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Question 1
Incorrect
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The TSH receptor produces its effects in the thyrocyte via:
Your Answer: A tyrosine kinase enzyme
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.
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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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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.
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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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Where is Müllerian inhibiting substance (MIS) secreted?
Your 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 4
Correct
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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.
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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 one of the following skin disorders is least commonly associated with hypothyroidism?
Your Answer: Pretibial myxoedema
Explanation:Pretibial myxoedema is an infiltrative dermopathy, resulting as a rare complication of Graves’ disease (hyperthyroidism) and very occasionally occurs in non-thyrotoxic Graves’ disease and Hashimoto’s thyroiditis.
Hypothyroidism typically presents with symptoms such as dry skin, brittle hair, and thinning of the outer third of the eyebrows. While skin conditions like dryness and hair changes are common in hypothyroidism due to reduced metabolic activity, acne is also not typically associated with it.
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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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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 7
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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Question 8
Correct
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Where is thyroglobulin produced?
Your Answer: Thyrocytes
Explanation:Thyroglobulin, or Tg, is a protein that functions as the precursor to thyroid hormones. It is synthesized by thyrocytes and then secreted into the colloid. It also functions as a negative-feedback regulator of thyroid hormone biosynthesis.
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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 will increase an individual’s appetite?
Your Answer: Leptin
Correct 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 10
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 11
Correct
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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.
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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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Which of the following stimulates glucagon release?
Your Answer: Ketones
Correct Answer: Exercise
Explanation:Studies have shown a small increase in glucagon levels during stress tests and exercise. This occurs in response to the reduction of blood glucose levels during physical activity; epinephrine levels are also a stimulus for the release of glucagon during exercise, since it suppresses insulin, which accounts for its stimulatory effects on glucagon. The use of stored fats for energy during exercise also stimulates the release of glucagon.
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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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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 14
Incorrect
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Select the correct statement about the microanatomy of the thyroid gland.
Your Answer: The parafollicular, or c cells, have no known function.
Correct Answer: The capillaries adjacent to thyroid cells have a fenestrated endothelium.
Explanation:Fenestrated capillaries have a very thin endothelium, which is perforated by numerous fenestrations or pores. Hormones are usually released into these capillaries, reaching their target cells through the circulatory system.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 15
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: They are produced by the same genes
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 16
Correct
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Where is leptin synthesized and secreted?
Your Answer: White adipose tissue
Explanation:Leptin is a hormone that helps regulate food intake and energy expenditure. It is synthetized by white adipose tissue and the gastric mucosa. It works by inhibiting the sensation of hunger, therefore, it opposes the actions of ghrelin, also known as the hunger hormone.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 17
Correct
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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.
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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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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.
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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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Which of the following values of bone mineral density measured by DEXA would signify osteopenia?
Your Answer: T score of -2.8
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
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 20
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 21
Correct
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What is the most common cause of primary hyperaldosteronism?
Your 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 22
Incorrect
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Which of the following stimuli increase growth hormone secretion?
Your Answer: Insulin-like growth factor I (IGF-I)
Correct 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.
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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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What is the most important source of heat production in the body?
Your Answer: Skeletal muscle contraction
Explanation:Thermogenesis is the process by which organisms produce heat. Through skeletal muscle contraction, or shivering, ATP is converted into kinetic energy, some of which converts into heat. These muscle contractions produce about 70% of total body heat.
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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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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.
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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 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.
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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 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 27
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 28
Incorrect
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In the menstrual cycle, ovulation is triggered by:
Your Answer: A pituitary LH surge due to due to an increase in GNRH pulses from the supraoptic nucleus in the hypothalamus
Correct 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 29
Correct
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Which of the following hormones cause negative feedback on the CRH/ACTH axis?
Your 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.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 30
Incorrect
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Choose the most correct missing words to complete the statement: A portion of circulating growth hormone is bound to the ____ receptor and activates the ____ pathway that mediates its effect.
Your Answer: Igf ii, jak 2stat
Correct Answer: Growth hormone receptor (extracellular domain), jak 2stat
Explanation:The growth hormone receptor is a transmembrane protein involved in the STATs, MAPK and PI3-kinase/Akt pathways. The JAK-STAT signalling pathway is activated by different ligands, such as growth hormone, interferon and interleukin. This pathway is involved in the expression of genes associated with oncogenesis, immunity, proliferation, differentiation and apoptosis. Errors in these pathways can produce leukaemia’s and other myeloproliferative disorders.
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This question is part of the following fields:
- Endocrinology
- Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY
