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Question 1
Correct
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Which of the following describes a principal action of insulin?
Your Answer: Inhibition of phosphorylase and gluconeogenic enzymes
Explanation:Insulin stimulates glycolysis and lipogenesis, but inhibits gluconeogenesis. Insulin promotes the dephosphorylating of glycogen phosphorylase, therefore suppressing glycogenolysis. Insulin also inhibits FOX3, FOX4, and FOX6 and their ability to promote hepatic gluconeogenesis.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 2
Correct
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The net effect of parathyroid hormone on calcium and phosphate homeostasis is?
Your Answer: Increase in Ca, decrease in phosphate
Explanation:Parathyroid hormone’s main target organs are the kidneys, bone, and intestine. In the kidney, it decreases reabsorption of phosphate and increases calcium reabsorption. It also promotes absorption of calcium from bone. PTH release results in a small drop in serum phosphate concentrations.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 3
Correct
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The febrile response to PGE2 will be impaired with the knockout of which one of the following prostaglandin receptors?
Your Answer: Ep3
Explanation:Prostaglandin EP3 receptor is a receptor for prostaglandin E2. Fever occurs as a result of the action of prostaglandin E2 and requires EP3 receptors in the preoptic area. Therefore, if there is an absence of EP3 receptors, fever caused by prostaglandin E2 will not occur.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 4
Correct
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Embryologically the anterior pituitary is formed from?
Your Answer: Rathkes pouch
Explanation:The ectoderm, located in the roof of the pharynx, forms Rathke’s pouch, which comes into contact with the ectoderm of the developing brain. The pouch eventually separates from the pharynx, becoming the anterior pituitary.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 5
Incorrect
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Where does the pituitary gland lie?
Your Answer: Above the pituitary stalk
Correct Answer: In a pocket of the sphenoid bone at the base of the brain
Explanation:The pituitary lies in a small depression in the sphenoid bone, known as the sella turcica or Turkish saddle.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 6
Incorrect
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What is the fat called that serves as a considerable source of heat in children?
Your Answer: Red adipose tissue
Correct Answer: Brown adipose tissue
Explanation:Brown adipose tissue, also known as BAT or brown fat, coforms the adipose tissue along with white adipose tissue (WAT) or white fat. While WAT is responsible for energy-storage, BAT is involved in thermogenesis and energy expenditure. It is more prevalent in children than in adults, and its activation during adolescence is associated to less weight gain and adiposity. BAT produces heat by non-shivering thermogenesis.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 7
Incorrect
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What is the effect of oxytocin on the breast?
Your Answer: Milk formation
Correct Answer: Milk ejection
Explanation:Oxytocin is a peptide hormone and neuropeptide, produced by the hypothalamus and released by the posterior pituitary. It causes the milk ejection or let-down reflex, causing the milk to be transported to the subareolar sinuses, allowing it to be released through the nipple. This response is initiated by the act of suckling by the baby, but it can be conditioned to be triggered by different stimuli.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 8
Incorrect
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Which of the following is responsible for converting inactive cortisone to active cortisol in the adrenal gland?
Your Answer: 12βHSD type 1
Correct Answer: 11βHSD type 1
Explanation:11β-Hydroxysteroid dehydrogenase, also known as HSD-11β or 11β-HSD, is a group of enzymes which catalyse the interconversion of active cortisol and corticosterone with inert cortisone and 11-dehydrocorticosterone.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 9
Incorrect
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Where is the melanocortin system located?
Your Answer: Cerebral cortex
Correct Answer: Hypothalamus
Explanation:The melanocortin system is a group of hormones which include hormones from the pro-opiomelanocortin (POMC)-expressing neurons, the neuropeptide Y (NPY) and agouti-related peptide (AgRP)-co-expressing neurons. This system is located in the hypothalamic arcuate nucleus; it also includes the hypothalamic arcuate nucleus and the melanocortin 4 receptor (MC4R)-expressing neurons located in the hypothalamic paraventricular nucleus. The system regulates energy expenditure and food intake.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 10
Incorrect
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What is the most important way in which heat is lost from the body?
