Exam 1

Question 1

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

Answer 1

Hashimotos’s thyroiditis

Question 2

The primary serum test to screen for thyroid disease is:

TSH
FT4
Reverse T3
Total T4

Answer 2

TSH

Question 3

What is the major carrier protein of the thyroid hormones in the blood?

Albumin
Thyroxine binding pre-albumin
Thyroxine binding globulin
Thyroglobulin

Answer 3

Thyroxine binding globulin

Question 4

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

Answer 4

TSH increased, T4 decreased Hyperthyroidism
TSH decreased, T4 normal Subclinical hypothyroidism
TSH decreased, T4 increased Hyperthyroidism
TSH increased, T4 normal Subclinical hypothyroidism

Question 5

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

Answer 5

Lumina of the follicle

Question 6

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

Answer 6

Monodeiondination of T4 in peripheral tissues

Question 7

The parafollicular cells of the thyroid gland secrete calcitonin.

True
False

Answer 7

True

Question 8

T3 and T4 are more physiologically active than FT3 and FT4.

True
False

Answer 8

False

Question 9

The most common cause of hyperthyroidism is:

Hashimoto’s thyroiditis
Grave’s disease
Pituitary tumor
Radiation therapy

Answer 9

Grave’s disease

Question 10

An effective way to see if the thyroid gland is metabolically active is with a nuclear medicine evaluation.

True
False

Answer 10

True

Question 11

The most common critical problem encountered with pre-term delivery is Respiratory Distress Syndrome

True
False

Answer 11

True

Question 12

Acetylcholinesterase is not diagnostic for:

Anencephaly
Trisomy 21
Open spina bifida
Abdominal wall defects

Answer 12

Trisomy 21

Question 13

Which test is a valuable first trimester screening test?

Pregnancy associated plasma protein A
Fetal fibronectin
Maternal alpha fetoprotein
Multiples of median

Answer 13

Pregnancy associated plasma protein A

Question 14

What is produced by the embryonic yolk sac and also the fetal liver?

Inhibin A
Acetylcholinesterase
Unconjugated estriol
Alpha fetoprotein

Answer 14

Alpha fetoprotein

Question 15

HCG is structurally similar to which hormone?

TSH
FT4
Cortisol
ACTH

Answer 15

TSH

Question 16

Which of the following increases during pregnancy:

Protein catabolism
Plasma volume
Calcium
Iron

Answer 16

Plasma volume

Question 17

A cluster of cells once implantation occurs is called a:

Zygote
Embryo
Blastocyte
Fetus

Answer 17

Embryo

Question 18

During pregnancy, in the second trimester, hCG levels ______.

Increase
Return to pre-pregnancy levels
Decrease

Answer 18

Decrease

Question 19

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

Answer 19

A normal MS-AFP level for 16 week gestation

Question 20

Which of the following is not quantified in the triple test for Down Syndrome?

Alpha-1 fetoprotein
Unconjugated estriol
Progesterone
hCG

Answer 20

Progesterone

Question 21

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

Answer 21

Neural tube defects

Question 22

The major growth factor induced by Growth Hormone is IGF-2

True
False

Answer 22

False

Question 23

What common substrate is used in the biosynthesis of adrenal steroids, including androgens and estrogens?

Cortisol
Catecholamines
Progesterone
Cholesterol

Answer 23

Cholesterol

Question 24

What hormone acts as an inhibiting hormone to Growth Hormone?

Dopamine
IGF-1
Somatostatin
Inhibin

Answer 24

Somatostatin

Question 25

Which of the following hormones can stimulate the production and release of TSH? Dopamine ACTH GH None of the above

Answer 25

None of the above

Question 26

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

Answer 26

* Anterior pituitary: ACTH FSH Growth hormone * Adrenal cortex: Aldosterone Cortisol * Adrenal medulla: Epinephrine Dopamine * Posterior pituitary: Arginine vasopressin * Hypothalamus: GnRH * Thyroid gland: T3

Question 27

Which of the following hormones inhibits GH and TSH? Dopamine Somatostatin Growth hormone releasing hormone Corticotropic releasing hormone

Answer 27

Somatostatin

Question 28

Match the hormone with the tissue it acts on. (answers used only once) TRH Thyroid TSH Pituitary ACTH Gonads LH Adrenal gland

Answer 28

TRH Pituitary TSH Thyroid ACTH Adrenal gland LH Gonads

Question 29

What is the only neuroendocrine signal that inhibits prolactin? Dopamine Growth hormone IGF-1 Epinephrine

Answer 29

Dopamine

Question 30

________failure of an endocrine gland is accompanied by dramatic increases in circulating levels of the corresponding pituitary tropic hormone. Primary Secondary Tertiary

Answer 30

Primary

Question 31

Which is not a cause of hypopituitarism? Trauma Infection Idiopathic Surgery All are causes of hypopituitarism

Answer 31

All are causes of hypopituitarism

Question 32

The major action of ________ is to regulate free water excretion. Oxytocin Dopamine Arginine vasopressin Prolactin

Answer 32

Arginine vasopressin

Question 33

Match the portion of the adrenal cortex with its major hormone. Zona glomerulosa Androgens Zona reticularis Aldosterone Zona fasciculata Cortisol

Answer 33

Zona glomerulosa Aldosterone Zona reticularis Androgens Zona fasciculata Cortisol

Question 34

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

Answer 34

Klinefelter Syndrome

Question 35

_________ has a surge during the luteal phase of a menstrual cycle. FSH LH Testosterone Progesterone

Answer 35

Progesterone

Question 36

Which of the following tissues doesn't not secrete steroid hormones? Ovaries Pituitary gland Testes Adrenal cortex

Answer 36

Pituitary gland

Question 37

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

Answer 37

Epinephrine Converts glycogen to glucose Norepinephrine Affects vascular smooth muscle and heart Dopamine Neurotransmitter in the brain affecting the vascular system

Question 38

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

Answer 38

After ovulation, progesterone rapidly increases

Question 39

An 83 year old male subject with low testosterone will see an increase in which anterior pituitary hormone? LH GH Prolactin ACTH

Answer 39

LH

Question 40

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

Answer 40

Addison's disease

Question 41

Homovanillic acid is the metabolite of_______. Dopamine Norepinephrine Epinephrine Vanillylmandelic acid

Answer 41

Dopamine

Question 42

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

Answer 42

Increased adrenal secretion of aldosterone

Question 43

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

Answer 43

Cushing's syndrome

Question 44

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

Answer 44

Glucocorticoids

Question 45

Rare catecholamine secreting benign tumor arising from chromaffin cells in the adrenal medulla, causes increased levels of epinephrine and norepinephrine. Medulloma Adenoma Adrenocarcinoma Pheochromocytoma

Answer 45

Pheochromocytoma