-
Question 1
Correct
-
In which of the following are the enzymatic mechanisms for producing aldosterone found?
Your Answer: Zona glomerulosa
Explanation:The zona glomerulosa is the outermost layer of the adrenal gland. In it, aldosterone is secreted as a response to an increase in potassium levels, decreased blood flow, or renin. This secretion is regulated by the renin-angiotensin system.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 2
Incorrect
-
The febrile response to PGE2 will be impaired with the knockout of which one of the following prostaglandin receptors?
Your Answer: Ep2
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.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 3
Correct
-
Which of the following features is least commonly seen in Gitelman’s syndrome?
Your Answer: Hypertension
Explanation:Gitelman syndrome is an autosomal recessive kidney disorder characterized by hypokalaemia metabolic alkalosis with hypocalciuria, and hypomagnesemia. In contrast to patients with Gordon’s syndrome, those suffering from Gitelman’s syndrome are generally normotensive or hypotensive.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 4
Correct
-
An important hormone controlling the differentiation of monocytes to osteoclasts, by inhibiting the RANKL/ RANK interaction is called?
Your Answer: Osteoprotegerin
Explanation:Osteoprotegerin, also known as osteoclastogenesis inhibitory factor (OCIF) is a glycoprotein that acts as a cytokine receptor. It works as a decoy receptor for the receptor activator of nuclear factor-kappaB ligand (RANKL)/osteoclast differentiation factor, thus inhibiting the differentiation of osteoclasts, which are capable of resorbing bone. Osteoprotegerin has been proposed as a therapeutic agent for osteoporosis.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 5
Correct
-
As assessed by immunocytochemistry and electron microscopy, the anterior pituitary gland contains how many different types of cells?
Your Answer: 5
Explanation:The pituitary is divided into three sections
-the anterior lobe which constitute the majority of the pituitary mass and is composed primarily of five hormone-producing cell types (thyrotropes, lactotropes, corticotropes, somatotropes and gonadotropes) each secreting thyrotropin, prolactin, ACTH, growth hormone and gonadotropins (FSH and LH) respectively.
There is also a sixth cell type in the anterior lobe -the non-endocrine, agranular, folliculostellate cells.
The intermediate lobe produces melanocyte-stimulating hormone and endorphins, whereas the posterior lobe secretes anti-diuretic hormone (vasopressin) and oxytocin.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 6
Correct
-
In terms of relative steroid potency, how much prednisone is equivalent to 100mg hydrocortisone?
Your Answer: 25mg
Explanation:Different corticosteroids have varying degrees of potency. 1 mg of prednisone is equivalent to 4 mg of hydrocortisone. Therefore, 25 mg of prednisone are equivalent to 100 mg of hydrocortisone.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 7
Correct
-
Where do the portal hypophysial vessels arise?
Your Answer: Median eminence
Explanation:The hypothalamic-hypophysial portal system connects the brain to the anterior pituitary. It is made up of two capillary beds, one in the median eminence and the other in the anterior pituitary. Blood from the plexus of the median eminence is carried by portal veins, draining into the cavernous and posterior intercavernous sinuses. This system delivers hypothalamic hormones to their target cells.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 8
Correct
-
The actions of dihydrotestosterone in male reproductive physiology include:
Your 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.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 9
Correct
-
To which of the following plasma proteins is T4 most bound in plasma?
Your Answer: Thyroxine-binding globulin
Explanation:Thyroxine-binding globulin, also known as TBG, is one of the three transport proteins responsible for carrying T4 and T3 through the circulatory system. It carries most of the T4 present in plasma, which it binds to strongly, shielding the hydrophobic hormones from the aqueous surroundings.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 10
Correct
-
Which of the following increase insulin secretion?
Your Answer: Sulfonylureas
Explanation:Sulfonylureas are a type of antidiabetic drug used to treat diabetes mellitus type 2. Their main mechanism of action is producing a rise in plasma insulin levels, through stimulation of insulin secretion and a decrease in hepatic clearance of insulin. Sulfonylureas include gliclazide, glipizide, glibenclamide and glimepiride.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 11
Incorrect
-
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
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 12
Correct
-
Endotoxin will typically act on which one of the following cells, to produce endogenous pyrogens?
Your 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.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 13
Correct
-
Which of the following stimuli increase growth hormone secretion?
Your Answer: Ghrelin
Explanation:Ghrelin is a hormone which serves as an endogenous ligand for the growth hormone secretagogue receptor. It acts on the pituitary and the hypothalamus by affecting the vagus nerve. It acts on the somatotrophs of the anterior pituitary, GHRH-secreting neurons, and on GHIH-secreting neurons in the hypothalamus, causing a time-dependent and pulsatile stimulation over the secretion of growth hormone.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 14
Correct
-
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.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 15
Correct
-
Which of the following cells secrete glucagon?
Your Answer: A cells
Explanation:Glucagon counteracts hypoglycaemia and opposes insulin by promoting gluconeogenesis and glycogenolysis. It also decreases fatty acid synthesis in the liver and adipose tissue, and promotes lipolysis. It is secreted by the pancreatic islet α-cells. Its production is regulated by the insulin produced in β-cells.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 16
Incorrect
-
Which of the following values of bone mineral density measured by DEXA would signify osteopenia?
Your Answer: T score of -0.9
Correct Answer: T score of -2.2
Explanation:DEXA T Scores:Normal T-score ≥ −1.0Osteopenia −2.5 < T-score < −1.0Osteoporosis T-score ≤ −2.5Severe osteoporosis T-score ≤ −2.5 with fragility fracture
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 17
Incorrect
-
The TSH receptor produces its effects in the thyrocyte via:
Your Answer: A nuclear receptor that dimerizes with the retinoid x receptor
Correct Answer: G-protein coupled activation of adenylyl cyclise and phospholipase c
Explanation:The thyrotropin receptor, also known as TSH receptor, responds to the thyroid stimulating hormone or thyrotropin to stimulate production of T3 and T4. It is a G protein-coupled receptor which leads to stimulation of phospholipase C and adenylyl cyclase, mediated by Gq/11 and Gs.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 18
Correct
-
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.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 19
Incorrect
-
Select a factor which stimulates glucagon secretion.
Your Answer: Somatostatin
Correct Answer: Protein meal
Explanation:Several studies have shown that glucagon levels are increased in individuals with a high protein diet. It is still debated, however, whether this type of diet affects insulin levels as well.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 20
Correct
-
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.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 21
Incorrect
-
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.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 22
Incorrect
-
Which of the following structures lie in close proximity to the thyroid?
Your Answer: 2 pairs of parathyroid glands.
Correct Answer: All of the options
Explanation:The thyroid gland receives its blood supply from the inferior and superior thyroid arteries. The recurrent laryngeal nerves emerges from the superior thoracic outlet bounded in part by the thyroid lobe. Two pairs of parathyroid glands lie near the thyroid. The common carotid artery splits into its external and internal branches at the upper border of the thyroid cartilage; these branches are separated by the gland.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 23
Incorrect
-
Which of the following hormones cause negative feedback on the CRH/ACTH axis?
Your Answer: All of the options
Correct Answer: Cortisol
Explanation:The hypothalamic–pituitary–adrenal axis, also known as HPA axis is a set of interactions that regulate the secretion of several hormones through negative feedback. Cortisol, for example, is produced by the adrenal cortex, binds to its receptors in the hypothalamus and adenohypophysis and inhibits secretion of corticotropin releasing hormone (CRH) and adrenocorticotropic hormone (ACTH). The drop in CRH secretion leads to a decrease in ACTH secretion, which in turn causes less cortisol to be secreted.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 24
Incorrect
-
Which one of the following is not part of the WHO diagnostic criteria for the metabolic syndrome?
Your Answer: High triglycerides
Correct Answer: High LDL
Explanation:The World Health Organization 1999 criteria require the presence of any one of diabetes mellitus, impaired glucose tolerance, impaired fasting glucose or insulin resistance, AND two of the following:
- Blood pressure: ≥ 140/90 mmHg
- Dyslipidaemia: triglycerides (TG): ≥ 1.695 mmol/L and high-density lipoprotein cholesterol (HDL-C) ≤ 0.9 mmol/L (male), ≤ 1.0 mmol/L (female)
- Central obesity: waist: hip ratio > 0.90 (male); > 0.85 (female), or body mass index > 30 kg/m2
- Microalbuminuria: urinary albumin excretion ratio ≥ 20 µg/min or albumin: creatinine ratio ≥ 30 mg/g
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 25
Correct
-
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.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 26
Correct
-
Which one of the following leads to decreased prolactin levels?
Your Answer: Dopamine
Explanation:Dopamine has an important effect on the regulation of prolactin secretion. Dopamine binds to type-2 dopamine receptors of the lactotroph cells that are functionally linked to membrane channels and G proteins and suppresses the high secretory activity of the pituitary lactotrophs.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 27
Correct
-
During bone growth-the epiphysis are separated from the diaphysis by actively proliferating cartilage known as:
Your Answer: Epiphysial plate
Explanation:The epiphysial plate, physis, or growth plate, is a hyaline cartilage plate located near the ends of long bones; it consists of growing tissue. It is found in children and teenagers; in adults, it is replaced by an epiphysial line or epiphysial closure. The epiphysial plate is divided into zones: zone of reserve, proliferation, maturation and hypertrophy, calcification, and ossification.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 28
Correct
-
The net effect of parathyroid hormone on calcium and phosphate homeostasis is?
Your Answer: Increase in Ca, decrease in phosphate
Explanation:Parathyroid hormone’s main target organs are the kidneys, bone, and intestine. In the kidney, it decreases reabsorption of phosphate and increases calcium reabsorption. It also promotes absorption of calcium from bone. PTH release results in a small drop in serum phosphate concentrations.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 29
Correct
-
What is the effect of oxytocin on the breast?
Your Answer: Milk ejection
Explanation:Oxytocin is a peptide hormone and neuropeptide, produced by the hypothalamus and released by the posterior pituitary. It causes the milk ejection or let-down reflex, causing the milk to be transported to the subareolar sinuses, allowing it to be released through the nipple. This response is initiated by the act of suckling by the baby, but it can be conditioned to be triggered by different stimuli.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 30
Correct
-
Which of the following may be a feature of primary hyperaldosteronism?
Your Answer: Muscular weakness
Explanation:Primary hyperaldosteronism or Conn’s syndrome is characterised by hypertension which may cause poor vision or headaches. Occasionally there may be muscular weakness, muscle spasms, tingling sensations, or excessive urination. Complications include cardiovascular disease such as stroke, myocardial infarction, kidney failure, and abnormal heart rhythms.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 31
Correct
-
Which enzyme is responsible for the conversion of testosterone to dihydrotestosterone?
Your Answer: 5α-reductase
Explanation:The enzyme 5α-reductase synthesizes DHT from testosterone in the prostate, testes, hair follicles, and adrenal glands. This enzyme reduces the 4,5 double-bond of the testosterone. Relative to testosterone, DHT is much more potent as an agonist of the androgen receptor.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 32
Correct
-
What is the fat called that serves as a considerable source of heat in children?
Your Answer: Brown adipose tissue
Explanation:Brown adipose tissue, also known as BAT or brown fat, coforms the adipose tissue along with white adipose tissue (WAT) or white fat. While WAT is responsible for energy-storage, BAT is involved in thermogenesis and energy expenditure. It is more prevalent in children than in adults, and its activation during adolescence is associated to less weight gain and adiposity. BAT produces heat by non-shivering thermogenesis.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 33
Correct
-
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.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 34
Correct
-
Which of the following is not a feature of Liddle’s syndrome?
Your Answer: Autosomal recessive inheritance
Explanation:Liddle’s syndrome is a rare autosomal dominant condition characterized by early, and frequently severe, high blood pressure associated with low plasma renin activity, metabolic alkalosis, low blood potassium, and normal to low levels of aldosterone. Liddle syndrome involves abnormal kidney function, with excess reabsorption of sodium and loss of potassium from the renal tubule, and is treated with a combination of low sodium diet and potassium-sparing diuretic drugs (e.g., amiloride).
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 35
Correct
-
Which of the following is least recognised as a potential complication of acromegaly?
Your 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
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 36
Incorrect
-
Which one of the following makes up most of the adrenal cortex?
Your Answer: Zona glomerulosa
Correct Answer: Zona fasciculata
Explanation:The zona fasciculata represents the widest area of the adrenal cortex, situated in the middle of the cortex. It produces glucocorticoids including; 11-deoxycorticosterone, corticosterone, and cortisol.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 37
Incorrect
-
Select the correct statement regarding the macro anatomy of the thyroid gland.
Your Answer: It arises embryologically from the 3rd and 4th brachial pouches.
Correct Answer: It surrounds the trachea at the front of the neck.
Explanation:The thyroid is located around the trachea, in the anterior portion of the neck. It is formed by two lobes which are connected by an isthmus. The presence of a pyramidal lobe, or third lobe, is considered to be a normal anatomical variant. It originates from the primitive pharynx and the neural crest and has a rich vascular supply.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 38
Incorrect
-
Which of the following describes a principal action of insulin?
Your Answer: Inhibition of protein degradation
Correct 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.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 39
Correct
-
What is the most abundant hormone release by the thyroid?
Your Answer: T4
Explanation:T3 and T4 are the two tyrosine-based hormones produced and secreted by the thyroid gland. Although T3 is the active form of the hormone, and thus, it is much more potent; T4 is the most abundant hormone secreted by the thyroid (93% of the total thyroid secretion) and it also has a longer half life since it binds to proteins much more strongly.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
-
Question 40
Correct
-
Calcium is transported over the brush border in the gut, via which transporter / channel?
Your Answer: TRPV 6
Explanation:Transient Receptor Potential Vanilloid 6 or TRPV 6 is a calcium channel located in the cell membrane which is present in a variety of organs, including small intestine, oesophagus, stomach, colon, placenta, kidney, and uterus. In the intestine, it is located in the apical brush-border membrane of the enterocyte, regulating the entry of calcium into the cell.
-
This question is part of the following fields:
- Endocrinology
- Medicine
-
SESSION STATS - PERFORMANCE PER SPECIALTY
