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Question 1
Incorrect
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Which of the following values of bone mineral density measured by DEXA would signify osteopenia?
Your Answer: Z score of -2.0
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 2
Incorrect
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The residual cleft of the intermediate lobe of the pituitary is lined by follicles resembling which human gland?
Your Answer: Parathyroid
Correct Answer: Thyroid
Explanation:The cells located between the two main pituitary lobes form what is known as the intermediate pituitary. This area secretes melanocyte-stimulating hormone and it is only a few cell layers thick. It is rich in follicles filled with colloid, and lined by basophilic cells. This configuration resembles that of another important gland: the thyroid.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 3
Incorrect
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Where is Müllerian inhibiting substance (MIS) secreted?
Your Answer: Zona glomerulosa
Correct 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
Incorrect
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Where does the anterior pituitary receive most of its blood supply?
Your Answer: Suprachiasmatic nucleus
Correct 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 5
Incorrect
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Which of the following stimulates glucagon release?
Your Answer: Somatostatin
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 6
Incorrect
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Phosphate absorption in the proximal tubules is via which transporting molecule?
Your Answer: TRPV 6
Correct Answer: Na/Pi co transporter
Explanation:Sodium/phosphate cotransporters are located in the renal proximal tubular brush border, and are the key elements in proximal tubular phosphate reabsorption and phosphate homeostasis.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 7
Incorrect
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Which one of the following is most likely to be seen in a patient with multiple endocrine neoplasia (MEN) type I?
Your Answer: Medullary thyroid carcinoma
Correct Answer: Insulinoma
Explanation:Multiple endocrine neoplasia type 1 (MEN-1 syndrome) or Wermer’s syndrome is part of a group of disorders, the multiple endocrine neoplasias, that affect the endocrine system through development of neoplastic lesions in the ‘three P’s’:Parathyroid (>90%): hyperparathyroidism due to parathyroid hyperplasiaPituitary (15-42%)Pancreas (60-70%, e.g. insulinoma, gastrinoma)
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 8
Incorrect
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What is the most important way in which heat is lost from the body?
Your Answer: Urination
Correct Answer: Radiation and conduction
Explanation:The body maintains a constant core temperature by balancing heat loss and heat gain. The mechanisms of heat loss are: radiation, evaporation, convection and conduction. Out of these mechanisms, the most important under normal conditions are radiation, through which body heat is given off to the surrounding atmosphere; and conduction, in which the body releases heat into the objects it comes into contact with.
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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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What is the effect of vasopressin on the kidney?
Your Answer: Increase collecting duct permeability to sodium and chloride
Correct 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.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 10
Incorrect
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Which one of the following leads to decreased prolactin levels?
Your Answer: Oestrogens
Correct 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.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 11
Incorrect
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Which one of the following features is least associated with primary hyperparathyroidism?
Your Answer: Renal calculi
Correct Answer: Sensory loss
Explanation:The signs and symptoms of primary hyperparathyroidism are those of hypercalcemia. They are classically summarized by stones, bones, abdominal groans, thrones and psychiatric overtones.
Stones refers to kidney stones, nephrocalcinosis, and diabetes insipidus (polyuria and polydipsia). These can ultimately lead to renal failure.
Bones refers to bone-related complications: osteitis fibrosa cystica, osteoporosis, osteomalacia, and arthritis.
Abdominal groans refers to gastrointestinal symptoms of constipation, indigestion, nausea and vomiting. Hypercalcemia can lead to peptic ulcers and acute pancreatitis.
Thrones refers to polyuria and constipation
Psychiatric overtones refers to effects on the central nervous system. Symptoms include lethargy, fatigue, depression, memory loss, psychosis, ataxia, delirium, and coma.
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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 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.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 13
Incorrect
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Embryologically the anterior pituitary is formed from?
Your Answer: Neural crest cells
Correct Answer: Rathkes pouch
Explanation:The ectoderm, located in the roof of the pharynx, forms Rathke’s pouch, which comes into contact with the ectoderm of the developing brain. The pouch eventually separates from the pharynx, becoming the anterior pituitary.
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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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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
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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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Which of the following structures lie in close proximity to the thyroid?
Your Answer: The common carotid arteries.
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.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 16
Incorrect
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Which glucose transporter is responsible for the uptake of glucose in ß cells?
Your Answer: GLUT 4
Correct 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.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 17
Incorrect
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Which hormone is associated with the temperature surge in hot flushes?
Your Answer: FSH
Correct Answer: LH
Explanation:Luteinizing hormone or LH is a hormone produced by the anterior pituitary gland. Studies have shown surges in LH levels during menopausal hot flushes, suggesting that a pulsatile release of LH is responsible for increased hypothalamic norepinephrine activity, causing the hot flushes.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 18
Incorrect
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Which of the following is not a feature of Liddle’s syndrome?
Your Answer: Hypertension
Correct 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).