Your Answer: Defecation
Correct Answer: Radiation and conduction
Explanation:The body maintains a constant core temperature by balancing heat loss and heat gain. The mechanisms of heat loss are: radiation, evaporation, convection and conduction. Out of these mechanisms, the most important under normal conditions are radiation, through which body heat is given off to the surrounding atmosphere; and conduction, in which the body releases heat into the objects it comes into contact with.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 11
Correct
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Regarding the structure of the 3 pituitary glycoprotein hormones FSH, LH, and TSH, which of the following is true about the α- and β-subunits of each hormone?
Your Answer: Maximal physiological activity occurs only on their combination
Explanation:Glycoprotein hormones (GPHs) are the most complex molecules that function as hormones. They each consist of two different subunits, α and β, which are non-covalently associated. The combination of these subunits results in an increase in their activity and β structure.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 12
Incorrect
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What is the primary cause of ketoacidosis in Type 1 diabetes?
Your Answer: Lipogenesis
Correct Answer: Lipolysis
Explanation:in type 1 diabetics the lack of insulin in the bloodstream prevents glucose absorption, thereby inhibiting the production of oxaloacetate (a crucial precursor to the β-oxidation of fatty acids) through reduced levels of pyruvate (a by-product of glycolysis), and can cause unchecked ketone body production (through fatty acid metabolism or lipolysis) potentially leading to dangerous glucose and ketone levels in the blood.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 13
Correct
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The reflex responses activated by cold are controlled by which area?
Your Answer: Posterior hypothalamus
Explanation:The posterior nucleus of the hypothalamus is responsible for thermoregulation and thermogenesis. Studies have shown that the neurons in the posterior hypothalamus which mediate the reflex of shivering are sensitive to temperature; damage to this nucleus produces hypothermia.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 14
Incorrect
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In a newly diagnosed acromegaly patient, which of the following would you not expect to find?
Your Answer: Carpal tunnel syndrome
Correct Answer: Hypohidrosis
Explanation:Features of acromegaly may include:
- Soft tissue swelling visibly resulting in enlargement of the hands, feet, nose, lips and ears, and a general thickening of the skin
- Soft tissue swelling of internal organs, notably the heart with associated weakening of its muscularity, and the kidneys, vocal cords (resulting in a characteristic thick, deep voice and slowing of speech)
- Generalized expansion of the skull at the fontanelle, frontal bossing, prognathism with associated macroglossia (enlargement of the tongue) and teeth spacing.
- Hypertrichosis, hyperpigmentation and hyperhidrosis (not hypohidrosis) may occur in these patients as well as carpal tunnel syndrome and impotence.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 15
Incorrect
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To which protein is T3 mostly bound in the serum?
Your Answer: Transthyretin
Correct Answer: Thyroxin-binding globulin
Explanation:In a normal person, approximately 0.03 per cent of the total serum T4, and 0.3 per cent of the total serum T3 are present in free or unbound form. The major serum thyroid hormone-binding proteins are: 1) thyroxine-binding globulin [TBG or thyropexin], 2) transthyretin [TTR or thyroxine-binding prealbumin (TBPA)], and 3) albumin (HAS, human serum albumin). TBG has highest affinity for T4, which is 50-fold higher than that of TTR and 7,000-fold higher that of HSA. As a result TBG binds 75% of serum T4, while TTR and HSA binds only 20% and Albumin 5%, respectively.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 16
Incorrect
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What is the principle site of action of adrenocorticotrophic hormone (ACTH)?
Your Answer: All tissues
Correct Answer: Adrenal gland
Explanation:Adrenocorticotropic hormone, also known as ACTH or corticotropin, is a polypeptide tropic hormone. It is synthesized by the corticotropic cells of the anterior pituitary. It works by regulating the secretion of glucocorticoid hormones from the cortex cells in the adrenal gland. It binds to the melanocortin (MC) 2 receptors on the surface of the adrenal zona glomerulosa cells, producing cortisol.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 17
Incorrect
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Which of the following increase insulin secretion?
Your Answer: K+ depletion
Correct Answer: Sulfonylureas
Explanation:Sulfonylureas are a type of antidiabetic drug used to treat diabetes mellitus type 2. Their main mechanism of action is producing a rise in plasma insulin levels, through stimulation of insulin secretion and a decrease in hepatic clearance of insulin. Sulfonylureas include gliclazide, glipizide, glibenclamide and glimepiride.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 18
Incorrect
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The main efferent input of the posterior pituitary gland comes from:
Your Answer: Sympathetic and parasympathetic stimulation from the hypothalamus
Correct Answer: Paracrine hormones secreted from the hypothalamus via axons.
Explanation:The posterior pituitary or neurohypophysis consists of a collection of axonal projections emerging from the hypothalamus. It releases hormones directly from these axonal endings into circulation; these hormones are oxytocin and vasopressin.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 19
Correct
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Which of the following hormones cause negative feedback on the CRH/ACTH axis?
Your Answer: Cortisol
Explanation:The hypothalamic–pituitary–adrenal axis, also known as HPA axis is a set of interactions that regulate the secretion of several hormones through negative feedback. Cortisol, for example, is produced by the adrenal cortex, binds to its receptors in the hypothalamus and adenohypophysis and inhibits secretion of corticotropin releasing hormone (CRH) and adrenocorticotropic hormone (ACTH). The drop in CRH secretion leads to a decrease in ACTH secretion, which in turn causes less cortisol to be secreted.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 20
Correct
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Which are the main hormones secreted by the posterior pituitary gland.
Your Answer: Oxytocin and vasopressin
Explanation:The posterior pituitary gland secretes oxytocin and vasopressin (antidiuretic hormone). These hormones are stored in Herring bodies before being secreted into the bloodstream.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 21
Correct
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Which one of the following features is least associated with primary hyperparathyroidism?
Your Answer: Sensory loss
Explanation:The signs and symptoms of primary hyperparathyroidism are those of hypercalcemia. They are classically summarized by stones, bones, abdominal groans, thrones and psychiatric overtones.
Stones refers to kidney stones, nephrocalcinosis, and diabetes insipidus (polyuria and polydipsia). These can ultimately lead to renal failure.
Bones refers to bone-related complications: osteitis fibrosa cystica, osteoporosis, osteomalacia, and arthritis.
Abdominal groans refers to gastrointestinal symptoms of constipation, indigestion, nausea and vomiting. Hypercalcemia can lead to peptic ulcers and acute pancreatitis.
Thrones refers to polyuria and constipation
Psychiatric overtones refers to effects on the central nervous system. Symptoms include lethargy, fatigue, depression, memory loss, psychosis, ataxia, delirium, and coma.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 22
Correct
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Which hormone is associated with the temperature surge in hot flushes?
Your Answer: LH
Explanation:Luteinizing hormone or LH is a hormone produced by the anterior pituitary gland. Studies have shown surges in LH levels during menopausal hot flushes, suggesting that a pulsatile release of LH is responsible for increased hypothalamic norepinephrine activity, causing the hot flushes.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 23
Incorrect
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Within the hypothalamus, the dopamine-secreting neurones of the intrahypothalamic system have their cell bodies in which nuclei?
Your Answer: Raphe
Correct Answer: Arcuate
Explanation:Arcuate nucleus dopaminergic neurons consist of a single group of neurons that project to the median eminence where they release dopamine into the hypophyseal portal circulation to inhibit pituitary prolactin secretion.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 24
Correct
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Which one of the following skin disorders is least commonly associated with hypothyroidism?
