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  • Question 1 - What is the definition of puberty in girls? ...

    Incorrect

    • What is the definition of puberty in girls?

      Your Answer: Development of secondary sexual characteristics

      Correct Answer: Becoming capable of sexual reproduction

      Explanation:

      Puberty is the process of reproductive and sexual development and the maturation which changes a child into an adult.

    • This question is part of the following fields:

      • Endocrinology
      15
      Seconds

  • Question 2 - Which of the following statements regarding prolactin is true? ...

    Incorrect

    • Which of the following statements regarding prolactin is true?

      Your Answer: Prolactin levels decrease during surgery

      Correct Answer: Prolactin levels increase during stress

      Explanation:

      Causes of Hyperprolactinemia: Prolactinomas, Medication (phenothiazines, metoclopramide, risperidone, selective serotonin reuptake inhibitors, oestrogens, verapamil), Stress, Pregnancy, Hypothyroidism, Kidney disease, Chest trauma

    • This question is part of the following fields:

      • Endocrinology
      73.5
      Seconds

  • Question 3 - Oxytocin causes increased myometrial contractions via which of the following messenger pathways? ...

    Correct

    • Oxytocin causes increased myometrial contractions via which of the following messenger pathways?

      Your Answer: Activates phospholipase-C which produces IP3 which triggers intracellular Calcium ion release

      Explanation:

      Oxytocin activates phospholipase C to produce inositol 1,4,5-trisphosphate (IP3), which releases Ca2+ from intracellular stores. There are thought to be other mechanisms by which myometrium is stimulated by Oxytocin including increased sensitisation of the myometrium and increased calcium entry into cells. cAMP and Protein Kinase A inhibit myometrial contractility.

    • This question is part of the following fields:

      • Endocrinology
      35.1
      Seconds

  • Question 4 - The source of progesterone that maintains the pregnancy during early 1st trimester: ...

    Correct

    • The source of progesterone that maintains the pregnancy during early 1st trimester:

      Your Answer: Corpus luteum

      Explanation:

      In early pregnancy Progesterone is produced by the corpus luteum.. This organ is fundamental for pregnancy maintenance until the placenta (syncytiotrophoblast) takes over its function at the 7-9th week of gestation, just after the expression of major histocompatibility complex antigens is suppressed in extra-embryonic fetal tissue.

    • This question is part of the following fields:

      • Endocrinology
      17.3
      Seconds

  • Question 5 - In relation to ovulation, when does the LH surge occur? ...

    Incorrect

    • In relation to ovulation, when does the LH surge occur?

      Your Answer: 48-96 hours before ovulation

      Correct Answer: 24-36 hours before ovulation

      Explanation:

      Ovulation usually occurs on day 14 in a typical 28-day cycle. Luteinizing hormone levels spike as a result of increased oestrogen levels secreted from maturing follicles. This LH spike occurs about 24-36 hours before the release of the oocyte from the mature follicle.

    • This question is part of the following fields:

      • Endocrinology
      27.2
      Seconds

  • Question 6 - What percentage of children does delayed puberty occur in? ...

    Incorrect

    • What percentage of children does delayed puberty occur in?

      Your Answer: 1%

      Correct Answer: 3%

      Explanation:

      Delayed puberty is defined as the absence of breast development in girls beyond the age of 13, and the absence of testicular development in boys beyond the age of 14. The incidence of delayed puberty is 3%, with the condition being more common in boys.

    • This question is part of the following fields:

      • Endocrinology
      6.8
      Seconds

  • Question 7 - Which of the following drugs is associated with reduced milk production whilst breastfeeding?...

    Correct

    • Which of the following drugs is associated with reduced milk production whilst breastfeeding?

      Your Answer: Cabergoline

      Explanation:

      Domperidone and metoclopramide are D2 dopamine receptor antagonists. They are primarily used to promote gastric motility. They are also known as galactagogues and they promote the production of milk. Cabergoline and bromocriptine are prolactin inhibitors and they reduce milk production.

    • This question is part of the following fields:

      • Endocrinology
      28.1
      Seconds

  • Question 8 - Oestrogen have all of the following actions, EXCEPT: ...

