Pathophysiology Practice 5
Endocrine: pituitary, thyroid, adrenal, pancreas, parathyroid
- 1.
Which is not a role of hormones of the endocrine system?
- A.
Regulation of digestion
- B.
Initiation of reactions on specific target cells
- C.
Use and storage of nutrients
- D.
Growth and development
- E.
Electrolyte and water metabolism
Correct Answer
B. Initiation of reactions on specific target cells -
- 2.
Which is false of hormones?
- A.
A single function can be regulated by several hormones
- B.
One hormone can regulate several functions
- C.
Hormones have an autocrine function that acts locally in the area they are released on other cells
- D.
Most are present in the body fluids at all times in inactive forms
- E.
Peptide hormones are produced as precursor hormones
Correct Answer
C. Hormones have an autocrine function that acts locally in the area they are released on other cells -
- 3.
Which is incorrect?
- A.
Protein and peptide hormones are synthesized in the rough endoplasmic reticulum
- B.
Lipid-soluble steroid hormones are synthesized in the smooth endoplasmic reticulum
- C.
Protein and peptide hormones are released as they are synthesized
- D.
Steroid and thyroid hormones are usually transmitted in bound forms
- E.
Hormones must be inactivated continuously to prevent accumulation and toxicity
Correct Answer
C. Protein and peptide hormones are released as they are synthesized -
- 4.
Where is the defect in a secondary endocrine disorder?
- A.
The cerebral cortex
- B.
The hypothalamus
- C.
The pituitary gland
- D.
The target gland
Correct Answer
C. The pituitary gland -
- 5.
Which hormone is not released from the anterior pituitary?
- A.
ADH
- B.
TSH
- C.
FSH
- D.
ACTH
- E.
LH
Correct Answer
A. ADH -
- 6.
Which is true of pituitary disorders?
- A.
50% of the pituitary gland is destroyed before manifestation of clinical symptoms
- B.
Symptoms of cold intolerance and decreased sexual function occur suddenly
- C.
The first hormone to show a decrease is growth hormone
- D.
Carcinomas account for a majority of anterior pituitary disorders
- E.
Microadenomas erode the sella turcica and may impinge on the surrounding cranial structures
Correct Answer
C. The first hormone to show a decrease is growth hormone -
- 7.
Which hormone is not necessary for normal growth?
- A.
Insulin
- B.
Thyroid hormones
- C.
Androgens
- D.
Glucocorticoids
- E.
Prolactin
Correct Answer
E. Prolactin -
- 8.
Which is false of growth hormone?
- A.
It has a half life of 20 to 50 minutes
- B.
It increases due to GH and decreases due to somatostatin
- C.
It is stimulated by hyperglycemia and decreased level of amino acids
- D.
It is secreted throughout life
- E.
It is secreted by somatotropes in the pituitary gland
Correct Answer
C. It is stimulated by hyperglycemia and decreased level of amino acids -
- 9.
Which is true?
- A.
Growth hormone does not cause growth
- B.
An increase in sugar levels after exercise would cause release of GH
- C.
IGF 2 is most important in terms of growth
- D.
Pyschosocial dwarfism does not involve hypopituitarism
- E.
Children with idiopathic congenital GH deficiency lack somatotropes
Correct Answer
A. Growth hormone does not cause growth -
- 10.
Which is not a presentation of isosexual precocious puberty?
- A.
Menarche
- B.
Thelarche
- C.
Normal or tall stature as adults
- D.
Adrenarche
- E.
Genital enlargement
Correct Answer
C. Normal or tall stature as adults -
- 11.
Which of the following catalyzes iodide oxidation?
- A.
NIS protein
- B.
Pendrin
- C.
TGB
- D.
TPO
- E.
TBG
Correct Answer
D. TPO -
- 12.
Which statement is false?
- A.
T4 has a higher affinity for binding than T3.
- B.
T3 makes up 7% of circulating thyroid hormone
- C.
T3 has a longer half life than T4
- D.
T3 is made from the coupling of one monoiodotyrosine and one diiodotyrosine
- E.
Most T4 converts to T3 in tissues
Correct Answer
C. T3 has a longer half life than T4 -
- 13.
What is the mechanism of regulation of thyroid hormones (more than one answer)?
- A.
Low levels of thyroid hormone in the blood stimulate increased secretion of TSH by the anterior pituitary
- B.
Elevated levels of thyroid hormones in the blood stimulate the pituitary to stop secreting TSH
- C.
The feedback mechanism acts primarily on the anterior pituitary and secondarily on the hypothalamus
- D.
The hypothalamus spontaneously releases TRH
- E.
TSH released by the anterior pituitary stimulates the action of the follicular cells
Correct Answer(s)
B. Elevated levels of thyroid hormones in the blood stimulate the pituitary to stop secreting TSH
C. The feedback mechanism acts primarily on the anterior pituitary and secondarily on the hypothalamus
E. TSH released by the anterior pituitary stimulates the action of the follicular cells -
- 14.
Myxedema refers to:
- A.
Euthyroidism
- B.
Hyperthyroidism
- C.
Hypothyrodism
- D.
Grave's disease
- E.
Enlargement or masses of the thyroid
Correct Answer
C. Hypothyrodism -
- 15.
Which of the following is not a clinical feature of hyperthyroidism?
- A.
Weight loss
- B.
Periorbital edema
- C.
Atrial fibrillation
- D.
Palpitations
- E.
Goiter
Correct Answer
B. Periorbital edema -
- 16.
Which is false concerning Grave's disease?
- A.
It is often associated with non-pitting edema
- B.
Prevalence is 5:1 in favor of females
- C.
Abnormal lymphocytes secrete TSI, which mimics TSH
- D.
Exopthalmus occurs in 50-70% of cases
- E.
Often presents with multinodular goiter
Correct Answer
E. Often presents with multinodular goiter -
- 17.
Which is not a lab finding of primary hyperthyroidism?
- A.
Increased free T4
- B.
Decreased TSH
- C.
Falsely high cholesterol
- D.
Increased free T3
Correct Answer
C. Falsely high cholesterol -
- 18.
Which is false of Hashimoto's thyroiditis?
- A.
TgAb, TPOAb, and TSH-R block Ab cause destruction of thyroid tissue
- B.
5:1 prevalence in favor of females
- C.
It is marked by goiter, transient hypothyroidism, then a hyperthyroid state
- D.
It is the most common type of hypothyroidism
Correct Answer
C. It is marked by goiter, transient hypothyroidism, then a hyperthyroid state -
- 19.
Which is true?
- A.
Goiter is associated with increased secretion of T3 and T4
- B.
Anaplastic thyroid cancer is the most common
- C.
Papillary thyroid cancer is slow growing
- D.
TBG is increased during pregnancy, which may increase free T4
Correct Answer
C. Papillary thyroid cancer is slow growing -
- 20.
Which is not a protein that binds to thyroid hormones?
- A.
TBG
- B.
TGB
- C.
TBPA
- D.
TBA
Correct Answer
B. TGB -
- 21.
Which is incorrectly matched?
- A.
Acini cells in the pancreas secrete digestive juices that travel to the duodenum
- B.
Beta cells release insulin that goes through the portal system to the liver
- C.
Alpha cells release glucagon that goes through the portal system to the liver
- D.
Delta cells release somatostatin into the blood stream to inhibit the effects of insulin and glucagon
Correct Answer
D. Delta cells release somatostatin into the blood stream to inhibit the effects of insulin and glucagon -
- 22.
Which of the following occurs in response to hypoglycemia in a healthy patient when fasting?
- A.
Release of insulin
- B.
Stimulation of glyconeogenesis
- C.
Stimulation of gluconeogenesis
- D.
Stimulation of glycogenolysis
Correct Answer
D. Stimulation of glycogenolysis -
- 23.
In addition to insulin, what is released from the beta cells of the pancreas? (more than one answer)
- A.
Amylin
- B.
C-peptide
- C.
Glucagon
- D.
Digestive juices
- E.
Somatostatin
Correct Answer(s)
A. Amylin
B. C-peptide -
- 24.
Which of the following is false?
- A.
Insulin has a half life of fifteen minutes once it is released into circulation
- B.
Increased amino acids can stimulate secretion of glucagon
- C.
When tissues are saturated with glycogen, more glucose is stored in triglycerides
- D.
Increased amino acids in the liver increase glucose levels
- E.
Amylin counteracts the actions of insulin
Correct Answer
E. Amylin counteracts the actions of insulin -
- 25.
Which is true in diagnosing type 1 vs. type 2 diabetes?
- A.
Type 1 diabetics are usually obese
- B.
Clinical onset of type 2 diabetes is sudden
- C.
Antibodies to the islets are found in type 1
- D.
Family history is under 15% in type 2
- E.
More African Americans have type 1 diabetes; more caucasians have type 2
Correct Answer
C. Antibodies to the islets are found in type 1 -
- 26.
The Somogyi effect refers to:
- A.
Glucose intolerance associated with pregnancy
- B.
Morning hyperglycemia that is not associated with nocturnal hypoglycemia
- C.
Rebounding hypoglycemia in response to hyperglycemia
- D.
Rebounding hyperglycemia in response to hypoglycemia
- E.
Increased risk of big babies and birth defects in mothers with gestational diabetes
Correct Answer
D. Rebounding hyperglycemia in response to hypoglycemia -
- 27.
Which of the following is not a feature of syndrome X?
- A.
Hypoglycemia
- B.
Hyperinsulinemia
- C.
Dyslipidemia
- D.
Hypertension
Correct Answer
A. Hypoglycemia -
- 28.
Which is true about C-peptide?
- A.
It is released by the alpha islet cells
- B.
It is normal or increased in patients with type 1 diabetes
- C.
Hypoglycemia with a low c-peptide level may indicate abuse of insulin
- D.
It is inhibited by somatostatin
Correct Answer
C. Hypoglycemia with a low c-peptide level may indicate abuse of insulin -
- 29.
Which is not a cause of hypoglycemia?
- A.
Treatment of diabetes with insulin
- B.
Starvation
- C.
Alcohol abuse
- D.
Low-carb, high-protein diet
- E.
Hormonal deficiency
Correct Answer
D. Low-carb, high-protein diet -
- 30.
Which layer is responsible for the secretion of aldosterone?
- A.
Zona glomerulosa
- B.
Zona fasciculata
- C.
Zona reticularis
- D.
Adrenal medulla
Correct Answer
A. Zona glomerulosa -
- 31.
Which is not a function of glucocorticoids?
- A.
Stimulation of gluconeogenesis
- B.
Breakdown of protein
- C.
Breakdown of bone
- D.
Conservation of sodium
- E.
Decreasing of inflammation
Correct Answer
D. Conservation of sodium -
- 32.
Which might be caused by excessive glucocorticoid production?
- A.
Hirsuitism
- B.
Increased inflammatory responses
- C.
Striae
- D.
Virilism
Correct Answer
C. Striae -
- 33.
Which indicates Cushing's syndrome but not Cushing's disease?
- A.
ACTH overproduction by the pituitary
- B.
Spontaneous hypersecretion of cortisol by the adrenal gland
- C.
Glucocorticoid excess
- D.
Pituitary tumors
- E.
Ectopic ACTH syndrome
Correct Answer
B. Spontaneous hypersecretion of cortisol by the adrenal gland -
- 34.
In primary aldosteronism, where is the likely defect?
- A.
Renal artery occlusion
- B.
Zona glomerulusa
- C.
Zona reticularis
- D.
Congestive heart failure
Correct Answer
B. Zona glomerulusa -
- 35.
Which is not a finding of aldosteronism?
- A.
Hypertension
- B.
Increased urinary renin in secondary aldosteronism
- C.
Hyperkalemia
- D.
Hypernatremia
- E.
Decreased urinary renin in primary aldosteronism
Correct Answer
C. Hyperkalemia -
- 36.
Which is a symptom of virilism but not hirsuitism?
- A.
Excessive growth of body hair in a male distribution on a female
- B.
Menstrual abnormalities
- C.
Breast atrophy
- D.
Receding hairline
- E.
Acne
Correct Answer
C. Breast atrophy -
- 37.
Which layer of the adrenal gland is affected by pheochomocytoma?
- A.
Zona reticularis
- B.
Zona fasciculata
- C.
Zona glomerulosa
- D.
Adrenal medulla
Correct Answer
D. Adrenal medulla -
- 38.
Which is most concerning in a patient with Addison's disease?
- A.
Decreased sodium retention
- B.
Water loss
- C.
Potassium retention
- D.
Increased insulin sensitivity
Correct Answer
C. Potassium retention -
- 39.
Which is false of Addison's disease?
- A.
Postural hypertension is a BP drop of 20 mmHg when standing
- B.
Postural tachycardia is a heart rate increase by 20 bpm when standing
- C.
In primary Addison's disease, there is a slight increase in cortisol after exogenous ACTH is given
- D.
Patients have low cortisol and high ACTH
- E.
Patients have low sodium and high potassium
Correct Answer
C. In primary Addison's disease, there is a slight increase in cortisol after exogenous ACTH is given -
- 40.
Calcitonin is released from the ___ and it responds to hypercalcemia by ___.
- A.
Parathyroid gland...inhibiting bone resorption
- B.
Parathyroid gland... stimulating bone resorption
- C.
Thyroid gland...inhibiting bone resorption
- D.
Thryroid gland...stimulating bone resorption
Correct Answer
C. Thyroid gland...inhibiting bone resorption -
- 41.
What is the normal range of phosphate?
- A.
1.5-2.2 mEq/L
- B.
2.5-4.5 mg/dL
- C.
4.5-5.5 mg/dL
- D.
8.5-10.5 mg/dL
Correct Answer
B. 2.5-4.5 mg/dL -
- 42.
Which statement is incorrect?
- A.
Secretion of parathyroid hormone occurs in response to hypocalcemia
- B.
PTH stimulates bone resorption
- C.
PTH allows renal tubular reabsorption of calcium
- D.
PTH decreases PO4 excretion via urine
- E.
PTH modulates vitamin D3 synthesis in the kidney
Correct Answer
D. PTH decreases PO4 excretion via urine -
- 43.
Which electrolyte regulates RNA translation, replication of DNA and ATP reactions?
- A.
Calcium
- B.
Vitamin D and metabolites
- C.
Phosphate
- D.
Magnesium
Correct Answer
D. Magnesium -
- 44.
Which of the following would cause tremors,athetoid or choreiform movements, confusion and positive Chvostek's or Trousseau's signs?
- A.
Hypermagnesemia
- B.
Hyperphosphatemia
- C.
Hypercalcemia
- D.
Hypomagnesemia
- E.
Hyperphosphatemia
Correct Answer
D. Hypomagnesemia -
- 45.
Which of the following is not a manifestation of hypophosphatemia?
- A.
Refeeding syndrome
- B.
Osteomalacia
- C.
Calcification
- D.
Tremors
- E.
Seizures
Correct Answer
C. Calcification -
- 46.
In order for a magnesium level to indicate cardiac arrest, it must be
- A.
Greater than or equal to 5 mEq/L
- B.
Greater than or equal to 10 mEq/L
- C.
Greater than or equal to 15 mEq/L
- D.
Greater than or equal to 20 mEq/L
- E.
Greater than or equal to 25 mEq/L
Correct Answer
C. Greater than or equal to 15 mEq/L -
- 47.
The normal range for magnesium is:
- A.
1.5 - 2.2 mEq/L
- B.
2.5 - 4.5 mEq/L
- C.
4.5 - 5.5 mEq/L
- D.
8.5 - 10.5 mEq/L
Correct Answer
A. 1.5 - 2.2 mEq/L -
- 48.
Which of the following inhibits bone resorption?
- A.
Parathyroid hormone
- B.
Calcitonin
- C.
Vitamin D
- D.
Calcitriol
Correct Answer
B. Calcitonin -
- 49.
Laxative use is a possible cause of which of the following?
- A.
Hyperphosphatemia
- B.
Hypercalcemia
- C.
Hypomagnesemia
- D.
Hypophosphatemia
- E.
Hypocalcemia
Correct Answer
A. Hyperphosphatemia -
- 50.
Which of the following is not a manifestation of hypocalcemia?
- A.
Bone pain
- B.
Dysrhythmias
- C.
Vomiting
- D.
Diarrhea
- E.
Convulsions
Correct Answer
C. Vomiting -
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