NR0B1) gene mutations.
Answer
C. Hypogonadism is only due to low gonadotropin levels
48
Adrenal atrophy and deļ¬ciency should be anticipated in any subject who has taken more than the equivalent of 7.5 mg/day of prednisolone for how many weeks?
Answer
C. More than 3 weeks
49
Which one of the following is not a feature of Allgrove syndrome?
Answer
A. Adrenal insuļ¬ciency due to ACTH deļ¬ciency
50
Which one of the following lab abnormalities are not seen in primary adrenal insuļ¬ciency?
Answer
B. Hypocalcemia
51
In a dedicated adrenal protocol CT, adrenal adenoma can be diagnosed with which one of the following?
Answer
A. Absolute washout greater than or equal to 60%
52
All the following are true regarding the adrenal hemorrhage, except one.
Answer
D. Unilateral hemorrhage is usually a result of anticoagulation therapy or a blood dyscrasia
53
How much percentage of adrenocortical carcinoma in a CT and MRI may show calciļ¬cation?
Answer
B. 20 to 30%
54
Which one of the following imaging is not particularly useļ¬ul in head and neck paragangliomia?
Answer
A. MIBG imaging
55
Which one of the following is not true regarding adrenal gland metastasis in radiological imaging?
Answer
C. Small metastases are often heterogenous on contrast-enhanced CT or MRI
56
Which one of the following hypoxic pathway (cluster 1) germline mutation gene is associated with pheochromocytoma and paraganglioma?
Answer
C. VHL
57
Which one of the following is not true regarding the adrenal incidentaloma?
Answer
A. They occur more frequent in males, most commonly in the fourth and ļ¬fth decades
58
Which one of the following is not true regarding the mitotane medical therapy in adrenocortical carcinoma?
Answer
D. Severe GI side eļ¬ects like constipation seem to be related to the higher mitotane plasma concentration
59
QT interval monitoring is required for which one of the following oral steroidogenesis inhibitors?
Answer
D. Osilodrostat
60
Which one of the following biochemical markers are highly elevated and is suggestive of adrenocortical carcinoma?
Answer
C. DHEAS
61
A 16-year-old girl was brought to the endocrine OPD for evaluation of primary amenorrhea. History from the mother revealed a spontaneous onset of breast development around the age of 11 years, which progressed normally. Her height is appropriate for her family. She was started on cyclic estrogen and progesterone therapy in a previous consultation for 6 months, but no menstrual bleed resulted. She is a very good football player who practices for 3-4 hours a day. Clinical examination showed a fully mature breast (Tanner stage 5) and absence of pubic hair (stage 1 only). Which one of the following diagnoses would be the most appropriate for her?
Answer
C. Complete androgen resistance
62
Which one of the following statements is not correct for congenital adrenal hyperplasia caused by 21 alpha hydroxylase deļ¬ciency?
Answer
D. About 90% of the mutant alleles are generated because of de novo point mutations in the active gene
63
Which one of the following statements about glvcolysis and gluconeogenesis is correct?
Answer
D. Red blood cells only metabolize glucose by anaerobic glycolysis (and the pentose phosphate pathway)
64
Which one of the following is not a risk factor for type 2 diabetes?
Answer
C. S. LDL > 160 mg%
65
Which of the following statements is correct for the measurement of blood glucose?
Answer
A. Venous whole blood glucose concentration is approximately 10-12% lower than plasma glucose concentration
66
For Continuous glucose monitoring (CGM) in pregnancy with diabetes, what is the recommended target range for blood glucose (mg/dL) for which time-in-range (TIR) is calculated?
Answer
C. 63-140
67
Which of the following enzmes acts as a glucose sensor in the beta cell by controlling the rate of entry of glucose into the glycolytic pathway
Answer
A. Glucokinase
68
A 34-year-old man was brought to the emergency department in an unconscious state with no relatives available for history. His physical condition showed the possibility of a road traļ¬c accident as he was bleeding from the scalp. Review of papers available in his pocket revealed that he is a known diabetic subject taking tablet Glipizide 5 mg and tab Metformin 500 mg, both twice a day. Which one of the following will be the most appropriate step in management in the emergency room?
Answer
C. Collect blood samples, start IV line with dextrose, urgent CT scan head, care of bleeding. and care of airway
69
A 32-year-old female with a known diagnosis of GCK-MODY, who is currently on no drug treatment, is planning a pregnancy. She came to ask for guidance on the management of GCK-MODY during pregnancy. Based on current recommendations and studies in GCK-MODY, which of the following statements is the most appropriate regarding insulin therapy?
Answer
A. Insulin therapy is not needed in the majority of pregnancies aļ¬ected by GCK-MODY
70
Which one of the following lesions seen in a patient with diabetic kidney disease is not a typical glomerular lesion?
Answer
D. Armani-Ebstein lesion
71
Which one of the following statements is not correct about diabetic macular edema?
Answer
B. It always requires focal LASER surgery, as early as possible
72
According to the International Working Group on the Diabetic Foot (IWGDF) risk stratiļ¬cation system, which of the following statements is true regarding the management of diabetic foot?
