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- Jun 18, 2006
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1. Home-use kits for determining a womans fertile period depend on the detection of one hormone in the urine. This hormone is
a. Estradiol
b. FSH
c. hCG
d. LH
e. Progesterone
2. The proliferative phase of the menstrual cycle (vis-a-vis the endometrium)
a. occurs in response to the rising serum levels of 17α−estradiol.
b. is dependent on the secretion of gonadotropins from the anterior pituitary.
c. is dependent on the secretion of GnRH from the hypothalamus.
d. all of the above
3. Which statement BEST characterizes the control of thyroid hormone metabolism?
a. The sodium-iodide symporter is under direct negative feedback control by circulating thyroid hormones.
b. TSH controls the synthesis, release, and peripheral metabolism of the thyroid hormones.
c. Thyroid hormones exert their control primarily by modulating the effects of TRH upon TSH synthesis and release by the pituitary gland.
d. Thyroid hormones have a bimodal effect on TSH blood levels: low concentrations stimulate
TSH release and high concentrations inhibit TSH release.
e. Equimolar concentrations of T4 and T3 have the same effect on TSH synthesis and release.
4. Which of the following statements about parathyroid hormone (PTH) is FALSE?
a. PTH acts by binding to a G protein-coupled calcium sensing receptor (CaR).
b. The two principal target organs of PTH are bone and kidney.
c. PTH increases calcium and decreases phosphate reabsorption in the distal convoluted tubule.
d. PTH increases intestinal calcium absorption by stimulating renal synthesis of 1,25(OH)2 vitamin D.
5. Which of the following statements is FALSE?
a. In the female, the first meiotic division is initiated at the time of ovulation.
b. In the male, the first and second meiotic divisions occur within the testicular tubules.
c. In the female, the second meiotic division is completed at the time of fertilization.
d. none of the above
6. Which of the following statements regarding glucagon action is TRUE?
Glucagon
a. stimulates glycogenolysis in muscle.
b. inhibits insulin secretion.
c. stimulates gluconeogenesis in liver.
d. inhibits adenylate cyclase.
e. inhibits phospholipase c.
7. Which of the following statements about human growth hormone (hGH) is TRUE?
hGH
a. secretion is diminished by fasting.
b. secretion falls to negligible levels shortly after puberty.
c. is inhibited by somatostatin.
d. is predominantly controlled by nerves in the hypothalamus which reach the pituitary via the
pituitary stalk.
8. Which of the following occurs first in the normal sequence of events during
adolescence in a girl?
a. breast bud development
b. menarche
c. maturation of the estradiol positive feedback loop
d. the growth-height spurt
9. The secretions of parvicellular neurosecretory cells
a. are carried to their target by a specialized portal vasculature.
b. can be regulated by hormonal feedback loops.
c. participate in the pituitary-adrenal cortical response to stress.
d. all of the above
10. A meal that is
1) rich in proteins containing amino acids that stimulate insulin secretion, and
2) low in carbohydrates does not cause hypoglycemia because
a. the meal causes a compensatory increase in T4 secretion.
b. cortisol in circulation prevents glucose from entering muscle.
c. glucagon secretion is also stimulated by the meal.
d. insulin does not bind to insulin receptors if the plasma concentration of amino acids is elevated.
11. The positive estradiol feedback loop is crucial to a normal menstrual cycle because
a. it allows for the cyclic recruitment of a cohort of antral follicles.
b. it maintains proper levels of LH and FSH throughout the cycle.
c. it provides for the release of the hormone responsible for ovulation.
d. it maintains corpus luteum viability.
12. The cells of the adrenal cortex are arranged in three layers, each with its commitment to secrete a particular hormone. As all of these hormones are steroids, you would expect the cells of all layers to
a. respond to GnRH.
b. possess cytochrome P450 side chain cleavage enzyme.
c. possess an aromatizing enzyme to convert androgen to glucocorticoids.
d. store their specific hormone in granules.
13. The vasculature of the adrenal gland (cortex and medulla)
a. is composed of tight, non-fenestrated capillaries in both zones of the gland.
b. provides for a blood-adrenal medulla-barrier as in the CNS.
c. is essential for up-regulation of the rate limiting enzyme (tyrosine hydroxylase) in norepinephrine biosynthesis.
d. provides low levels of glucocorticoids to the medulla.
