Pituitary Gland

110 Questions | By Terrichan | Last updated: Nov 16, 2018 | Total Attempts: 245

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This is a quiz on the pituitary gland lectures in Week 1 endocrine. Notes can be found in imueos. Blogspot. Com under the label: pituitary gland.

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Questions and Answers

1.

Pituitary gland is controlled by
- A.
  
  Hypothalamus
- B.
  
  Cortex
- C.
  
  Pontine
2.

Hypothalamus connected to pituitary gland via
- A.
  
  Nerves
- B.
  
  Blood
- C.
  
  Pituitary stalk (infundibulum)
- D.
  
  No connection
3.

The pituitary gland lies in the
- A.
  
  Nasal fossa
- B.
  
  Sella turcica
- C.
  
  Infront of the medulla oblongata
4.

Which approach does the surgeon take for a pituitary gland surgery?
- A.
  
  Trans-nasal
- B.
  
  Trans-cortex
- C.
  
  Trans-rectal
- D.
  
  Trans-sphenoidal
5.

The anterior pituitary arises embryologically as an:
- A.
  
  Invagination of the roof of the pharynx (rathke's pouch)
- B.
  
  Primitive gut
- C.
  
  Primitive lung
6.

On both sides of the gland, there are sinuses called the Cavernous Venous Sinuses. These sinuses contains nerves & internal carotid artery. Which nerves are located in these sinuses?

Discuss
- A.
  
  Medially: Opthalmic (3), Abducent(6) Laterally: Opthalmic & Maxillary (5)
- B.
  
  Medially: Oculomotor (3), Abducent(6) Laterally: Opthalmic & Maxillary (5)
- C.
  
  Medially: Ophthalmic (3), Abducent(6) Laterally: Oculomotor & Maxillary (5)
7.

Which nerve will be compressed 1st when a pituitary gland enlarges?
- A.
  
  Opthalmic
- B.
  
  Oculomotor
- C.
  
  Maxillary
- D.
  
  Abducent
8.

In enlargement of a pituitary gland anterior superiorly, the optic nerves will be compressed (temporal half - side view). The patient will not be able to see the sides. What condition is this called?
- A.
  
  Temporal hemionopia
- B.
  
  Semitemporal hemionopia
- C.
  
  Bitemporal hemionopia
- D.
  
  Bitemporal myopia
9.

What are the parts of the anterior pituitary?
- A.
  
  Pars distalis(pars anterior), Pars tuberalis, Pars intermedia
- B.
  
  Pars nervosa, Median eminence, infundibular stalk
10.

Which of the parts of the posterior pituitary is the connection to the hypothalamus?
- A.
  
  Pars nervosa
- B.
  
  Median eminence
- C.
  
  Infundibular stalk
11.

The pars distalis/anterior consists of 2 types of cells:
12.

Which are the secretory cells of the pars anterior?
- A.
  
  Chromophobes
- B.
  
  Chromophils
13.

There are 2 different type of chromophils (of the pars anterior), the acidophils & basophils. What does the acidophils secrete?
- A.
  
  TSH, ACTH
- B.
  
  Growth hormones & prolactin
- C.
  
  LH, FSH
- D.
  
  ICSH
14.

What does the pars intermedia (of the anterior pituitary) secrete?
- A.
  
  TSH
- B.
  
  MSH
- C.
  
  ICSH
- D.
  
  ACTH
15.

There are 2 types of nuclei in the posterior pituitary. The paraventricular nucleus and the supraoptic nuclue. Which on secretes oxytocin?
- A.
  
  Paraventricular
- B.
  
  Supraoptic
16.

Which are the hormones that are produced from amino acids?
- A.
  
  Thyroxine, serotonin
- B.
  
  Cortisol, sex hormones
17.

Which are the hormones produced from lipid? (cholesterol/steroids)
- A.
  
  TSH & TRH
- B.
  
  Somatostatin & cortisol
- C.
  
  Cortisol & sex hormone
18.

Why does steroid hormones (sex hormone & cortisol) & thyroid hormone require carrier proteins to be transported in blood?
- A.
  
  It is not target organ effective
- B.
  
  It travels slowly in blood in the free form
- C.
  
  It is insoluble in water
- D.
  
  It has a large molecular weight
19.

Which is responsible for the effects of the hormones to be seen?

Discuss
- A.
  
  ATP
- B.
  
  Protein Kinase A
- C.
  