Answer
A. History of foot ulcer or amputation (minor or major) or kidney failure puts the patient in a high ulcer risk category
73
Which one of the following statements is not correct about diabetic neuropathy?
Answer
C. The common symptoms induced by the involvement of small ļ¬bers include loss of protective sensation (LOPS)
74
Which one of the following criteria is not true about the deļ¬nition of resolution of diabetic ketoacidosis (DKA)?
Answer
D. Normalization of anion gap
75
Which one of the following statements is not correct about autoimmune type 1 diabetes?
Answer
A. Individuals who have a single IA-2 autoantibody should be monitored less frequently than multiple-autoantibodyāpositive individuals, as they have a low risk of progressing through type 1 diabetes stages
76
Phosphatidylinositol-3-kinase (PI3K) inhibitors are now used to treat hormone receptor-positive (HR+), human epidermal growth factor receptor-2--negative (HER2ā), PIK3CA- mutated advanced breast cancer. Diabetes is a frequently observed adverse event with PI3K inhibitors (PI3Ki). Which patients are at higher risk of developing diabetes while receiving PI3K inhibitor therapy?
Answer
D. Patients receiving PI3K inhibitors at higher doses and for longer durations
77
Which one of the following is not associated with increased risk of progression to clinical type 1 diabetes among individuals with islet autoantibodies?
Answer
D. Smoking
78
A 57-year-old male presented with a history of sustained D5 fracture following a fall from a bike. He had no history of prior fractures or other risk factors. On evaluation, his biochemical investigations showed creatinine, calcium, phosphorus, iPTH and vitamin D levels were within normal limits. The DXA scan showed T-scores of-2.3 in the spine and -1.3 in the hip. Which of the following indicates severe grade of osteoporosis?
Answer
C. T score spine (-3.2) and Hip (-2.6) with trochanteric femur fracture
79
Odanacatib is an osteoporosis drug that inhibits the Cathepsin K pathway. It has a signiļ¬cant impact on improving BMD and preventing fragility and fractures. Which of the following is one of the important side eļ¬ects of Odanacatib compared to placebo detected in clinical trials?
Answer
B. Stroke
80
A 65-year-old lady a case of metastatic left-sided breast carcinoma, who had previously been treated with surgery and chemo-radiotherapy two years prior. She is presently on an aromatase inhibitor -Letrozole. She sustained a fracture at the D-l 1 vertebrae following a fall in the washroom. She had a history of CAD, post-PTCA status eight months before. On evaluation, her DXA scan showed Spine BMD of -3.4 and neck of femur BMD of -2.8. Which of the following is the most appropriate treatment for her?
Answer
C. Denosumab
81
A 55-year-old lady presented with a history of recurrent renal calculi for 5 years. She also had a history of depression for one year on medications. Her mother also had a history of renal calculi. On evaluation, found to have calcium of 11.2 mg% (N-8.8 -10.2mg%), phosphorus 2.3 mg/dI (N-2.5-4.5 mg/dl), iPTH of 140 pg/mI (N-18.4-80.1 pg/mI), 25 (OH)D -12.9 ng/ml (N- 20- 100 ng/ml). Further investigation showed a left inferior parathyroid adenoma. Which of the following is an indication for parathyroid surgery in her?
Answer
C. BMD, T score
82
A 34-year-old lady presented with nausea, vomiting, weakness and altered behaviour for one day. She had no prior signiļ¬cant diseases; she is on intermittent supplementation for myalgia and body pain. On evaluation, the patient was found to have serum calcium 14.2 mg% (N-8.8-10.2 mg%), phosphorus 5.6 mg% (2.5- 4.5 mg%), creatinine 1.45 mg% and iPTH <5 pg/mI. What is the preferred next investigation to establish the diagnosis?
Answer
C. 25 (OH) D
83
A 23-year-old presented with a history of high serum calcium level with serum calcium of 14.5 mg% (N-8.8- 10.2 mg%), iPTH of 820 pg/ml. On examination, a lesion 3 Ć 2 cm is palpable on the left side of the neck region near the inferior pole of the thyroid. On evaluation, he was found to have hypertensive and polycystic kidney disease. A 4DCT scan showed a cystic parathyroid adenoma. Which of the following genetic mutations is the most likely cause?
Answer
D. CDC-73
84
A 10-year-old boy presented with a history of recurrent episodes of seizures since the age of seven. He is currently requiring 3 anti-epileptic medications. Recently, he was admitted with a history of fever. On evaluation, low calcium, low iPTH, and low vitamin D were detected, whereas phosphorus was elevated. All these features are suggestive of hypoparathyroidism. Which of the following genetic disorders is not associated with developmental abnormalities of the parathyroid glands?
Answer
C. William syndrome
85
A 12-year-old girl presented with features of hypocalcemia. On examination, the patient was found to have short stature, a rounded face and short 4th metacarpals. Biochemical investigation showed low calcium and elevated iPTH, suggestive of pseudohypoparathyroidism (PHP). Which of the following statements is NOT TRUE about PHP?
Answer
D. PHP1B associated with the mutation of the paternal allele of the GNAS gene
86
A 14-year-old boy presented with a history of poor development of secondary sexual features. On evaluation. the patient was found to have micropenis, cleft lip, scoliosis, dental agenesis, skeletal defect and ectrodactyly. Hormonal investigations showed low LH, FSH and Testosterone. What is the most probable genetic abnormality in this case?
Answer
A. FGFR1
87
A 15-year-old boy presented with poor development of secondary sexual characteristics. On examination, testicular volume was < 2 ml, and SPL was 3 cm with no axillary or pubic hair There was no anosmia or hyposmia on clinical examination. Which of the following tests is associated with reversible GnRH deļ¬ciency?
Answer
B. TAC3
88
A 6-year-old boy presented with the development of precocious puberty features, characterised by penile enlargement and the appearance of pubic hair for one year. He had no prior history of adrenal insuļ¬ciency or genital ambiguity. On examination, he has an SPL of 5 cm and a testicular volume of 4 ml, SMR P3A3. Blood pressure was 140/80 mmHg. Which of the following deļ¬ciencies is most likely the cause?
Answer
C. 11 Beta Hydroxylase
89
A 6-year-old boy presented with a history of gelastic seizure for 3 years, a history of enlargement of phallic size, the appearance of pubic hair and aggressive behaviour for one year. On examination, the child had polydactyl and biļ¬d epiglottis. MRI of the brain is suggestive of a 1.5 x 1cm lesion in the hypothalamic region. Which of the following condition is associated with the above manifestation?
Answer
D. Pallister-Hall syndrome
90
Which of the following parameters is NOT included for determining predicted height in Greulich and Pyleās method?
Answer
A. Mid-parenteral height
91
Which of the followings NOT TRUE about IGF-1 /lGFSP3 testing and interpretation in a child with suspected growth hormone deļ¬ciency-GHD?
Answer
C. IGF-1 has speciļ¬city of ā„ 90% in childlren 10 years
92
A 23-year-old presented with a history of tendon xanthoma and cutaneous planar xanthomas on the hands, wrists and elbows. Family history of father died of CAD at 34 years of age. Blood investigations showed LDL-C of 1560 mg% and, another occasions, 1356 mg%. All these ļ¬ndings are suggestive of Familial Hypercholesterolemia. Genetic testing showed an LDL receptor mutation with non-detectable LDL receptor activity. Which of the following drugs is not the preferred treatment in this case?
Answer
B. Evolocumab
93
A 24-year-old presented with a history of tendon Edition xanthoma at the ankle, elbow and knee regions. Blood investigations showed LDL-C of 450 mg% and on other occasions 480 mg%, suggestive of hypercholesterolemia. The CBC and peripheral blood smear showed anisocytosis, poikilocytosis, and megathrombocytes. USG showed moderate splenomegaly: What is the diagnosis?
Answer
A. Sitosterolemia
94
A 33-year-old presented with a history of renal calculi. His biochemical investigations showed calcium of 11.2 (N-8.8- 10.2) mg%, iPTH of 110 pg/mt Parathyroid scintigraphy was normal. CT abdomen showed a pancreatic lesion of size 3 x 2 cm. Dermatological examination revealed collagenoma lesions on the neck and the upper chest. Which of the following functional pancreatic neuroendocrine tumours is common in this setting?
Answer
B. Gastrinoma
95
Which of the following is NOT TRUE about the management of primary hyperparathyroidism in MEN-1?
Answer
A. Surgery is recommended for all adults, irrespective of calcium level
96
A 5-year-old child presented with a history of mucocutaneous candidiasis noticed since the neonatal period. She is currently admitted with a history of seizures and biochemical investigations suggestive of primary hypoparathyroidism. On examination, the child has vitiligo, alopecia, nail dystrophy and enamel hypoplasia suggestive of APS-l. Which of the following is NOT TRUE about APS-l?
Answer
C. Multiple family members aļ¬ected
97
Which of the following antibodies is the most preferred screening test for the- diagnosis of Autoimmune polyglandular syndrome -l(APS-I)?
Answer
D. Anti-interferon, antibody
98
Which of the following tests is least useful for detecting large deletions, duplications, and rearrangements?
Answer
A. Sanger sequencing
99
In a Mendelian genetic disorder the phenomenon of recurrent mutations of the same gene but diļ¬erent Edition molecular forms and location are known as
Answer
C. Allelic heterogeneity
100
A 42-year-old male presented with uncontrolled hypertension for 5 years. He had no prior history of hypokalemic weakness, stroke or CAD. Biochemical investigation showed PAC of 15 ng/dl and PRA of 1.2 ng/ml/hr. CT abdomen showed a 2 x 1 cm lesion on the left side, a bulky adrenal on the right side. He was suggested to undergo adrenal venous sampling (AVS). Which of the following is NOT TRUE about the interpretation of the AVS test?
Answer
D. Use Aldosterone to DRC ratio for better interpretation
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