14. The first wave response to stress is associated with all of the following, EXCEPT
a. increased release of CRH from the paraventricular nucleus
b. decreased blood pressure
c. increased β-endorphin release
d. increased circulating glucose levels
15. Increased skin and mucosa pigmentation in patients with primary adrenal insufficiency is directly related to
a. increased activation of the sympathetic nervous system.
b. increased ACTH levels.
c. decreased cortisol levels.
d. decreased aldosterone levels.
16. The number of antral follicles that are recruited at the beginning of the follicular phase of the menstrual cycle is controlled by
a. Estradiol.
b. FSH.
c. Inhibin B.
d. Progesterone.
e. LH.
17. Following adrenalectomy
a. liver glycogen storage will be increased.
b. the patient will be hyperglycemic.
c. the patient will develop osteoporosis.
d. K+ levels will be increased.
18. At high doses, glucocorticoids
a. enhance local inflammatory processes.
b. decrease the number of circulating thymus-derived lymphocytes (T-cells).
c. produce hypotension.
d. all of the above
19. Insulin-INDEPENDENT glucose uptake occurs in
a. adipose tissue
b. cardiac muscle
c. skeletal muscle
d. the brain
e. the uterus
20. The hormone(s) released during the suckling reflex is (are)
a. LH.
b. Prolactin.
c. Estradiol.
d. Cortisol.
e. all of the above
21. A 48-year old farmer has a 10-month history of muscle weakness, easy bruising, backache, headache, and depression. He is a lifelong smoker who has previously been healthy. His only medication is a nonsteroidal anti-inflammatory agent taken for rib pain. Upon examination, truncal obesity with a buffalo hump, thin skin with easy bruising, and a blood pressure of
180/100 mmHg are noted. Laboratory studies reveal elevated free cortisol with an absence of a circadian rhythm. A high-dose dexamethasone test suppresses AM cortisol levels to less than 50% of basal levels. Which of the following is the most likely diagnosis?
a. Addison disease due to autoimmune destruction of the adrenal.
b. Ectopic Cushing disease due to small cell carcinoma of the lung.
c. 17-α-hydroxylase difficiency due to a congenital defect.
d. Pituitary Cushing disease due to a primary adenoma.
e. Primary hyperaldosteronism due to an adrenal adenoma.
22. Which of the following statements about human growth hormone (hGH) is FALSE?
a. Many of the growth-promoting effects of hGH are due to insulin-like growth factor-1 (IGF-1).
b. hGH enhances the uptake of glucose.
c. hGH enhances lipolysis.
d. The major peak of hGH secretion occurs during the first few hours of sleep at night.
23. Which of the following would you expect to find in a patient whose diet has been low in calcium for 2 months?
a. increased formation of 24,25-dihydroxycholecalciferol
b. increased parathyroid hormone secretion
c. a high plasma calcitonin concentration
d. increased plasma phosphates
24. The corpus luteum of a post-pubertal/non-menopausal woman is
a. a source of progesterone.
b. associated with the maintenance of the straight (basal) arteries of the endometrium.
c. responsible for regeneration of the endometrium after menstruation.
d. is derived solely from the thecal cells of the follicle.
25. A 31-year old woman with a past medical history of a significant pituitary adenoma presents with amenorrhea. Prior to diagnosis of pituitary adenoma, she had irregular menses. This irregularity persisted, and over the last 4 months she has had no menses. She denies sexual activity. On review of system, she notes progressive fatigue and 10 pounds of weight gain over
several months. The pituitary adenoma was treated with radiation therapy one year ago. She is taking no medications. Lung, cardiac, abdominal and neurologic examinations are normal. Pelvic examination reveals normal female genitalia without uterine or ovarian masses. Urine pregnancy is negative. On head-neck examination, she has somewhat coarse, brittle brown hair, but no
goiter or neck masses. Which of the following hormonal deficiencies should you be concerned about in this patient?
a. LH and FSH deficiency
b. TSH deficiency
c. ACTH deficiency
d. all of the above
26. Hypophysectomy would result in
a. an inability to concentrate urine.
b. hyper-fertility.
c. elevated cortisol levels.
d. increased rates of axonal transport of neurosecretory granules.
