Exam 1 Flashcards
A patient has the following thyroid profile: decreased total T4, decreased Free T4, positive thyroid peroxidase antibody, increased TSH. What is the most like scenario?
Idiopathic hyperthyroidism
Hashimotos’s thyroiditis
A normal thyroid
Grave’s disease
Hashimotos’s thyroiditis
The primary serum test to screen for thyroid disease is:
TSH
FT4
Reverse T3
Total T4
TSH
What is the major carrier protein of the thyroid hormones in the blood?
Albumin
Thyroxine binding pre-albumin
Thyroxine binding globulin
Thyroglobulin
Thyroxine binding globulin
Match the test results with the likely diagnosis.
TSH increased, T4 decreased Hyperthyroidism
TSH decreased, T4 normal Hyperthyroidism
TSH decreased, T4 increased Subclinical hypothyroidism
TSH increased, T4 normal Hypothyroidism
TSH increased, T4 decreased Hyperthyroidism
TSH decreased, T4 normal Subclinical hypothyroidism
TSH decreased, T4 increased Hyperthyroidism
TSH increased, T4 normal Subclinical hypothyroidism
Once synthesized, the thyroid hormones are stored in what area of the thyroid gland?
Epithelial cell wall of the follicule
Lumina of the follicle
Isthus of the thyroid gland
Extracellular space of the thyroid gland
Lumina of the follicle
How is the majority of reverse T3 (rT3) made?
Monodeiondination of T4 in peripheral tissues
Monodeiondination of T3 in peripheral tissues
From T3 in the thyroid gland
From thyroglobulin in the thyroid gland
Monodeiondination of T4 in peripheral tissues
The parafollicular cells of the thyroid gland secrete calcitonin.
True
False
True
T3 and T4 are more physiologically active than FT3 and FT4.
True
False
False
The most common cause of hyperthyroidism is:
Hashimoto’s thyroiditis
Grave’s disease
Pituitary tumor
Radiation therapy
Grave’s disease
An effective way to see if the thyroid gland is metabolically active is with a nuclear medicine evaluation.
True
False
True
The most common critical problem encountered with pre-term delivery is Respiratory Distress Syndrome
True
False
True
Acetylcholinesterase is not diagnostic for:
Anencephaly
Trisomy 21
Open spina bifida
Abdominal wall defects
Trisomy 21
Which test is a valuable first trimester screening test?
Pregnancy associated plasma protein A
Fetal fibronectin
Maternal alpha fetoprotein
Multiples of median
Pregnancy associated plasma protein A
What is produced by the embryonic yolk sac and also the fetal liver?
Inhibin A
Acetylcholinesterase
Unconjugated estriol
Alpha fetoprotein
Alpha fetoprotein
HCG is structurally similar to which hormone?
TSH
FT4
Cortisol
ACTH
TSH
Which of the following increases during pregnancy:
Protein catabolism
Plasma volume
Calcium
Iron
Plasma volume
A cluster of cells once implantation occurs is called a:
Zygote
Embryo
Blastocyte
Fetus
Embryo
During pregnancy, in the second trimester, hCG levels ______.
Increase
Return to pre-pregnancy levels
Decrease
Decrease
A laboratory measures maternal serum AFP (MS-AFP) at 16-18 weeks gestation as a screen for fetal disorders. The 16 week MS-AFP median is 32 mg/L and a 37 year old woman has a MS-AFP level of 34 mg/L. This result is consistent with:
A normal MS-AFP level for 16 week gestation
Possible neural tube defects, including spina bifida
Possible multiple birth
Possible trisomy disorder, including Down Syndrome
A normal MS-AFP level for 16 week gestation
Which of the following is not quantified in the triple test for Down Syndrome?
Alpha-1 fetoprotein
Unconjugated estriol
Progesterone
hCG
Progesterone
A pregnant patient presents to her OB/GYN in the first trimester of pregnancy with abnormal ultrasound readings, normal hCG, and AFP values of 8 MoM (normal is <2 MoM). Based on this evidence, what is most likely manifesting in the fetus?
Neural tube defects
Trisomy abnormalities like Down Syndrome
This is a normal pregnancy
None of the above
Neural tube defects
The major growth factor induced by Growth Hormone is IGF-2
True
False
False
What common substrate is used in the biosynthesis of adrenal steroids, including androgens and estrogens?
Cortisol
Catecholamines
Progesterone
Cholesterol
Cholesterol
What hormone acts as an inhibiting hormone to Growth Hormone?
Dopamine
IGF-1
Somatostatin
Inhibin
Somatostatin
Which of the following hormones can stimulate the production and release of TSH?
Dopamine
ACTH
GH
None of the above
None of the above
Match the hormone with its tissue of origin. (answers may be used more than once)
ACTH Adrenal cortex
Aldosterone Anterior pituitary
Epinephrine Anterior pituitary
FSH Posterior pituitary
Cortisol Adrenal medulla
Arginine vasopressin Anterior pituitary
Growth hormone Hypothalamus
GnRH Hypothalamus
Dopamine Thyroid gland
T3 Anterior pituitary
- Anterior pituitary: ACTH
FSH
Growth hormone - Adrenal cortex: Aldosterone
Cortisol - Adrenal medulla: Epinephrine
Dopamine - Posterior pituitary: Arginine vasopressin
- Hypothalamus: GnRH
- Thyroid gland: T3
Which of the following hormones inhibits GH and TSH?
Dopamine
Somatostatin
Growth hormone releasing hormone
Corticotropic releasing hormone
Somatostatin
Match the hormone with the tissue it acts on. (answers used only once)
TRH Thyroid
TSH Pituitary
ACTH Gonads
LH Adrenal gland
TRH Pituitary
TSH Thyroid
ACTH Adrenal gland
LH Gonads
What is the only neuroendocrine signal that inhibits prolactin?
Dopamine
Growth hormone
IGF-1
Epinephrine
Dopamine
________failure of an endocrine gland is accompanied by dramatic increases in circulating levels of the corresponding pituitary tropic hormone.
Primary
Secondary
Tertiary
Primary
Which is not a cause of hypopituitarism?
Trauma
Infection
Idiopathic
Surgery
All are causes of hypopituitarism
All are causes of hypopituitarism
The major action of ________ is to regulate free water excretion.
Oxytocin
Dopamine
Arginine vasopressin
Prolactin
Arginine vasopressin
Match the portion of the adrenal cortex with its major hormone.
Zona glomerulosa Androgens
Zona reticularis Aldosterone
Zona fasciculata Cortisol
Zona glomerulosa Aldosterone
Zona reticularis Androgens
Zona fasciculata Cortisol
A person who has features that includes: narrow shoulders, poor muscle development, longer legs, and an extra X chromosome would be diagnosed with:
Turner Syndrome
Klinefelter Syndrome
Hirsutism
Hashimoto’s
Klinefelter Syndrome
_________ has a surge during the luteal phase of a menstrual cycle.
FSH
LH
Testosterone
Progesterone
Progesterone
Which of the following tissues doesn’t not secrete steroid hormones?
Ovaries
Pituitary gland
Testes
Adrenal cortex
Pituitary gland
Match the hormone with its decription.
Epinephrine Affects vascular smooth muscle and heart
Norepinephrine Neurotransmitter in the brain affecting
the vascular system
Dopamine Converts glycogen to glucose
Epinephrine Converts glycogen to glucose
Norepinephrine Affects vascular smooth muscle and heart
Dopamine Neurotransmitter in the brain affecting
the vascular system
A physician of reproductive endocrinology and infertility would like to determine when a patient ovulates. The physician orders serial assays of plasma progesterone. From these assays, how can the physician recognize when ovulation occurs?
Right before ovulation, progesterone rapidly increases
After ovulation, progesterone rapidly decreases
After ovulation, progesterone rapidly increases
There is a gradual, steady increase in progesterone throughout the menstrual cycle
After ovulation, progesterone rapidly increases
An 83 year old male subject with low testosterone will see an increase in which anterior pituitary hormone?
LH
GH
Prolactin
ACTH
LH
Plasma for cortisol determinations were collected at 7am, after waking the patient, and at 10pm that evening. The cortisol level for both morning and evening samples were well below the reference range for the specified times. This is consistent with:
A normal finding
Cushing syndrome
Addison’s disease
Hyperpituitarism
Addison’s disease
Homovanillic acid is the metabolite of_______.
Dopamine
Norepinephrine
Epinephrine
Vanillylmandelic acid
Dopamine
The major action of angiotensin II is:
Increased adrenal secretion of aldosterone
Increased pituitary secretion of vasopressin
Decreased adrenal secretion of aldosterone
Increased secretion of thyroid hormone
Increased adrenal secretion of aldosterone
A person with symptoms that include: easy bruising, hypertension, increased cortisol, decreased ACTH, and weight gain in the face and abdomen, are likely to be diagnosed with:
Addison’s disease
Conn’s syndrome
Grave’s disease
Cushing’s syndrome
Cushing’s syndrome
A 37 year old patient presents with low ACTH and low cortisol. What hormone replacement therapy is indicated?
Glucocorticoids
Mineralocorticoids
DHEA
All of the above
Glucocorticoids
Rare catecholamine secreting benign tumor arising from chromaffin cells in the adrenal medulla, causes increased levels of epinephrine and norepinephrine.
Medulloma
Adenoma
Adrenocarcinoma
Pheochromocytoma
Pheochromocytoma
