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Question 1
Correct
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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: 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 2
Incorrect
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Which one of the following will increase an individual’s appetite?
Your Answer: Glucagon-like peptide-1
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 3
Incorrect
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The TSH receptor produces its effects in the thyrocyte via:
Your Answer: Opening of voltage-gated iodine channels in the thyrocyte membrane
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 4
Incorrect
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In which of the following are the enzymatic mechanisms for producing aldosterone found?
Your Answer: Paraganglia cells
Correct 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
Incorrect
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Which of the following structures lie in close proximity to the thyroid?
Your Answer: The inferior thyroid 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 6
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: Growth hormone receptor (intracellular domain), 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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Question 7
Correct
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The growth promoting protein anabolic effects of insulin are mediated by:
Your 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 8
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 -0.9
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 9
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 10
Incorrect
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What is the fat called that serves as a considerable source of heat in children?
Your Answer: Red adipose tissue
Correct Answer: Brown adipose tissue
Explanation:Brown adipose tissue, also known as BAT or brown fat, coforms the adipose tissue along with white adipose tissue (WAT) or white fat. While WAT is responsible for energy-storage, BAT is involved in thermogenesis and energy expenditure. It is more prevalent in children than in adults, and its activation during adolescence is associated to less weight gain and adiposity. BAT produces heat by non-shivering thermogenesis.
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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 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 12
Incorrect
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Which of the following cells secrete glucagon?
Your Answer: F cells
Correct 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 13
Incorrect
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Which of the following features is least commonly seen in Gitelman’s syndrome?
Your Answer: Hypomagnesaemia
Correct 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 14
Incorrect
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Which of the following describes a principal action of insulin?
Your Answer: Stimulation of the release of free fatty acids from adipose tissue
Correct Answer: Inhibition of phosphorylase and gluconeogenic enzymes
Explanation:Insulin stimulates glycolysis and lipogenesis, but inhibits gluconeogenesis. Insulin promotes the dephosphorylating of glycogen phosphorylase, therefore suppressing glycogenolysis. Insulin also inhibits FOX3, FOX4, and FOX6 and their ability to promote hepatic gluconeogenesis.
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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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Embryologically the anterior pituitary is formed from?
Your Answer: Pituicytes
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 16
Incorrect
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Growth hormone deficiency causes?
Your Answer: Protein anabolism
Correct Answer: Decreased epiphyseal growth
Explanation:Growth hormone deficiency is caused by conditions affecting the pituitary gland, such as tumours. Its effects depend on the age of the patient: in infancy and childhood, growth failure is most likely to occur. The epiphyseal plate is the area in long bones where growth occurs, and it is the area affected by growth hormone deficiency. Poor growth/shortness is the main symptom of GH deficiency in children, usually resulting in growth at about half the usual rate for age.
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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 apical enzyme responsible for the oxidation and reaction of iodide with thyroglobulin is:
Your Answer: D1 deionodase
Correct Answer: Thyroid peroxidise
Explanation:Thyroid peroxidase is an enzyme that is secreted into the thyroid colloid. It works by oxidizing iodide ions into iodine which are incorporated into thyroglobulin, in order to produce T3 and T4.
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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 is not a feature of Liddle’s syndrome?
Your 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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What is pendrin?
Your Answer: Na+/Cl- antiporter
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 20
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 21
Correct
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Endotoxin will typically act on which one of the following cells, to produce endogenous pyrogens?
Your 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 22
Incorrect
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Which of the following is responsible for converting inactive cortisone to active cortisol in the adrenal gland?