Your Answer: Pretibial myxoedema
Explanation:Pretibial myxoedema is an infiltrative dermopathy, resulting as a rare complication of Graves’ disease (hyperthyroidism) and very occasionally occurs in non-thyrotoxic Graves’ disease and Hashimoto’s thyroiditis.
Hypothyroidism typically presents with symptoms such as dry skin, brittle hair, and thinning of the outer third of the eyebrows. While skin conditions like dryness and hair changes are common in hypothyroidism due to reduced metabolic activity, acne is also not typically associated with it.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 25
Incorrect
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Which glucose transporter is responsible for the uptake of glucose in ß cells?
Your Answer: GLUT 3
Correct Answer: GLUT 2
Explanation:Glucose transporter 2, also known as GLUT2 is a transmembrane carrier protein which is not insulin dependent. It is found in the liver and the pancreatic islet ß cells, where it functions as the primary glucose transporter that allows the transfer of glucose between these organs and blood.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 26
Incorrect
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Which of the following structures lie in close proximity to the thyroid?
Your Answer:
Correct Answer: All of the options
Explanation:The thyroid gland receives its blood supply from the inferior and superior thyroid arteries. The recurrent laryngeal nerves emerges from the superior thoracic outlet bounded in part by the thyroid lobe. Two pairs of parathyroid glands lie near the thyroid. The common carotid artery splits into its external and internal branches at the upper border of the thyroid cartilage; these branches are separated by the gland.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 27
Incorrect
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Where do the portal hypophysial vessels arise?
Your Answer:
Correct Answer: Median eminence
Explanation:The hypothalamic-hypophysial portal system connects the brain to the anterior pituitary. It is made up of two capillary beds, one in the median eminence and the other in the anterior pituitary. Blood from the plexus of the median eminence is carried by portal veins, draining into the cavernous and posterior intercavernous sinuses. This system delivers hypothalamic hormones to their target cells.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 28
Incorrect
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Calcium is transported over the brush border in the gut, via which transporter / channel?
Your Answer:
Correct Answer: TRPV 6
Explanation:Transient Receptor Potential Vanilloid 6 or TRPV 6 is a calcium channel located in the cell membrane which is present in a variety of organs, including small intestine, oesophagus, stomach, colon, placenta, kidney, and uterus. In the intestine, it is located in the apical brush-border membrane of the enterocyte, regulating the entry of calcium into the cell.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 29
Incorrect
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Which of the following is least recognised as a potential complication of acromegaly?
Your Answer:
Correct Answer: Mental retardation
Explanation:Acromegaly is a condition that results from excess growth hormone (GH) after the growth plates have closed. It is typically due to the pituitary gland producing too much growth hormone. In more than 95% of people the excess production is due to a benign tumour, known as a pituitary adenoma. The condition is not inherited.Complications:Severe headacheArthritis and carpal tunnel syndromeEnlarged heartLiver fibrosis and bile duct hyperplasiaHypertensionDiabetes mellitus (excess of GH leads to insulin resistance)Heart failureKidney failureColorectal cancerCompression of the optic chiasm leading to loss of vision in the outer visual fields (typically bitemporal hemianopia.)Increased palmar sweating and sebum production over the face (seborrhoea) are clinical indicators of active GH-producing pituitary tumours.hypertensiondiabetes (>10%)cardiomyopathycolorectal cancer
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 30
Incorrect
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Which of the following stimulates glucagon release?
Your Answer:
Correct Answer: Exercise
Explanation:Studies have shown a small increase in glucagon levels during stress tests and exercise. This occurs in response to the reduction of blood glucose levels during physical activity; epinephrine levels are also a stimulus for the release of glucagon during exercise, since it suppresses insulin, which accounts for its stimulatory effects on glucagon. The use of stored fats for energy during exercise also stimulates the release of glucagon.
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This question is part of the following fields:
- Endocrinology
- Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY
