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  • Question 1 - In girls what is the first sign of puberty? ...

    Correct

    • In girls what is the first sign of puberty?

      Your 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
      8
      Seconds

  • Question 2 - Hirsutism can be found in all of the following conditions, EXCEPT: ...

    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
      15.2
      Seconds

  • Question 3 - Placental production of hPL, hCG, Oestrogen and Progesterone are examples of which type...

    Correct

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

      Your 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
      57.6
      Seconds

  • Question 4 - 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
      13
      Seconds

  • Question 5 - Regarding placental anatomy: ...

    Incorrect

    • Regarding placental anatomy:

      Your Answer: The intervillous space contains fetal blood

      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
      18.7
      Seconds

  • Question 6 - Which of the following is the primary stimulator of uterine involution following child...

    Correct

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

      Your 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
      6.7
      Seconds

  • Question 7 - 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
      21.7
      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
      22.3
      Seconds

  • Question 9 - 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
      4.9
      Seconds

  • Question 10 - 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
      11.9
      Seconds

  • Question 11 - Which of the following causes an increase in Sex Hormone Binding Globulin (SHBG)?...

    Correct

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

      Your 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
      19.6
      Seconds

  • Question 12 - What is the definition of puberty in girls? ...

    Correct

    • What is the definition of puberty in girls?

      Your 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
      9.6
      Seconds

  • Question 13 - What is the most common cause of premature menopause in the UK? ...

    Correct

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

      Your Answer: Idiopathic

      Explanation:

      Premature menopause is most commonly idiopathic.

    • This question is part of the following fields:

      • Endocrinology
      66.5
      Seconds

  • Question 14 - Raised FSH levels are found in all of the following conditions, EXCEPT: ...

    Correct

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

      Your 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
      27
      Seconds

  • Question 15 - 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:

      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
      9.7
      Seconds

  • Question 16 - Which of the following statements regarding prolactin is true? ...

    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
      16.7
      Seconds

  • Question 17 - 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
      31.6
      Seconds

  • Question 18 - All of the following are autosomal recessive conditions EXCEPT which one? ...

    Correct

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

      Your 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
      42.8
      Seconds

  • Question 19 - Which of the following changes would you expect in pregnancy? ...

    Incorrect

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

      Your Answer: Increased TSH, Increased 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
      23.7
      Seconds

  • Question 20 - 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:

      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
      10.5
      Seconds

  • Question 21 - 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
      30.4
      Seconds

  • Question 22 - What percentage of testosterone is bound to SHBG? ...

    Correct

    • What percentage of testosterone is bound to SHBG?

      Your 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
      4.4
      Seconds

  • Question 23 - 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
      10.3
      Seconds

  • Question 24 - 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: FSH induces the theca cells to make aromatase

      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
      113.9
      Seconds

  • Question 25 - Where are ADH (vasopressin) and Oxytocin synthesised? ...

    Correct

    • Where are ADH (vasopressin) and Oxytocin synthesised?

      Your 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
      7.2
      Seconds

  • Question 26 - A 32 year old woman with a 6 month history of fatigue and...

    Correct

    • 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.

    • This question is part of the following fields:

      • Endocrinology
      28.6
      Seconds

  • Question 27 - At ovulation the surge in LH causes rupture of the mature oocyte via...

    Incorrect

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

      Your Answer: Granulosa interna

      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

    • This question is part of the following fields:

      • Endocrinology
      20.4
      Seconds

  • Question 28 - What is the role of DHEA produced by the fetal adrenal glands? ...

    Incorrect

    • What is the role of DHEA produced by the fetal adrenal glands?

      Your Answer: Stimulate gonadal development of the foetus

      Correct Answer: Stimulate placenta to form oestrogen

      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
      37.1
      Seconds

  • Question 29 - All the following hormones are products of placental synthesis, EXCEPT: ...

    Correct

    • All the following hormones are products of placental synthesis, EXCEPT:

      Your Answer: Prolactin

      Explanation:

      The metabolic adaptations of pregnancy are orchestrated by hormones produced by the placenta and maternal pituitary gland, which undergo dramatic changes during gestation. After involution of ovarian sex steroid production by wk 6, placental oestrogen and progesterone production increases exponentially to term. Concurrently, there are progressive increases in prolactin (PRL), produced by the maternal pituitary gland and decidua, and human chorionic somatomammotropin (CSH, also called human placental lactogen), which has structural similarities to GH and PRL.

    • This question is part of the following fields:

      • Endocrinology
      6.6
      Seconds

  • Question 30 - Gonadotropin-releasing hormone (GnRH) stimulates the release of: ...

    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
      14.4
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Endocrinology (25/30) 83%
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