  CAMP
- D.
  
  G-protein
20.

Which hormone receptors/2nd messengers are protein kinases (phosphorylates intracellular mediators to produce action)
- A.
  
  Cyclip AMP
- B.
  
  Receptor tyrosine kinase
- C.
  
  Calcium
- D.
  
  Phosphoinositides
- E.
  
  Cyclic GMP
21.

Which of these hormones have a receptor that is a protein kinase?
- A.
  
  Epinephrine
- B.
  
  ADH
- C.
  
  Insulin
22.

Which hormone will be able to diffuse thru the cell membrane by simple diffusion?
- A.
  
  Thyroid hormone
- B.
  
  Steroid hormone
- C.
  
  Growth hormone
23.

Which hormone has a positive feedback mechanism
- A.
  
  Oxytocin
- B.
  
  LH
- C.
  
  FSH
- D.
  
  ADH
24.

Growth hormone is controlled by a diurnal rhythm. When during the day GH is high in amount?
- A.
  
  During sleep
- B.
  
  After waking up
- C.
  
  During 1st few hours of deep sleep
- D.
  
  During strenous exercise
25.

When during the day ACTH & Cortisol are high in amount?
- A.
  
  After waking up
- B.
  
  Last few hours before waking up
- C.
  
  During sleep
- D.
  
  Before sleeping
26.

The endocrine system depends on hormone-receptor interaction by 2 types of receptors: extracellular and intracellular. Extracellular will require a cascade of 2nd messengers to relay it’s message inside the cell, however intracellular directly binds to DNA to produce it’s intended actions.Which hormone binds to intracellular receptors?

Discuss
- A.
  
  Growth hormone
- B.
  
  Testosterone
- C.
  
  ADH
- D.
  
  AVP
27.

Which nuclei of the hypothalamus stimulates the anterior pituitary?
- A.
  
  Parvocellular neuron (small neuron)
- B.
  
  Magnocellular neuron (large neuron)
28.

In which part of the brain does the parvocellular neurosecretory neurons (paraventricular, supraoptic & arcuate) project into, before releasing peptides into the blood vessels to stimulate the synthesis and secretion of hormone from the anterior pituitary?
- A.
  
  Pars intermedia
- B.
  
  Pars anterior
- C.
  
  Pars posterior
- D.
  
  Median eminence
29.

Tropic hormones are those that act on target endocrine gland to promote hormone secretion. Which of these is not a tropic hormone (act on exocrine gland)?
- A.
  
  Thyroid hormone
- B.
  
  LH
- C.
  
  GH
- D.
  
  FSH
- E.
  
  Prolactin
30.

All glycoprotein hormones (TSH, LH, FSH) consist of alpha & beta subunits. However, the alpha subunit is also present in the a placental glycoprotein hormone. Therefore it’s action is similar to LH.Which of these is the placental hormone?

Discuss
- A.
  
  Progesterone
- B.
  
  Oestrogen
- C.
  
  Human chorionic gonadotrophin (hCG).
- D.
  
  LH
- E.
  
  FSH
31.

The hormones of the posterior pituitary are synthesized as a larger precursor molecule in the cell bodies of the neurons of the hypothalamus. The precursor molecule of the vasopressin is:
- A.
  
  Prepropressophysin
- B.
  
  Preprooxyphysin
32.

The ADH will increase water reabsorption at which part of the nephron?
- A.
  
  DCT & CD
- B.
  
  PCT & DCT
- C.
  
  DCT & LOH
- D.
  
  LOH
33.

Which receptor does ADH bind to to increase the water channels in the Collecting Duct (aquaporins)?
- A.
  
  V1 receptor
- B.
  
  V2 receptor
- C.
  
  V3 receptor
- D.
  
  V4 receptor
34.

Besides increasing water reabsorption in the distal nephron, what is the other function of ADH?

Discuss
- A.
  
  Inhibit renin release
- B.
  
  Decrease glomerular filtration rate
- C.
  
  Increase vasoconstriction
- D.
  
  Stimulate ACTH secretion from anterior pituitary (synergy with CRH)
- E.
  
  Glycogenolysis in liver (glycogen b/d)
35.

What stimulates ADH secretion?
- A.
  
  Mental/Physical stress
- B.
  
  Nausea/Vomiting
- C.
  
  Decrease plasma osmolality
- D.
  
  Nicotine
- E.
  
  Alcohol
36.