27. Which statement concerning thyroid hormone action is TRUE?
a. Thyroid hormone stimulation of membrane-bound Na, K-ATPase plays a central role in obligatory thermogenesis (heat production).
b. Thyroid hormone is transported into cells largely bound to serum proteins.
c. T4 and T3 have roughly equal binding affinity for intracellular receptors.
d. Following cellular uptake, thyroid hormone is transported to nuclear binding sites by cytosol binding proteins.
e. Thyroid hormone works primarily by regulating ATP-ADP exchange in mitochondria.
28. During suckling you would predict that in the mothers brain
a. there would be a higher firing rate for LH neurons compared to the same neurons in nonlactating women.
b. the capillaries in the anterior pituitary would develop tight junctions.
c. the oxytocin nerve terminals in the posterior pituitary would be more ensheathed in pituicyte processes compared to the same terminals in non-lactating women.
d. magnocellular neurons in the supraoptic and paraventricular nuclei show heightened bursts of activity compared to the same neurons in non-lactating women.
29. Which of the following tests would suggest that a patient has a large follicle approaching maturity?
a. a positive Fern test
b. a basal body temperature curve showing an increase in temperature in the last 10 days
c. a sticky cervical mucus with a pH of 6.8
d. an increase in progesterone
e. all of the above
30. In cells of the adrenal cortex the mitochondria play a specific role in hormone production. This role is
a. the enzymatic modification of peptide hormones.
b. to metabolize ACTH.
c. to form lipid droplets.
d. the enzymatic modification of cholesterol and other steroid hormone precursors.
31. Which of the following statements about vitamin D is FALSE?
a. The best indicator of body stores of vitamin D is the serum level of 25-OH vitamin D.
b. The principal target organ of 1,25(OH)2 vitamin D is the intestine.
c. The conversion of 25-hydroxyvitamin D to 1,25(OH)2 vitamin D is stimulated by an increase in serum phosphate.
d. The major regulators of 1,25(OH)2 vitamin D are serum phosphate and PTH.
32. Which of the following statements about thyroid hormone synthesis is TRUE?
a. The apical membrane enzyme thyroid peroxidase is primarily responsible for cleaving thyroid hormone from its storage proteins and promoting thyroid hormone release from the gland.
b. Iodine, a major component of the thyroid hormones, is also a major inhibitor of thyroid hormone synthesis.
c. The thyroid gland primarily secretes T3, which is subsequently converted to T4 in tissues such as liver and kidney.
d. Release of hormone from the thyroid gland is the rate-limiting step in thyroid hormone synthesis.
33. Section through the pituitary stalk, which connects the hypothalamus to the pituitary gland, will result in
a. an increase in serum estradiol.
b. an increase in serum prolactin.
c. hyperglycemia.
d. all of the above
e. none of the above
34. A 25-year-old man presents with a complaint of rapid weight loss despite a voracious appetite. Physical examination reveals a pulse rate of 110 bpm at rest, fine moist skin, symmetrically enlarged thyroid, mild bilateral quadriceps muscle weakness and fine tremor. These findings strongly suggest hyperthyroidism. Serum TSH and free thyroxine are ordered.
What results are MOST likely in an individual with hyperthyroidism?
Free thyroxine level TSH level
a. low low
b. high low
c. low high
d. high high
35. Which of the following statements is FALSE?
a. The enzyme converting testosterone into estradiol is aromatase.
b. In the mature follicle, aromatase is present in the theca layer.
c. Aromatase is present in both the male and the female.
d. Because the follicle cannot make precursors, it has to import the testosterone precursor, DHEA, from the adrenal.
36. Removal of the uterus in an adult will result in
a. infertility.
b. an increase in gonadotropins.
c. anovulation.
d. all of the above.
