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Question 1
Correct
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Which one of the following will increase an individual’s appetite?
Your Answer: Ghrelin
Explanation:Ghrelin is a hormone which exerts a strong influence on hunger and energy balance. It helps regulate appetite by being secreted when the stomach is empty, to stimulate hunger. When the stomach is filled, its secretion stops.
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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 apical enzyme responsible for the oxidation and reaction of iodide with thyroglobulin is:
Your Answer: Thyroid peroxidise
Explanation:Thyroid peroxidase is an enzyme that is secreted into the thyroid colloid. It works by oxidizing iodide ions into iodine which are incorporated into thyroglobulin, in order to produce T3 and T4.
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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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A 14-year-old girl presents with short stature, webbed neck and primary amenorrhoea.Given the likely clinical diagnosis, which hormone replacement is most crucial over the longer term?
Your Answer: Oestrogen
Explanation:This girl most likely has Turner syndrome (TS) also known as 45,X, a condition in which a female is partly or completely missing an X chromosome. Signs and symptoms vary among those affected. Often, a short and webbed neck, low-set ears, low hairline at the back of the neck, short stature, and swollen hands and feet are seen at birth. Typically, they are without menstrual periods, do not develop breasts, and are unable to have children. Heart defects, diabetes, and low thyroid hormone occur more frequently. Most people with TS have normal intelligence. Many, however, have troubles with spatial visualization such as that needed for mathematics. Vision and hearing problems occur more often. Turner syndrome is not usually inherited from a person’s parents. No environmental risks are known and the mother’s age does not play a role. As a chromosomal condition, there is no cure for Turner syndrome. However, much can be done to minimize the symptoms including prescribing growth hormone, either alone or with a low dose of androgen, and oestrogen replacement therapy which is crucial long term for maintaining good bone integrity, cardiovascular health and tissue health
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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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Which of the following factors is most likely to lead to an increase in serum cortisol levels?
Your Answer: Severe emotional stress
Explanation:Cortisol is widely known as the stress hormone. Alterations in cortisol levels have been found in relation to mood disorders, illness, trauma, pain, fear, exertion, and anxiety, amongst other stimuli.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 5
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 6
Incorrect
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Where is Müllerian inhibiting substance (MIS) secreted?
Your Answer: Leydig cells
Correct Answer: Sertoli cells
Explanation:Müllerian inhibiting substance, also known as Anti-Müllerian hormone (AMH) or Müllerian-inhibiting hormone (MIH) is a glycoprotein hormone which prevents the development of the Müllerian ducts into the uterus. Its production by Sertoli cells continues during childhood in males and decreases after puberty.
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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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The actions of dihydrotestosterone in male reproductive physiology include:
Your Answer: Increase in muscle mass at puberty
Correct Answer: Development of external genitalia in utero and at puberty
Explanation:Dihydrotestosterone mediates the differentiation of the urogenital sinus and genital tubercles, leading to the fusion of the urethral and labial folds; thus, it leads to the development of external genitalia in the male.
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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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The febrile response to PGE2 will be impaired with the knockout of which one of the following prostaglandin receptors?
Your Answer: Ep1
Correct 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 9
Incorrect
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Which one of the following features is least associated with primary hyperparathyroidism?
Your Answer: Peptic ulceration
Correct 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 10
Correct
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In a newly diagnosed acromegaly patient, which of the following would you not expect to find?
Your 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 11
Incorrect
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What is the most common cause of primary hyperaldosteronism?
Your Answer: Adrenocortical adenoma
Correct Answer: Bilateral idiopathic adrenal hyperplasia
Explanation:Primary aldosteronism, also known as primary hyperaldosteronism or Conn’s syndrome, is excess production of the hormone aldosterone by the adrenal glands resulting in low renin levels. Primary hyperaldosteronism has a number of causes. About 66% of cases are due to enlargement of both adrenal glands and 33% of cases are due to an adrenal adenoma that produces aldosterone. Other uncommon causes include adrenal cancer and an inherited disorder called familial hyperaldosteronism
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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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The growth promoting protein anabolic effects of insulin are mediated by:
Your Answer: Igf-1
Correct Answer: Phosphatidylinositol 3-kinase
Explanation:Phosphatidylinositol 3-kinase or PI-3Ks are a group of enzymes which are involved in a number of different cellular functions. PI-3Ks interact with insulin and the insulin receptor substrate, regulating glucose uptake. They are an important element in the insulin signalling pathway.
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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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Compact/cortical bone makes up
Your Answer: The outer layer of most bones and accounts for 80% of bone in the body
Explanation:Cortical, lamellar, or compact bone, is more dense than spongy bone and it forms the rigid, outer layer of bones, also called cortex. It consists of packed osteons, with a central osteonic canal surrounded by concentric rings. Spaces called lacunae are filled with osteocytes, and channels called canaliculi go from the lacunae to the osteonic canal. The strength of cortical bone allows it to support the body and protect organs. It also stores different elements, such as calcium.
