Exam 1 Review

Which hormone is not of clinical significance in the patient presenting with panhypopituitarism?

ACTH

hCG

TSH

GH

hCG

What is the difference between a tropic hormone and a direct effector hormone?

Tropic and direct effector hormones are both similar in that both act directly on peripheral tissue.

Tropic and direct effector hormones are both similar in that both act directly on another endocrine gland.

Tropic hormones act on endocrine glands, while direct effector hormones act on peripheral tissue.

Tropic hormones act on peripheral tissue while direct effectors act directly on endocrine glands.

Tropic hormones act on endocrine glands, while direct effector hormones act on peripheral tissue.

All of the following are examples of negative feedback except:

thermostat control

thyroid regulation

oxytocin’s effect on uterine contractions

adrenal hormones

oxytocin’s effect on uterine contractions

Which of the following hormones inhibits GH and TSH?

dopamiine

somatostatin

growth hormone releasing hormone

corticotropic releasing hormone

somatostatin

T/F: A single, random measurement is all that is needed to diagnose conditions that are affected by growth hormone.

False

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?

traume

infection

idiopathic

surgery

all are causes

all are causes

T/F: the major growth factor induced by growth hormone is IGF-1

true

TRH acts on what tissue?

Adrenal gland

thyroid

gonads

pituitary

pituitary

What of the following statements is true of steroid hormones?

Steroid hormones can initiate action immediately.

Steroid hormones are typically synthesized from cholesterol.

Steroid hormones are hydrophilic.

All of the above statements are true.

Steroid hormones are typically synthesized from cholesterol

What hormone’s mechanism of elimination is: rapidly degraded within blood circulation?

catecholamines

steroid hormones

thyroid hormones

catecholamins

What hormone’s mechanism of elimination is by inactivating metabolic pathways and excretion in urine or bile?

catecholamines

steroid hormones

thyroid hormones

steroid hormones

What hormone’s mechanism of elimination is: inactivated by intracellular deiodinases?

catecholamines

steroid hormones

thyroid hormones

thyroid hormones

Which is not a factor that affects hormone levels?

menopause

time of day

emotional stress

diet

none are factors

all are factors

all are factors

Growth hormone is secreted by what type of cell in the pituitary gland?

lactotrophs

somatotrophs

corticotrophs

thyrotrophs

somatotrophs

T/F: All hormones have the same pulse frequency

false

ACTH tissue of origin

anterior pituitary

Aldosterone tissue of origin

adrenal cortex

Epinephrine tissue of origin

adrenal medulla

FSH tissue of origin

anterior pituitary

Arginine vasopressin tissue of origin

posterior pituitary

GnRH tissue of origin

hypothalamus

T/F: Insulin like growth factors can cross react with insulin receptions and cause hypoglycemia.

true

T/F: acromegaly is often seen with GH producing tumor

true

Which hormone is regulated by tonic inhibition?

TSH

ACTH

Growth hormone

Prolactin

prolactin

A pregnant patients presents to her OBGYN 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

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

Alpha-1-fetoprotein

Unconjugated estriol

Progesterone

hCG

Progesterone

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

Increase

Return to pre-pregnancy levels

Decrease

decrease

Which of the following increases during pregnancy:

Protein catabolism

Plasma volume

Calcium

Iron

Plasma volume

hCG is structurally similar to which hormone?

TSH
FT4

Cortisol

ACTH

TSH

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

Inhibin A

Acetylecholinesterase

Unconjugated estriol

Alpha fetoprotein

Alpha fetoprotein

In a pregnancy with Down’s syndrome, the hCG levels are what compared to unaffected, typical pregnancies?

The same

2x higher

6x higher

Significantly lower

2x higher

The calcium needs of the mother ___ during pregnancy.

Decrease

Stay the same

Increase

Increase

Pregnancy causes changes in respiration with a ___ in pO2 and a ___ in pCO2.

Decrease, decrease

Increase, increase

Decrease, increase

Increase, decrease

Increase, decrease

The condition that stems from a genetic defect in females that has a partial or complete loss of one of the X chromosomes.

Klinefelter syndrome

Turner syndrome

Hirsutism

PCOS

Turner syndrome

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 through 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

The additional test that turns a neonatal triple screen test panel into a quadruple screen test panel is the addition of:

Fetal fibronectin

Progesterone

Glucose tolerance test

Inhibin A

Inhibin A

Which test is commonly used to asses probability of a patient going into labor within a week or two?

Inhibin A

PAPP-A

Fetal fibronectin

uE3

fetal fibronection

Which is one of the most common birth defects seen in a developing fetus?

Respiratory distress syndrome

Neural tube defects

Trisomy 18

Isoimmunization

Neural tube defects

The testes produce approximately what amount of circulating testosterone in males?

5%

50%

75%

95%

95%

Which hormone stimulates spermatogenesis in males?

GH
LH
FSH
testosterone

FSH

A male with primary gonadal insufficiency would be expected to have what values?

Increased testosterone, decreased FSH or LH

Low testosterone, increased FSH or LH, impaired sperm production

Low testosterone, low GnRH, FSH, or LH

Increased testosterone, FSH, LH, and adequate sperm production

Low testosterone, increased FSH or LH, impaired sperm production

A person who has features that includes: narrow shoulders, poor muscle development, longer legs, and extra X chromosome would be diagnosed with:

Turner syndrome

Klinefelter Syndrome

Hirsutism

Swyer Syndrome

Klinefelter Syndrome

T/F: Individuals with prostates who are on testosterone replacement therapy should have PSAs tests performed on a regular basis.

False

Which is the principal estrogen synthesized by the ovaries?

Estriol

Estrone

Estradiol

DHT

Estradiol

Which of the following tissues doesn’t not secrete steroid hormones?

Ovaries

Pituitary gland

Testes

Adrenal cortex

Pituitary gland

Match the portion of the adrenal cortex with its major hormone.

Zona glomerulosa, Zona reticularis, Zona fasciculata

Androgens, Cortisol, Aldosterone

Zona glomerulosa - aldosterone

Zona reticularis - androgens

Zona fasciculata - cortisol

Which of the following hormone levels can be evaluated by analysis of urinary byprodcuts metanephrines and vanillylmandelic acid?

AVP and oxytocin

Epinephrine and norepinephrine

T3 and T4

AVP and aldosterone

Epinephrine and norepinephrine

Plasma for cortisol determinations were collected at 7 AM, after waking the patient, and at 10 PM that evening, The cortisol levels for both morning and evening samples were well below reference ranges for the specified times. This is consistent with:

A normal finding

Cushing syndrome

Addison’s disease

Hyperpituitarism

Addison’s disease

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

Congential adrenal hyperplasia that is caused by a defect in 21-hydroxylase will have what impact on other levels?

Decrease in precursors (17-OHP), ACTH, and cortisol

Increase in precursors (17-OHP), ACTH, and cortisol

Increase in precursors (17-OHP) and ACTH; decrease in cortisol

Decrease in precursors (17-OHP) and ACTH; increase in cortisol

Increase in precursors (17-OHP) and ACTH; decrease in cortisol

Renin from the kidneys is responsible for:

converting angiotensin 1 to angiotensin 2

converting angiotensinogen to angiotensin 1

causing aldosterone to be released

converting angiotensin 2 to angiotensinogen

Converting angiotensinogen to angiotensin 1

Which is not typically caused by primary aldosteronism?

Hypertension

Hypokalemia

Metabolic alklalosis

Hyperkalemia

Hyperkalemia

In the regulation of cortisol loop, the hypothalamus releases ___, which acts on the anterior pituitary to cause it to release ___ which acts on the adrenal gland to release ___.

CRH, ACTH, Cortisol

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

Turner’s syndrome

Cushing’s syndrome

Cushing’s syndrome

What portion of the adrenals produces glucocorticoids?

Adrenal medulla

Zona glomerulosa

Zona fasiculata

Zona reticularis

zona fasiculata

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

Homovanillic acid is the metabolite of:

dopamine

norepinephrine

epinephrine

vanillylmandelic acid

dopamine

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

cortisol

catecholamines

progesterone

cholesterol

cholesterol

Match the hormone with the tissue it acts on

TRH, TSH, ACTH, LH

Thyroid, Adrenal gland, Gonads, Pituitary

TRH - pituitary

TSH - thyroid

ACTH - adrenal gland

LH - gonads

Which is not a cause of hypopituitarism?

trauma

infection

idiopathic

surgery

all are causes

all are causes

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 NTD, including spina bifida

Possible multiple birth

Possible trisomy disorder, including Down Syndrome

A normal MS-AFP level for 16 week gestation

Acetylcholinesterase is not diagnostic for:

Anencephaly

Trisomy 21

Open spina bifida

Abdominal wall defects

trisomy 21

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

Testing of ___ indicates ovulation and potential fertility.

GnRH

LH

Testosterone

Estradiol

LH

This is typically a hormone that is generally considered to be an unbroken chain of amino acids

amine

peptide

glycoprotein

fatty acid

peptide

This is the most common feedback mechanism in the human body.

negative

positive

neutral

negative

Prolactin secreting cells in the pituitary are known as:

somatotrophs

corticotrophs

lactotrophs

thyrotrophs

lactotrophs

Which of these pituitary hormones is a direct effector?

TSH

FSH

ACTH

Prolactin

prolactin

T/F: IGF-3 is the preferred test for grown hormone evaluation

false

Which is not an anterior pituitary hormone?

ACTH

AVP

LH

GH

AVP

The adrenal cortex has how many secretions?

1

2

3

4

3

Secondary adrenal insufficiency is caused by an issue of hormone secretion from where?

Adrenals

Pituitary

Hypothalamus

pituitary

T/F: Cushing’s disease is caused by a decreased amount of cortisol

false

T/F: Men acquire 40% of their testosterone from their adrenal glands

false

GnRH is released from which gland?

Hypothalamus

Anterior pituitary

Posterior pituitary

Testes

hypothalamus

Which hormone is required for successful implantation of an embryo?

Estrogen

Testosterone

Progesterone

GnRH

progesterone

T/F: Glomerular filtration rate decreases in pregnancy

false

T/F: trisomy 21 is commonly referred to as down syndrome

true

T/F: calcium needs of the mother decreases during pregnancy

false

In a pregnancy with Down’s syndrome, the hCG levels are how much higher typically?

2x higher

False negatives can be seen in immunoassays methodologies due to what?

hook effect

What hormone can be decreased during pregnancy due to structural similarities to hCG?

TSH

Pregnancy causes changes in respiration with a ___ in pO2 and ___ in pCO2

increase, decrease

What 3 glands secrete testosterone?

testes, ovaries, and adrenal glands

What hormone stimulates production of testosterone?

LH

What hormone is secreted by the placenta to maintain the uterus?

progesterone

What disorder is often associated with infertility and hirsutism?

PCOS

This is a genetic defect in females that has a partial or complete loss of one of the X chromosomes.

Turner syndrome

Where is the adrenal gland located?

top of kidneys

What are catecholamines synthesized from?

tyrsone

What are metabolized into a final end product of vanillylmandelic acid?

norepinephrine and epinephrine

T/F: trauma can cause hypopituitarism

true

What tissue does TRH act on?

pituitary

What test is preferred for assessing GH?

IGF-1

What is the originating tissue of ACTH?

anterior pituitary gland

Complete loss of function of hypopituitarism is called:

panhypopituitarism