37. Which of the following is FALSE?
a. Human chorionic gonadotropin (hCG) is secreted by the blastocycst and prevents luteolysis (destruction of the corpus luteum).
b. Fertilization of the oocyte occurs in the Fallopian tube.
c. The luteoplacental shift occurs at the time of implantation of the fertilized egg into the uterus.
d. Ovulation occurs 1-1.5 days after the initiation of the LH surge.
38. A 15-year old boy presents with a relative deficiency of testicular testosterone production. Otherwise, he is going through the normal adolescence process. Compared to his peers, he will most probably turn out to be
a. taller.
b. of a similar stature.
c. shorter.
39. Compared to the normal adult range, FSH levels are expected to be
a. much lower in the newborn.
b. much higher in menopausal women.
c. much higher in a 5-year old girl with congenital absence of ovaries.
d. all of the above
40. A patient presents with a serum K+ of 5.7 meq/l (normal range: 3.5-5.0), a serum Na+ of 129 meq/l (normal: 136-145), a glucose of 45 mg% (normal: 60-100), and low blood pressure. He has not been feeling well for quite some time. If the diagnosis turned out to be dysfunction in the HPA axis, what would you expect?
a. Cushing syndrome
b. Addisons disease (primary adrenal insufficiency)
c. an ectopic ACTH-secreting tumor in the lungs
d. secondary adrenal insufficiency (disease originates in the pituitary)
41. When can you remove the ovaries without harming pregnancy?
a. anytime
b. during the second week of pregnancy
c. after the 10th week of pregnancy
d. never
42. A patient is diagnosed with acromegaly. Patients with this disease typically have
a. decreased gluconeogenesis
b. insulin resistance
c. decreased protein synthesis
d. decreased lipolysis
43. The hormone measured in urine to test for pregnancy is
a. LH
b. Progesterone
c. hCG
d. FSH
44. Which part of the adrenal gland would you expect to be atrophied after hypophysectomy?
a. the medulla
b. the zona glomerulosa
c. the zona fasciculata
d. none of the above
45. The mature ovarian follicle utilizes the cooperation between two cell types to make estradiol. The help from the thecal cells
a. is dependent on LH receptors in the theca.
b. consists of transfer of the aromatase enzyme to the granulosa via gap junctions.
c. includes stimulation of vascularization of the granulosa compartment during the follicular phase.
d. all of the above
46. Which of the following are the immediate effects of calcitonin on serum levels of calcium and phosphate? serum calcium serum phosphate
a. increased increased
b. increased decreased
c. decreased decreased
d. no change no change
e. decreased no change
47. A 19-year-old unmarried woman has a history of irregular menstrual cycles, worsening acne, and hair growth on her face, breasts, and lower abdomen. She is sexually active, uses condoms for contraception, and is otherwise well. However, she is very concerned regarding the new hair growth. What is the likely cause for her symptoms?
a. congenital adrenal hyperplasia
b. Sertoli-Leydig cell tumor of the ovary
c. elevated E2, testosterone, and LH levels as a result of polycystic ovariandisease
d. Cushing syndrome
48. The secretory phase of the menstrual cycle (vis-a-vis the endometrium)
a. is preceded by ovulation.
b. occurs after fertilization.
c. is androgen dependent.
d. all of the above
49. Which of the following statements about growth and development is TRUE?
a. Thryoid hormone is essential for normal growth.
b. Serum IGF-1 levels decrease throughout childhood.
c. Growth hormone is essential for prenatal linear growth.
d. Prepubertal growth rates are constant throughout the year.
50. Insulin deficiency leads to
a. increased cellular uptake of glucose.
b. enhanced lipolysis and accumulation of ketone bodies, intermediates in lipid metabolism, in the blood.
c. decreased fatty acid release from adipose tissue.
d. indirect depression of use of glucose by excess fatty acids in the blood.