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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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Endotoxin will typically act on which one of the following cells, to produce endogenous pyrogens?
Your Answer: Neutrophils
Correct Answer: Monocytes
Explanation:Endotoxin, also known as lipopolysaccharides or lipoglycans, are molecules that consist of a lipid and a polysaccharide. They bind to many cell types, but especially to monocytes, promoting the secretion of proinflammatory cytokines, acting as a pyrogen.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 15
Correct
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Where does the pituitary gland lie?
Your 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 16
Correct
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What is the effect of vasopressin on the kidney?
Your Answer: Increase collecting duct permeability to water
Explanation:Vasopressin, also known as antidiuretic hormone or ADH, which increases water reabsorption in the kidney’s collecting ducts. It works by increasing water permeability in the collecting ducts and distal convoluted tubules. It induces the exocytosis of AQP-CD-laden vesicles, transferring water channels from intracellular vesicles to the apical plasma membrane, therefore allowing more water to be reabsorbed from the urine in the collecting ducts to the blood.
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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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What is the most important way in which heat is lost from the body?
Your Answer: Vaporisation of sweat
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 18
Correct
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Which glucose transporter is responsible for the uptake of glucose in ß cells?
Your 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 19
Incorrect
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What causes increased insulin sensitivity?
Your Answer: Growth hormone treatment
Correct Answer: Exercise
Explanation:Physical activity, through its effect on insulin sensitivity, is one of the main modifiable risk factors for type 2 diabetes. It is estimated that by each weekly 500 kcal increment in exercise related energy consumption, the lifetime risk of suffering from type 2 diabetes is reduced by 9%. Up to two hours after exercise, glucose uptake is elevated due to insulin independent mechanisms; however, insulin sensitivity remains increased for at least 16 hours after exercising.
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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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Physiological effects of T3 on the heart include all the following except:
Your Answer: Increased expression of β-myosin heavy chain gene
Explanation:Tri-iodothyronine, also known as T3, is a hormone which can affect almost every system in the human body. In the heart, it increases the number of β1-adrenergic receptors, enhances the response to circulating catecholamines, increases the proportion of α-myosin heavy chains in the atria, and increases the expression of serca pump gene.
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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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In the microanatomy of the pituitary gland, the pituicytes present are in fact modified forms of which cells?
Your Answer: Astrocytes
Explanation:Pituicytes are glial cells present in the pars nervosa, the posterior pituitary gland. Their irregular shape resembles that of astrocytes, and their cytoplasm also has intermediate filaments. They differ from astrocytes in that they have large cytoplasmic lipid droplets.
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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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In the menstrual cycle, ovulation is triggered by:
Your Answer: A pituitary LH surge due to the positive feedback effect of circulating oestrogens
Explanation:FSH and LH are secreted to start the development of a follicle at the start of each menstrual cycle. A surge in oestrogen causes a positive feedback in the LH cells of the pituitary; this causes ovulation.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 23
Correct
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Which cell secretes parathyroid hormone?
Your Answer: Chief cells
Explanation:Parathyroid chief cells, also known as parathyroid principal cells or parathyroid cells, are the most prevalent type of cell in the parathyroid gland and the only ones present at birth. They secrete parathyroid hormone (PTH).
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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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On which chromosome is the gene for insulin located?
Your Answer: Chromosome 11
Explanation:Humans have 23 pairs of chromosomes, and usually, two pairs of copies of chromosome 11. It is one of the most complex, gene-rich chromosomes in the human genome, and it is associated with a number of diseases. Studies have shown they the human insulin gene is located on the short arm of chromosome 11.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 25
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 26
Correct
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Which of the following biochemical profiles is seen in a normal 65 year old female? (in comparison to a normal 24 yr. old female)
Your Answer: Increased FSH, LH; decreased oestrogen, progesterone
Explanation:During menopause, a woman’s number of ovarian follicles becomes depleted; as a result, oestrogen and progesterone levels drop, and LH and FSH levels increase. One of the criteria to diagnose menopause is the absence of menstrual period for a year, along with a serum FSH level increased to 30 mIU/ml or higher. LH also rises with the onset of menopause.
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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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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: The α-subunits are not interchangeable
Correct 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 28
Incorrect
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Which of the following is least recognised as a potential complication of acromegaly?
Your Answer: Colorectal cancer
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 29
Correct
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What microscopic changes are visible in an active thyroid gland?
Your Answer: Follicle lining cells are cuboid or columnar.
Explanation:Active follicles are lined by cuboidal or columnar cells; this is because active follicles are smaller and have less colloid. Their cells are tall because they are actively secreting hormones, whereas older follicles have a flat epithelium and are filled with more colloid.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 30
Correct
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Where does the anterior pituitary receive most of its blood supply?
Your Answer: Portal hypophysial vessels
Explanation:The anterior pituitary receives its arterial supply from the superior hypophyseal artery, which is a branch of the internal carotid that forms a capillary around the hypothalamus; thus forming the hypothalamo-hypophysial portal system.
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This question is part of the following fields:
- Endocrinology
- Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY
