Endo Physio MCQ Flashcards

1
Q

Thyroxine:
A. is in excess in Graves’ disease because of high levels of TSH in the body
B. acts primarily by binding to G protein linked receptors on the plasma membrane
C. deficiency in newborn will not cause mental retardation as long as treatment begins before 2years of age
D. converted to triiodothyronine(T3) by liver and other tissues

A

D. converted to triiodothyronine(T3) by liver and other tissues

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2
Q
Low blood glucose concentration will lead to all of the following EXCEPT:
A. sweating 
B. increased gluconeogenesis 
C. loss of consciousness
D. increased heart rate
E. decreased ACTH
F. decreased insulin
G. increased growth hormone
A

E. decreased ACTH

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3
Q

Hypocalcemia is seen in all of the following EXCEPT:
A. vitamin D deficiency
B. hypoparathyroidism
C. renal failure
D. impaired gut reabsorption
E. excessive calcitonin secretion in thyroid cancer

A

E. excessive calcitonin secretion in thyroid cancer

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4
Q

If a thyroid tumor secreted an excessive amount of calcitonin, we would expect
A. an elevated level of osteoclast activity.
B.increasingly brittle bones.
C.a reduced rate of endochondral ossification.
D.a rise in blood calcium concentration.
E.an elevated level of osteoblast activity.

A

E.an elevated level of osteoblast activity.

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5
Q

Aldosterone:
A. increases reabsorption of potassium at the proximal convoluted tubules
B. secretion is stimulated by high blood potassium levels
C. increases secretion of renin
D. can lead to development of metabolic acidosis

A

B. secretion is stimulated by high blood potassium levels

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6
Q
All of the following predispose to hyponatremia EXCEPT:
A. congestive heart failure
B. vomitting
C. diarrhea
D. Cushing's Syndrome
E. Adrenal insufficiency
A

D. Cushing’s Syndrome

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7
Q

In diabetic ketoacidosis, the following will be seen EXCEPT:
A. hyperventilation
B. low arterial pH
C. contraction of extracellular fluid volume
D. low plasma bicarbonate concentration
E. excretion of hypotonic urine

A

E. excretion of hypotonic urine

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8
Q

ADH deficiency may lead to all of the following except:
A. increased urine output
B. increased thirst
C. increased urinary sodium excretion
D. urinary osmolality of <200mOsm/kg (usually 1000something)
E. increased plasma osmolality

A

C. increased urinary sodium excretion

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9
Q

Which of the following statements about growth hormone is FALSE?
A. Growth hormone is synthesized in the anterior pituitary
B. Its secretion is enhanced by thyroid hormones
C. Its secretion increases with ageing
D. It increases IGF-1 production
E. Its secretion increased with exercise

A

C. Its secretion increases with ageing

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10
Q

All of the following may increase growth hormone secretion except
A. a low blood glucose concentration
B. sleep
C. the amino acid arginine
D. stress
E. insulin-like growth factor 1 (IGF-1)

A

E. insulin-like growth factor 1 (IGF-1)

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11
Q

When the pituitary stalk is cut (eliminating hypothalamic control of pituitary function), secretion of all of the following hormones will decrease EXCEPT
A. growth hormone
B. prolactin
C. follicular stimulating hormone (FSH)
D. Luteinizing hormone (LH)
E. Thyroid stimulating hormone (TSH)

A

B. prolactin

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12
Q

All of the following statements about thyroid hormones are true EXCEPT:
A. both T4 and T3 enter cells of target organs
B. T4 concentrations in blood are higher than that of T3
C. T3 is produced only by the thyroid gland
D. T3 is more biologically active than T4
E. The receptor for T3 is found in the nucleus

A

C. T3 is produced only by the thyroid gland

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13
Q

In Grave’s disease, the following features may be observed EXCEPT:
A. Heat intolerance
B. Weight loss
C. Protrusion of the eyeballs (Exopthalmos)
D. High plasma concentration of free thyroxine
E. High plasma concentration of thyroid stimulating hormone (TSH)

A

E. High plasma concentration of thyroid stimulating hormone (TSH)

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14
Q
Thyroid hormone deficiency may be associated with all of the following EXCEPT:
A.      cold intolerance
B.      mental retardation
C.      a slow heart rate
D.      weight loss 
E.       short stature
A

D. weight loss

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15
Q

Increased aldosterone secretion by an adrenal tumour may cause all of the following except:
A. hypertension
B. muscle weakness
C. a low plasma potassium concentration
D. decreased urine volume
E. low plasma rennin activity

A

D. decreased urine volume

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16
Q

Aldosterone deficiency may lead to all of the following EXCEPT:
A. high plasma renin activity
B. high plasma potassium concentration
C. low plasma sodium concentration
D. increased secretion of vasopressin (ADH)
E. high urine volume

A

E. high urine volume

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17
Q

Cushing’s syndrome is LEAST likely to be caused by:
A. lung cancer
B. tumour of adrenal cortex
C. tumour in anterior pituitary gland
D. tumour of the posterior pituitary gland

A

D. tumour of the posterior pituitary gland

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18
Q

Which of the following statements is FALSE with respect to Addison’s disease?
A. Nowadays most commonly due to tuberculosis
B. Associated with increased skin pigmentation
C. Low blood pressure is likely
D. Serum potassium concentration is likely to be high
E. Serum sodium concentration may be low

A

A. Nowadays most commonly due to tuberculosis

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19
Q
All of the following hormones are protein-bound in the circulation except:
A.   Tri-iodothyronine (T3)
B.   Insulin-link growth factor 1 (IGF1)
C.   Norepinephrine 
D.  Cortisol
E.   Testosterone
A

C. Norepinephrine

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20
Q
All of the following hormones have receptors located on the plasma membrane except:
A.   Tri-iodothyronine (T3) 
B.   Growth Hormone
C.   Norepinephrine
D.  Lutheinizing hormone (LH)
E.   Thyroid stimulating hormone (TSH)
A

A. Tri-iodothyronine (T3)

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21
Q

Cyclic AMP mediates the actions of all of the following hormones except:
A. Thyroid stimulating hormone (TSH)
B. Growth hormone
C. Norepinephrine
D. Luteinizing hormone (LH)
E. Follicular stimulating hormone (FSH)

A

B. Growth hormone

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22
Q
A 60 year old man with lung cancer. Low plasma osmolality, Low sodium concentration, High urine osmolality. What is his likely condition?
A. His aldosterone levels are high
B. Reduced salt intake
C. He has an ADH secreting tumour
D. His ADH receptors are not responding
A

C. He has an ADH secreting tumour

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23
Q

Each of the following hormones is an amino acid derivative EXCEPT:

a) epinephrine
b) melatonin
c) thyroxine (T4)
d) thyroid stimulating hormone (TSH)
e) norepinephrine

A

d) thyroid stimulating hormone (TSH)

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24
Q

When adenyl cyclase is activated:

a) cAMP is formed
b) cAMP is broken
c) G-proteins bind to cAMP
d) steroid hormones enter the cell

A

a) cAMP is formed

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25
Q

Which of the following hormones does NOT act by a second messenger system:

a) glucagon
b) epinephrine
c) growth hormone
d) testosterone
e) ACTH

A

d) testosterone

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26
Q

Low blood glucose level typically results in the secretion of all of the following EXCEPT:

a) glucagon
b) thyroxine (T4)
c) hGH
d) PTH
e) none of the above

A

d) PTH

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27
Q

The action of glucocorticoids involves many functions, but only one of the following is a correct one:

a) increases inflammatory responses
b) decreases lipid hydrolysis (lipolysis)
c) increases glucose levels
d) retention of electrolytes by the kidneys
e) increases osteoclast activity

A

c) increases glucose levels

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28
Q

This hormone acts on the intestines and causes increased calcium absorption:

a) calcitonin
b) calcitriol
c) thyroxine
d) pancreatic polypeptide
e) corticotropin releasing factor (CRF)

A

b) calcitriol

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29
Q

Thyroid stimulating hormone (TSH) causes all of the following EXCEPT:

a) activation of thyroid follicular cells
b) increased iodide trapping in thyroid follicles
c) increased thyroglobulin synthesis
d) increased release of T3/ T4
e) all of above are correct

A

e) all of above are correct

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30
Q

Hyposecretion of cortisol is caused by:

a) cretinism
b) diabetes mellitus
c) diabetes insipidus
d) Addison’s disease
e) Grave’s disease

A

d) Addison’s disease

31
Q

A tumor in the adrenal zona glomerulosa can cause hypersecretion of hormones produced in that region. Which of the following might you expect to find in a patient with such a tumor:

a) increased blood sodium levels
b) increased blood glucose levels
c) decreased blood calcium levels
d) increased dehydration
e) increased ketoacidosis

A

a) increased blood sodium levels

32
Q

Which of the following characteristics is the same for the nervous and endocrine systems:

a) target cells affected
b) time to onset of actions
c) duration of actions
d) mechanism of signalling and communication
e) none of the above

A

e) none of the above

33
Q
During stress such as fasting or strenuous exercise, the anterior pituitary releases:
A. ACTH 
B. oxytocin
C. FSH 
D. ADH 
E. LH
A

A. ACTH

34
Q
Which of the following hormones can produce hyperglycemia?
A. PTH 
B. growth hormone 
C. ADH 
D. prolactin 
E. TSH.
A

B. growth hormone

35
Q
Calcitonin inhibits:
A. osteoclast activity
B. thyroid activity
C. mammary gland activity
D. pancreatic activity
E. osteoblast activity.
A

A. osteoclast activity

36
Q
The metabolic effects of epinephrine are similar to those of:
A. glucose 
B. insulin 
C. aldosterone 
D. calcitonin 
E. glucagon
A

E. glucagon

37
Q
Parathyroid hormone (PTH) is released in response to:
A. low levels of plasma calcium
B. low levels of plasma sodium
C. high levels of plasma sodium
D. high levels of plasma calcium
E. none of the preceding.
A

A. low levels of plasma calcium

38
Q
Vitamin D is converted into a hormone that participates in the regulation of:
A. sodium balance 
B. calcium balance 
C. chloride balance 
D. water balance 
E. answers A and C.
A

B. calcium balance

39
Q
Glucocorticoids are secreted from cells in the:
A. pancreas 
B. Iiver 
C. adrenal medulla 
D. placenta 
E. none of the preceding.
A

E. none of the preceding.

40
Q
The hormone primarily responsible for setting the basal metabolic rate and for promoting the maturation of the brain is:
A. cortisol 
B. ACTH 
C. TSH 
D. thyroxine 
E. none of the preceding.
A

D. thyroxine

41
Q
Many nonsteroid hormones act upon their target cells by causing:
A. cyclic AMP to become ATP
B. the inactivation of adenylate cyclase
C. cyclic AMP to become protein kineses
D. the activation of adenylate cyclase
E. both A and D apply.
A

D. the activation of adenylate cyclase

42
Q
Which of the following would result from a thyroidectomy (removal of the thyroid gland)?
A. decreased TSH secretion
B. increased T3 and thyroxine secretion
C. increased calcitonin secretion
D. increased TSH secretion
E. both B and C apply.
A

D. increased TSH secretion

43
Q
The secretion of which hormone would be increased in a person with endemic goiter?
A. TSH. 
B. thyroxine 
C. triiodothyronine; 
D. all of the preceding apply
A

A. TSH.

44
Q

Which of the following hormone pairs is not produced by the same endocrine gland?
A. LH/FSH
B. ACTH/ADH
C. prolactin/GH
D. CRH/PIH.
E. all of the preceding are correctly paired.

A

B. ACTH/ADH

45
Q
A tumor of the beta cells of the pancreatic islets would probably affect the body's ability to:
A. lower blood glucose level
B. lower blood calcium level
C. raise blood calcium level
D. raise blood glucose level
E. raise blood sodium level.
A

D. raise blood glucose level

46
Q
Which hormone stimulated the production of erythrocytes in myeloid tissues?
A. GH 
B. progesterone 
C. ICSH/LH
D. ADH 
E. none of the preceding.
A

E. none of the preceding.

47
Q

Stress causes the adrenal medulla to release:

a. Norepinephrine and ANP
b. Epinephrine and vasopressin
c. Epinephrine and norepinephrine
d. Epinephrine, norepinephrine and vasopressin

A

c. Epinephrine and norepinephrine

48
Q
Which of these is not produced by the anterior pituitary?
A.ACTH
B.follicle-stimulating hormone
C.somatostatin
D.somatotropin
A

C.somatostatin

49
Q
Which of the following is not a hormone function?
A.increase cellular oxygen consumption
B.cause osteoblasts to divide
C.convert fibroblasts to osteoblasts
D.alter genetic expression
A

C.convert fibroblasts to osteoblasts

50
Q
Which of the following directly stimulates mitosis?
A.insulin
B.somatotropin
C.corticotropin
D.growth hormone releasing hormone
A

B.somatotropin

51
Q
Which of the following is not true of T3?
A.needed for normal mental growth
B.increases carbohydrate utilization
C.decreases lipid synthesis
D.decreases protein synthesis
A

D.decreases protein synthesis

52
Q
Graves disease can cause all of these except which one?
A.exophthalmos (popping out eyes)
B.a positive autoimmune test
C.general edema
D.intolerance to heat
A

C.general edema

53
Q
Osteoporosis most likely results from \_\_\_\_\_.
A.a deficiency of dietary calcium
B.increased calcitonin levels
C.increased PTH secretion
D.osteitis fibrosa
E. decreased oestrogen secretion
A

E. decreased oestrogen secretion

54
Q
Which of the following is the last step in the sequence of hormone synthesis in the adrenal medulla?
A.tyrosine
B.dopamine
C.epinephrine
D.norepinephrine
A

D.norepinephrine

55
Q
Which of these is not true of cortisol?
A.stimulates gluconeogenesis
B.decreases blood glucose
C.decreases protein synthesis
D.stimulated by ACTH
A

B.decreases blood glucose

56
Q
The hormone melatonin is secreted from the \_\_\_\_\_ gland.
A.pituitary
B.pineal
C.thyroid
D.thymus
A

B.pineal

57
Q
  1. Cortisol
    A) is synthesised and secreted in the zona glomerulosa of the adrenal cortex
    B) secretion is increased by high plasma glucose concentration
    C) Increase lipolysis
    D) acts mainly through activation of adenylyl cyclase on plasma membrane of target cell
    E) has no effect on muscle and liver glucose
A

C) Increase lipolysis

58
Q
  1. Hypothyroidism
    A) Usually caused by a lack of thyroid-stimulating hormone
    B) Can be diagnosed by measuring serum T3
    C) is often associated with a low plasma calcium concentration
    D) Short stature
A

D) Short stature

59
Q
  1. In the hormonal control of intermediary metabolism, which is false?
    A) Insulin stimulates glucose uptake by fat cells
    B) Glucagon stimulates glycogenolysis in muscle
    C) Glucagon stimulates gluconeogenesis in liver
    D) Cortisol increases gluconeogenesis in liver
    E) GH increases lipolysis in adipose tissue
A

B) Glucagon stimulates glycogenolysis in muscle

60
Q
  1. With regards to Vitamin D, which of the following statements is false?
    A) 1,25 hydroxy d3 potentiates parathyroid hormone action
    B) 1,25 hydroxy d3 stimulates renal tubular reabsorption of calcium
    C) 1,25-dihydroxyvitamin D3 increases intestinal absorption of phosphate
    D) Vitamin D might lead to hypocalcemia
    E) 25-hydroxylation of vitamin D3 is stimulated by parathyroid hormones
A

E) 25-hydroxylation of vitamin D3 is stimulated by parathyroid hormones

61
Q
  1. Calcium
    A) is more than 90% bound to protein in the circulation
    B) level in the blood is usually very low in patients with calcitonin-producing tumours
    C) binds to a calcium-sensing receptor in parathyroid gland cells to suppress parathyroid hormone production
    D) concentration in blood has no effect on calcitonin secretion
    E) absorption by the intestine is decreased by calcitonin
A

C) binds to a calcium-sensing receptor in parathyroid gland cells to suppress parathyroid hormone production

