Block 13 Pituitary Hypothal Disorder Drugs

21 Questions | By Chachelly | Last updated: Feb 22, 2013 | Total Attempts: 333

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1.

Which of the following statements concerning the pituitary gland is CORRECT?
- A.
  
  TSH is derived from the hypothalamus
- B.
  
  TSH is stored in the pars nervosa of the pituitary gland
- C.
  
  Herring bodies store oxytocin and FSH
- D.
  
  Somatotrophs are acidophils and they produce GH
- E.
  
  Chromophobes secrete oxytocin and vasopressin
2.

Which of the following statements concerning the embryology of the pituitary gland is CORRECT?
- A.
  
  The anterior pituitary is derived from the mesencephalon
- B.
  
  Rathke’s pouch is derived from the posterior pituitary
- C.
  
  The Pars Distalis is derived from endoderm
- D.
  
  Mesoderm gives rise to the anterior pituitary
- E.
  
  Neuroectoderm gives rise to the neurohypophysis
3.

Which of the following statements concerning the pituitary gland is CORRECT?
- A.
  
  ACTH is derived from the hypothalamus
- B.
  
  Herring bodies store oxytocin and vasopressin
- C.
  
  TSH is stored in the pars nervosa of the pituitary gland
- D.
  
  Acidophils produce FSH and ACTH
- E.
  
  Chromophils secrete oxytocin and vasopressin
4.

Which cell type produces growth hormone ?
- A.
  
  Neurosecretory cells of paraventricular nuclei
- B.
  
  Pituicytes
- C.
  
  Corticotrophs
- D.
  
  Somatotrophs
- E.
  
  Hepatocytes
5.

Both the anterior and posterior pituitary glands depend upon input from hypothalamic nuclei for release of pituitary hormones. In the following table which row correctly lists the type of connections between the hypothalamus and the anterior and posterior pituitary glands? Hypothalamus to anterior pituitary Hypothalamus to posterior pituitary A Axonal connections Axonal connections B Releasing factors Releasing factors C Axonal connections Releasing factors D Releasing factors Axonal connections
- A.
  
  A
- B.
  
  B
- C.
  
  C
- D.
  
  D
6.

A laboratory experiment was performed utilizing microscope-florescence-imaging of a Ca⁺⁺ - sensitive dye (a technique that enables investigators to monitor intracellular Ca⁺⁺) on freshly isolated cells from the anterior pituitary gland of a mouse. On addition of a newly discovered peptide hormone to the fluid bathing the cells, it was observed that intracellular Ca⁺⁺ increased in some cells but not in others. All cells were determined as viable (alive) by an independent test. What is the most likely explanation for the failure of some cells to respond to the hormone?
- A.
  
  Chemical signals are only exposed to specific cells
- B.
  
  Some cells are completely without receptors
- C.
  
  Some cells are completely without ligands
- D.
  
  Signal chemicals often break down before reaching the target.
- E.
  
  Some cells lack the necessary receptors
7.

The presence of a tumor in the anterior pituitary causes a decrease in ACTH secretion. Which of the following correctly describes changes in plasma levels of hormones?
- A.
  
  Increased CRH, increased ACTH, and increased cortisol
- B.
  
  Decreased CRH, decreased ACTH, and decreased cortisol
- C.
  
  Increased CRH, decreased ACTH, and decreased cortisol
- D.
  
  Increased CRH, increased ACTH, and decreased cortisol
- E.
  
  Decreased CRH, decreased ACTH, and increased cortisol
8.

A 28 year-old woman attends her doctor because she has not had a menstrual cycle of two months, but commercial pregnancy tests have proven negative. She reports that a few weeks before her expected menstrual cycle was missed, she had suffered an accident in a gym, in which she had fallen from a climbing rope from a height of around 10 feet. She had fallen “head-first” onto some weight-training equipment, and although she had not lost consciousness, she sustained bruising on the left side of her face around her cheek, eye and temples. The woman reports that following the accident she had noticed that she was feeling continually fatigued, and had gained weight. She feels thirsty most of the time and is perplexed as to why she needs to urinate more often than before. Physical examination confirms that the woman is not pregnant and reveals traces of a white crystalline deposit around her nipples. The level of which hormone would be expected to be elevated in the plasma of this patient?
- A.
  
  Luteunizing Hormone (LH)
- B.
  
  Thyroid Stimulating Hormone (TSH)
- C.
  
  Follicle Stimulating Hormone FSH)
- D.
  
  Oxytocin
- E.
  
  Prolactin (Prl)
9.

Following brain surgery, a patient receiving postoperative care in an intensive care unit began to produce large volumes of dilute urine. The patient is administered an analogue of which of the following hormones?
- A.
  
  Aldosterone
- B.
  
  Vasopressin
- C.
  
  Oxytocin
- D.
  
  Cortisol
- E.
  
  Epinephrine
10.

A 43-year old female patient comes to your office with the following symptoms: lethargy, postural hypotension, recent weight loss, and muscle weakness. Your tentative diagnosis is adrenal cortical dysfunction. You order a set of laboratory tests which come back with the following results: undetectable levels of plasma ACTH and very low plasma cortisol. In addition, you can demonstrate that exogenous CRF increases plasma cortisol. What is the most likely explanation for this patient’s endocrine problem?
- A.
  
  Disappearance of cortisol producing adrenal cortical cells
- B.
  
  Nonfunctional corticotrophs of the anterior pituitary.
- C.
  
  Nonfunctional corticotrophs of the posterior pituitary.
- D.
  
  Insufficient production of CRF by hypothalamic neurons.
- E.
  
  Absence of ACTH receptors on adrenal cortical cells.
11.

A 29 year old woman is diagnosed with acromegaly. Typically, she would exhibit which one of the following abnormalities?
- A.
  
  Hypoglycemia
- B.
  
  Decreased gluconeogenesis
- C.
  
  Insulin resistance
- D.
  
  Decreased protein synthesis
- E.
  
  Increased storage of fat in adipose tissue
12.

A 6-year-old boy of short stature is given a subcutaneous injection of growth hormone releasing hormone (GHRH) and blood samples are taken 1 hour later for measurement of plasma growth hormone (GH). Laboratory results demonstrated an increase in GH concentration following the injection of GHRH. What would be the most likely conclusion based upon these findings?
- A.
  
  The patient’s short stature is most likely explained by inadequate hypothalamic release of GHRH
- B.
  
  The patients’ short stature is most likely explained by inability of somatotrophs to release GH.
- C.
  
  The liver cannot produce insulin-like growth factor-1 (IGF-1).
- D.
  
  Somatotrophes of the anterior pituitary are inactive because of hypersecretion of somatostatin.
- E.
  
  Endogenous GHRH had suppressed the release of somatostatin.
13.

A 25-year-old male patient comes to a local clinic with the following complaints. He has to urinate frequently and he is constantly drinking water. A 24-urine collection is taken with the following findings. Urine volume is 6 liters per day and the specific gravity of the urine is 1.005 (normal range is 1.010-1.025). Your tentative diagnosis is diabetes insipidus. You administer intravenously an analogue of vasopressin and observe that the subsequent 24 hour urine collection is reduced to 3 liters per day. What is the most likely explanation for his polyuria?
- A.
  
  Aquatrophs of the anterior pituitary are not being stimulated by vasopressin releasing hormone.
- B.
  
  V1 receptors on epithelial cells of the collecting tubules and ducts are absent.
- C.
  
  V2 receptors on epithelial cells of the collecting tubules and ducts are absent.
- D.
  
  High plasma concentration of vasopressin acting at magnocellular neurons of the paraventricular nucleus of the hypothalamus has suppressed hypothalamic release of vasopressin.
- E.
  
  Magnocellular neurons of the paraventricular nucleus of the hypothalamus are not responding to an increase in whole body osmolarity and are not releasing vasopressin from the posterior pituitary
14.

Which drug for treating acromegaly acts by blocking receptors for growth hormone?
- A.
  
  Somatropin
- B.
  
  Pegvisomant
- C.
  
  Octreotide
- D.
  
  Desmopressin
- E.
  
  Cabergoline
15.

By which of the following mechanisms does bromocriptine relieves symptoms of hyperprolactinemia in a patient with prolactin-secreting pituitary adenoma?
- A.
  
  Blocking prolactin receptors
- B.
  
  Blocking receptors for prolactin releasing hormone
- C.
  
  A cytotoxic effect on pituitary adenoma cells
- D.
  
  Activating receptors for prolactin-inhibiting hormone
- E.
  
  Stimulating the breakdown of prolactin
16.

A 35-year-old woman presented to the clinic complaining of continuous thirst and polyuria. She had had a basal skull fracture following a car accident six month previously from which she recovered completely. She reported that she often awoke at night because of thirst and a need to urinate. Urinalysis showed a urine osmolality of 20 mOsm/Kg and undetectable plasma ADH levels. Which if the following drugs would be appropriate for the patient?
- A.
  
  Conivaptan
- B.
  
  Sermorelin
- C.
  
  Desmopressin
- D.
  
  Octreotide
- E.
  
  Bromocriptine
17.

A 40-year-old man who presented with a history of violent attacks of watery diarrhea, cramping and paroxysmal vasomotor attacks (red to purple flushing of face and neck) is diagnosed with carcinoid syndrome. Which of the following drugs can most likely control his symptoms?
- A.
  
  Sermorelin
- B.
  
  Conivaptan
- C.
  
  Pegvisomant
- D.
  
  Octreotide
- E.
  
  Somatrem
- F.
  
  Desmopressin
18.

A 30-year-old pregnant woman at term was started oxytocin to induce labor. It acts as uterine stimulant by which of the following mechanisms?
- A.
  
  Activating IP3-DAG-Ca+2 pathway
- B.
  
  Activating cAMP pathway
- C.
  
  Activating cGMP-NO pathway
- D.
  
  Activating Na+-K+ channels
19.

A 35-year-old man presented to the hospital with a history of joint pain, headache, excessive sweating, and deepening of the voice. A physical examination revealed protrusion of the jaw, enlargement of the hands, thickening of the skin, and a barrel chest. A CT scan disclosed a pituitary adenoma and the patient underwent radiotherapy. Which of the following drugs was most likely prescribed while waiting for radiotherapy to work?
- A.
  
  Somatrem
- B.
  
  Sermorelin
- C.
  
  Somatropin
- D.
  
  Octreotide
- E.
  
  Cabergoline
20.

A 32-year old man was admitted to the hospital because of prolonged, massive watery diarrhea for the last two days. Physical and lab exams indicated a pancreatic tumor and radioimmunoassay confirmed the diagnosis of vipoma. The patient was given IV fluids for hydration and was scheduled for surgery. Which of the following drugs would be appropriate to control the patient’s diarrhea?
- A.
  
  Somatotropin
- B.
  
  Conivaptan
- C.
  
  Bromocriptine
- D.
  
  Octreotide
- E.
  
  Cabergoline
21.

A 52-year-old man was admitted to the hospital because of a sharp substernal pain of one hour duration. On admission the patient lost consciousness and physical examination revealed nonpalpable pulses and absent heart sounds. Cardioversion was tried without success, then cardiopulmonary resuscitation was started and a large dose of vasopressin was given IV. The beneficial effect of the drug in this setting seems mainly mediated by which of the following actions?
- A.
  
  The increased venous return to the heart
- B.
  
  The decreased water diuresis
- C.
  
  The cerebral vasodilation
- D.
  
  The positive inotropic effect
- E.
  
  The decreased cardiac automaticity