Endocrine Week 1 Study Guide Questions

ENDOCRINE WEEK 1 STUDY GUIDE QUESTIONS 1. ADH is released by which nucleus within the hypothalamus: A. B. C. D. Paraventricular Supra-optic Arcuate Pre-optic Answer: B 2. The composition of the hypothalamus: A. The anterior part is made of adenohypophysis and the posterior neurohypophysis. B. The anterior part is made of adenohypophysis and the posterior adenohypophysis. C. The posterior part is made of adenohypophysis and the anterior neurohypophysis. D. The anterior part is made of adenohypophysis and the posterior adenohypophysis. part is made of part is made of part is made of part is made of Answer: A 3. Which of the following statements are correct about the functions of oxytocin? A. Oxytocin is release by the paraventricular nucleus of the hypothalamus of which binds on a Gq coupled receptor on the myometrium to cause it to relax. B. Oxytocin when released by the paraventricular nucleus it binds on a Gs coupled receptor on the myoepithelial cells of the breast, causing them to contract and thus causing the milk to be ejected. C. Oxytocin triggers an PIP2 signalling mechanism that increases the intracellular Ca2+ concentration to cause the contraction the myometrium of the uterus and the myoepithelial cells of the breast. D. Post partum haemorrhage has no effect on the release of the oxytocin from the posterior pituitary. Answer: C 4. Which row of the table below is FALSE? A B C Paraventricular Preoptic Arcuate A. B. C. D. A and B B and C A, B and C None Oxytocin, TRH and CRH. GnRH GHRH and PIH Answer: D 5. When CRH is released by the paraventricular nucleus it binds into which cell within the anterior pituitary? A. B. C. D. E. Lactotroph. Gonadotroph. Corticotrope. Somatotroph. Thyrotrope. Answer: C 6. In Cushing’s disease: A. There is a decreased synthesis of beta-adrenergic receptors, thereby decreasing the sensitivity of the sympathetic nervous system, causing symptoms such as bradycardia and low breathing rate. B. There is a decreased selectin activity which causes decreased white blood cell margination, which even though there is an increased serum white blood cell count there is an increased likelihood of infection. C. It is due to an adrenal cause there is an activation of the melanocyte stimulating hormone, which causes an activation of the melanocyte that will increase melanin production and thus cause hyperpigmentation. D. Cortisol acts as a direct agonist to insulin receptors which will cause hyperglycaemia. E. The increased cortisol once binds to adipose tissues, it causes fat re-distribution from centrally to periphery. Answer: B 7. Which of these hormones are made directly in the hypothalamus? A. B. C. D. E. Oxytocin and AVP. Oxytocin and GH. GH and AVP. GH and LH LH and FSH Answer: A 8. There are various endocrine causes that can cause secondary hypertension. Which of the following causes is incorrect? A. B. C. D. Hyperthyroidism. Cushing’s disease. Pheochromocytoma. Hyperparathyroidism. Answer: A 9. For a patient suspected of having Cushing syndrome, which diagnostic test is best for distinguishing between adrenal tumor and a tumor from an ectopic site causing the disease? A. B. C. D. Low dose dexamethasone test. High dose dexamethasone test. Urinary cortisol over 24 hours. Late night salivary test. Answer: B 10. What is the rationale behind using CRH stimulation test for distinguishing between adrenal tumor vs ectopic tumor as a cause of increased cortisol? A. It is selective to the CRH receptors in the lungs, pancreas and the kidney. B. The ectopic sites have 1 or no CRH receptors, therefore they will not be an increased rise in ACTH levels. C. The CRH will bind onto CRH receptors on both the pituitary and the ectopic sites. If the issue is from the pituitary there will be a decrease, but if it is an ectopic issue there will be a rise. D. None of the above. Answer: B 11. How does Sheehan’s syndrome contribute to pituitary apoplexy? A. It causes an increased pituitary demand for blood, and since there is lots of blood loss in childbirth there will be an increased risk of infarction to the pituitary. B. It causes the blood vessels to become weaker, and thus rupture and cause a haemorrhage. C. There an increase of calcium within the blood vessel walls of the arteries of supplying the pituitary. This causes the vessels to become constricted and thus cause an infarction of the pituitary. D. It causes a mutation within the pituitary causes a pituitary adenoma and which will compress near by vessels causing a haemorrhage at the pituitary. E. All of the above. Answer: A 12. During ovulation: A. In the follicular phase both LH and FSH stimulate this phase, however, LH has a much greater effect. B. In both the follicular and the ovulatory phases, the follicles are still frozen in prophase I. C. FSH stimulates the thecal cells to make androgens and LH stimulates the granulosa cells to convert androgens into estrogens. D. When the egg ruptures from the tertiary follicle the remaining part is all decomposed. E. The tertiary follicle when sense an increase in estrogen it stimulates the release of inhibit B which acts to inhibit the pre-optic and arcuate nuclei. Answer: B 13. In the lactation pathway, which of the steps INCORRECT? A. The immunoglobulins are transported across the basolateral side of the alveolar cell via receptor mediate endocytosis. B. In response to breast feeding the paraventricular nucleus in the hypothalamus release TRH on to lactotrophs in the in posterior pituitary to release prolactin which binds onto a tyrosine independent kinase receptor that will trigger a JAK cascade that increases the synthesis and integration of electrolyte and water transporters in the alveolar cells. C. The intensity and frequency of suckling decreases with the introduction of solid foods. D. Mechanoreceptors surrounding the areolar sense the suckling and send signals via the spinal cord to inhibit the accurate nucleus from releasing dopamine. Answer: B - The only reason why B is false, is because it mentions tyrosine independent kinase receptor, and this is false, as the receptor that prolactin acts on is tyrosine kinase associate receptor. 14. Which of the following statements is FALSE: A. The uterine glands in the endometrium make thick broth composed of glycoproteins, lipids and proteins that form a thick mucus in the cervix to prevent things from entering if there is an embryo implanted within the endometrium. B. In non-pregnant women the low progesterone levels cause a disturbed vasodilation and vasoconstriction activity of the spiral and coil arteries in the stratum functionalis, which causes both the vessels and the stratum factionalis to shed of which causes bleeding in the form of menstruation. C. The menstrual phase is followed by the proliferative phase, which involves regeneration of the stratus functionalis and angiogenesis. D. In the fallopian tube there is cilia like cells that beat to the ampulla causing current waves in the fluid, which cause the egg to go to the ampulla. E. Various pyrolytic enzymes act on the tertiary graffion to cause the secondary oocyte to get popped out into the blood stream, which is then carried via secondary blood vessels into the ampulla of the fallopian tube. Answer: E - Note: the proteolytic enzyme part of option E is correct, but the part about the secondary oocyte going to secondary blood vessels, is incorrect, which is why option E is false. 15. The pathogenesis of acromegaly may involve: A. The accurate nucleus releasing excess growth hormone releasing hormone, which will act on the somatropes found in the posterior pituitary, resulting in increased growth hormone release. B. In the eccrine glands, there is a downregulation of the tyrosine kinase associate receptors and thus decrease the JAK-2 and STAT cascade resulting in an increase in sweating. C. There is an upregulation of insulin receptors and glucose transporters, resulting in hypoglycaemia in the blood. D. There is an inhibition of muscular satellite cells, which means that there is a decrease in collagen synthesis and amino acid uptake, so there is muscle atrophy and weakness. Answer: A 16. All of the following are features of hyperthyroidism EXCEPT: A. B. C. D. E. Dyspnoea. Tachycardia. Increased BMD. Increased temperature. Weight loss. Answer: C 17. Propylthiouracil (PTU) and methimazole (MMI) are medications that can be used in the management of hyperthyroidism. A woman who is 12 weeks pregnancy who presents with hyperthyroidism features. Which of the following drugs would you prescribe and why? A. Since she is her first week of pregnancy PTU is preferred over MMI due to extensive protein binding, which means that there will be less interference with organogenesis as it is less likely to cross the placenta. B. Since she is her first week of pregnancy MMI is preferred over PTU due to extensive protein binding, which means that there will be less interference with organogenesis as it is less likely to cross the placenta. C. Since she is in her first week of pregnancy, she is more at risk of hepatotoxicity therefore PTU is preferred over MMI. D. Since she is in her first week of pregnancy, she is more at risk of hepatotoxicity therefore MMI is preferred over PTU. Answer: A 18. For a patient being treated with radioactive iodine therapy, why is levothyroxine, prescribed? A. B. C. D. Prevents I (131) from crossing the placenta in pregnant women. Increased the efficacy and potency of I (131). Prevents I (131) from causing permanent damage of the colloid cells. Prevents I (131) from causing hypothyroidism, as it acts an HRT. Answer: D 19. What is the role of GAD anti-bodies in the pathogenesis of T1DM? A. Targets the pancreatic islet cell antigens and recognises them as foreign thus causing the destruction of beta cell destruction. B. Inhibits glutamic acid de-carboxylase which causes a decreased conversion of glutamic acid into GABA and thus decreased production of insulin and beta cell protective factors. C. Inhibits glutamic acid de-carboxylase which causes a decreased conversion of glutamic acid into GABA and thus inhibits the opening of voltage gated Ca2+ channels which prevents the release of insulin. D. All of the above Answer: B 20. All of the following are small peptides EXCEPT: A. B. C. D. E. Answer: D TSH. GH. LH. PTH. None of the above.