Endocrine Quiz

Question 1

1) Which of the following statements concerning the pituitary gland is INCORRECT?

a) It is separated from sphenoid bone by the diaphragma sellae

b) The sphenoid sinus is inferior to itc) It receives its arterial supply from the internal carotid

arteryd) It is suspended from the floor of the 3rd ventricle by the

infundibulume) It is deeply placed within the sella turcica of the skull

Question 1

1) Which of the following statements concerning the pituitary gland is INCORRECT?

a) It is separated from sphenoid bone by the diaphragma sellae

b) The sphenoid sinus is inferior to itc) It receives its arterial supply from the internal carotid

arteryd) It is suspended from the floor of the 3rd ventricle by the

infundibulume) It is deeply placed within the sella turcica of the skull

Question 2

2) Match each zone of the adrenal gland with the hormone type produced

1. Zona Fasciculata A. Mineralocorticoids

2. Zona Glomerulosa B. Catecholamines

3. Medulla C. Androgens

4. Zona Reticulata D. Glucocorticoids

Question 2

2) Match each zone of the adrenal gland with the hormone type produced

1. Zona Fasciculata A. Mineralocorticoids

2. Zona Glomerulosa B. Catecholamines

3. Medulla C. Androgens

4. Zona Reticulata D. Glucocorticoids

Question 3

Which of the following is consistent with a diagnosis of Cushing’s disease:

a) Hyperpigmentation

b) Postural hypotension

c) Weight loss

d) Tiredness

e) Dry and coarse skin

Question 3

Which of the following is consistent with a diagnosis of Cushing’s disease:

a) Hyperpigmentation

b) Postural hypotension

c) Weight loss

d) Tiredness

e) Dry and coarse skin

Question 4

After the complicated home birth of a normal and healthy baby, a mother develops polyuria and hypoglycaemia, she says she is drinking a lot more than average and is always tired. What should be clinically suspected?

a) Conscientious objector to vaccinationb) Conn’s syndromec) Gestational Diabetes Mellitus d) Sheehan’s syndrome

Question 4

After the complicated home birth of a normal and healthy baby, a mother develops polyuria and hypoglycaemia, she says she is drinking a lot more than average and is always tired. What should be clinically suspected?

a) Conscientious objector to vaccinationb) Conn’s syndromec) Gestational Diabetes Mellitus d) Sheehan’s syndrome

Question 5

Macroadenoma’s that are picked up clinically are most likely to be:

a) Non-functional/ silent

b) Functional Gonadotroph cell type

c) Functional lacotroph cell type

d) Functional Plurihormonal adenomas

Question 5

Macroadenoma’s that are picked up clinically are most likely to be:

a) Non-functional/ silent

b) Functional Gonadotroph cell type

c) Functional lacotroph cell type

d) Functional Plurihormonal adenomas

Question 6

A 22 year old girl presents with a headache, some visual loss, irregular periods and galactorrhea. Serum prolactin is measured at 75ng/mL. She has no regular medication. What is the most likely pathology?

a) Rathke’s cleft cystb) Functional Lactotroph cell pituitary adenomac) Craniopharyngiomad) Prolactin-releasing hormone adenoma of the

hypothalamus

Question 6

A 22 year old girl presents with a headache, some visual loss, irregular periods and galactorrhea. Serum prolactin is measured at 75ng/mL. She has no regular medication. What is the most likely pathology?

a) Rathke’s cleft cystb) Functional Lactotroph cell pituitary adenomac) Craniopharyngiomad) Prolactin-releasing hormone adenoma of the

hypothalamus

Question 7

The Hypothalamus supplies releasing hormones to the Adenohypophysis via the hypophyseal portal system. How does the hypothalamus supply the Neurohypophysis with its hormones?

a) Hypophyseal portal system with eventually communicates with the inferior hypophyseal artery

b) Infundibulum that drains oxytocin and ADH to the median eminence

c) Hypothalamo-hypophyseal tract from the supra-optic nucleus and the paraventricular nucleus that eventually drains to the inferior hypophyseal artery

d) Via the pars nervosa

Question 7

The Hypothalamus supplies releasing hormones to the Adenohypophysis via the hypophyseal portal system. How does the hypothalamus supply the Neurohypophysis with its hormones?

a) Hypophyseal portal system with eventually communicates with the inferior hypophyseal artery

b) Infundibulum that drains oxytocin and ADH to the median eminence

c) Hypothalamo-hypophyseal tract from the supra-optic nucleus and the paraventricular nucleus that eventually drains to the inferior hypophyseal artery

d) Via the pars nervosa

Question 8

Which hormone class uses a cytoplasmic receptor as opposed to a cell-surface or nuclear receptor?

a) Amino acid derivatives

b) Steroid hormones

c) Polypeptide hormones

d) Polysaccharide hormones

Question 8

Which hormone class uses a cytoplasmic receptor as opposed to a cell-surface or nuclear receptor?

a) Amino acid derivatives

b) Steroid hormones

c) Polypeptide hormones

d) Polysaccharide hormones

Question 9

What inhibits secretion of ADH?

a) Dopamine

b) Somatostatin

c) Hypertension

d) Stress

Question 9

What inhibits secretion of ADH?

a) Dopamine

b) Somatostatin

c) Hypertension

d) Stress

Question 10

Prolactin secretion is stimulated by:

a) Thyrotropin-releasing hormone

b) Dopamine

c) Gonadotropin-releasing hormone

d) Gonadotrphs (LH and FSH)

Question 10

Prolactin secretion is stimulated by:

a) Thyrotropin-releasing hormone

b) Dopamine

c) Gonadotropin-releasing hormone

d) Gonadotrphs (LH and FSH)

Question 11

Diabetes insipidus is most likely to produce:

a) High urine osmolality

b) High plasma osmolality

c) Low 24 hour urine volumes

d) Low plasma sodium

Question 11

Diabetes insipidus is most likely to produce:

a) High urine osmolality

b) High plasma osmolality

c) Low 24 hour urine volumes

d) Low plasma sodium

Question 12

SIADH typically presents in a patient as:

a) Hypervolemia

b) Oedema

c) Hypertension

d) Hyponatremia

Question 12

SIADH typically presents in a patient as:

a) Hypervolemia

b) Oedema

c) Hypertension

d) Hyponatremia

Question 13

Pituitary adenomas inherited via an autosomal dominant fashion are most likely to have:

a) p53 mutation

b) MENS type 1

c) KRAS mutation

d) MENS type 2

Question 13

Pituitary adenomas inherited via an autosomal dominant fashion are most likely to have:

a) p53 mutation

b) MENS type 1

c) KRAS mutation

d) MENS type 2

Question 14

GH (somatotroph cell) adenomas are diagnosed by:

a) Dexamethasone suppression test

b) Oral glucose load

c) Desmopressin administration test

d) Sleep deprivation test

Question 14

GH (somatotroph cell) adenomas are diagnosed by:

a) Dexamethasone suppression test

b) Oral glucose load

c) Desmopressin administration test

d) Sleep deprivation test

Question 15

What is a sequelae of surgical removal of the adrenal glands on a pre-existing microadenoma?

a) Destructive macroadenoma

b) Cushing’s syndrome

c) Conn’s syndrome

d) Osteoporosis

Question 15

What is a sequelae of surgical removal of the adrenal glands on a pre-existing microadenoma?

a) Destructive macroadenoma

b) Cushing’s syndrome

c) Conn’s syndrome

d) Osteoporosis

Question 16

How does breastfeeding act like a contraceptive?

Question 16

How does breastfeeding act like a contraceptive?

Lactation increases prolactin levels Prolactin inhibits LH and FSH and prolactin also –ve feeds back to hypothalamus GnRH, LH and FSH suppression blocks folliculogenesis anovulation!!!!

Question 17

What are two common infections that can cause hypopituitarism?

Question 17

What are two common infections that can cause hypopituitarism?

TB and syphilis

Question 18

True/ False: The anabolic effects of GH are mediated by IGF-1

Question 18

True/ False: The anabolic effects of GH are mediated by IGF-1

Question 19

Acromegaly characteristics include:

a) Moon face

b) Abdominal striae

c) Prognathism and mandibular enlargement

d) Buffalo hump

Question 19

Acromegaly characteristics include:

a) Moon face

b) Abdominal striae

c) Prognathism and mandibular enlargement

d) Buffalo hump

Question 20

Name 3 visual disorders that can result from endocrine disease

Question 20

Name 3 visual disorders that can result from endocrine disease

1. Bitemporal hemianopia from pituitary adenomas via mass effect

2. Diabetic retinopathy from DM3. Exophthalmos, periorbital oedema etc from

Hyperthyroidism4. Corneal calcification from Hyperparathyoidism

via hypercalcaemia5. Glaucoma from increased Corticosteroids/

cortisol

Question 21

True/ False: The Kidney and the adrenal medulla are derived from the same mesodermal origin.

Question 21

True/ False: The Kidney and the adrenal medulla are derived from the same mesodermal origin.

Question 22

17a-hydroxylase deficiency is characterised by:

a) Increased aldosterone levels

b) Increased Corticosterone levels

c) Increased DHEA levels

d) Metabolic acidosis

Question 22

17a-hydroxylase deficiency is characterised by:

a) Increased aldosterone levels

b) Increased Corticosterone levels

c) Increased DHEA levels

d) Metabolic acidosis

Question 23

Which corticosteroid has the most mineralocorticoid action?

a) Hydrocortisone

b) Prednisolone

c) Dexamethasone

d) Fludrocortisone

Question 23

Which corticosteroid has the most mineralocorticoid action?

a) Hydrocortisone

b) Prednisolone

c) Dexamethasone

d) Fludrocortisone

Question 24

What does increased urinary free cortisol mean?

Question 24

What does increased urinary free cortisol mean?

Urinary-free cortisol concentrations increase with Cushing disease, an adrenal adenoma and carcinoma, a pituitary adenoma, some other cancers (especially lung), the use of anti-inflammatory drugs containing cortisol or cortisone, and with depression and stress.

Question 25

What does unchanged ACTH levels after low dose and high dose dexamethasone suppression test mean?

Question 25

What does unchanged ACTH levels after low dose and high dose dexamethasone suppression test mean?

Ectopic ACTH production is likely

Question 26

What does a relatively unchanged serum cortisol level mean after synthacten test?

Question 26

What does normal serum cortisol level mean after synthacten test?

Maybe there is no adrenal cortex to respond to the synthetic ACTH and that’s why it didn’t pump more cortisol out – Addison’s disease most likely

Question 27

What are the four main routes to getting a Cushing Syndrome?

Question 27

What are the four main routes to getting a Cushing Syndrome?

1. Corticotroph cell pituitary adenoma

2. Adrenal adenoma

3. Paraneoplastic/ Ectopic ACTH secretion – SCC

4. Iatrogenic

Question 28

Characteristics of Conn Syndrome include:

a) Decreased serum renin

b) Hypotension

c) Metabolic acidosis

d) Hyperkalaemia

Question 28

Characteristics of Conn Syndrome include:

a) Decreased serum renin

b) Hypotension

c) Metabolic acidosis

d) Hyperkalaemia

Question 29

A 29 year old female presents with hirsutism, the beginnings of male pattern baldness, and irregular menstruation. On examination, external genitalia is normal. The most probable pathology is:

a) 21-hydroxylase deficiency

b) 17a-hydroxylase deficiency

c) 11b-hydroxylase deficiency

d) 12,20-lyase deficiency

Question 29

A 29 year old female presents with hirsutism, the beginnings of male pattern baldness, and irregular menstruation. On examination, external genitalia is normal. The most probable pathology is:

a) 21-hydroxylase deficiency

b) 17a-hydroxylase deficiency

c) 11b-hydroxylase deficiency

d) 12,20-lyase deficiency

Question 30

If a known hypothyroid 35 year old male presented with myalgia, lethargy, nausea, vomiting and diarrhoea with reduced blood pressure and blood sugar levels after finding out his wife was cheating on him, what will be the safest treatment?

a) Oral 100mcg Thyroxinb) 1Litre of 5% glucose IVc) 100mg Hydrocortisone IVd) Testosterone patch

Question 30

If a known hypothyroid 35 year old male presented with myalgia, lethargy, nausea, vomiting and diarrhoea with reduced blood pressure and blood sugar levels after finding out his wife was cheating on him, what will be the safest treatment?

a) Oral 100mcg Thyroxinb) 1Litre of 5% glucose IVc) 100mg Hydrocortisone IVd) Testosterone patch

Question 31

Which signs/ symptoms/ findings can be present in BOTH Addison’s disease and Cushing disease?

a) Hypotension

b) Hypoglycaemia

c) Hyponatraemia

d) Hyperpigmentation

Question 31

Which signs/ symptoms/ findings can be present in BOTH Addison’s disease and Cushing disease?

a) Hypotension

b) Hypoglycaemia

c) Hyponatraemia

d) Hyperpigmentation

Question 32

Primary hyperaldosteronism causing Conn’s syndrome is diagnosed using:

a) Plasma aldosterone

b) Plasma Renin

c) Plasma aldosterone: Plasma Renin

d) Blood pressure

Question 32

Primary hyperaldosteronism causing Conn’s syndrome is diagnosed using:

a) Plasma aldosterone

b) Plasma Renin

c) Plasma aldosterone: Plasma Renin

d) Blood pressure