62
Q
  1. A middle-aged man has lung cancer. His plasma sodium concentration is 125mmol/L (normal range: 135-145), his plasma osmolality is 265 mOsm/kg (normal range: 280-295), his urine osmolality is 650 mOsm/kg (normal range: 650-1200). What is the most likely problem?
    A) Aldosterone production was increased due to metastasis of the cancer to the adrenal glands.
    B) There was polydipsia due to spread of the cancer to the thirst center of the hypothalamus.
    C) There was an excess secretion of Na+
    D) There was an excess ADH production
    E) There is excessive sodium loss in the urine because of kidney damage
A

D) There was an excess ADH production

63
Q
84.	The response of hepatocytes to glucagon involves all the following molecules EXCEPT
A) Adenylate Cyclase
B) G proteins
C) Protein Kinase A
D) Phosphorylase kinase
E) Phospholipase C
A

E) Phospholipase C

64
Q
  1. Growth Hormone
    A. Is not affected by glucose concentration
    B. Is mediated by cAMP
    C. Increases glucose uptake by fat and muscle cells
    D. Increases with physical exercise
    e) Decreases plasma Calcium
A

D. Increases with physical exercise

65
Q
  1. Thyroxine
    A. Is increased due to increased tsh in graves disease
    B. T3 acts by cAMP linked receptor on plasma membrane
    C. Deficiency in natal life before age of 3 will not lead to mental retardation
    D. Deficiency due to lack of iodine will not lead to goiter
    E. Is converted to T3 in liver and other cells
A

E. Is converted to T3 in liver and other cells

66
Q
  1. ACTH
    A. Stimulates the secretion of adrenaline from the adrenal glands
    B. Is produced by neurons whose cells bodies are located in the hypothalamus
    C. In excess may cause hyperglycemia
    D. Regulates aldosterone production
    E. Deficiency of will lead to hyperkalemia
A

C. In excess may cause hyperglycemia

67
Q
  1. With respect to T3, which of the following statements is false?
    A. T3 is secreted by the thyroid gland
    B. T3 is not produced outside the thyroid gland
    C. T3 is more biologically active than thyroxine
    D. More than 99% of the circulating T3 is bound to protein in plasma
    E. T3 acts on the pituitary gland to inhibit the secretion of TSH
A

B. T3 is not produced outside the thyroid gland

68
Q
90.	Insulin
A. Stimulates gluconeogenesis
B. Inhibits lipolysis
C. Decreases glucose uptake by fats
D. Increases glucagon secretion
E. Decreases protein synthesis
A

B. Inhibits lipolysis

69
Q
91.	Which of the following does not stimulate adenyl cyclase?
A. Insulin
B. Glucagon
C. TSH
D. Adrenaline
E. Noradrenaline
A

A. Insulin

70
Q
  1. PTH
    A. Synthesised in parafollicular cells of thyroid gland
    B. Has no effect on Vit D metabolism
    C. Increases renal tubular absorption of phosphate
    D. Excess leads to bone demineralisation
    E. Deficiency has no major effect on plasma calcium concentration because a concurrent change in calcitonin secretion helps to maintain plasma calcium at the normal range
A

D. Excess leads to bone demineralisation

71
Q

What is true about plasma calcium?

a. It is not bound to proteins in circulation
b. Low plasma Ca2+ results in tetany
c. Low calcium stimulates calcitonin
d. High calcium is a sign of vitamin D deficiency
e. Low calcium may be a sign of hyperthyroidism

A

b. Low plasma Ca2+ results in tetany

72
Q
Conversion to active VitD3 is by: 
A. 25-hydroxylation
B. 1-hydroxylation
C. 17-hydroxylation
D. 21-hydroxylation
A

B. 1-hydroxylation

25 in liver, 1 in kidney (final step) stimulated by PTH. 17 is for cortisol.

73
Q
Which is not released by the hypothalamus? 
A. thyrotropin-releasing hormone 
B. adrenocorticotropic hormone 
C. dopamine 
D. somatostatin
A

B. ACTH (ACTH is by pituitary, hypothalamus are all “releasing” hormones)

74
Q

Growth hormone and prolactin both act on tyrosine kinase receptors
A. true
B. false

A

A. true

GH, prolactin, insulin and IGF-1 at on TKR