Block 5 Parthyroid Phys Pharm MCQ's
- 1.A 34 year-old female patient is seen for kidney stones. The physician orders blood work and asks the patient to collect her urine over a 24 hour period. The results of the laboratory tests show a modest increase in plasma [Ca++] and substantial decrease in the Ca++ in her urine. An increase in what hormone would most likely account for these findings?
- A.
Calcitriol
- B.
Calcitonin
- C.
Estrogen
- D.
Parathyroid hormone
- E.
Leptin
- 2.Hyperparathyroidism usually decreases the plasma level of which ion?
- A.
Iron
- B.
Calcium
- C.
Phosphate
- D.
Potassium
- E.
Sodium
- 3.In children, how do parathyroid hormone (PTH) and calcitonin affect bone deposition and resorption?
- A.
PTH increases bone deposition and calcitonin increases bone resorption
- B.
PTH increases bone resorption and calcitonin inhibits bone resorption
- C.
PTH increases bone resorption and calcitonin increases bone resorption
- D.
PTH increases bone deposition and calcitonin inhibits bone resorption
- E.
PTH increases bone deposition and calcitonin has no influence on either bone deposition or resorption
- 4.A 54-year-old woman takes dietary supplements that provide her with 1000 mg of elemental calcium per day. If she had already been on a normal diet, what effect will this supplement have on hormone levels in her plasma?"
- A.
A decrease in circulating PTH (parathyroid hormone) levels.
- B.
A decrease in circulating CT (calcitonin) levels
- C.
A decrease in vitamin D levels.
- D.
A decrease in 25(OH)D levels.
- E.
A decrease in 1,25(OH)2D levels.
- F.
A decrease in thyroid hormone levels.
- G.
No effect
- 5.Which of the following drugs stimulate new bone formation?
- A.
Calcitriol
- B.
Alendronate
- C.
Estradiol
- D.
Raloxifene
- E.
Teriparatide
- F.
Cinacalcet
- 6.A 64-year-old man complains to his physician of lower back pain. He reports that he has had rheumatoid arthritis for over 10 years, for which he takes oral prednisone, but the new back pain is different. Physical exam reveals nothing remarkable, except that he is an inch shorter than at his last visit, 1.5 years ago. Which of the following actions of prednisone are most likely to be contributing to the new back pain?
- A.
Inhibition of intestinal calcium absorption
- B.
Decreased ACTH secretion
- C.
Increased blood glucose levels
- D.
Decreased IL-1, IL-2 and 11-6 actions
- E.
Body fat redistribution
- 7.Which of the following is an expected metabolic response to HIGH plasma calcium levels?
- A.
Increased parathyroid hormone release
- B.
Decreased synthesis of 1,25 dihydroxy vitamin D3
- C.
Increased calcium absorption from the intestine
- D.
Decreased renal excretion of calcium
- E.
Increased calcium mobilization from bone
- 8.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-dihydroxycholecalciferol
- E.
Parathyroid hormone
- 9.Adrenal Gland Physiology, Pharmacology and Biochemistry: A predominantly male patient mentions that his childhood sexual development was a bit turbulent because of 5a-reductase deficiency. What is the function of 5a-reductase?
- A.
A) Makes testosterone in the testis
- B.
B) Is needed for the synthesis of glucocorticoids and mineralocorticoids
- C.
C) Turns testosterone into highly potent dihydrotestosterone
- D.
D) Turns androgens into estrogens
- E.
E) Catalyzes the conversion of cholesterol into pregnenolone
- 10.A 48 YO man with a family history of heart disease has followed a heart-healthy lifestyle for 15 years. However, 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 hypersecretion hypersecretion hypersecretion B hypersecretion hypersecretion hyposecretion C hypersecretion hyposecretion hyposecretion D hyposecretion hyposecretion hyposecretion E hyposecretion hyposecretion hypersecretion
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
- 11.A patient with lethargy, nausea, and reported muscle weakness is given a series of tests to rule out physical causes. During these tests it is revealed that plasma corticotropin is above normal and cortisol is below normal. Renin is above normal and aldosterone is below normal. Adrenal androgens are below normal. Which of the following clinical conditions would be most likely to produce this set of signs and symptoms?
- A.
Cushing's Disease
- B.
Ectopic corticotropin-producing tumor
- C.
Secondary renal insufficiency
- D.
Congenital adrenal hyperplasia E) Addison's Disease
- E.
Addison's Disease
- 12.Within the chromaffin cells of the adrenal medulla, which ion's influx is an absolute requirement for epinephrine secretion?
- A.
Calcium
- B.
Sodium
- C.
Chloride
- D.
Potassium
- E.
Iodide
- 13.What would be an expected outcome of 11-deoxycorticosterone-induced hypervolemia and hypertension on the renin-angiotensin-aldosterone system? [renin]pi [angiotensin II]pi [aldosterone]pi A Increase Increase Increase B Decrease Decrease Decrease C Increase Decrease Decrease D Decrease Increase Decrease E Decrease Decrease Increase
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
- 14.Polyuria, polydipsia, weakness, and fatigue are characteristic of several endocrine disorders. In one patient, the physician notes both peripheral neuropathy and visual changes as well. What clinical condition would be most likely to produce these six findings?
- A.
Addison's disease
- B.
Conn's syndrome
- C.
Cushing's syndrome
- D.
Diabetes mellitus
- E.
Diabetes insipidus
- 15.What branch of the autonomic nervous system elicits catecholamine release from the adrenal medulla and what is the neurotransmitter and receptor responsible for increased epinephrine release from adrenal medullary chromaffin cells? Branch of ANS Neurotransmitter Receptor A Parasympathetic Norepinephrine Alpha-1 B Sympathetic Norepinephrine Alpha-1 C Sympathetic Acetylcholine Muscarinic D Parasympathetic Acetylcholine Muscarinic E Sympathetic Acetylcholine Nicotinic
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
- 16.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.
- 17.In pheochromocytoma, 3-methoxy-4-hydroxymandelic acid is formed enzymatically as a breakdown product of norepinephrine. The formation of this metabolite would be slowed down not only by inhibitors of MAO or COMT, but also by a
- A.
Glutamate decarboxylase inhibitor
- B.
COX-2 inhibitor
- C.
Tricyclic antidepressant
- D.
Tryptophan hydroxylase inhibitor
- E.
Tyrosine hydroxylase inhibitor
- 18.Of these drugs, the one best suited for the treatment of pheochromocytoma is a
- A.
Glutamate decarboxylase inhibitor
- B.
COX-2 inhibitor
- C.
Tricyclic antidepressant
- D.
Tryptophan hydroxylase inhibitor
- E.
Tyrosine hydroxylase inhibitor
- 19.Which of the following aspects of hormone storage, transport, or action are common to both thyroid hormone and steroid hormones?
- A.
Activate receptor tyrosine kinase.
- B.
Are stored in granules
- C.
Travel primarily as free hormones in the circulation.
- D.
Are highly bound to plasma proteins.
- E.
Have half-lives of about 1 minute.
- 20.In the synthesis of adrenal medullary hormones cortisol stimulates the conversion of
- A.
Tyrosine to dopa.
- B.
Tyrosine to dopamine.
- C.
Dopamine to dopa.
- D.
Epinephrine to norepinephrine.
- E.
Norepinephrin to epinephrine.
- 21.Select the cardiovascular effect that will most likely result from activation of beta-1 and beta-2 receptors by the catecholamines released from the adrenal medulla.
- A.
Increased CO, increased TPR, decreased HR
- B.
Increased CO, decreased TPR, increased HR
- C.
Decreased CO, decreased TPR, increased HR.
- D.
Decreased CO, decreased TPR, decreased HR
- E.
Decreased CO, decreased TPR, decreased HR
- 22.In situations of stress and anxiety, epinephrine synthesis can be increased when cortisol Stimulates the enzyme
- A.
Tyrosine hydroxylase
- B.
Amino acid decarboxylase
- C.
COMT( catecholamine-O- methyl-transferase)
- D.
MAO(monoamine oxidase)
- E.
PNMT(phenylethanolamine-N-methyl transferase)
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