    Correct

    • Oestrogen have all of the following actions, EXCEPT:

      Your Answer: Prevention of thrombosis

      Explanation:

      The properties of oestrogen:
      Structure: Stimulates endometrial growth, maintenance of vessels and skin,
      reduces bone resorption, increases bone formation, increases uterine growth
      Protein synthesis: Increases hepatic synthesis of binding proteins
      Coagulation: Increases circulating levels of factors II, VII, IX, X, antithrombin III and plasminogen; increases platelet adhesiveness
      Lipid: Increases HDL and reduces LDL,increases triglycerides, reduces
      ketone formation, increases fat deposition
      Fluid balance: Salt and water retention
      Gastrointestinal: Reduces bowel motility, increases cholesterol in bile

    • This question is part of the following fields:

      • Endocrinology
      66.4
      Seconds

  • Question 9 - Where is fetal DHEA produced? ...

    Correct

    • Where is fetal DHEA produced?

      Your Answer: Adrenals

      Explanation:

      DHEA is formed in the mother’s adrenal gland as well as the fetal adrenal glands. These weak androgens are transported by the blood to the placenta and are converted into oestradiol, estrone and estriol in the trophoblast.

    • This question is part of the following fields:

      • Endocrinology
      17.8
      Seconds

  • Question 10 - The following hormones are secreted from the anterior pituitary gland, EXCEPT: ...

    Correct

    • The following hormones are secreted from the anterior pituitary gland, EXCEPT:

      Your Answer: HCG

      Explanation:

      The following hormones are excreted from the anterior pituitary gland: TSH, GN, ACTH, LH, FSH, MSH, PRL.
      Human chorionic gonadotropin (hCG, or human chorionic gonadotrophin) is a placental hormone secreted by syncitiotrophoblasts during the second week of gestation.

    • This question is part of the following fields:

      • Endocrinology
      16.2
      Seconds

  • Question 11 - At ovulation the surge in LH causes rupture of the mature oocyte via...

    Correct

    • At ovulation the surge in LH causes rupture of the mature oocyte via action on what?

      Your Answer: Theca externa

      Explanation:

      The luteinizing hormone (LH) surge during ovulation causes: Increases cAMP resulting in increased progesterone and PGF2 production PGF2 causes contraction of theca externa smooth muscle cells resulting in rupture of the mature oocyte

    • This question is part of the following fields:

      • Endocrinology
      33.4
      Seconds

  • Question 12 - The ovaries produce androgen and progesterone. What is the common precursor for both...

    Correct

    • The ovaries produce androgen and progesterone. What is the common precursor for both of these hormones?

      Your Answer: Cholesterol

      Explanation:

      Cholesterol is the common precursor for progesterone and androgen production.

    • This question is part of the following fields:

      • Endocrinology
      56.3
      Seconds

  • Question 13 - The ovaries produce androgen and progesterone. What is the common precursor for both...

    Correct

    • The ovaries produce androgen and progesterone. What is the common precursor for both of these hormones?

      Your Answer: Cholesterol

      Explanation:

      Both the female hormones, namely progesterone and oestrogen as well as the male hormones or androgens are lipid soluble. The common precursor of these is cholesterol.

    • This question is part of the following fields:

      • Endocrinology
      6.3
      Seconds

  • Question 14 - Adult Polycystic Kidney Disease (PKD) typically follows which pattern of inheritance ...

    Correct

    • Adult Polycystic Kidney Disease (PKD) typically follows which pattern of inheritance

      Your Answer: Autosomal Dominant

      Explanation:

      PKD can follow either Autosomal dominant or recessive inheritance. Autosomal dominant is however the most common inheritance pattern and is seen in adult PKD. Infantile PKD is recessive

    • This question is part of the following fields:

      • Endocrinology
      11.5
      Seconds

  • Question 15 - All of the following are autosomal recessive conditions EXCEPT which one? ...

    Incorrect

    • All of the following are autosomal recessive conditions EXCEPT which one?

      Your Answer: Sickle Cell

      Correct Answer: Osteogenesis Imperfecta

      Explanation:

      Osteogenesis imperfect is an autosomal dominant condition. All the rest of the options are autosomal recessive conditions.

