Hormones II

Which one of the following hormones causes the hypothalamus to trigger the surge of luteinizing hormone (LH) from the anterior pituitary just before ovulation?

 

Progesterone

 

Follicle-stimulating hormone (FSH)

 

Estrogen

 

Gonadotropin-releasing hormone (GnRH)

 

• Estrogen

Because of the biochemical properties of steroid hormones, the majority of these hormones, at physiological concentration:

 

remain free in the circulation.

 

are bound with low affinity to albumin.

 

are conjugated to glucuronides.

 

are bound with high affinity to a carrier protein in the circulation.

• are bound with high affinity to a carrier protein in the circulation

The urinary metabolite of cortisol and adrenal androgens is:

 

11-desoxycortisol.

 

renin.

 

17-hydroxyprogesterone.

 

17-ketosteroid.

• 17-ketosteroid

In the classic plasma renin activity assay that measures the main function of the enzyme and uses inhibitors of angiotensinase, what is actually measured at the end of the assay?

 

Plasma renin

 

Angiotensin-converting enzyme

 

Angiotensin I

 

Angiotensin II

• Angiotensin I

Laboratory assessment of which of the following hormones is used to evaluate ovulation?

 

Progesterone

 

All of the above

 

FSH

 

Estradiol

• Progesterone

Which one of the following statements concerning androstenedione is incorrect?

 

In adrenal carcinoma, cortisol is greatly elevated, but androstenedione is greatly decreased.

 

The precursor molecule in the formation of androstenedione is dihydroepiandrostenedione (DHEA).

 

Androstenedione metabolites are measured as 17-ketosteroids.

 

11-Hydroxylase deficiency leads to elevated plasma androstenedione.

• In adrenal carcinoma, cortisol is greatly elevated, but androstenedione is greatly decreased

A typical characteristic in a woman with polycystic ovary disease (PCOS. includes:

 

increased serum LH concentration.

 

decreased serum androstenedione concentration.

 

persistent ovulation.

 

markedly increased serum FSH concentration.

• increased serum LH concentration

In nonpregnant women, progesterone is synthesized and secreted by the:

 

corpus luteum.

 

placenta.

 

pituitary gland.

 

Both a and b are correct.

• corpus luteum

Typical findings in a woman in menopause include:

 

increased progesterone.

 

decreased serum LH/FSH.

 

decreased estrogen and inhibin.

 

hirsutism.

• decreased estrogen and inhibin

Which one of the following statements regarding FSH/LH is incorrect?

 

LH acts to stimulate Leydig cells in the testes to synthesize testosterone.

 

FSH, secreted by the anterior pituitary, induces follicular maturation.

 

FSH acts on the cells of the follicle to increase responsiveness of LH receptors.

 

Progesterone produced by the corpus luteum causes LH levels to increase.

• Progesterone produced by the corpus luteum causes LH levels to increase

Renin is synthesized in the …………….. and stimulates the production of angiotensin I, which eventually leads to ……………

 

kidney; lowering of the blood pressure and volume

 

kidney; stimulation of aldosterone production

 

adrenal gland; stimulation of cortisol production

 

adrenal gland; an increase in blood pressure and volume

• kidney, stimulation of aldosterone production

Deficiency of which of the following enzymes can lead to congenital adrenal hyperplasia (CAH)?

 

21-Alpha-hydroxylase

 

Both a and b

 

11-Beta-hydroxylase

 

17-Ketosteroidase

• 21-Alpha-hydroxylase

In measurement of testosterone in blood:

 

morning specimens are preferred because of the diurnal release of testosterone.

 

assessment of serum 17-ketosteroids is included.

 

specimens must be collected in EDTA anticoagulant.

 

5-androstenediol derivatives are actually measured.

• morning specimens are preferred because of the diurnal release of testosterone

How would CAH affect cortisol and adrenal androgen levels in blood?

 

Cortisol increased, adrenal androgens increased

 

Cortisol increased, adrenal androgens decreased

 

Cortisol decreased, adrenal androgens increased

 

Cortisol decreased, adrenal androgens decreased

• Cortisol decreased, adrenal androgens increased

Inhibin:

 

promotes synthesis of testosterone by the Sertoli cells.

 

increases in males with elevated GnRH.

 

inhibits release of FSH from the male pituitary gland.

 

augments release of LH from the male pituitary gland

• inhibits release of FSH from the male pituitary gland

A 14-year-old male comes to his physician with infantile genitalia and the lack of development of any secondary sex characteristics. The patient is short in stature. Upon discussion of family history, it was discovered that several male relatives had similar defects in testicular development. Based on this information, laboratory results would indicate:

 

elevated testosterone and decreased FSH/LH.

 

decreased testosterone and decreased follicle-stimulating hormone (FSH)/luteinizing hormone (LH).

 

decreased testosterone and elevated FSH/LH.

 

elevated testosterone and elevated FSH/LH.

• decreased testosterone and elevated FSH/LH

Glucocorticoids:

 

repress inflammatory genes.

 

decrease blood glucose concentration.

 

stimulate lipogenesis.

 

stimulate erythropoiesis.

• repress inflammatory genes

A patient with Cushing syndrome has plasma cortisol measured at 8 AM. The nighttime cortisol level will be ………. from the 8 AM value.

 

unchanged

 

increased

 

decreased

• unchanged

Regarding the phases of the menstrual cycle, the suppression of luteinizing hormone synthesis by progesterone occurs during which one of the following phases?

 

Ovulation

 

Follicular phase

 

Luteal phase

 

Both a and b

• Luteal phase

The parent substance in the biosynthesis of androgens and estrogens is:

 

Cholesterol

 

Progesterone

 

Cortisol

 

Catecholamines

• Cholesterol

The adrenal cortical hormone that promotes sodium resorption and potassium and hydrogen ion excretion by the renal tubules and thus affects water balance in the body is:

 

androstenedione.

 

calcium.

 

aldosterone.

 

cortisol.

• aldosterone

The formation of estriol in a pregnant woman is dependent on:

 

Fetal and placental function

 

Maternal ovarian function

 

Fetal adrenal function

 

Maternal liver function

• fetal and placental function

For the past 3 weeks, serum estriol levels in a pregnant woman have been steadily increasing. This is consistent with:

 

A normal pregnancy

 

Fetal death

 

Congenital cytomegalovirus infection

 

Hemolytic disease of the newborn

• a normal pregnancy

Which of the following is secreted by the placenta and used for the early detection of pregnancy?

 

Luteinizing hormone (LH)

 

Follicle-stimulating hormone (FSH)

 

Progesterone

 

Human chorionic gonadotropin (HCG)

• Human chorionic gonadotropin (HCG)

Which of the following steroid hormones is (are. synthesized and secreted by the zona reticularis of the adrenal cortex?

 

Estradiol

 

Cortisol

 

Androstenedione

 

All of the above

• Androstenedione

The primary glucocorticoid is:

 

epinephrine.

 

aldosterone.

 

cortisol.

 

glucose.

• cortisol

During an evaluation of adrenal function, a patient had plasma cortisol determinations in the morning after awakening and in the evening at approximately 7:30 PM. Laboratory results indicated that the evening value was approximately half as high as the morning concentration. This is indicative of:

 

ectopic hormone production.

 

a normal finding.

 

adrenal gland tumor.

 

Cushing syndrome.

• a normal finding

During an evaluation of adrenal function, a patient had plasma cortisol determinations in the morning after awakening and in the evening at approximately 7:30 PM. Laboratory results indicated that the evening value was approximately half as high as the morning concentration. This is indicative of:

 

ectopic hormone production.

 

a normal finding.

 

adrenal gland tumor.

 

Cushing syndrome.

• Estradiol

The placenta secretes numerous hormones, both protein and steroid. Which of the following hormones is not secreted by the placenta?

 

Progesterone

 

Estrogen

 

Human placental lactogen (HPL)

 

Luteinizing hormone (LH)

 

Human chorionic gonadotropin (HCG)

• Luteinizing hormone (LH)

Unconjugated estriol (uE3. is clinically useful for identifying which of the following?

 

Molar pregnancy

 

Fetal anencephaly

 

Fetal death

 

A fetus with Down syndrome

• A fetus with Down Syndrome

Which of the following hormones is useful in identifying women with ectopic pregnancies or abnormal intrauterine pregnancies?

 

Human chorionic gonadotropin

 

Human luteinizing hormone

 

Human progesterone

 

Human pituitary gonadotropin

• Human chorionic gonadotropin

Which of the following laboratory tests provides a valid index of glucocorticoid secretion?

 

Serum thyroxine

 

Urinary free cortisol

 

Urinary epinephrine

 

Urinary sodium

• Urinary free cortisol

Which metabolite is most often increased in carcinoid tumors?

 

Homovanillic acid

 

Epinephrine

 

3-Methoxy-4-hydroxyphenylglycol (MHPG)

 

5-Hydroxyindolacetic acid (5-HIAA)

• 5-Hydroxinaolacetic acid (5-HIAA)

The goal of early detection and treatment of neonatal hypothyroidism is to eliminate?

 

Development of an enlarged heart

 

Carcinoid tumors

 

Possibility of developing acromegaly

 

Severe mental retardation associated with thyroid hormone deficiency in early infancy

• severe mental retardation associated with thyroid hormone deficiency in early infancy

Which of the following describes the hypothalamic hormones?

 

They act as inhibitor of selected enzyme reactions.

 

They act indirectly on endocrine glands.

 

They act as releasing hormones on the pituitary.

 

They are all glycoproteins.

• they act as releasing hormones on the pituitary

Which one of the following hormones shuts off synthesis and release of LH from the male pituitary gland?

 

Testosterone

 

Inhibin

 

Prolactin

 

FSH

• testosterone

The biologically most active, naturally occurring androgen is:

 

Dehydroepiandrosterone

 

Testosterone

 

Epiandrosterone

 

Androstenedione

• testosterone

Progesterone:

 

Is produced in adult testes and is responsible for genital development, beard growth, muscle development, and sexual drive

 

Parallels activity of the corpus luteum by rapidly increasing following ovulation and then abruptly falling to initial low concentrations prior to the onset of menstruation

 

Is lowest is serum during the luteal phase of the menstrual cycle and highest during the follicular phase

 

Is produced by the placenta during pregnancy, with highest levels seen at conception and then steadily decreasing to non-detectable levels at term

• Parallels activity of the corpus luteum by rapidly increasing following ovulation and then abruptly falling to initial low concentrations prior to the onset of menstruation

Which of the following is the principle estrogen produced by the ovaries and measured to evaluate ovarian function?

 

Epiestriol

 

Estriol

 

Hydroxyestrone

 

Estradiol

• Estradiol

Cushing's syndrome is characterized by which of the following?

 

Excess secretion of pituitary ACTH

 

Adrenal insufficiency

 

ACTH independent

 

ACTH dependent

• ACTH independent

The major site of cortisol synthesis is the ………. of the adrenal gland.

 

zona glomerulosa

 

medulla

 

zona reticularis

 

zona fasciculata

• zona fasciculata