-
Question 1
Incorrect
-
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.
-
This question is part of the following fields:
- Endocrinology
-
-
Question 2
Correct
-
Placental production of hPL, hCG, Oestrogen and Progesterone are examples of which type of mechanism
Your Answer: Endocrine
Explanation:Endocrine hormones are released from their site of origin and travel through the blood to act on other distant target organs. Autocrine hormones act within the same cell and exocrine glands secrete their products into ducts.
-
This question is part of the following fields:
- Endocrinology
-
-
Question 3
Incorrect
-
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.
-
This question is part of the following fields:
- Endocrinology
-
-
Question 4
Incorrect
-
All of the following are autosomal recessive conditions EXCEPT which one?
Your Answer: Cystic Fibrosis
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
-
-
Question 5
Correct
-
Gonadotropin-releasing hormone (GnRH) stimulates the release of:
Your Answer: Luteinizing hormone
Explanation:Gonadotropin-releasing hormone (GnRH) is the hormone responsible for the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary gland.
-
This question is part of the following fields:
- Endocrinology
-
-
Question 6
Incorrect
-
Which of the following causes an increase in Sex Hormone Binding Globulin (SHBG)?
Your Answer: PCOS
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
-
-
Question 7
Incorrect
-
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: Morning urinary cortisol
Correct 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
-
-
Question 8
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
-
-
Question 9
Correct
-
Question 10
Correct
-
What is the definition of premature menopause?
Your 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
-
-
Question 11
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
-
-
Question 12
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
-
-
Question 13
Incorrect
-
Regarding placental anatomy:
Your Answer: The decidua capsularis forms part of the placenta
Correct 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
-
-
Question 14
Correct
-
Which of the following statements regarding prolactin is true?
Your 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
-
-
Question 15
Incorrect
-
Where is fetal DHEA produced?
Your Answer: Hypothalamus
Correct 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
-
-
Question 16
Correct
-
High levels of alpha feto protein are found in all, EXCEPT?
Your 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
-
-
Question 17
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
-
-
Question 18
Correct
-
Where is fetal DHEA produced?
Your 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
-
-
Question 19
Correct
-
Prognathism and macroglossia are features of which of the following?
Your 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
-
-
Question 20
Correct
-
Which of the following hormones are required for alveolar morphogenesis during pregnancy?
Your Answer: Progesterone, Prolactin and hPL
Explanation:The changes seen in breast tissue with the menstrual cycle are accentuated during pregnancy. Deposition of fat around glandular tissue occurs, and the number of glandular ducts is increased by oestrogen, while progesterone and human placental lactogen (hPL) increase the number of gland alveoli. Prolactin is essential for the stimulation of milk secretion and during pregnancy prepares the alveoli for milk production. Although prolactin concentration increases throughout pregnancy, it does not then result in lactation since it is antagonized at an alveolar receptor level by oestrogen.
-
This question is part of the following fields:
- Endocrinology
-
-
Question 21
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
-
-
Question 22
Incorrect
-
All of the following organs are involved in oestrogen production except:
Your Answer: Placenta
Correct Answer: Anterior pituitary
Explanation:Oestrogen can be produced by variety of organs including the corpus leuteum, placenta, adrenal glands and testes. However it is not produced by the anterior pituitary. The anterior pituitary produces LH and FSH which in turn causes oestrogen secretion.
-
This question is part of the following fields:
- Endocrinology
-
-
Question 23
Correct
-
Hirsutism can be found in all of the following conditions, EXCEPT:
Your Answer: Patient on oral contraceptive pills
Explanation:Classically, hirsutism has been considered a marker of increased androgen levels in females from increased production of androgens (i.e. testosterone) either by the adrenals or due to an ovarian disease. The ovarian causes for hyperandrogenism are polycystic ovarian syndrome (PCOS) and ovarian tumours. Adrenal causes include Cushing’s syndrome, androgen-producing tumours, and congenital adrenal hyperplasia (CAH), most commonly due to 21-hydroxylase deficiency. Less common causes include the hyperandrogenic-insulin resistant-acanthosis nigricans syndrome (HAIRAN). Hyperprolactinemia by increasing adrenal dehydroepiandrosterone sulphate (DHEA-S) production may cause hirsutism. Androgenic drugs are also an important cause of hirsutism. About 20% of the patients may present with idiopathic hirsutism (IH) with normal androgen levels and ovarian function. The cause of increased hair in these women is thought to be related to disorders in peripheral androgen activity. Onset of IH occurs shortly after puberty with slow progression. PCOS and IH account for 90% of the hirsutism in women. Hirsutism can also occur in some premenopausal women and continue for a few years after menopause. This is due to decrease in ovarian oestrogen secretion with continuous androgen production.
-
This question is part of the following fields:
- Endocrinology
-
-
Question 24
Correct
-
Question 25
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
-
-
Question 26
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
-
-
Question 27
Incorrect
-
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.
-
This question is part of the following fields:
- Endocrinology
-
-
Question 28
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 Osteoporosis
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
-
-
Question 29
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: 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.
-
This question is part of the following fields:
- Endocrinology
-
-
Question 30
Correct
-
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.
-
This question is part of the following fields:
- Endocrinology
-
SESSION STATS - PERFORMANCE PER SPECIALTY
