Disorders of the Pituitary Gland

Question 1

1. Which one of the following anterior pituitary hormones
   is regulated through suppression via the secretion of a
   hypothalamic hormone?
   a. ACTH
   b. Prolactin
   c. Growth hormone
   d. LH, FSH
   e. IGF-1

Answer 1

b. Prolactin

Question 2

2. Which one of the following hormones exerts a predominant negative feedback via the anterior pituitary? The
   other hormones predominantly feed back at the level of
   the hypothalamus.
   a. IGF-1
   b. Sex steroids
   c. Inhibins
   d. Cortisol
   e. Thyroid hormone

Answer 2

e. Thyroid hormone

Question 3

3. Which one of the following statements is correct?

a. IGF-1 and IGF-2 circulate bound to albumin.
b. IGF-1 and IGFBP-3 levels are independent of one
another.
c. IGF-1 and IGF-2 circulate together bound to IGFBP-3
and the acid-labile subunit (ALS).
d. The acid-stable subunit binds to IGF-1.
e. IGF-1 and insulin form a complex

Answer 3

c. IGF-1 and IGF-2 circulate together bound to IGFBP-3
and the acid-labile subunit (ALS).

Question 4

4. Which of the following statements is correct regarding
   growth hormone (GH)?

a. Physiologically, GH secretion is episodic and pulsatile.
b. GH concentrations reach a very low levels during the
period of deepest sleep.
c. GH actions are mediated through cortisol.
d. GH secretion is stable throughout the day.
e. A single measurement of GH is sufficient for diagnostic purposes

Answer 4

a. Physiologically, GH secretion is episodic and pulsatile.

Question 5

5. Which one of the following statements is true?

a. GH lowers blood glucose and can cause hypoglycemia.
b. GH raises blood glucose by stimulating gluconeogenesis and reducing insulin sensitivity.
c. GH is suppressed by hypoglycemia.
d. GH inhibits lipolysis.
e. GH is the only determinant of IGF-1 concentrations.

Answer 5

b. GH raises blood glucose by stimulating gluconeogenesis and reducing insulin sensitivity.

Question 6

6. What is the most common case of acromegaly?

a. IGF-1–secreting tumors
b. Macro GH
c. Anterior pituitary GH-secreting tumors (somatotropinomas)
d. Multiple endocrine neoplasia type 1 syndrome
e. Gonadotropin-secreting tumors

Answer 6

c. Anterior pituitary GH-secreting tumors (somatotropinomas

Question 7

7. Which one of the following statements is true regarding
   macroprolactin?

a. This is a complex between prolactin and an immunoglobulin.
b. This is a very high-molecular-weight form of prolactin due to alternative splicing.
c. Macroprolactin lowers the plasma prolactin concentration.
d. Macroprolactin heralds a dangerous pituitary tumor.
e. Macroprolactin cannot be detected in the laboratory

Answer 7

a. This is a complex between prolactin and an immunoglobulin.

Question 8

8. Which one of the following statements is true?

a. In men, FSH stimulates testosterone production by
Leydig cells. LH directs Sertoli cells to nourish developing sperm during spermatogenesis.
b. LH and FSH are secreted by separate and distinct
pituitary cells.
c. LH and FSH secretion is stimulated by steady high
concentrations of GnRH.
d. LH and FSH are single-chain polypeptides.
e. LH and FSH are secreted episodically

Answer 8

e. LH and FSH are secreted episodically

Question 9

9. Which one of the following statements is true?

a. Cortisol is directly regulated by CRH.
b. The major site of cortisol feedback is the anterior
pituitary gland.
c. ACTH directly regulates CRH.
d. Increased ACTH increases cortisol secretion.
e. ACTH is a glycoprotein hormone made up of alpha
and beta subunits.

Answer 9

d. Increased ACTH increases cortisol secretion.

Question 10

10. Which of the following suggests diabetes insipidus (DI)?

a. Urine osmolality >600 mOsm/kg (mmol/kg)
b. Serum osmolality <270 mOsm/kg (mmol/kg)
c. Urine osmolality <300 mOsm/kg (mmol/kg) plus
serum osmolality >300 mOsm/kg
d. Edema and hypertension
e. Very high urine sodium

Answer 10

c. Urine osmolality <300 mOsm/kg (mmol/kg) plus
serum osmolality >300 mOsm/kg