Block 3 Flashcards
A 52 years old female patient presents to your office with chief complaint of irregular periods. When asked for details she also complains of hot flashes and irritability. A blood test confirms a diagnosis of perimenopause. She then expresses her interest in HRT. You warned the patient about the side effects of estrogen therapy. Which of the following side effects is least likely to be associated with estrogen therapy?
Increase the risk of thrombosis Increase HDL Increase LDL Increase endometrial growth Increase water retention
Increase LDL
Growth hormone (GH), also known as somatotropin , is a peptide hormone that stimulates growth, cell reproduction and regeneration. An investigational drug, BIN1029, tested in preclinical trial was found to act on the hypothalamus and pituitary gland to inhibit the release of GH by feedback mechanism. Question 1: Which of the following endogenous molecules has the same mechanism of action?
Ghrelin Insulin-like growth factor-1 Growth hormone–releasing hormone Somatostatin Adenocorticotropic hormone
B
Question 2: Which of the following pituitary gland-acting drugs would be effective in the treatment of acromegaly?
Urofollitropin Menotropin Pegvisomant Cosyntropin Leuprolide
C
Insulin is a hormone produced by beta cells in the pancreas. Its primary function is to lower blood glucose. The release of insulin is controlled by blood glucose levels and several hormones including glucagon, GH, glucocorticoids and thyroid hormone. Which of the following statements is least accurate description of the biological functions of insulin?
Promotes the formation of storage forms of energy and suppress their catabolism
Promotes glucose uptake into cells and its conversion to glycogen
Promotes gluconeogenesis
Stimulates the transport of amino acids and subsequent protein synthesis
Increases the production of body fat
C
A 37-year-old male presents with fatigue, nausea, vomiting, weight loss, malaise and dizziness. On examination, marked skin and buccal hyperpigmentation and orthostatic hypotension were diagnosed. He has no relevant family history. Baseline biochemistry is highly suggestive of Addison’s disease.
Which of the following sets of laboratory results would confirm a diagnosis of Addison’s disease in this patient?
Low cortisol, low adenocorticotropic hormone (ACTH)
High cortisol, low adenocorticotropic hormone (ACTH)
Low cortisol, high adenocorticotropic hormone (ACTH)
High cortisol, high adenocorticotropic hormone (ACTH)
The results do not relate to the conditions described
C
A 57-year-old male was referred for evaluation of polyuria which he had been experiencing for at least one year. His brother had a history of polyuria, but less intense. Polyuria in adults is defined as urine output more than 3L/day (>40ml/kg/day). He is also experiencing excessive thirst. His medical history is unremarkable except for hyperlipidemia, for which he takes atorvastatin. He was diagnosed with Diabetes Insipidus following blood electrolyte test and urinalysis. Which of the following drugs would be recommended in this patient?
Pergolide Desmopressin Hydrocortisone Cosyntropin Follitropin
IDK
A 68-year-old retired lawyer initially complained of frequency of micturition, urinary urgency, and hesitancy associated with a weak stream. Over the past months, he has reported a few episodes of hematuria and incontinence. In addition to his urologic symptoms, the patient complained of low-grade, constant back pain and bouts of constipation. A digital rectal examination revealed enlarged prostate gland with several palpably discreet nodules. His prostate-specific antigen (PSA) level is 25ng/mL (range: 0.0–4.0 ng/mL) up from 12ng/mL six months ago. Histologic evaluation of the biopsy specimens revealed adenocarcinoma representing 55% of biopsied material (figure below) confirming a diagnosis of prostate cancer. An antagonist of androgen receptor was prescribed. Which of the following drugs has been prescribed
Mestranol Donazol Norgestrel Clomiphene Flutamide
E
Progestins are a group of naturally occurring or synthetic steroid hormones. The naturally occurring progestin is progesterone. Progesterone is produced in response to LH and has numerous biological functions including the inhibition of the formation of gonadotropins. Which of following indications is least likely to be associated with progestins therapy?
Contraception Dysfunctional Uterine Bleeding Dysmenorrhea Endometriosis Acne
E
Leuprolide is a synthetic analogue of gonadotropin-releasing hormone (GnRH) used to treat breast cancer and prostate cancer. Which of the following statements describes best the mechanism of leuprolide?
Stimulate GnRH receptors in a pulsatile fashion causing downregulation of receptors resulting in impaired release of FSH and LH
Stimulate GnRH receptors in a non-pulsatile fashion causing upregulation of receptors resulting in impaired release of FSH and LH
Stimulate GnRH receptors in a non-pulsatile fashion causing downregulation of receptors resulting in impaired release of FSH and LH
Stimulate GnRH receptors in a pulsatile fashion causing downregulation of receptors resulting in increased release of FSH and LH
Stimulate the LHRH receptor in a non-pulsatile fashion causing downregulation of receptors resulting in increased release of FSH and LH
Stimulate GnRH receptors in a non-pulsatile fashion causing downregulation of receptors resulting in impaired release of FSH and LH