Your Answer: 12βHSD type 2
Correct 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 23
Incorrect
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The actions of dihydrotestosterone in male reproductive physiology include:
Your Answer: Maturation of the Wolffian duct/internal genitalia
Correct 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 24
Incorrect
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During bone growth-the epiphysis are separated from the diaphysis by actively proliferating cartilage known as:
Your Answer: Limiting plate
Correct Answer: Epiphysial plate
Explanation:The epiphysial plate, physis, or growth plate, is a hyaline cartilage plate located near the ends of long bones; it consists of growing tissue. It is found in children and teenagers; in adults, it is replaced by an epiphysial line or epiphysial closure. The epiphysial plate is divided into zones: zone of reserve, proliferation, maturation and hypertrophy, calcification, and ossification.
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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 of the following skin coloration abnormalities occurs due to adrenal insufficiency due to primary adrenal disease?
Your Answer: Albinism
Correct 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 26
Incorrect
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Which one of the following makes up most of the adrenal cortex?
Your Answer: Paraganglia cells
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 27
Incorrect
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Where is the melanocortin system located?
Your Answer: Pituitary
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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Question 28
Correct
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Which of the following is correctly paired?
Your Answer: F cells : pancreatic polypeptide
Explanation:Pancreatic polypeptide is secreted by F-cells, which represent the smallest proportion of islet cells in the pancreas. These cells establish the embryological origin of the pancreas. Pancreatic polypeptide regulates endocrine and exocrine activities by the pancreas.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 29
Incorrect
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Which of the following is least recognised as a potential complication of acromegaly?
Your Answer: Colorectal cancer
Correct Answer: Mental retardation
Explanation:Acromegaly is a condition that results from excess growth hormone (GH) after the growth plates have closed. It is typically due to the pituitary gland producing too much growth hormone. In more than 95% of people the excess production is due to a benign tumour, known as a pituitary adenoma. The condition is not inherited.Complications:Severe headacheArthritis and carpal tunnel syndromeEnlarged heartLiver fibrosis and bile duct hyperplasiaHypertensionDiabetes mellitus (excess of GH leads to insulin resistance)Heart failureKidney failureColorectal cancerCompression of the optic chiasm leading to loss of vision in the outer visual fields (typically bitemporal hemianopia.)Increased palmar sweating and sebum production over the face (seborrhoea) are clinical indicators of active GH-producing pituitary tumours.hypertensiondiabetes (>10%)cardiomyopathycolorectal cancer
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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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What is the effect of vasopressin on the kidney?
Your Answer: Increase the glomerulus filtration rat
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 31
Incorrect
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In terms of relative steroid potency, how much prednisone is equivalent to 100mg hydrocortisone?
Your Answer: 10mg
Correct 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 32
Incorrect
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Where does the pituitary gland lie?
Your Answer: Around the 4th ventricle
Correct Answer: In a pocket of the sphenoid bone at the base of the brain
Explanation:The pituitary lies in a small depression in the sphenoid bone, known as the sella turcica or Turkish saddle.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 33
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 34
Incorrect
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Which of the following predominate in the adrenal medulla?
Your Answer: Norepinephrine secreting cells
Correct Answer: Epinephrine secreting cells
Explanation:Chromaffin cells, also known as pheochromocytes, are cells located in the adrenal medulla which specialize in the synthesis, storage, and secretion of catecholamines: 80% epinephrine and 20% norepinephrine is released into the bloodstream. For this reason, they are considered to be neuroendocrine cells.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 35
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: Ep5
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 36
Incorrect
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Where is thyroglobulin produced?
Your Answer: Colloid
Correct 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 37
Incorrect
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Where do the portal hypophysial vessels arise?
Your Answer: Arcuate nucleus
Correct Answer: Median eminence
Explanation:The hypothalamic-hypophysial portal system connects the brain to the anterior pituitary. It is made up of two capillary beds, one in the median eminence and the other in the anterior pituitary. Blood from the plexus of the median eminence is carried by portal veins, draining into the cavernous and posterior intercavernous sinuses. This system delivers hypothalamic hormones to their target cells.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 38
Incorrect
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Which of the following hormones would stimulate secretion of TSH?