ANSWER KEY
1 D
2 D
3 C
4 A
5 A
6 C
7 C
8 A
9 D
10 C
11 C
12 B
13 C
14 B
15 B
16 B
17 D
18 B
19 D
20 B
21 D
22 B
23 B
24 A
25 D
26 A
27 A
28 D
29 A
30 D
31 C
32 B
33 B
34 B
35 B
36 A
37 C
38 A
39 B
40 B
41 C
42 B
43 C
44 C
45 A
46 C
47 C
48 A
49 A
50 B
a. Estradiol
b. FSH
c. hCG
d. LH
e. Progesterone
2. The proliferative phase of the menstrual cycle (vis-a-vis the endometrium)
a. occurs in response to the rising serum levels of 17α−estradiol.
b. is dependent on the secretion of gonadotropins from the anterior pituitary.
c. is dependent on the secretion of GnRH from the hypothalamus.
d. all of the above
3. Which statement BEST characterizes the control of thyroid hormone metabolism?
a. The sodium-iodide symporter is under direct negative feedback control by circulating thyroid hormones.
b. TSH controls the synthesis, release, and peripheral metabolism of the thyroid hormones.
c. Thyroid hormones exert their control primarily by modulating the effects of TRH upon TSH synthesis and release by the pituitary gland.
d. Thyroid hormones have a bimodal effect on TSH blood levels: low concentrations stimulate
TSH release and high concentrations inhibit TSH release.
e. Equimolar concentrations of T4 and T3 have the same effect on TSH synthesis and release.
4. Which of the following statements about parathyroid hormone (PTH) is FALSE?
a. PTH acts by binding to a G protein-coupled calcium sensing receptor (CaR).
b. The two principal target organs of PTH are bone and kidney.
c. PTH increases calcium and decreases phosphate reabsorption in the distal convoluted tubule.
d. PTH increases intestinal calcium absorption by stimulating renal synthesis of 1,25(OH)2 vitamin D.
5. Which of the following statements is FALSE?
a. In the female, the first meiotic division is initiated at the time of ovulation.
b. In the male, the first and second meiotic divisions occur within the testicular tubules.
c. In the female, the second meiotic division is completed at the time of fertilization.
d. none of the above
6. Which of the following statements regarding glucagon action is TRUE?
Glucagon
a. stimulates glycogenolysis in muscle.
b. inhibits insulin secretion.
c. stimulates gluconeogenesis in liver.
d. inhibits adenylate cyclase.
e. inhibits phospholipase c.
7. Which of the following statements about human growth hormone (hGH) is TRUE?
hGH
a. secretion is diminished by fasting.
b. secretion falls to negligible levels shortly after puberty.
c. is inhibited by somatostatin.
d. is predominantly controlled by nerves in the hypothalamus which reach the pituitary via the
pituitary stalk.
8. Which of the following occurs first in the normal sequence of events during
adolescence in a girl?
a. breast bud development
b. menarche
c. maturation of the estradiol positive feedback loop
d. the growth-height spurt
9. The secretions of parvicellular neurosecretory cells
a. are carried to their target by a specialized portal vasculature.
b. can be regulated by hormonal feedback loops.
c. participate in the pituitary-adrenal cortical response to stress.
d. all of the above
10. A meal that is
1) rich in proteins containing amino acids that stimulate insulin secretion, and
2) low in carbohydrates does not cause hypoglycemia because
a. the meal causes a compensatory increase in T4 secretion.
b. cortisol in circulation prevents glucose from entering muscle.
c. glucagon secretion is also stimulated by the meal.
d. insulin does not bind to insulin receptors if the plasma concentration of amino acids is elevated.
11. The positive estradiol feedback loop is crucial to a normal menstrual cycle because
a. it allows for the cyclic recruitment of a cohort of antral follicles.
b. it maintains proper levels of LH and FSH throughout the cycle.
c. it provides for the release of the hormone responsible for ovulation.
d. it maintains corpus luteum viability.
12. The cells of the adrenal cortex are arranged in three layers, each with its commitment to secrete a particular hormone. As all of these hormones are steroids, you would expect the cells of all layers to
a. respond to GnRH.
b. possess cytochrome P450 side chain cleavage enzyme.
c. possess an aromatizing enzyme to convert androgen to glucocorticoids.
d. store their specific hormone in granules.
13. The vasculature of the adrenal gland (cortex and medulla)
a. is composed of tight, non-fenestrated capillaries in both zones of the gland.
b. provides for a blood-adrenal medulla-barrier as in the CNS.
c. is essential for up-regulation of the rate limiting enzyme (tyrosine hydroxylase) in norepinephrine biosynthesis.
d. provides low levels of glucocorticoids to the medulla.
14. The first wave response to stress is associated with all of the following, EXCEPT
a. increased release of CRH from the paraventricular nucleus
b. decreased blood pressure
c. increased β-endorphin release
d. increased circulating glucose levels
15. Increased skin and mucosa pigmentation in patients with primary adrenal insufficiency is directly related to
a. increased activation of the sympathetic nervous system.
b. increased ACTH levels.
c. decreased cortisol levels.
d. decreased aldosterone levels.
16. The number of antral follicles that are recruited at the beginning of the follicular phase of the menstrual cycle is controlled by
a. Estradiol.
b. FSH.
c. Inhibin B.
d. Progesterone.
e. LH.
17. Following adrenalectomy
a. liver glycogen storage will be increased.
b. the patient will be hyperglycemic.
c. the patient will develop osteoporosis.
d. K+ levels will be increased.
18. At high doses, glucocorticoids
a. enhance local inflammatory processes.
b. decrease the number of circulating thymus-derived lymphocytes (T-cells).
c. produce hypotension.
d. all of the above
19. Insulin-INDEPENDENT glucose uptake occurs in
a. adipose tissue
b. cardiac muscle
c. skeletal muscle
d. the brain
e. the uterus
20. The hormone(s) released during the suckling reflex is (are)
a. LH.
b. Prolactin.
c. Estradiol.
d. Cortisol.
e. all of the above
21. A 48-year old farmer has a 10-month history of muscle weakness, easy bruising, backache, headache, and depression. He is a lifelong smoker who has previously been healthy. His only medication is a nonsteroidal anti-inflammatory agent taken for rib pain. Upon examination, truncal obesity with a buffalo hump, thin skin with easy bruising, and a blood pressure of
180/100 mmHg are noted. Laboratory studies reveal elevated free cortisol with an absence of a circadian rhythm. A high-dose dexamethasone test suppresses AM cortisol levels to less than 50% of basal levels. Which of the following is the most likely diagnosis?
a. Addison disease due to autoimmune destruction of the adrenal.
b. Ectopic Cushing disease due to small cell carcinoma of the lung.
c. 17-α-hydroxylase difficiency due to a congenital defect.
d. Pituitary Cushing disease due to a primary adenoma.
e. Primary hyperaldosteronism due to an adrenal adenoma.
22. Which of the following statements about human growth hormone (hGH) is FALSE?
a. Many of the growth-promoting effects of hGH are due to insulin-like growth factor-1 (IGF-1).
b. hGH enhances the uptake of glucose.
c. hGH enhances lipolysis.
d. The major peak of hGH secretion occurs during the first few hours of sleep at night.
23. Which of the following would you expect to find in a patient whose diet has been low in calcium for 2 months?
a. increased formation of 24,25-dihydroxycholecalciferol
b. increased parathyroid hormone secretion
c. a high plasma calcitonin concentration
d. increased plasma phosphates
24. The corpus luteum of a post-pubertal/non-menopausal woman is
a. a source of progesterone.
b. associated with the maintenance of the straight (basal) arteries of the endometrium.
c. responsible for regeneration of the endometrium after menstruation.
d. is derived solely from the thecal cells of the follicle.
25. A 31-year old woman with a past medical history of a significant pituitary adenoma presents with amenorrhea. Prior to diagnosis of pituitary adenoma, she had irregular menses. This irregularity persisted, and over the last 4 months she has had no menses. She denies sexual activity. On review of system, she notes progressive fatigue and 10 pounds of weight gain over
several months. The pituitary adenoma was treated with radiation therapy one year ago. She is taking no medications. Lung, cardiac, abdominal and neurologic examinations are normal. Pelvic examination reveals normal female genitalia without uterine or ovarian masses. Urine pregnancy is negative. On head-neck examination, she has somewhat coarse, brittle brown hair, but no
goiter or neck masses. Which of the following hormonal deficiencies should you be concerned about in this patient?
a. LH and FSH deficiency
b. TSH deficiency
c. ACTH deficiency
d. all of the above
26. Hypophysectomy would result in
a. an inability to concentrate urine.
b. hyper-fertility.
c. elevated cortisol levels.
d. increased rates of axonal transport of neurosecretory granules.
27. Which statement concerning thyroid hormone action is TRUE?
a. Thyroid hormone stimulation of membrane-bound Na, K-ATPase plays a central role in obligatory thermogenesis (heat production).
b. Thyroid hormone is transported into cells largely bound to serum proteins.
c. T4 and T3 have roughly equal binding affinity for intracellular receptors.
d. Following cellular uptake, thyroid hormone is transported to nuclear binding sites by cytosol binding proteins.
e. Thyroid hormone works primarily by regulating ATP-ADP exchange in mitochondria.
28. During suckling you would predict that in the mothers brain
a. there would be a higher firing rate for LH neurons compared to the same neurons in nonlactating women.
b. the capillaries in the anterior pituitary would develop tight junctions.
c. the oxytocin nerve terminals in the posterior pituitary would be more ensheathed in pituicyte processes compared to the same terminals in non-lactating women.
d. magnocellular neurons in the supraoptic and paraventricular nuclei show heightened bursts of activity compared to the same neurons in non-lactating women.
29. Which of the following tests would suggest that a patient has a large follicle approaching maturity?
a. a positive Fern test
b. a basal body temperature curve showing an increase in temperature in the last 10 days
c. a sticky cervical mucus with a pH of 6.8
d. an increase in progesterone
e. all of the above
30. In cells of the adrenal cortex the mitochondria play a specific role in hormone production. This role is
a. the enzymatic modification of peptide hormones.
b. to metabolize ACTH.
c. to form lipid droplets.
d. the enzymatic modification of cholesterol and other steroid hormone precursors.
31. Which of the following statements about vitamin D is FALSE?
a. The best indicator of body stores of vitamin D is the serum level of 25-OH vitamin D.
b. The principal target organ of 1,25(OH)2 vitamin D is the intestine.
c. The conversion of 25-hydroxyvitamin D to 1,25(OH)2 vitamin D is stimulated by an increase in serum phosphate.
d. The major regulators of 1,25(OH)2 vitamin D are serum phosphate and PTH.
32. Which of the following statements about thyroid hormone synthesis is TRUE?
a. The apical membrane enzyme thyroid peroxidase is primarily responsible for cleaving thyroid hormone from its storage proteins and promoting thyroid hormone release from the gland.
b. Iodine, a major component of the thyroid hormones, is also a major inhibitor of thyroid hormone synthesis.
c. The thyroid gland primarily secretes T3, which is subsequently converted to T4 in tissues such as liver and kidney.
d. Release of hormone from the thyroid gland is the rate-limiting step in thyroid hormone synthesis.
33. Section through the pituitary stalk, which connects the hypothalamus to the pituitary gland, will result in
a. an increase in serum estradiol.
b. an increase in serum prolactin.
c. hyperglycemia.
d. all of the above
e. none of the above
34. A 25-year-old man presents with a complaint of rapid weight loss despite a voracious appetite. Physical examination reveals a pulse rate of 110 bpm at rest, fine moist skin, symmetrically enlarged thyroid, mild bilateral quadriceps muscle weakness and fine tremor. These findings strongly suggest hyperthyroidism. Serum TSH and free thyroxine are ordered.
What results are MOST likely in an individual with hyperthyroidism?
Free thyroxine level TSH level
a. low low
b. high low
c. low high
d. high high
35. Which of the following statements is FALSE?
a. The enzyme converting testosterone into estradiol is aromatase.
b. In the mature follicle, aromatase is present in the theca layer.
c. Aromatase is present in both the male and the female.
d. Because the follicle cannot make precursors, it has to import the testosterone precursor, DHEA, from the adrenal.
36. Removal of the uterus in an adult will result in
a. infertility.
b. an increase in gonadotropins.
c. anovulation.
d. all of the above.
37. Which of the following is FALSE?
a. Human chorionic gonadotropin (hCG) is secreted by the blastocycst and prevents luteolysis (destruction of the corpus luteum).
b. Fertilization of the oocyte occurs in the Fallopian tube.
c. The luteoplacental shift occurs at the time of implantation of the fertilized egg into the uterus.
d. Ovulation occurs 1-1.5 days after the initiation of the LH surge.
38. A 15-year old boy presents with a relative deficiency of testicular testosterone production. Otherwise, he is going through the normal adolescence process. Compared to his peers, he will most probably turn out to be
a. taller.
b. of a similar stature.
c. shorter.
39. Compared to the normal adult range, FSH levels are expected to be
a. much lower in the newborn.
b. much higher in menopausal women.
c. much higher in a 5-year old girl with congenital absence of ovaries.
d. all of the above
40. A patient presents with a serum K+ of 5.7 meq/l (normal range: 3.5-5.0), a serum Na+ of 129 meq/l (normal: 136-145), a glucose of 45 mg% (normal: 60-100), and low blood pressure. He has not been feeling well for quite some time. If the diagnosis turned out to be dysfunction in the HPA axis, what would you expect?
a. Cushing syndrome
b. Addisons disease (primary adrenal insufficiency)
c. an ectopic ACTH-secreting tumor in the lungs
d. secondary adrenal insufficiency (disease originates in the pituitary)
41. When can you remove the ovaries without harming pregnancy?
a. anytime
b. during the second week of pregnancy
c. after the 10th week of pregnancy
d. never
42. A patient is diagnosed with acromegaly. Patients with this disease typically have
a. decreased gluconeogenesis
b. insulin resistance
c. decreased protein synthesis
d. decreased lipolysis
43. The hormone measured in urine to test for pregnancy is
a. LH
b. Progesterone
c. hCG
d. FSH
44. Which part of the adrenal gland would you expect to be atrophied after hypophysectomy?
a. the medulla
b. the zona glomerulosa
c. the zona fasciculata
d. none of the above
45. The mature ovarian follicle utilizes the cooperation between two cell types to make estradiol. The help from the thecal cells
a. is dependent on LH receptors in the theca.
b. consists of transfer of the aromatase enzyme to the granulosa via gap junctions.
c. includes stimulation of vascularization of the granulosa compartment during the follicular phase.
d. all of the above
46. Which of the following are the immediate effects of calcitonin on serum levels of calcium and phosphate? serum calcium serum phosphate
a. increased increased
b. increased decreased
c. decreased decreased
d. no change no change
e. decreased no change
47. A 19-year-old unmarried woman has a history of irregular menstrual cycles, worsening acne, and hair growth on her face, breasts, and lower abdomen. She is sexually active, uses condoms for contraception, and is otherwise well. However, she is very concerned regarding the new hair growth. What is the likely cause for her symptoms?
a. congenital adrenal hyperplasia
b. Sertoli-Leydig cell tumor of the ovary
c. elevated E2, testosterone, and LH levels as a result of polycystic ovariandisease
d. Cushing syndrome
48. The secretory phase of the menstrual cycle (vis-a-vis the endometrium)
a. is preceded by ovulation.
b. occurs after fertilization.
c. is androgen dependent.
d. all of the above
49. Which of the following statements about growth and development is TRUE?
a. Thryoid hormone is essential for normal growth.
b. Serum IGF-1 levels decrease throughout childhood.
c. Growth hormone is essential for prenatal linear growth.
d. Prepubertal growth rates are constant throughout the year.
50. Insulin deficiency leads to
a. increased cellular uptake of glucose.
b. enhanced lipolysis and accumulation of ketone bodies, intermediates in lipid metabolism, in the blood.
c. decreased fatty acid release from adipose tissue.
d. indirect depression of use of glucose by excess fatty acids in the blood.
ANSWER KEY
1 D
2 D
3 C
4 A
5 A
6 C
7 C
8 A
9 D
10 C
11 C
12 B
13 C
14 B
15 B
16 B
17 D
18 B
19 D
20 B
21 D
22 B
23 B
24 A
25 D
26 A
27 A
28 D
29 A
30 D
31 C
32 B
33 B
34 B
35 B
36 A
37 C
38 A
39 B
40 B
41 C
42 B
43 C
44 C
45 A
46 C
47 C
48 A
49 A
50 B