    • This question is part of the following fields:

      • Endocrinology
      29
      Seconds

  • Question 16 - During the menstrual cycle which hormone typically reaches its peak level on day...

    Correct

    • During the menstrual cycle which hormone typically reaches its peak level on day 21 (assuming a 28 day cycle)?

      Your Answer: Progesterone

      Explanation:

      LH, FSH and Oestrogen have their peaks just before ovulation on day 14 whereas progesterone peaks around day 21.

    • This question is part of the following fields:

      • Endocrinology
      18.4
      Seconds

  • Question 17 - Raised FSH levels are found in all of the following conditions, EXCEPT: ...

    Incorrect

    • Raised FSH levels are found in all of the following conditions, EXCEPT:

      Your Answer: Postmenopausal women

      Correct Answer: Women on combined oral contraceptive pills

      Explanation:

      Oestrogen- and progesterone-containing oral contraceptives inhibit LH, which suppresses the FSH and LH levels, preventing follicular development and ovulation. Combined pills suppress FSH and LH throughout the cycle, inhibit endometrial proliferation, and produce a scanty cervical mucus. 

    • This question is part of the following fields:

      • Endocrinology
      77.9
      Seconds

  • Question 18 - Which of the following drugs is most appropriate to use to stimulate lactation?...

    Incorrect

    • Which of the following drugs is most appropriate to use to stimulate lactation?

      Your Answer: Metoclopramide

      Correct Answer: Domperidone

      Explanation:

      Domperidone and metoclopramide are D2 dopamine receptor antagonists. They are primarily used to promote gastric motility. They are also known as galactagogues and they promote the production of milk. Cabergoline and bromocriptine are prolactin inhibitors and they reduce milk production.

    • This question is part of the following fields:

      • Endocrinology
      21.1
      Seconds

  • Question 19 - Whilst reviewing a 34 year old patient with amenorrhoea in clinic they tell...

    Correct

    • Whilst reviewing a 34 year old patient with amenorrhoea in clinic they tell you they have gained over 10kg in weight in the past 8 weeks and have noticed worsening acne. Routine bloods taken that morning show a random glucose 11.1mmol/l, normal thyroid function tests and negative pregnancy test. BP is 168/96 mmHg. You suspect Cushing's. What would the most appropriate investigation be to conform the diagnosis?

      Your Answer: Dexamethasone suppression test

      Explanation:

      In Cushing’s syndrome there is excess cortisol. Causes are broadly divided into 2 types: ACTH dependent disease: excess ACTH from the pituitary (Cushing’s disease), ectopic ACTH-producing tumours or excess ACTH administration. Non-ACTH-dependent: adrenal adenomas, adrenal carcinomas, excess glucocorticoid administration. The recommended diagnostic tests for the presence of Cushing’s syndrome are 24-hour urinary free cortisol, 1 mg overnight dexamethasone suppression test and late-night salivary cortisol. There are several other tests that may also be performed to find the cause. ACTH and cortisol measured together may show if this is ACTH dependent or not. MRI pituitary and CT abdo and pelvis may show if tumour is the cause.

    • This question is part of the following fields:

      • Endocrinology
      29.1
      Seconds

  • Question 20 - Which of the following is the primary source of oestrogen ? ...

    Correct

    • Which of the following is the primary source of oestrogen ?

      Your Answer: Granulosa cells

      Explanation:

      Ovarian granulosa cells (GC) are the major source of oestradiol synthesis. Induced by the preovulatory luteinizing hormone (LH) surge, cells of the theca and, in particular, of the granulosa cell layer profoundly change their morphological, physiological, and molecular characteristics and form the progesterone-producing corpus luteum that is responsible for maintaining pregnancy. 

    • This question is part of the following fields:

      • Endocrinology
      27.3
      Seconds

  • Question 21 - A 32 year old woman with a 6 month history of fatigue and...

    Incorrect

    • A 32 year old woman with a 6 month history of fatigue and some weight gain reports to clinic for a review. Her medical records show evidence of hypothyroidism. On examination, a non tender, hard goitre is palpated. Further tests reveal elevated anti TPO (anti thyroid peroxidase) and anti -Tg (anti thyroglobulin). Which of the following conditions is most likely to present like this?