Your Answer: T3
Correct Answer: TRH
Explanation:Thyrotropin-releasing hormone, also known as TRH, thyrotropin-releasing factor, TRF is a hormone produced by the hypothalamus. It functions as a releasing hormone, promoting the production of thyroid-stimulating hormone or thyrotropin and prolactin.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 39
Incorrect
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What is the most important way in which heat is lost from the body?
Your Answer: Defecation
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 40
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 41
Incorrect
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Which one of the following leads to decreased prolactin levels?
Your Answer: Hypoglycaemia
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 42
Incorrect
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Which enzyme is responsible for the conversion of testosterone to dihydrotestosterone?
Your Answer: 17α-hydroxylase
Correct Answer: 5α-reductase
Explanation:The enzyme 5α-reductase synthesizes DHT from testosterone in the prostate, testes, hair follicles, and adrenal glands. This enzyme reduces the 4,5 double-bond of the testosterone. Relative to testosterone, DHT is much more potent as an agonist of the androgen receptor.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 43
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 44
Incorrect
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Calcium is transported over the brush border in the gut, via which transporter / channel?
Your Answer: Ca2+ dependant ATPase
Correct Answer: TRPV 6
Explanation:Transient Receptor Potential Vanilloid 6 or TRPV 6 is a calcium channel located in the cell membrane which is present in a variety of organs, including small intestine, oesophagus, stomach, colon, placenta, kidney, and uterus. In the intestine, it is located in the apical brush-border membrane of the enterocyte, regulating the entry of calcium into the cell.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 45
Correct
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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: 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 46
Incorrect
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What causes increased insulin sensitivity?
Your Answer: Catecholamine release
Correct 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 47
Incorrect
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The action of progesterone on different organs/systems includes:
Your Answer: Uterus: pro-oestrogenic effect g. increase in uterine excitability, increase in oestrogen receptors
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 48
Incorrect
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Which of the following biochemical profiles is seen in a normal 65 year old female? (in comparison to a normal 24 yr. old female)
Your Answer: Decreased FSH, LH; decreased oestrogen, progesterone
Correct Answer: Increased FSH, LH; decreased oestrogen, progesterone
Explanation:During menopause, a woman’s number of ovarian follicles becomes depleted; as a result, oestrogen and progesterone levels drop, and LH and FSH levels increase. One of the criteria to diagnose menopause is the absence of menstrual period for a year, along with a serum FSH level increased to 30 mIU/ml or higher. LH also rises with the onset of menopause.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 49
Incorrect
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Compact/cortical bone makes up
Your Answer: Inner layer of most bones and accounts for 80% 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 50
Incorrect
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As assessed by immunocytochemistry and electron microscopy, the anterior pituitary gland contains how many different types of cells?
Your Answer: 3
Correct 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 51
Incorrect
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In a newly diagnosed acromegaly patient, which of the following would you not expect to find?
Your Answer: Carpal tunnel syndrome
Correct Answer: Hypohidrosis
Explanation:Features of acromegaly may include:
- Soft tissue swelling visibly resulting in enlargement of the hands, feet, nose, lips and ears, and a general thickening of the skin
- Soft tissue swelling of internal organs, notably the heart with associated weakening of its muscularity, and the kidneys, vocal cords (resulting in a characteristic thick, deep voice and slowing of speech)
- Generalized expansion of the skull at the fontanelle, frontal bossing, prognathism with associated macroglossia (enlargement of the tongue) and teeth spacing.
- Hypertrichosis, hyperpigmentation and hyperhidrosis (not hypohidrosis) may occur in these patients as well as carpal tunnel syndrome and impotence.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 52
Incorrect
-
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 53
Incorrect
-
What is the most abundant hormone release by the thyroid?
Your Answer: T3
Correct Answer: T4
Explanation:T3 and T4 are the two tyrosine-based hormones produced and secreted by the thyroid gland. Although T3 is the active form of the hormone, and thus, it is much more potent; T4 is the most abundant hormone secreted by the thyroid (93% of the total thyroid secretion) and it also has a longer half life since it binds to proteins much more strongly.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 54
Incorrect
-
What microscopic changes are visible in an active thyroid gland?
Your Answer: Follicle lining cells are flat.
Correct Answer: Follicle lining cells are cuboid or columnar.
Explanation:Active follicles are lined by cuboidal or columnar cells; this is because active follicles are smaller and have less colloid. Their cells are tall because they are actively secreting hormones, whereas older follicles have a flat epithelium and are filled with more colloid.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 55
Incorrect
-
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 56
Incorrect
-
The net effect of parathyroid hormone on calcium and phosphate homeostasis is?
Your Answer: Decrease in Ca, increase in phosphate
Correct 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 57
Incorrect
-
The main efferent input of the posterior pituitary gland comes from:
Your Answer: Sympathetic and parasympathetic stimulation via the brainstem
Correct Answer: Paracrine hormones secreted from the hypothalamus via axons.
Explanation:The posterior pituitary or neurohypophysis consists of a collection of axonal projections emerging from the hypothalamus. It releases hormones directly from these axonal endings into circulation; these hormones are oxytocin and vasopressin.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 58
Incorrect
-
Select the correct statement regarding the macro anatomy of the thyroid gland.
Your Answer: The gland is poorly vascularised.
Correct Answer: It surrounds the trachea at the front of the neck.
Explanation:The thyroid is located around the trachea, in the anterior portion of the neck. It is formed by two lobes which are connected by an isthmus. The presence of a pyramidal lobe, or third lobe, is considered to be a normal anatomical variant. It originates from the primitive pharynx and the neural crest and has a rich vascular supply.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 59
Incorrect
-
Which glucose transporter is responsible for the uptake of glucose in ß cells?
Your Answer: GLUT 3
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 60
Incorrect
-
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 61
Correct
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Select a factor which stimulates glucagon secretion.
Your Answer: Protein meal
Explanation:Several studies have shown that glucagon levels are increased in individuals with a high protein diet. It is still debated, however, whether this type of diet affects insulin levels as well.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 62
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 63
Incorrect
-
Which of the following hormones cause negative feedback on the CRH/ACTH axis?
Your Answer: All of the options
Correct 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 64
Incorrect
-
The reflex responses activated by cold are controlled by which area?
Your Answer: Posterior pituitary
Correct Answer: Posterior hypothalamus
Explanation:The posterior nucleus of the hypothalamus is responsible for thermoregulation and thermogenesis. Studies have shown that the neurons in the posterior hypothalamus which mediate the reflex of shivering are sensitive to temperature; damage to this nucleus produces hypothermia.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 65
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 66
Incorrect
-
To which protein is T3 mostly bound in the serum?
Your Answer: Transthyretin
Correct 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 67
Correct
-
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 68
Correct
-
In the microanatomy of the pituitary gland, the pituicytes present are in fact modified forms of which cells?
Your Answer: Astrocytes
Explanation:Pituicytes are glial cells present in the pars nervosa, the posterior pituitary gland. Their irregular shape resembles that of astrocytes, and their cytoplasm also has intermediate filaments. They differ from astrocytes in that they have large cytoplasmic lipid droplets.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 69
Incorrect
-
In the menstrual cycle, ovulation is triggered by:
Your Answer: A pituitary FSH surge due to the positive feedback effect of oestrogens
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 70
Incorrect
-
With regards to the deiodinases, where would you find D1?