What happens where there is excess in vasopressin?
- A.
  
  Diabetes insipidus
- B.
  
  Diabetes mellitus
- C.
  
  SIADH
- D.
  
  Dehydration
37.

What happens where there is deficiency in vasopressin?
- A.
  
  Diabetes insipidus
- B.
  
  Diabetes mellitus
- C.
  
  SIADH
- D.
  
  Dehydration
38.

What is the complication of SIADH?
- A.
  
  Oedema formation
- B.
  
  Dehydration
- C.
  
  Hypertension
- D.
  
  Excess urine formation
39.

What are the actions of prolactin?
- A.
  
  Milk ejection
- B.
  
  Milk synthesis
- C.
  
  Milk secretion
- D.
  
  Cervical dilatation
- E.
  
  Uterine contraction
40.

Which of the following are the actions of oxytocin?
- A.
  
  Uterine contraction
- B.
  
  Assistance in parturition
- C.
  
  Milk ejection
- D.
  
  Sperm transport (ejaculation)
41.

Besides the ant & post pituitary hormones is the intermediate lobe, which does release it’s own hormones as well. The hormone, pro-opiomelanocortin (POMC) in the intermediate lobe will be hydrolysed into different hormones.Which of the following are the hormones secreted from the intermediate lobe?

Discuss
- A.
  
  ADH
- B.
  
  ACTH
- C.
  
  MSH
- D.
  
  Prolactin
42.

In pituitary tumour, the pituitary stalk will be compressed. Which of the following is the side effect of the compressed pituitary stalk?
- A.
  
  Headache
- B.
  
  Vomiting
- C.
  
  Prolactinemia
- D.
  
  Disorientation
- E.
  
  Increased ADH secretion
43.

The growth hormone is synthesized by the somatotropes. It is a single polypeptide with disulphide linkages. How many disulphide linkages does the GH have?
- A.
  
  1
- B.
  
  2
- C.
  
  3
- D.
  
  4
- E.
  
  5
44.

When GH binds to a cell surface receptor (receptor no.1), it will pull another cell surface receptor (receptor no. 2) and binds with it, causing dimerization of 2 GH receptors, forming a dimeric complex. The GH-dimeric receptor complex associates with and activates the JAK-2 protein (a tyrosine kinase) causing phosphorylation of the receptor and autophosphorylation of JAK-2 on tyrosine residues. This event will activate a number of signal pathways:

Discuss
- A.
  
  State protein activation & gene transcription
- B.
  
  MAP kinase pathway activation
- C.
  
  Tyrosine Kinase pathway activation
- D.
  
  PI 3 kinase pathway activation
- E.
  
  PLC activation, production of diacylglycerol & protein kinase C activation
45.

Secretion of growth hormone is regulated & stimulated by:
- A.
  
  Metabolic fuels
- B.
  
  Stress
- C.
  
  Sleep & exercise
- D.
  
  Hyperglycemia
- E.
  
  High amino acid & fatty acid
46.

The growth effect of the growth hormone is mediated by insulin-like growth factors (IGF/Somatomedins –Mediate), which are a family of growth promoting proteins produced by liver cells. It is produced when GH binds to it’s receptors. There are 4 IGFs. Which one of the following is the active IGF for growth?
- A.
  
  IGF-1
- B.
  
  IGF-2
- C.
  
  IGF-3
- D.
  
  IGF-4
- E.
  
  IGF-5
47.

It is structurally similar to proinsulin (insulin-like). IGF is also originally known as ‘sulfation factor’.Why was it known as a 'sulfation factor'?
- A.
  
  Incorporate sulphate into bones
- B.
  
  Incorporate sulphate into muscles
- C.
  
  Incorporate suphate into cartilage
- D.
  
  Produces sulphur
- E.
  
  Assists in metabolism of sulphur in the body
48.

Growth hormone effects are seen in:

Discuss
- A.
  
  Cartillage growth
- B.
  
  Linear & width bone growth
- C.
  
  Organ growth
- D.
  
  Muscle growth
49.

Besides growth effects, what are other effects of growth hormone ?

Discuss
- A.
  
  Protein synthesis
- B.
  
  Increased glycogen synthesis in liver (for storage, from increased glucose), Increase hepatic glucose production (glyconeogenesis), Decrease tissue glucose uptake (more glucose in blood), Decreased rate of glycolysis (not used)
- C.
  