      Your Answer: Endemic goitres

      Correct Answer: Hashimoto's

      Explanation:

      The case presented points to a diagnosis of an autoimmune thyroiditis leading to hypothyroidism. The most common form of autoimmune hypothyroidism, Hashimoto’s, often presents with a goitre, positive for antibody tests against thyroid components i.e. anti-TPO and anti-thyroglobulin. Graves disease and toxic diffuse goitre are more likely to cause hyperthyroidism. While De-Quervain’s and endemic goitre may cause hypothyroidism, they don’t result in positive antibody tests.

    • This question is part of the following fields:

      • Endocrinology
      77.3
      Seconds

  • Question 22 - Where is Glucagon produced? ...

    Incorrect

    • Where is Glucagon produced?

      Your Answer: Islet beta cells

      Correct Answer: Islet alpha cells

      Explanation:

      The alpha cells in the islets of Langerhans are responsible for the production and secretion of glucagon. The B cells secrete insulin, the D cells secrete somatostatin, and the F cells secrete pancreatic polypeptide. The B cells, which are the most common and account for 60–75% of the cells in the islets, are generally located in the centre of each islet.

    • This question is part of the following fields:

      • Endocrinology
      27
      Seconds

  • Question 23 - What is the definition of premature menopause? ...

    Incorrect

    • What is the definition of premature menopause?

      Your Answer: Menopause at or before 35 years of age

      Correct Answer: Menopause at or before 40 years of age

      Explanation:

      Menopause is defined as the cessation of menstruation for a period of 12 months. Premature menopause is defined as cessation of menstruation before the age of 40.

    • This question is part of the following fields:

      • Endocrinology
      193.5
      Seconds

  • Question 24 - Which of the following causes an increase in Sex Hormone Binding Globulin (SHBG)?...

    Incorrect

    • Which of the following causes an increase in Sex Hormone Binding Globulin (SHBG)?

      Your Answer: Hypothyroidism

      Correct Answer: Liver cirrhosis

      Explanation:

      Liver cirrhosis is known to lead to decreased levels of SHBG. Other causes of high SHBG are:
      Oestrogens e.g. oral contraceptives
      Pregnancy
      Hyperthyroidism
      Liver cirrhosis
      Anorexia nervosa
      Drugs e.g. anticonvulsants

    • This question is part of the following fields:

      • Endocrinology
      38.5
      Seconds

  • Question 25 - Delayed puberty in girls is defined as? ...

    Incorrect

    • Delayed puberty in girls is defined as?

      Your Answer: Absence of pubic hair development in girls beyond 15

      Correct Answer: Absence of breast development in girls beyond 13 years old

      Explanation:

      Breast development occurs from the age of 9-13 at the onset of puberty. Delayed puberty is defined as the absence of breast development after the age of 13.

    • This question is part of the following fields:

      • Endocrinology
      8.6
      Seconds

  • Question 26 - Maternal blood flow through the uterine artery at term is approximately ...

    Correct

    • Maternal blood flow through the uterine artery at term is approximately

      Your Answer: 750ml/min

      Explanation:

      Uterine blood flow increases 40-fold to approximately 700 mL/min at term, with 80 per cent of the blood distributed to the intervillous spaces of the placentae, and 20 per cent to the uterine myometrium.

    • This question is part of the following fields:

      • Endocrinology
      4.3
      Seconds

  • Question 27 - Where is fetal DHEA produced? ...

    Incorrect

    • Where is fetal DHEA produced?

      Your Answer: Anterior pituitary

      Correct Answer: Adrenals

      Explanation:

      Dehydroepiandrosterone (DHEA) is a steroid hormone synthesised from cholesterol (via Pregnenolone) by the adrenal glands. The foetus manufactures DHEA, which stimulates the placenta to form oestrogen, thus keeping a pregnancy going. Production of DHEA stops at birth, then begins again around age seven and peaks when a person is in their mid-20s

    • This question is part of the following fields:

      • Endocrinology
      15.5
      Seconds

  • Question 28 - Which of the following is the primary stimulator of uterine involution following child...

    Incorrect

    • Which of the following is the primary stimulator of uterine involution following child birth?

      Your Answer: FSH

      Correct Answer: Oxytocin

      Explanation:

      Oxytocin stimulates the myoepithelial cells in the breast causing the milk production. It also helps augment contractions in labour and cause uterine involution after childbirth.

    • This question is part of the following fields:

      • Endocrinology
      4.9
      Seconds

  • Question 29 - Where are ADH (vasopressin) and Oxytocin synthesised? ...

    Incorrect

    • Where are ADH (vasopressin) and Oxytocin synthesised?

      Your Answer: Anterior Pituitary

      Correct Answer: Hypothalamus

      Explanation:

      ADH and vasopressin are synthesized in the supraoptic and periventricular nuclei of the hypothalamus, they are eventually transported to the posterior pituitary where they are stored to be released later.

    • This question is part of the following fields:

      • Endocrinology
      20.4
      Seconds

  • Question 30 - Placental production of hPL, hCG, Oestrogen and Progesterone are examples of which type...

    Incorrect

    • Placental production of hPL, hCG, Oestrogen and Progesterone are examples of which type of mechanism

      Your Answer: Exocrine

      Correct Answer: Endocrine

      Explanation:

      Hormones that are secreted into the circulation at one site but have effects on distal target organs are endocrine as is the case with the hormones above. Autocrine and Intracrine messengers act within the same cell. Exocrine glands secrete their products into ducts. Apocrine is a histological term used to describe some types of exocrine gland.

    • This question is part of the following fields:

      • Endocrinology
      20.7
      Seconds

  • Question 31 - Human Chorionic Gonadotrophin (HCG) is structurally similar to which of the following hormones?...

    Incorrect

    • Human Chorionic Gonadotrophin (HCG) is structurally similar to which of the following hormones?

      Your Answer: Oxytocin

      Correct Answer: Thyroid Stimulating Hormone (TSH)

      Explanation:

      TSH, FSH, LH and HCG are all similar glycoproteins. These hormones consist of a common α-subunit and specific β-subunit. All are glycosylated, which determines their bioactivity and half-life.

    • This question is part of the following fields:

      • Endocrinology
      5.9
      Seconds

  • Question 32 - Which of the following is the primary stimulator of uterine involution following child...

    Incorrect

    • Which of the following is the primary stimulator of uterine involution following child birth?

      Your Answer: Prolactin

      Correct Answer: Oxytocin

      Explanation:

      Oxytocin is the primary stimulus for uterine involution following childbirth.

    • This question is part of the following fields:

      • Endocrinology
      11.3
      Seconds

  • Question 33 - What is the most common cause of premature menopause in the UK? ...

    Incorrect

    • What is the most common cause of premature menopause in the UK?

      Your Answer: Chemotherapy

      Correct Answer: Idiopathic

      Explanation:

      Premature menopause is most commonly idiopathic.

    • This question is part of the following fields:

      • Endocrinology
      25.4
      Seconds

  • Question 34 - High levels of alpha feto protein are found in all, EXCEPT? ...

    Incorrect

    • High levels of alpha feto protein are found in all, EXCEPT?

      Your Answer: Neural tube defects

      Correct Answer: Trisomy 21

      Explanation:

      Pregnant maternal serum AFP levels elevated: Neural tube defects (e.g., spina bifida, anencephaly); Omphalocele; Gastroschisis.

      Pregnant maternal serum AFP low levels: Down syndrome

    • This question is part of the following fields:

      • Endocrinology
      27.7
      Seconds

  • Question 35 - You review a 58 year old patient in clinic. She asks what the...

    Incorrect

    • You review a 58 year old patient in clinic. She asks what the results of her recent DEXA scan are. You note her hip BMD hip T-score is -1.4. You note she has a history of olecranon fracture 4 years ago. What is her classification according to WHO criteria?

      Your Answer: Severe Osteopenia

      Correct Answer: Osteopenia

      Explanation:

      Her T-score puts her in the osteopenic range. The presence of fragility fractures is more important in the osteoporotic patient. Olecranon fracture is not a typical fragility fracture.

