KMU Past Paper Practice

A 48-year-old man is found to have an adrenal cortical mass during evaluation of hypertension and hypokalemia. He has no episodic palpitations or sweating. Which tumor-related functional abnormality best explains his presentation?

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A 61-year-old woman has a large nonfunctioning adrenal cortical tumor and presents with persistent flank discomfort rather than an endocrine syndrome. Which feature best accounts for this mode of presentation?

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A patient with a catecholamine-secreting adrenal tumor has repeated episodes of hyperglycemia despite no previous history of diabetes. Which physiological effect most directly contributes to the rise in glucose?

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A 43-year-old man with recurrent catecholamine surges develops acute breathlessness and reduced left ventricular systolic function. Coronary angiography does not show an obstructive lesion. Which complication best explains the cardiac dysfunction?

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Two patients have the same type of adrenal medullary tumor. One has persistent hypertension, while the other has abrupt episodic attacks separated by symptom-free intervals. Which factor best explains this difference?

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Histology of an adrenal medullary neoplasm shows nests of polygonal neuroendocrine cells surrounded by a delicate vascular network and supporting cells. From which normal cell type did the neoplastic cells most likely arise?

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A family has several members with medullary thyroid carcinoma and pheochromocytoma. Genetic testing demonstrates an abnormality affecting RET. Which type of molecular alteration best fits this syndrome?

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A woman with a confirmed hereditary MEN syndrome has undergone treatment of the endocrine tumor that caused her initial symptoms. She is currently well. Which long-term principle remains most appropriate?

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A thyroid specimen from a patient belonging to a MEN2 family shows multifocal medullary thyroid carcinoma arising in a background of proliferation of parafollicular cells. Which pathological change best represents this inherited predisposition?

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A pancreatic mass is composed of uniform cells arranged in nests and trabeculae. The pathologist wants to confirm neuroendocrine differentiation. Which pair of markers would provide the most useful support?

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A patient has recurrent episodes strongly suggestive of a small functional pancreatic neuroendocrine tumor. Biochemical testing supports the diagnosis, but CT does not identify a definite lesion. Which additional localization method is most appropriate?

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A clinician suspects a functional GEP-NET in a patient with a characteristic endocrine syndrome. Which investigation strategy best follows the diagnostic principles for these tumors?

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A patient with an insulin-secreting pancreatic tumor develops confusion, blurred vision and eventually a seizure during a prolonged fast. Which mechanism best explains these neurological manifestations?

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A patient with a functional pancreatic NET develops glucose intolerance, fatty stools and gallstones. Which physiological action of the secreted hormone best links these manifestations?

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A 50-year-old man with a secretory pancreatic NET has persistent watery diarrhea and hypokalemia. Gastric assessment also shows reduced acid secretion. Which mediator best accounts for this combination?

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A patient with metastatic intestinal neuroendocrine disease has recurrent flushing and diarrhea. During some attacks he also develops wheezing without evidence of infection or heart failure. Which manifestation of the secretory syndrome best explains the wheeze?

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A patient with suspected GEP-NET has a mildly elevated general neuroendocrine marker but no clear hormone syndrome. Which interpretation is most appropriate?

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A patient with a well-differentiated metastatic GEP-NET has strong somatostatin-receptor expression on functional imaging. Hormone-related symptoms are controlled, but tumor-directed therapy is required. Which treatment principle specifically uses the demonstrated receptor expression?

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A patient with a small insulin-secreting pancreatic tumor has troublesome symptoms despite the lesion being only a few centimeters in size. Which principle best explains why a relatively small functional NET can cause prominent disease?

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A patient with a gastrin-secreting neuroendocrine tumor continues to have severe acid-related symptoms while localization and definitive tumor treatment are being arranged. Which immediate therapeutic principle most directly reduces the morbidity caused by the hormone excess?

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