Your Answer: Pituitary gland
Correct 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 71
Correct
-
In the absence of insulin:
Your Answer: Glucose uptake by most of the brain is normal
Explanation:Although it is known that insulin levels affect glucose uptake, oxidation and storage in peripheral tissues, its role in the brain isn’t as clear. However, studies have shown that bulk brain glucose uptake isn’t affected by insulin. Glucose transport into the neurons is GLUT3 dependent, and its transport into glia and brain endothelial cells rely on GLUT1. Insulin isn’t necessary for GLUT1 or GLUT3, which explains why brain glucose uptake isn’t affected by insulin levels.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 72
Incorrect
-
Choose the correct statement regarding trabecular bone:
Your Answer: Receives nutrients from bone ECF
Correct Answer: All of the options are correct
Explanation:Trabecular, spongy or cancellous bone. It is located inside the cortical bone and makes up around 20% of all bone in the body. It is made of spicules or plates with a high surface to volume ratio, where many cells sit on the surface of the end plates. It receives its nutrients from the extracellular fluid (ECF), exchanging about 10 mmol of calcium every 24 hours.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 73
Incorrect
-
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 74
Incorrect
-
What is the primary cause of ketoacidosis in Type 1 diabetes?
Your Answer: Glycogenolysis
Correct Answer: Lipolysis
Explanation:in type 1 diabetics the lack of insulin in the bloodstream prevents glucose absorption, thereby inhibiting the production of oxaloacetate (a crucial precursor to the β-oxidation of fatty acids) through reduced levels of pyruvate (a by-product of glycolysis), and can cause unchecked ketone body production (through fatty acid metabolism or lipolysis) potentially leading to dangerous glucose and ketone levels in the blood.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 75
Incorrect
-
On which chromosome is the gene for insulin located?
Your Answer: Chromosome 19
Correct 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 76
Incorrect
-
To which of the following plasma proteins is T4 most bound in plasma?
Your Answer: Transferrin
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 77
Incorrect
-
Which of the following forms one of the characteristic and functional cells making up the anterior pituitary gland?
Your Answer: Myocyte
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 78
Incorrect
-
Physiological effects of T3 on the heart include all the following except:
Your Answer: Increased expression of serca pump gene
Correct 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 79
Incorrect
-
What is the most common cause of primary hyperaldosteronism?
Your Answer: Ectopic secretion
Correct 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 80
Incorrect
-
Which hormone secreting cell of the human anterior pituitary gland secretes growth hormone?
Your Answer: Gonadotroph
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 81
Incorrect
-
Which cell secretes parathyroid hormone?
Your Answer: C cells
Correct 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 82
Incorrect
-
Select the correct statement about the microanatomy of the thyroid gland.
Your Answer: The individual thyroid cells rest on the capillary basal lamin
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 83
Incorrect
-
An important hormone controlling the differentiation of monocytes to osteoclasts, by inhibiting the RANKL/ RANK interaction is called?
Your Answer: Osteoprotectin
Correct 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 84
Correct
-
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 85
Incorrect
-
The onset of puberty is triggered by
Your Answer: None of the above
Correct 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 86
Incorrect
-
Where does one find the thyroid receptors?
Your Answer: Rough endoplasmic reticulum
Correct Answer: Cell nucleus
Explanation:Unlike many of the steroid receptors, inactive receptors for T3 are located in the nucleus. T4 is first converted into T3 within the cytoplasm of the cell, T3 then enters the nucleus and binds to its receptor. The hormone-receptor complex can now bind to DNA and activate specific genes.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 87
Incorrect
-
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 88
Incorrect
-
Which of the following increase insulin secretion?
Your Answer: Somatostatin
Correct 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 89
Incorrect
-
Pendrin is a Cl-/I- exchanger whose function is:
Your Answer:
Correct Answer: Transfer of iodide across the thyrocyte apical membrane into the colloid
Explanation:Pendrin is an anion transporter present in the inner ear, thyroid and kidney. It regulates the entrance of iodide from the thyroid cell to the colloid space. It has been proposed that its role could be the maintenance of the ionic composition of the endolymph.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 90
Incorrect
-
Which are the main hormones secreted by the posterior pituitary gland.
Your Answer:
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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SESSION STATS - PERFORMANCE PER SPECIALTY
