Endo Hypthal Pitu Phys Pharm MCQ's
- 1.A 23-year old male patient comes to your office who is 3 feet 6 inches tall. your initial diagnosis is that an endocrine disorder accounts for his short stature. To confirm your diagnosis you run a series of laboratory tests. The laboratory results come back with the following findings: 1) plasmaIGF-1levels are extremely low, 2) plasma GH levels are very high, and 3) exogenous GHRH elicits a further increase in GH. What would be the most likely defect in this individual to explain his dwarfism?
- A.
Excessive production of somatostat in by periventricular hypothalamic neurons.
- B.
Inadequate production of GHRH by arcuate neurons of the hypothalamus
- C.
Inadequate production of IGF-1 by somatotrophs of the anterior pituitary gland.
- D.
Overproduction of GHRH by arcuate neurons of the hypothalamus.
- E.
Inability of the liver to produce IGF-1.
- 2.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
- 3.While doing a pediatric rotation, you observe a visit by 10-year-old male patient who is below the 1Oth percentile for height. The pediatrician makes an initial diagnosis of dwarfism caused by pituitary dysfunction. However, the physician asks you to develop a strategy to determine if the actual cause is growth hormone receptor dysfunction. Laboratory values for serum growth hormone were above normal. Which of the following would constitute a key piece of information in your diagnostic strategy?
- A.
Low plasma levels of growth hormone binding protein
- B.
Low plasma levels of IGF-1
- C.
Elevated plasma levels for growth hormone releasing hormone
- D.
Decreased plasma levels of somatostatin
- 4.Although the production of IGF-1 by the liver makes an important contribution to circulating levels of IGF-1,many other tissues produce IGFs. For most tissues,IGF-1 is considered to act as what type of signaling factor?
- A.
Hormone
- B.
Paracrine
- C.
Autocrine
- D.
Intracrine
- E.
Neuroendocrine
- 5.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 1.010-1.025j.ysur te_ntative 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
- D.
High plasma concentration of vasopressin acting at magnocellular neurons of the Para ventricular nucleus of the hypothalamus has suppressed hypothalamic release of vasopressin
- E.
Magnocellular neurons of the Para ventricular and suproptic nuclei of the hypothalamus are not responding to an increase in whole body osmolarity and are not releasing vasopressin from the posterior pituitary.
- 6.Which drug for treating acromegaly acts by blocking receptors for growth hormone?
- A.
Somatropin
- B.
Pegvisomant
- C.
Octreotide
- D.
Sermorelin
- E.
Cabergoline
- 7.By which of the following mechanisms does bromocriptine relieve 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.
Stimulating dopamine receptors
- E.
Stimulating serotonin receptors
- 8.A 3O-year-old man who suffered a head injury presented one month after recovery with excessive thirst and urination. After examination and lab tests he was diagnosed with neurogenic diabetes insipidus. Desmopressin was prescribed to him. Which of the following is its mechanism of action?
- A.
It stimulatesV2 receptors
- B.
It prevents the breakdown of ADH
- C.
It stimulate the release of ADH from posterior pituitary
- D.
It stimulates V1 receptors
- 9.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.
Leuprolide
- B.
Cosyntropin
- C.
Somatropin
- D.
Octreotide
- E.
Protirelin
- 10.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 2O mOsm/Kg and undetectable plasma ADH levels. Which if the following drugs would be appropriate for the patient?
- A.
Hydrochlorothiazide
- B.
Amiloride
- C.
Desmopressin
- D.
Carbamazepine
- E.
Chlorpropamide
- 11.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
- 12.A 48 YO man with a family history of heart disease has followed a heart-healthy lifestyle for fifteen years. Despite these efforts he has recently experienced unusual fatigue and lightheadedness , especially when rising suddenly. Physical examination, demonstrates postural hypotension and a darker-than usual complexion for midwinter in the Midwest (he works and exercises indoors). Lab work reveals that he is hyponatremic, . hyperkalemic, and hypocalcemic Further blood tests are ordered to assay plasma corticotropin-releasing hormone(CRH), corticotropin (ACTH), and cortisol. What combination of hyper and/or hyposecretion for these hormones would be the most likely given this man's signs and symptoms? . CRH secretion ACTH secretion Cortisol secretion A Hyper-secretion Hyper-secretion Hyper-secretion B Hyper-secretion Hyper-secretion Hypo-secretion C Hyper-secretion Hypo-secretion Hypo-secretion D Hypo-secretion Hypo-secretion Hypo-secretion E Hypo-secretion Hypo-secretion hyper-secretion
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
- 13.A 19 YO man decides to begin a vegan diet, but he fails to adequately compensate for the nutritional content of the dairy products in his former diet, so his intake of calcium drops dramatically. Which of the following hormones' direct actions will be most important in the maintenance of his plasma calcium?
- A.
Insulin
- B.
Thyroid hormone
- C.
Calcitonin
- D.
1,25-dihyroxycholecalciferol
- E.
Parathyroid hormone
- 14.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 gaffe, in which she had fallen from a climbing rope" head first" onto some weight-training equipment, and 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.
Luteinizing Hormone (LH)
- B.
Thyroid Stimulating Hormone (TSH)
- C.
Follicle Stimulating Hormone (FSH)
- D.
Oxytocin
- E.
Prolactin (Prl)
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