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Question 1
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 2
Incorrect
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Aromatase is key to Oestradiol production in the ovaries. Which of the following statements is true?
Your Answer: Progesterone induces the granulosa 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
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Question 3
Incorrect
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What percentage of children does delayed puberty occur in?
Your Answer: 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 4
Correct
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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)
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This question is part of the following fields:
- Endocrinology
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Question 5
Correct
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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
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This question is part of the following fields:
- Endocrinology
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Question 6
Correct
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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.
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This question is part of the following fields:
- Endocrinology
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Question 7
Correct
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Question 8
Incorrect
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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.
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This question is part of the following fields:
- Endocrinology
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Question 9
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 10
Correct
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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
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This question is part of the following fields:
- Endocrinology
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Question 11
Correct
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Which of the following drugs is most appropriate to use to stimulate lactation?
Your Answer: Domperidone
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.
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This question is part of the following fields:
- Endocrinology
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Question 12
Incorrect
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All of the following organs are involved in oestrogen production except:
Your Answer: Adrenal glands
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.
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This question is part of the following fields:
- Endocrinology
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Question 13
Incorrect
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Oxytocin causes increased myometrial contraction via which of the following messenger pathways?
Your Answer: None of the above
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 14
Incorrect
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All of the following are autosomal recessive conditions EXCEPT which one?
Your Answer: Sickle Cell
Correct Answer: Osteogenesis Imperfecta
Explanation:Osteogenesis imperfect is an autosomal dominant condition. All the rest of the options are autosomal recessive conditions.
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This question is part of the following fields:
- Endocrinology
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Question 15
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 16
Incorrect
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What is the definition of premature menopause?
Your Answer: Menopause at or before 45 years of age
Correct 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.
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This question is part of the following fields:
- Endocrinology
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Question 17
Incorrect
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Which of the following drugs is associated with reduced milk production whilst breastfeeding?
Your Answer: Fluoxetine
Correct 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.
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This question is part of the following fields:
- Endocrinology
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Question 18
Incorrect
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In normal pregnancy, levels of all of the following hormones increases, EXCEPT:
Your Answer: Free cortisol
Correct Answer: FSH
Explanation:Hormones that increase during pregnancy and their roles:
- Human Chorionic Gonadotropin (hCG): Peaks between the eighth to tenth weeks of gestation and supports the corpus luteum to maintain progesterone production.
- Progesterone: Initially produced by the corpus luteum and later by the placenta, it rises steadily throughout pregnancy, suppressing the maternal immune response to fetal antigens and preparing the endometrium for implantation.
- Estrogen: Produced by the placenta from fetal and maternal precursors, estrogen levels increase to promote uterine growth and blood flow.
- Human Placental Lactogen (hPL): Rises significantly during pregnancy, influencing maternal metabolism by increasing insulin resistance and promoting lipolysis.
- Relaxin: Increases early in pregnancy to relax the uterine muscles, inhibit contractions, and prepare the cervix and pelvis for childbirth.
- Prolactin: Levels increase to prepare the breasts for lactation.
- Corticotropin-Releasing Hormone (CRH): Increases towards the end of pregnancy and is involved in the timing of labor.
- Adrenocorticotropic Hormone (ACTH): Levels increase, contributing to elevated cortisol levels during pregnancy.
- Total Thyroxine (T4): Levels increase due to elevated thyroid-binding globulin (TBG) production stimulated by increased estrogen levels, meeting the increased metabolic demands of pregnancy.
- Parathyroid Hormone (PTH): Levels increase to regulate calcium metabolism, ensuring adequate calcium for fetal bone development.
- Cortisol: Levels increase due to higher production by the adrenal glands and increased binding to cortisol-binding globulin (CBG), supporting glucose metabolism, managing stress, and aiding fetal development, particularly lung maturation.
During pregnancy, some hormones either remain stable or do not increase significantly. These include:
- Follicle-Stimulating Hormone (FSH): Levels decrease due to the negative feedback from high levels of estrogen and progesterone.
- Luteinizing Hormone (LH): Levels also decrease due to negative feedback from elevated estrogen and progesterone.
- Growth Hormone (GH): Although a variant of growth hormone (hGH-V) is produced by the placenta and increases, the maternal pituitary GH levels may not significantly increase.
- Melatonin: Generally remains stable during pregnancy, though some studies suggest there may be slight fluctuations.
- Insulin: While insulin resistance increases due to hPL and other factors, the actual levels of insulin may not increase proportionally; instead, pancreatic beta-cell function adapts to meet the increased demand.
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This question is part of the following fields:
- Endocrinology
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Question 19
Incorrect
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Which of the following hormones are required for alveolar morphogenesis during pregnancy?
Your Answer: Oestrogen and hPL
Correct 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.
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This question is part of the following fields:
- Endocrinology
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Question 20
Incorrect
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At ovulation the surge in LH causes rupture of the mature oocyte via action on what?
Your Answer:
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 21
Incorrect
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Regarding placental anatomy:
Your Answer:
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.
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This question is part of the following fields:
- Endocrinology
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Question 22
Incorrect
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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:
Correct 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 23
Incorrect
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Where is fetal DHEA produced?
Your Answer:
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.
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This question is part of the following fields:
- Endocrinology
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Question 24
Incorrect
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Question 25
Incorrect
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DHEA is synthesized from which molecule?
Your Answer:
Correct 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 26
Incorrect
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Where are ADH (vasopressin) and Oxytocin synthesised?
Your Answer:
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.
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This question is part of the following fields:
- Endocrinology
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Question 27
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:
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 28
Incorrect
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In relation to ovulation, when does the LH surge occur?
Your Answer:
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 29
Incorrect
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Beta and Delta Thalassemia are associated with abnormalities to which chromosome
Your Answer:
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
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This question is part of the following fields:
- Endocrinology
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Question 30
Incorrect
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Placental production of hPL, hCG, Oestrogen and Progesterone are examples of which type of mechanism
Your Answer:
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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SESSION STATS - PERFORMANCE PER SPECIALTY