  Promotes lipolysis, reduce TG snthesis, increase oxidation of free FA in liver when taken into tissue (form ketone bodies)
- D.
  
  Stimulate production & release of IGFs in liver
- E.
  
  Prolactin-like effect, stimulate mammary gland (lactogenesis)
50.

Hyposecretion of Growth hormone.Which type of condition corresponds to these findings?-Low GH-Low IFG-1-Responds to GH stimulation

Discuss
- A.
  
  GH- deficient dwarfs
- B.
  
  Pygmies
- C.
  
  Laron type dwarfs
51.

Hyposecretion of Growth hormone. Which type of condition corresponds to these findings? -Normal GH -Low IFG-1 -Does not respond to GH stimulation
- A.
  
  GH- deficient dwarfs
- B.
  
  Pygmies
- C.
  
  Laron type dwarfs
52.

Hyposecretion of Growth hormone. Which type of condition corresponds to these findings? -High GH -Low IFG-1 -Does not respond to GH stimulation
- A.
  
  GH- deficient dwarfs
- B.
  
  Pygmies
- C.
  
  Laron type dwarfs
53.

Hypersecretion of growth hormoneWhich condition is seen when there is hypersecretion of growth hormone in children?
- A.
  
  Gigantism
- B.
  
  Acromegaly
54.

Hypersecretion of Growth Hormones:In adults, hypersecretion of growth hormone will cause Acromegaly. It occurs after the epiphyseal plate closes, therefore there is cessation of long bone growth. Instead there is acral bone growth.What is seen in acral bone growth?
- A.
  
  Buffalo hump
- B.
  
  Protruding jaw
- C.
  
  More facial hair
- D.
  
  Larger skull
- E.
  
  Enlarged hands & feet
55.

Excessive growth hormone secretion can be due to a pituitary tumour or an ectopic functional tumour. Will hyperglycemia be able to suppress GH levels if it's due to a tumour?

Discuss
- A.
  
  Yes
- B.
  
  No
56.

This is a histologic image of the pituitary gland. The basophils are bluish in colour and the acidophils pinkish. What are chromophobes?
- A.
  
  Cells of the basophils
- B.
  
  Cells that secrete growth hormone
- C.
  
  A secretory cell
- D.
  
  Lies in the pars anterior of the anterior pituitary
57.

What is the best description of a pituitary tumour?
- A.
  
  Enlargement of pituitary
- B.
  
  Neoplasm located in the sella turcica
- C.
  
  Malignancy of the pituitary gland
58.

What are the signs & symptoms of a pituitary adenoma?
- A.
  
  Headache
- B.
  
  Visual field defect/tunnel vision (bitemporal hemionopia)
- C.
  
  Lowered hormonal secretion
- D.
  
  Hypertension
- E.
  
  Mild hyperprolactinemia
59.

How is a microadenoma classified?
- A.
  
  More than 1cm
- B.
  
  More than 4cm
- C.
  
  Less than 2cm
- D.
  
  Less than 1cm
60.

This is a histologic picture of a pituitary adenoma. What is seen in this image?
- A.
  
  Monomorphic
- B.
  
  Large amounts of cytoplasm
- C.
  
  Delicate stippled chromatin
- D.
  
  Conspicuous nucleoli
61.

This is a surgical measure taken to treat a pituitary tumour because it is minimally invasive. What approach is this?
- A.
  
  Trans-nasal approach
- B.
  
  Trans-sphenoidal approach
- C.
  
  Trans-sella turcica approach
- D.
  
  Trans-maxillary approach
62.

Pituitary adenoma is a very common incidental finding, where it is not symptomatic in most people. Therefore, nothing is usually done when a pituitary adenoma is discovered. For more severe cases, a trans-sphenoidal surgery is done.What is the indication of trans-sphenoidal surgery in pituitary tumour?

Discuss
- A.
  
  Progressive mass effect (visual loss, headache)
- B.
  
  Hypertension
- C.
  
  Hypersecretory disorders (Cushings, acromegaly, hyperthyroid)
- D.
  
  Mild increase in hormonal secretion
- E.
  
  Massive acute haemorrhagic necrosis of an adenoma (pituitary apoplexy/Sheehan's syndrome
63.

What is Sheehan's syndrome?
- A.
  
  The pituitary adenoma is very large
- B.
  
  It is the malignancy of the pituitary
- C.
  
  The pituitary adenoma is haemorrhagic & necrotic
- D.
  
  The pituitary gland is infected with microorganisms
64.

What is the treatment for prolactinoma?
- A.
  
  Prolactin agonist
- B.
  
  Prolactin antagonist
- C.
  
  Dopamine antagonist
- D.
  
  Dopamine agonist
65.

What is the treatment of GH-oma?
- A.
  
  Growth hormone anologues
- B.
  
  Somatostatin analogues
- C.
  
  Somatotropin inhibitors
66.

Besides trans-sphenoidal surgery, a pituitary adenoma can be surgically treated via radiation/Gamma knife.It is used for patients whose previous surgical resection is incomplete, recurrent, medically unfit for a surgery or uncontrollable by other treatment.What are the complications of gamma knife radiation?
- A.
  
  Hyperpituitarism
- B.
  
  Hypopituitarism
- C.
  
  Prolactinemia
- D.
  
  Glioma (tumour of glial cells)
- E.
  
  Sarcoma (malignant cancer of CT)
67.

What are the clinical features of prolactinoma?
- A.
  
  Amenorrhea
- B.
  
  Menorrhagia
- C.
  
  Galactorrhoea
- D.
  
  Loss of libido
- E.
  
  Infertility
68.

What is the common cause of prolactinoma?
- A.
  
  Stalk effect
- B.
  
  Damage to lactotroph
- C.
  
  Damage to stalk
- D.
  
  Massive proliferation of lactotroph
69.

What is this patient suffering from?(Note the darkening of skin)View another image from: http://www.sd-neurosurgeon.com/images/nelsons%20disease%201.jpg
- A.
  
  Cushing's syndrome
- B.
  
  Addison's disease
- C.
  
  Acromegaly
- D.
  
  Nelson syndrome
70.

What is cushing's disease?
- A.
  
  ACTH deficiency
- B.
  
  GH deficiency
- C.
  
  Cortisol deficiency
- D.
  
  Thyroid deficiency
71.

Suprasellar tumours induce hypo/hyperfunctioning of anterior pituuitary/diabetes mellitus/ both. The 2 types of of suprasellar tumours are:1) Gliomas from chiasma2) Craniopharyngiomas (most)What are the 2 variants of craniopharyngiomas?

Discuss
- A.
  
  Adamantinomatous
- B.
  
  Reticullar
- C.
  
  Whorlly
- D.
  
  Papillary
72.

Endocrinopathies are classified as primary, secondary, or tertiary.Which organ is dysfunctional if the endocrine disorder is a secondary disease?
- A.
  
  Adrenal cortex
- B.
  
  Pancreas
- C.
  
  Hypothalamus
- D.
  
  Pituitary gland
73.

SIADH can be caused by pituitary tumour, ectopic tumours, trauma, infections or drug induced.Which of these drugs can induce a hypersecretion of vasopressin/ADH/AVP?
- A.
  
  Propanolol
- B.
  
  Nicotine
- C.
  
  Chlopropamide
- D.
  
  Carbamezine
- E.
  
  Morphine
74.

In SIADH, water is excessively and actively reabsorbed from the tubules. Which of the following problems might occur with the active reabsorption of water in the tubules?

Discuss
- A.
  
  Diluted plasma
- B.
  
  Concentrated urine
- C.
  
  Inhibition of aldosterone secretion
- D.
  
  Hypokalaemia
- E.
  
  Hyponatraemia
75.

What is the treatment for SIADH in relation to blocking the renal action?
- A.
  
  Doxycycline
- B.
  
  Demeclocycline
- C.
  
  AVP antagonist
- D.
  
  V2 receptor inhibitor
76.

There are 2 types of diabetes insipidus:2 types: 1) Cranial DI (Central/Neurogenic) Defective/ decreased production of vasopressin by the hypothalamo-neurohypophyseal system (Hypothalamus/ Post pituitary) 2) Nephrogenic DI Defective renal response to vasopressin (hormone resistance) Defective V2 vasopressin receptors in kidney (receptor disease) Defective water channel proteins (aquaporins)How are these 2 differentiated?
- A.
  
  Give DDAVP. If there is no antidiuretic effect, then it is a cranial DI
- B.
  
  Give DDAVP. If there is antidiuretic effect, then it is a cranial DI
77.

What is the dynamic (stimulation) tests done for vasopressin?

Discuss
- A.
  
  Water loading test
- B.
  
  Water excretion test
- C.
  
  Water deprivation test
- D.
  
  24 hour urine analysis
78.

The arrow indicates the administration of DDAVP (desmopressin). From graph B, upon administration of DDAVP, what would you observe in a patient suffering from cranial diabetes insipidus>
- A.
  
  Urine osmolality remains the same
- B.
  
  Plasma osmolality increases
- C.
  
  Urine osmolality increases
- D.
  
  Plasma osmolality remains the same
79.

An insulin tolerance test is done to evaluate GH hyposecretion. Assuming that the patient has enough GH reserves, what happens when an insulin is injected to a patient with GH deficiency?
- A.
  
  GH serum level remains the same
- B.
  
  GH serum level rises
80.

In gigantism & acromegaly, a patient will appear with prognatism as a clinical feature.What is prognatism?
- A.
  
  Excess hair
- B.
  
  Buffalo hump
- C.
  
  Gynecomastia & lactation
- D.
  
  Frontal bossing & protruding mandible
- E.
  
  Enlarged hands & feet
81.

An oral glucose tolerance test is done to evaluate GH hypersecretion. Assuming that this is not a tumour, what happens when an the patient is placed in a hyperglycemic state?
- A.
  
  GH serum level increases
- B.
  
  GH serum level decreases
- C.
  
  GH serum level remains the same
82.

Given these laboratory data:TRH level: normalTSH level: normalT3 & T4 level: LowIs this hypothyroidism due to primary, secondary or tertiery cause?

Discuss
- A.
  
  Primary
- B.
  
  Secondary
- C.
  
  Tertiery
83.

Given these laboratory data: TRH level: low TSH level: low T3 & T4 level: Low Is this hypothyroidism due to primary, secondary or tertiery cause?
- A.
  
  Primay
- B.
  
  Secondary
- C.
  
  Tertiery
84.

In hypothyroidism, the cause can be evaluated by simply giving a TRH injection. If TRH is given, and after that TSH serum level is discovered to be normal, where is the defect that is causing the disease?
- A.
  
  Hypothalamus
- B.
  
  Pituitary gland
- C.
  
  Thyroid gland
85.

What is this child suffering from?
- A.
  
  Hyperthyroidism
- B.
  
  Hypothyroidism
86.

In the case of maternal iodine deficiency –> may cause neonatal hypothyroidism/ cretin. However cretin is easily treatable. The child will be given TSH. If the level of T4 remains low, what is the treatment for the child?
- A.
  
  TRH
- B.
  
  More TSH
- C.
  
  T3
- D.
  
  T4
87.

What is Grave's disease?
- A.
  
  Hypothyroidism
- B.
  
  Hyperthyroidism
- C.
  
  Hypercortisolism
- D.
  
  Hyperprolactinemia
88.

Besides tumours, hyperthyroidism can also be caused by?
- A.
  
  Hyperactive lifestyle
- B.
  
  Hyperglycemia
- C.
  
  Affected sleeping patterns
- D.
  
  TSH receptor stimulating antibodies on thyroid gland
89.

To rule out tumour, in hyperthyroidism, T3 suppression test is done. Large doses of T3 is given. What will happen to the level of TSH?
- A.
  
  Increased
- B.
  
  Remain the same
- C.
  
  Decreased
90.

In panhypopituitarism, pituitary hormone production is disrupted. There is a sequential loss of hormonal secretion. Which of these hormones will be decreased 1st?
- A.
  
  HGH (human growth hormone)
- B.
  
  LH
- C.
  
  FSH
- D.
  
  ACTH
- E.
  
  TSH
91.

What is dipsogenic diabetes insipidus?

Discuss
- A.
  
  Defect in the thirst mechanism located in the posterior hypothalamus
- B.
  
  Defect in the negative feedback in the posterior hypothalamus
- C.
  
  Defect in the thirst mechanism located in the anterior hypothalamus
- D.
  
  Defect in the anterior pituitary in producing ADH
92.

What is gestational diabetes insipidus?
- A.
  
  Occurs during pregnancy, woman is unable to produce vasopressin
- B.
  
  Occurs after pregnancy, woman is unable to produce vasopressin
- C.
  
  Occurs during pregnancy, the urinary bladder is compressed, therefore the micturition is more frequent
- D.
  
  Occurs during pregnancy, woman produce vasopressinase in the placenta
- E.
  
  Occurs during pregnancy, fetus produces vasopressinase
93.

How much of urine in the urinary bladder that distends & activates the stretch receptors initiating the micturition reflex?
- A.
  
  100ml
- B.
  
  200ml
- C.
  
  250ml
- D.
  
  300ml
- E.
  
  500ml
94.

How do you calculate the BMI?
- A.
  
  Weight (g)/ Height (m)
- B.
  
  Weight (kg)/ Height (m)
- C.
  
  Weight (kg)/ Height2 (m2)
- D.
  
  Weight2 (kg2)/ Height (m)
95.

Which of these is the BMI range by which one is considered overweight?
- A.
- B.
  
  18.5-24.9
- C.
  
  25-29.9
- D.
  
  >30
96.

What are the signs of dehydration?
- A.
  
  Dry mouth
- B.
  
  Increased BP varying with posture
- C.
  
  Loss in skin turgor
- D.
  
  Sunken eyes
- E.
  
  Decreased pulse rate
97.

What is blood pressure?
- A.
  
  Force per unit of volume (exerted on the wall of a blood vessel)
- B.
  
  Force per unit of area (exerted on the wall of a blood vessel)
- C.
  
  Mean arterial pressure (exerted on the wall of a blood vessel)
- D.
  
  Frequency of the arterial pulsation palpated per minute
98.

What is pulse rate
- A.
  
  Rhythmical contraction of an artery
- B.
  
  Rhythmical dilation of an artery
- C.
  
  Blood pressure on the artery
- D.
  
  Frequency of the arterial pressure palpated per minute
99.

What is Multiple Endocrine Neoplasia (MEN)?
- A.
  
  Autosomal dominant disorder
- B.
  
  Autosomal recessive disorder
- C.
  
  Sex-linked dominant disorder
- D.
  
  Sex-linked recessive disorder
100.

What is Wermer's syndrome also known as?
- A.
  
  MEN type 1
- B.
  
  MEN type 2
- C.
  
  MEN type 3
- D.
  
  MEN type 4
101.

What is the key manifestation of Multiple Endocrine Neoplasia (MEN) type 1?

Discuss
- A.
  
  Hyperparathyroidism
- B.
  
  Pituitary adenoma
- C.
  
  Carcinoid tumours
- D.
  
  Adrenal adenoma
102.

What is the MEN type 1 gene mutation?
- A.
  
  Renin
- B.
  
  Podocyne
- C.
  
  Menin
103.

What is MEN type 2A known as?
- A.
  
  Wermer's syndrome
- B.
  
  Cushing's syndrome
- C.
  
  Sipple's syndrome
- D.
  
  Nelson's syndrome
104.

What is the key manifestation for MEN type 2A?
- A.
  
  Hyperparathyroidism
- B.
  
  Medullary carcinoma of thyroid
- C.
  
  Pheochromocytoma
105.

Which of these are manifestations of MEN type 2B?

Discuss
- A.
  
  Medullary carcinoma of thyroid
- B.
  
  Pituitary adenoma
- C.
  
  Mucosal neuromas
- D.
  
  Marfanoid habitus (Marfan)
- E.
  
  Ganglioneuromatosis of bowel
106.

What is this patient suffering from?
- A.
  
  Cushing's disease
- B.
  
  Addison's disease
- C.
  
  MEN type 1
- D.
  
  MEN type 2A
- E.
  
  MEN type 2B
107.

A patient suffering from MEN type 2B has multiple neuromas on the lips & tongue. Click here for picture. What is the treatment for this patient?

Discuss
- A.
  
  Blood drainage from the neuromas
- B.
  
  Total thyroidectomy with central lymph node dissection
- C.
  
  Surgical gamma knife resection of neuromas
- D.
  
  Tetracycline IV infusion
- E.
  
  Corticosteroid application on the affected sites to reduce inflammation
108.

What is Carney complex?
- A.
  
  Autosomal dominant disorder
- B.
  
  Autosomal recessive disorder
- C.
  
  Sex-linked disorder
109.

Which of these are causes of hypersecretion?
- A.
  
  MEN
- B.
  
  Carney complex
- C.
  
  McCure-Albright Syndrome
- D.
  
  Goodpasture's syndrome
- E.
  
  Neurofibrosis
110.

Which of these medication is a treatment for pituitary adenoma with functional growth hormone hypersecretion?
- A.
  
  Pegvisomant
- B.
  
  Somatotropic analogue
- C.
  
  Dopamine antagonist

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