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Question 1
Correct
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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.
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This question is part of the following fields:
- Endocrinology
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Question 2
Correct
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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.
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This question is part of the following fields:
- Endocrinology
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Question 3
Correct
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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
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Question 4
Incorrect
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Oxytocin causes increased myometrial contraction via which of the following messenger pathways?
Your Answer: Releases cAMP that triggers intracellular Calcium ion release
Correct Answer: Activates phospholipase-C which produces IP3 which triggers intracellular Calcium ion release
Explanation:Oxytocin acts via the G protein receptors and the calcium-calmodulin complex. It activates phospholipase C which produces IP3 to further trigger the calcium-calmodulin complex increasing intracellular Ca ion release.
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This question is part of the following fields:
- Endocrinology
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Question 5
Incorrect
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Adult Polycystic Kidney Disease (PKD) typically follows which pattern of inheritance
Your Answer: Autosomal Recessive
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.
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This question is part of the following fields:
- Endocrinology
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Question 6
Incorrect
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What percentage of testosterone is bound to SHBG?
Your Answer: 30%
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.
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This question is part of the following fields:
- Endocrinology
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Question 7
Incorrect
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The ovaries produce androgen and progesterone. What is the common precursor for both of these hormones?
Your Answer: Sorbitol
Correct Answer: Cholesterol
Explanation:Cholesterol is the common precursor for progesterone and androgen production.
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This question is part of the following fields:
- Endocrinology
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Question 8
Incorrect
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At ovulation the surge in LH causes rupture of the mature oocyte via action on what?
Your Answer: Granulosa externa
Correct 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
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This question is part of the following fields:
- Endocrinology
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Question 9
Incorrect
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Which of the following inhibit Glucagon?
Your Answer: Cholecystokinin
Correct Answer: Uraemia
Explanation:Glucagon release is inhibited by increased blood glucose, ketones, free fatty
acids, insulin, raised urea levels and somatostatin. Glucagon is produced by alpha cells of the pancreas and increases the plasma glucose level by stimulating glycogenolysis and gluconeogenesis. -
This question is part of the following fields:
- Endocrinology
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Question 10
Correct
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Aromatase is key to Oestradiol production in the ovaries. Which of the following statements is true?
Your 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
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Question 11
Incorrect
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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
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This question is part of the following fields:
- Endocrinology
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Question 12
Incorrect
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Question 13
Correct
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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.
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This question is part of the following fields:
- Endocrinology
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Question 14
Correct
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Beta and Delta Thalassemia are associated with abnormalities to which chromosome
Your 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
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This question is part of the following fields:
- Endocrinology
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Question 15
Incorrect
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Question 16
Incorrect
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Which of the following is the primary stimulator of uterine involution following child birth?
Your Answer: Progesterone
Correct Answer: Oxytocin
Explanation:Oxytocin is the primary stimulus for uterine involution following childbirth.
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This question is part of the following fields:
- Endocrinology
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Question 17
Incorrect
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The ovaries produce androgen and progesterone. What is the common precursor for both of these hormones?
Your Answer: Glycerol
Correct 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.
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This question is part of the following fields:
- Endocrinology
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Question 18
Correct
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Human Chorionic Gonadotrophin (HCG) is structurally similar to which of the following hormones?
Your 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.
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This question is part of the following fields:
- Endocrinology
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Question 19
Correct
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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
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Question 20
Incorrect
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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).
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This question is part of the following fields:
- Endocrinology
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Question 21
Incorrect
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During the menstrual cycle which hormone typically reaches its peak level on day 21 (assuming a 28 day cycle)?
Your Answer: LH
Correct Answer: Progesterone
Explanation:LH, FSH and Oestrogen have their peaks just before ovulation on day 14 whereas progesterone peaks around day 21.
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This question is part of the following fields:
- Endocrinology
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Question 22
Incorrect
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Placental production of hPL, hCG, Oestrogen and Progesterone are examples of which type of mechanism
Your Answer: Autocrine
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.
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This question is part of the following fields:
- Endocrinology
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Question 23
Incorrect
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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: Polycystic Ovarian Syndrome
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.
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This question is part of the following fields:
- Endocrinology
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Question 24
Incorrect
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What is the definition of puberty in girls?
Your Answer: Development of pubic hair
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.
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This question is part of the following fields:
- Endocrinology
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Question 25
Incorrect
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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
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This question is part of the following fields:
- Endocrinology
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Question 26
Incorrect
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In relation to ovulation, when does the LH surge occur?
Your Answer: 1-2 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.
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This question is part of the following fields:
- Endocrinology
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Question 27
Incorrect
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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
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This question is part of the following fields:
- Endocrinology
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Question 28
Incorrect
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What percentage of children does delayed puberty occur in?
Your Answer: 0.10%
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.
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This question is part of the following fields:
- Endocrinology
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Question 29
Correct
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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: 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.
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This question is part of the following fields:
- Endocrinology
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Question 30
Incorrect
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Where is Glucagon produced?
Your Answer:
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.
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This question is part of the following fields:
- Endocrinology
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SESSION STATS - PERFORMANCE PER SPECIALTY