    • This question is part of the following fields:

      • Endocrinology
      23.7
      Seconds

  • Question 36 - DHEA is synthesized from which molecule? ...

    Correct

    • DHEA is synthesized from which molecule?

      Your Answer: Cholesterol

      Explanation:

      Dehydroepiandrosterone is an androgen precursor produced primarily by the adrenal glands in women. The steroid hormone is produced from cholesterol at birth by the fetal adrenal glands, after which its output reduces. DHEA production picks up again from the age of 5-7 years and peaks between the ages of 20-30.

    • This question is part of the following fields:

      • Endocrinology
      16.1
      Seconds

  • Question 37 - Which of the following Oestrogens (Oestrogens) becomes the predominant circulating oestrogen during pregnancy?...

    Correct

    • Which of the following Oestrogens (Oestrogens) becomes the predominant circulating oestrogen during pregnancy?

      Your Answer: Estriol

      Explanation:

      Oestradiol is the predominant form of oestrogen during the reproductive life of a female. The estrogenic potency of oestradiol is 12 times more than estrone and 80 times that of estriol.

    • This question is part of the following fields:

      • Endocrinology
      16.3
      Seconds

  • Question 38 - Prognathism and macroglossia are features of which of the following? ...

    Incorrect

    • Prognathism and macroglossia are features of which of the following?

      Your Answer: Sheehan's syndrome

      Correct Answer: Acromegaly

      Explanation:

      These are features of excess growth hormone i.e. Acromegaly. Down’s and Cri du chat typically cause Micrognathia (small jaw)

    • This question is part of the following fields:

      • Endocrinology
      44.9
      Seconds

  • Question 39 - Which of the following statements regarding progesterone production in the ovary is true?...

    Incorrect

    • Which of the following statements regarding progesterone production in the ovary is true?

      Your Answer: Synthesised from androgen by Granulosa cells

      Correct Answer: Synthesised from cholesterol by Luteal cells

      Explanation:

      After the release of the oocyte, the theca and the granulosa cells form the corpus luteum which undergoes extensive vascularization for continued steroidogenesis. Progesterone is secreted by the luteal cells and is synthesized from cholesterol.

    • This question is part of the following fields:

      • Endocrinology
      4
      Seconds

  • Question 40 - Adult Polycystic Kidney Disease (PKD) typically follows which pattern of inheritance ...

    Incorrect

    • Adult Polycystic Kidney Disease (PKD) typically follows which pattern of inheritance

      Your Answer: X linked dominant

      Correct Answer: Autosomal Dominant

      Explanation:

      Polycystic kidney disease (PKD) can either be autosomal dominant or recessive. The autosomal dominant variant is more common in adult PKD however, the recessive pattern is more common in infantile PKD.

    • This question is part of the following fields:

      • Endocrinology
      14.9
      Seconds

  • Question 41 - What percentage of testosterone is bound to SHBG? ...

    Incorrect

    • What percentage of testosterone is bound to SHBG?

      Your Answer: 100%

      Correct Answer: 70%

      Explanation:

      About 97% of the testosterone that is secreted loosely binds to the SHBG and circulates in the blood for several hours in this bound state until it is transported to the target organs.

    • This question is part of the following fields:

      • Endocrinology
      59.1
      Seconds

  • Question 42 - Regarding placental anatomy: ...

    Correct

    • Regarding placental anatomy:

      Your Answer: Fetal blood vessels develop in the mesenchymal core of the chorionic villi

      Explanation:

      The chorionic plate represents the fetal surface of the placenta, which in turn is covered by the amnion. The amnion is composed of a single layered epithelium and the amnionic mesenchyme, an avascular connective tissue. The amnionic mesenchyme is only weakly attached to the chorionic mesenchyme and can easily be removed from the delivered placenta. The chorionic mesenchyme contains the chorionic vessels that are continuous with the vessels of the umbilical cord. Within the mesoderm of secondary villi, haematopoietic progenitor cells develop and start to differentiate. At about day 20 post-conception, first placental blood cells and endothelial cells develop independent of the vascular system of the embryo proper.13 14 The development of first placental vessels transforms the respective villi into tertiary villi.

    • This question is part of the following fields:

      • Endocrinology
      18.1
      Seconds

  • Question 43 - Which of the following changes would you expect in pregnancy? ...

    Incorrect

    • Which of the following changes would you expect in pregnancy?

      Your Answer: Decreased TSH Decreased Total T3 and T4

      Correct Answer: Decreased TSH Increased Total T3 and T4

      Explanation:

      Human chorionic gonadotrophin (hCG) has thyrotrophic activity owing to subunit homology with thyroid-stimulating hormone (TSH) and maternal TSH production is suppressed during the first trimester of pregnancy, when hCG levels are highest. The TSH response to thyrotrophin-releasing hormone (TRH) is reduced during the first trimester but returns to normal after this. Thyroid binding globulin increases in the first 2 weeks of pregnancy and reaches a plateau by 20 weeks. This leads to increased production of total T3 (tri-iodothyronine) and T4 (thyroxine).

    • This question is part of the following fields:

      • Endocrinology
      11.9
      Seconds

  • Question 44 - Beta and Delta Thalassemia are associated with abnormalities to which chromosome ...

    Incorrect

    • Beta and Delta Thalassemia are associated with abnormalities to which chromosome

      Your Answer: X Chromosome

      Correct Answer: Chromosome 11

      Explanation:

      Fetal haemoglobin (HBF) is the main haemoglobin type in the foetus and persists after birth for around 6 months. Fetal haemoglobin is composed of two alpha and two gamma subunits The alpha globulin chain is coded for by genes on Chromosome 16. Alpha Thalassemia are therefore associated with Chromosome16 defects The beta and delta globulin chains are coded for by genes on Chromosome 11. Beta and Delta Thalassemia are therefore associated with Chromosome 11 Defects

    • This question is part of the following fields:

      • Endocrinology
      8.2
      Seconds

  • Question 45 - Which of the following Oestrogens (Oestrogens) becomes the predominant circulating oestrogen during pregnancy?...

    Incorrect

    • Which of the following Oestrogens (Oestrogens) becomes the predominant circulating oestrogen during pregnancy?

      Your Answer: Mestranol

      Correct Answer: Estriol

      Explanation:

      The 3 main oestrogens are Estrone (E1) Oestradiol (E2) and Estriol (E3). Oestradiol is the predominant oestrogen during female reproductive years except during the early follicular phase when Estrone predominates. During pregnancy Estriol levels rise significantly and this becomes the dominant oestrogen during pregnancy. Ethinylestradiol and Mestranol are oestrogen found in COCP’s

    • This question is part of the following fields:

      • Endocrinology
      25.7
      Seconds

  • Question 46 - A patient with amenorrhoea is seen in clinic. History and examination reveal the...

    Incorrect

    • A patient with amenorrhoea is seen in clinic. History and examination reveal the patient runs 10-20 miles every day and her BMI is 17.8. Which of the following is likely to explain her symptoms?

      Your Answer: WHO type II Ovulation Disorders

      Correct Answer: WHO type I Ovulation Disorders

      Explanation:

      World Health Organization (WHO) Group I ovulation disorder is due to hypothalamic pituitary failure. This is sometimes termed hypothalamic amenorrhoea or hypogonadotropic hypogonadism. Women can improve frequency of ovulation, conception and an uncomplicated pregnancy by increasing their body weight (if BMI of <19) and/or moderating their exercise levels (if they undertake high levels of exercise). GnRH and LH may be administered in these patients. PCOS falls under type II ovulation disorders. WHO Group III ovulation disorder is due to ovarian failure.

    • This question is part of the following fields:

      • Endocrinology
      22.7
      Seconds

  • Question 47 - In normal pregnancy, levels of all of the following hormones increases, EXCEPT: ...

    Incorrect

    • In normal pregnancy, levels of all of the following hormones increases, EXCEPT:

      Your Answer: Prolactin

      Correct Answer: FSH

      Explanation:

      Hormones that increase during pregnancy and their roles:

      1. Human Chorionic Gonadotropin (hCG): Peaks between the eighth to tenth weeks of gestation and supports the corpus luteum to maintain progesterone production.
      2. Progesterone: Initially produced by the corpus luteum and later by the placenta, it rises steadily throughout pregnancy, suppressing the maternal immune response to fetal antigens and preparing the endometrium for implantation.
      3. Estrogen: Produced by the placenta from fetal and maternal precursors, estrogen levels increase to promote uterine growth and blood flow.
      4. Human Placental Lactogen (hPL): Rises significantly during pregnancy, influencing maternal metabolism by increasing insulin resistance and promoting lipolysis.
      5. Relaxin: Increases early in pregnancy to relax the uterine muscles, inhibit contractions, and prepare the cervix and pelvis for childbirth.
      6. Prolactin: Levels increase to prepare the breasts for lactation.
      7. Corticotropin-Releasing Hormone (CRH): Increases towards the end of pregnancy and is involved in the timing of labor.
      8. Adrenocorticotropic Hormone (ACTH): Levels increase, contributing to elevated cortisol levels during pregnancy.
      9. Total Thyroxine (T4): Levels increase due to elevated thyroid-binding globulin (TBG) production stimulated by increased estrogen levels, meeting the increased metabolic demands of pregnancy.
      10. Parathyroid Hormone (PTH): Levels increase to regulate calcium metabolism, ensuring adequate calcium for fetal bone development.
      11. Cortisol: Levels increase due to higher production by the adrenal glands and increased binding to cortisol-binding globulin (CBG), supporting glucose metabolism, managing stress, and aiding fetal development, particularly lung maturation.

      During pregnancy, some hormones either remain stable or do not increase significantly. These include:

      1. Follicle-Stimulating Hormone (FSH): Levels decrease due to the negative feedback from high levels of estrogen and progesterone.
      2. Luteinizing Hormone (LH): Levels also decrease due to negative feedback from elevated estrogen and progesterone.
      3. Growth Hormone (GH): Although a variant of growth hormone (hGH-V) is produced by the placenta and increases, the maternal pituitary GH levels may not significantly increase.
      4. Melatonin: Generally remains stable during pregnancy, though some studies suggest there may be slight fluctuations.
      5. Insulin: While insulin resistance increases due to hPL and other factors, the actual levels of insulin may not increase proportionally; instead, pancreatic beta-cell function adapts to meet the increased demand.

    • This question is part of the following fields:

      • Endocrinology
      24.2
      Seconds

  • Question 48 - Which major hormone of pregnancy is produced by the placenta from 16-hydroxydehydroepiandrosterone sulphate...

    Incorrect

    • Which major hormone of pregnancy is produced by the placenta from 16-hydroxydehydroepiandrosterone sulphate (16-OH DHEAS)?

      Your Answer: Pregnenolone

      Correct Answer: Estriol

      Explanation:

      The placenta produces Estriol from 16-OH DHEAS. Estriol is the major oestrogen (oestrogen) of pregnancy and the placenta is the primary site of production. Pregnenolone is synthesised by the placenta from cholesterol and this is converted to dehydroepiandrosterone (DHEA) in the fetal adrenal gland

    • This question is part of the following fields:

      • Endocrinology
      7.1
      Seconds

  • Question 49 - In girls what is the first sign of puberty? ...

    Incorrect

    • In girls what is the first sign of puberty?

      Your Answer: Menarche

      Correct Answer: Breast development

      Explanation:

      The first sign of puberty in females is the development of breasts.

    • This question is part of the following fields:

      • Endocrinology
      35.3
      Seconds

  • Question 50 - Aromatase is key to Oestradiol production in the ovaries. Which of the following...

    Incorrect

    • Aromatase is key to Oestradiol production in the ovaries. Which of the following statements is true?

      Your Answer:

      Correct Answer: FSH induces the granulosa cells to make aromatase

      Explanation:

      The two main cell types of the ovaries:
      1. The theca cells produce androgen in the form of androstenedione. The theca cells are not able to convert androgen to oestradiol themselves. The produced androgen is therefore taken up by granulosa cells.
      2. The neighbouring granulosa cells then convert the androgen into oestradiol under the enzymatic action of aromatase FSH induces the granulosa cells to produce aromatase for this purpose

    • This question is part of the following fields:

      • Endocrinology
      0
      Seconds

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