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Question 1
Incorrect
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The febrile response to PGE2 will be impaired with the knockout of which one of the following prostaglandin receptors?
Your Answer: Ep1
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.
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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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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 3
Correct
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Physiological effects of T3 on the heart include all the following except:
Your Answer: Increased expression of β-myosin heavy chain gene
Explanation:Tri-iodothyronine, also known as T3, is a hormone which can affect almost every system in the human body. In the heart, it increases the number of β1-adrenergic receptors, enhances the response to circulating catecholamines, increases the proportion of α-myosin heavy chains in the atria, and increases the expression of serca pump gene.
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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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What causes increased insulin sensitivity?
Your Answer: Exercise
Explanation:Physical activity, through its effect on insulin sensitivity, is one of the main modifiable risk factors for type 2 diabetes. It is estimated that by each weekly 500 kcal increment in exercise related energy consumption, the lifetime risk of suffering from type 2 diabetes is reduced by 9%. Up to two hours after exercise, glucose uptake is elevated due to insulin independent mechanisms; however, insulin sensitivity remains increased for at least 16 hours after exercising.
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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 one of the following features is least associated with primary hyperparathyroidism?
Your Answer: Polyuria
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 6
Incorrect
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Which one of the following skin disorders is least commonly associated with hypothyroidism?
Your Answer: Eczema
Correct 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 7
Correct
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Which one of the following is not part of the WHO diagnostic criteria for the metabolic syndrome?
Your 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 8
Incorrect
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Where is Müllerian inhibiting substance (MIS) secreted?
Your Answer: Leydig cells
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 9
Incorrect
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Which of the following may be a feature of primary hyperaldosteronism?
Your Answer: Vitiligo
Correct 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.
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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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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.
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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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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.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 12
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 13
Correct
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Which hormone secreting cell of the human anterior pituitary gland secretes growth hormone?
Your 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 14
Incorrect
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Which of the following is not a feature of Liddle’s syndrome?
Your Answer: Alkalosis
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 15
Incorrect
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Where is leptin synthesized and secreted?
Your Answer: Yellow adipose tissue
Correct 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 16
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 17
Incorrect
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The net effect of active Vitamin D on calcium and phosphate homeostasis is?
Your Answer: Increase in Ca, decrease in phosphate
Correct Answer: Increase in Ca, increase in phosphate
Explanation:Bone and its metabolism are regulated by several hormones, amongst which is vitamin D. It is heavily involved in the metabolism and homeostasis of calcium and phosphate through several processes. Vitamin D works in the intestine, kidney, bone and parathyroid glands to maintain levels of calcium and phosphate, promoting its absorption, bone resorption, and proper functioning of the parathyroid to maintain adequate serum calcium levels.
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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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Which of the following derivatives of proopiomelanocortin is an opioid peptide?
Your Answer: ß-endorphin
Explanation:ß-endorphin is an endogenous opioid neuropeptide which is mainly synthesized and stored in the anterior pituitary gland, derived from the precursor proopiomelanocortin (POMC). Some studies have shown that immune system cells are also capable of synthesizing ß-endorphin. β-endorphin is thought to exert a tonic inhibitory influence upon GNRH secretion and to be an important regulator of reproductive function.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 19
Correct
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To which protein is T3 mostly bound in the serum?
Your Answer: Thyroxin-binding globulin
Explanation:In a normal person, approximately 0.03 per cent of the total serum T4, and 0.3 per cent of the total serum T3 are present in free or unbound form. The major serum thyroid hormone-binding proteins are: 1) thyroxine-binding globulin [TBG or thyropexin], 2) transthyretin [TTR or thyroxine-binding prealbumin (TBPA)], and 3) albumin (HAS, human serum albumin). TBG has highest affinity for T4, which is 50-fold higher than that of TTR and 7,000-fold higher that of HSA. As a result TBG binds 75% of serum T4, while TTR and HSA binds only 20% and Albumin 5%, respectively.
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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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Which of the following is responsible for converting inactive cortisone to active cortisol in the adrenal gland?
Your Answer: 11βHSD type 1
Explanation:11β-Hydroxysteroid dehydrogenase, also known as HSD-11β or 11β-HSD, is a group of enzymes which catalyse the interconversion of active cortisol and corticosterone with inert cortisone and 11-dehydrocorticosterone.
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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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The action of progesterone on different organs/systems includes:
Your Answer: Brain: stimulation of LH secretion thus triggering ovulation
Correct Answer: Breasts: stimulation of lobular and alveolar development
Explanation:Progesterone is a sex hormone which affects mainly the reproductive system. In the breasts, it mediates the lobuloalveolar maturation to allow for milk production; this is done in conjunction with prolactin. It acts to maintain female reproductive and sex characteristics.
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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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Where does the anterior pituitary receive most of its blood supply?
Your Answer: Anastomotic connections from posterior pituitary
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 23
Incorrect
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Compact/cortical bone makes up
Your Answer: The outer layer of most bones and accounts for 20% 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 24
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 25
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 26
Correct
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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.
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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 of the following skin coloration abnormalities occurs due to adrenal insufficiency due to primary adrenal disease?
Your Answer: Hyperpigmentation
Explanation:Addison’s disease, also known as primary adrenal insufficiency, or hypocortisolism is an endocrine disorder. Hyperpigmentation is one of its most common signs; it occurs as a result of an increase in pro-opiomelanocortin to produce more ACTH in response to the decreased levels of cortisol. Pro-opiomelanocortin is a precursor of melanocyte stimulating hormone (MSH), which stimulates melanocytes, causing darkening of the skin.
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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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Periodic fevers occur in humans with mutations in the gene for pyrin. Pyrin is a protein found in which one of the following cells?
Your Answer: Monocytes
Correct Answer: Neutrophils
Explanation:Pyrin, also known as marenostrin or TRIM20, is a protein encoded by the Mediterranean fever (MEFV) gene, causing the autoinflammatory disease familial Mediterranean fever (FMF). Pyrin produces an increased sensitivity to intracellular signals. It is produced mainly in neutrophils, which display an increased ratio of cells entering apoptosis when exposed to pyrin.
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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 hormone is associated with the temperature surge in hot flushes?
Your 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 30
Correct
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Which cells secrete insulin?
Your 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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SESSION STATS - PERFORMANCE PER SPECIALTY