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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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To which of the following plasma proteins is T4 most bound in plasma?
Your Answer: Retinal-binding globulin
Correct 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.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 20
Correct
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The onset of puberty is triggered by
Your Answer: Increase in pulsatile GNRH secretion from hypothalamus
Explanation:The onset of puberty is associated with high GNRH pulsing, which precedes the rise in sex hormones. Brain tumours which increase GNRH output may also lead to premature puberty. The cause of the GNRH rise is unknown.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 21
Incorrect
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What is pendrin?
Your Answer: Na+/i- symporter
Correct Answer: Cl-/i- antiporter
Explanation:Pendrin is an anion exchange transporter; it is a sodium-independent chloride-iodine exchanger which also accepts formate and bicarbonate. It is present in many different types of cells in the body, particularly the inner ear, thyroid, and kidney. Mutations in pendrin are associated with Pendred syndrome, which causes syndromic deafness and thyroid disease.
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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 forms one of the characteristic and functional cells making up the anterior pituitary gland?
Your Answer: Astrocyte
Correct Answer: Corticotrope
Explanation:The anterior pituitary, also known as adenohypophysis or pars anterior contains the following types of cells: – acidophil cells: somatotroph cells, which produce growth hormone; and lactotrophs, which produce prolactin- basophil cells: corticotropes, which produce adrenocorticotropic hormone; thyrotropes, which produce thyroid stimulating hormone; and – gonadotrophs, which produce luteinizing hormone and follicle stimulating hormone.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 23
Incorrect
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Which of the flowing plasma proteins has the greatest affinity for T4?
Your Answer: Transferrin
Correct Answer: Thyroxin-binding globulin
Explanation:There are three principal plasma thyroid hormone-binding proteins, thyroxine-binding globulin (TBG), transthyretin (TTR), and albumin. TBG is synthesized in the liver and due to its relatively high affinity for iodothyronines, binds and carries approximately 70–75% of circulating T4 and T3.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 24
Incorrect
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Which cells secrete insulin?
Your Answer: Hepatocytes
Correct Answer: B cells of the pancreatic islets
Explanation:Insulin is synthesised and stored by the B cells of the pancreatic islets (70% of islet cells), glucagon is synthesised and stored in the A cells (20%) and somatostatin is synthesised and stored in the D cells (10%).
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 25
Incorrect
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Which are the main hormones secreted by the posterior pituitary gland.
Your Answer: Oxytocin and prolactin
Correct Answer: Oxytocin and vasopressin
Explanation:The posterior pituitary gland secretes oxytocin and vasopressin (antidiuretic hormone). These hormones are stored in Herring bodies before being secreted into the bloodstream.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 26
Incorrect
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Which hormone secreting cell of the human anterior pituitary gland secretes growth hormone?
Your Answer: Lactotroph
Correct Answer: Somatotroph
Explanation:Somatotroph cells are responsible for the production of growth hormone. Somatotrophs occupy nearly 40% of the total surface area of the anterior pituitary, and they are acidophilic in nature.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 27
Incorrect
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Within the hypothalamus, the dopamine-secreting neurones of the intrahypothalamic system have their cell bodies in which nuclei?
Your Answer: Paraventricular
Correct Answer: Arcuate
Explanation:Arcuate nucleus dopaminergic neurons consist of a single group of neurons that project to the median eminence where they release dopamine into the hypophyseal portal circulation to inhibit pituitary prolactin secretion.
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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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Compact/cortical bone makes up
Your Answer: The middle layer of most bones and accounts for 100% of bone in the body
Correct Answer: The outer layer of most bones and accounts for 80% of bone in the body
Explanation:Cortical, lamellar, or compact bone, is more dense than spongy bone and it forms the rigid, outer layer of bones, also called cortex. It consists of packed osteons, with a central osteonic canal surrounded by concentric rings. Spaces called lacunae are filled with osteocytes, and channels called canaliculi go from the lacunae to the osteonic canal. The strength of cortical bone allows it to support the body and protect organs. It also stores different elements, such as calcium.
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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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With regards to the deiodinases, where would you find D1?
Your Answer: Liver
Explanation:The liver produces an important amount of T3 by outer ring deiodination thanks to its elevated concentration of type I deiodinase. It can also be found in the kidney.
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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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Where is the melanocortin system located?
Your Answer:
Correct Answer: Hypothalamus
Explanation:The melanocortin system is a group of hormones which include hormones from the pro-opiomelanocortin (POMC)-expressing neurons, the neuropeptide Y (NPY) and agouti-related peptide (AgRP)-co-expressing neurons. This system is located in the hypothalamic arcuate nucleus; it also includes the hypothalamic arcuate nucleus and the melanocortin 4 receptor (MC4R)-expressing neurons located in the hypothalamic paraventricular nucleus. The system regulates energy expenditure and food intake.
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This question is part of the following fields:
- Endocrinology
- Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY
