1 endocrine system

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Endocrine System

1. In a patient following total parathyroidectomy., all of the following willhappen except:A. Patient will die if no treatment is given

B. Patient will develop renal stonesC. Patient will improve by I/V calcium gluconateD. Patient will benefit from vitamin D therapyE. Patient will develop muscle spasmKey: B

2. A patient develops symtpms & signs of growth hrmone excess. Thetype of cells most likely to be increased in pituitary are:A. BasophilsB. EosinophilsC. Chromophobes

D. Oxyntic cellsE. Chief cellsKey: C

3. Which one of the following fasting blood sugar levels require furtherevaluation:A. 2 mmol/lB. 4.5 mmol/lC. 6.5 mmol/lD. 8 mmol/lE. 10 mmol/l

key: C4. A male, age 35, comes to casualty department of a tertiary care hospital,

with the complains of episodes of hypoglycemia occurringfrequently. The best and appropriate investigation will be:A. Glucose tolerance test and curve studyB. Fasting blood sugar onlyC. Fasting blood sugar and C-peptide measurementD. Insulin assayE. Fasting blood sugar and insulin assayKey: C

5. A woman in first trimester of pregnancy was found to have blood levels

at 300 mg%. what would be the most appropriate treatment for her:A. SulfonylureaB. AcarboseC. InsulinD. BiguanideE. Insulin & sulfonylureaKey: C

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6. A 16 year-old girl fractures her right wrist while playing ping-pong with afriend. She is short & thin, her bones appear small & fragile, & hergrowth & development have been delayed. While her blood pressureis being taken, the patient develops tetany of the right obtained:serum calcium l=6.8 mg/dL, urinary calcium = 50 mg/day, serum

phosphate =16 mg/dL, & urinary phosphate = 600 mg/day (N = 300-600). Which of the following is the most likely diagnosis?A. OsteoporosisB. Pagets diseaseC. Primary hypoparathyroidismD. Secondary hypoparathyroidismE. Vitamin D deficiencyKey: E

7. Parathormone:A. Increases calcium excretion

B. Increase serum phosphateC. Is produced by P cells of thyroidD. Is a steroid hormoneE. Can lead to renal stonesKey: E

8. A 55-year-old man is brought to ER in semicomatose state;hypoglycemia is diagnosed with blood glucose blevel of 40 mg/dl.The treatment should be:A. 10 % dextrose. IVB. glucagons. IV

C. 50% dextrose, IVD. Oral glucoseE. 5 % dextrose + potassium, IVkey; C

9. In an untreated adrenalectomized subject, a physician would likely find:A. Increased daily excretion of 17- hydroxysteroidsB. Increased daily exctetion of 17- ketosteroidsC. Increased skin pigmentationD. Increased volume of exteacellular fluidKey: C

10. A pregnant woman comes to you with raised total T3 & T4; the cause is:A. Increased TRHB. Increased TSHC. Increased TBGD. Toxic adenomaE. Gravs diseaseKey: C

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11.A 6-year-old boy with short stature & delayed bone age is started onrecombinant growth hormone therapy. Which of the followinglaboratory findings in serum is most likely after 3 months of therapy:A. Decreased insulin-like growth factor I concentrationB. Increased alkaline phosphatase activity

C. Increased calcium concentrationD. Increased phosphorus concentrationE. Increased urea nitrogen (BUN) concentrationKey; B

12. A 23-year-old student has severe diarrhea resulting from an intestinalparasite that the he acquired on a trip to Quetta. He loses 4.0 litersof intestinal fluid over a 6-hour period, but fells to sick to drink anyfluids. His urine output during the 6-hour ordeal is only 0.1 liters.Which of the following best be scribes his status at the end of the 6-hours period as compared to the hour before the onset of diarrhea? :A. Decreased plasma angiotensin II levels

B. Decreased urine osmolarityC. Increased extracellular fluid volumeD. Increased glomerular filration rateE. Increased plasma aldosterone levelsKey; E

13. Secondary hyperaldosteronism can be produced by one of the following:A. Increased angiotensin IIB. Salt excessC. Increased renninD. Increased ACTH

E. Increased cortisolKey: C14. A 70-kg (154-lb) man on a fixed NaCl intake (200 mmol/day) is given

daily injections of a potent imeralocorticoid hormone for 4 days. Hehas free access to water & consumes his usual caloric intake.Excretion of NaCl is as follows?

Day NaCl (mmol)1 302 903 1804 200Assuming that 1 L of isotonic saline contains 150 mmol of NaCl & weight 1kg, how much will he weigh (in kg) at the end of day 4?A. 66B. 68C. 70D. 72E. 74

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key: D

15. A women comes in ER semiconscious,k with a history of PPH 10 yearback; her labs shows Na 110 mmol/L. what is the diagnosis :A. Hypothyroidism

B. SIADHC. Sheehans syndromeD. Addisons diseaseE. Cushings syndromeKey: C

16. Anitibodies in Graves diseases are actually :A. Antibody to thyroid tissue colloid and its carbohydrate contentB. Antibody to the TSh receptorsC. Antibody to thyroglobulinD. A & C

E. A & BKey; B

17. A 28 years old female patient with toxic goiter, wants to treat herexophthalamus for cosmetic reasons; the best way is:A. Partial thyroidectomy with T4 suppplementationB. Total thyroidectomy withreplacementC. Radio tive iodineD. Antithyroid drugs onlyE. PrednisoloneKey: E

18. A patient dies of chronic renal failure; which of the following structureswill be hypertrophied if autopsy is done:A. Adrenal cortexB. Adrenal medullaC. Adrenal glandD. Thyroid glandE. Parathyroid glandKey: E

19. The intracellular domain of the insulin receptors has which of thefollowing enzyme activities:A. Adenylyl cyclaseB. PhosphodiesteraseC. Phospholipase CD. Phosphoprotien phophatasE. Tyrosin kinaseKey: E

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20. Preoperative management pheochromocytoma include :A. receptor blockade aloneB. receptor blockade aloneC. both a & receptor blockadeD. blood transfusion

E. anti-coagulantskey; C

21. Secretion of growth hormone is increased with:A. CortisolB. ExerciseC. REMsleepD. GlucoseE. FFAKey: B

22.Which substance maintains plasma Ca level:A. 1,25 dihydroxy cholecalciferol

B. protactinC. calcitoninD. growth hormoneE. phosphate ionskey: A

23. which one is not the effect of Cushings syndrome:A. buffalo humpB. hypotension

C. osteoporosisD. moon faceE. purplish striaekey: B

24. Steroid hormone acts via;:A. Formation of CAMPB. Formation of DAG+lP 3C. Gene transcriptionD. Tyrosine kinas activityE. Altering ion channelsKey: C

25. The following is true regarding aldosterone:A. Production is stimulated by a fall in renal blood flowB. Secretion is stimulated by a fall in potassium ion concentrationC. Causes sodium loss & potassium retention in sweat & salivaD. Production is increased by a fall in plasma rennin conc.E. When secreted in excess leads to muscle weakness & hypotensionKey: A

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26. A 2-year-old baby girl, on her regular checkup by a doctor, noticed tohave an enlarged clitoris, the most likely diagnosis would be:A. Klienfelter syndromeB. Turner syndromeC. Downs syndrome

D. MosacismE. Adrenogenital syndromeKey; E

27. A 15-year-old girl is brought to the physician because of irritability,restlessness, difficulty concentrating & deteriorating academicperformance over the past 2 moths. She has had occasionalpalpitations & a 1-kg (2-lb) weight loss during this period despite anincreased appetite. Menarche was at the age of 12 year & her mensesoccur at regular intervals. Examination shows no abnormalities.Serum triiodothyronine (T3) & thyroxine (T4) levels are increased.

Which of the following is the most likely diagnosis:A. Attention-deficit/hyperactivity disorderB. Diabetes mellitusC. HyperthyroidismD. Pituitary adenomaE. Thyroid cancerKey: C

28. Among the various findings of patient of hypothyroidism, the mostparticular finding is:A. Cold intolerance

B. SomnolenceC. BradycardiaD. Increased relaxation phase of ankle jerkE. Sluggish activityKey: D

29. A 15-year-old lady without any signs & symptoms neither had anysignificant medial history was found to be hyoponatremic. The mostlikely cause is:A. Excessive diuretic useB. SIADHC. Psychogenic polydipsiaD. Decreased salt intakeE. Use of hormonesKey: B

30. After thyroidectomy which one of the following after effects you wouldexpect:

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A. Elevated T4B. Elevated free T4C. Elevated T3D. Elevated TSHE. Elevated calcium level

Key: D

31. Tumors of the adrenal edulla that are actively producing catecholaminesare called pheochromocytomas. Patients with these tumorsexperience sudden peridodic increased in catecholamine bloodlevels. During such an episode patients may experience:A. Decreased heart rateB. Decreased blood pressureC. Decreased blood glucoseD. Decreased sweat secretionE. Cardiac ischemia

Key: E

32. Secondary hyperaldosteronism is due to:A. ACTH increaseB. Cortisol increaseC. Rennin increaseD. Rennin decreaseE. None of the aboveKey: C

33. During strenuous exercise:

A. Insulin will rise & glucagons will fallB. Insulin will fall & glucagons will riseC. Plasma glucose becomes very lowD. Glycogenolysis decreasesE. Gluconeogeneis decreasesKey: B

34. Following is true regarding release of the catecholamines adrenaline &noradrenaline from the adrenal medulla:A. Increases blood level of glucose by favoring glycogenolysis in liver &

muscle cellsB. Decrease blood levels of free fatty acids & ketone bodiesC. Increase muscle & splanchnic blood flowD. Increases even when the parasympathetic nerves to the adrenal

glands are cutE. Decreases plasma acid levelKey: A

35. Regarding growth hormone all of the following are true except:

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A. Secretion increases during sleepB. Increases insulin secretionC. Is secreted by basophilic cells of anterior pituitary glandD. Causes Na+ & K retentionE. Secretion increases in wasting diseases

Key: C

36. Dietary deficiency of iodine causes all of the following except:A. Inhibits T3 & T4 productionB. Inhibits synthesis of thyroglobulinC. Stimulates TSHD. Causes goiter in pregnancyE. Causes colloid goiterKey; B

37. Adrenocorticotropic hormone (ACTH) promotes the production of

cortisol by stimulating which of the following reactions :A. 11-deoxycortisol to cortisolB. 17-hydroxyprogesterone to 11-deoxycortisolC. progesterone to 17-hydroxyprogesteroneD. pregnenolone to progesteroneE. cholesterol to pregnenolonekey: E

38. After a severe postpartum hemorrhage a patient apparently recoveredwell. However she was unable to breast feed & gradually notedbreast atrophy & no resumption of menses. Later she developed

constipation slurred speech & moderate nonpitting edema. The likelydiagnosis is:A. Acute tubular necrosisB. Amenorrhea galactorrhea syndromeC. Ashermans syndromeD. Sheehans syndromeE. Forbes Albright syndromeKey: D

39. Regarding transport & metabolism of adrenal cortex hormones all of thefollowing are true except:A. Cortisol is bound to transcortinB. Total plasma cortisol level is about 13.5 ug/dl.C. Transcortin is increased in multiple myelomaD. Transcortin is also increased in pregnancyE. Transcortin is decreased in nephrosisKey: C

40. the least appropriate statement for growth hormone is:

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A. it is polypeptideB. secreted by anterior pituitaryC. exerts is anabolic action by somatomedinsD. half life in 6-7 hoursE. effects CHO metabolism

key: D

41. Cortisol increases all of following except:A. NeutrophilsB. RBCsC. PlateletsD. MonocytesE. LymphocytesKey: E

42. Following is least likely to be true about cortisol :

A. Its a gluco-corticoidB. Increased in stress reactionC. Increases blood sugarD. Is catabolic hormoneE. Causes increased Na excretionKey: E

43. The effect of insulin on glucose transport is to:A. Permit transport against a conc. gradientB. Enhance transport across the cell membraneC. Enhance transport across the tubular epithelium of the kidney

D. Enhance transport into the brainE. Enhance transport thru the intestinal mucosaKey: B

44.A patient with T3 value of 3 (lower cut limit) T4 value of 8 (lower cutlimit) & TSH 200 (high); what is the diagnosisA. HyperpituitarismB. HyperthyroidismC. HypothyroidismD. HyperparathyroidismE. GoiterKey: C

45. Which of the following hormone is not a tyrosine derivative?A. Epinephrine

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B. NorepinephrineC. ProlactinD. ThyroxineE. TriiodothyronineKey; C

46. Which hormone lowers cholesterol level:A. ProgestogenB. InsulinC. Growth hormoneD. CortisolE. ThyroxinKey: E

47. Which of the following is not the action of the glucagons?:A. Increased gluconeogenesisB. Increased ketone body formation

C. Decreased lipolytic activityD. Increased blood glucose levelE. Increased glycogenolysisKey: C

48. Regarding glucagons all of the following are true except:A. Is non-ketogenicB. Can casue hyperglycemiaC. Is lipolyticD. Is gluconeogenicE. Is glycogenolyticKey: A

49.

The receptors for growth factors is located:A. Inside cytoplasmB. Inside nucleusC. On nuclear membraneD. On cell membraneE. NoneKey; D

50. The following is true regarding thyrotoxicosis:A. Propylthiouracil lowers serum T3 level mainly by blocking peripheral

conversion from T4B. Symptoms of sympathetic overactivity are due to raised catecholamine

levelsC. Carbimazole blocks hormone synthesis at more than one sites in the

biosynthetic pathwaysD. One drop of lugols iodine solution daily will lower the BMRE. Lodine is used alone in the preoperative preparation of the patientKey; C

51. Intermediary in the synthesis of cortisol & androgen:

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A. PregnenoloneB. EstrogenC. ProgesteroneD. AldosteroneE. Corticosterone

Key; A

52. Following is true regarding thyroxine & triiodothyronine:A. Circulate in equal concentrationB. Concentration increased in pregnancyC. Concentration increased by methimazoleD. Acts normally by uncoupling oxidative phosphorylationE. Increase the duration of tendon reflexesKey: B

53. A young woman has puffy eyes & hoarse voice, & her plasma TSH conc.

is ow but increases markedly when she is given TRH she probablyhas:A. Hyperthyroidism due to a thyroid tumorB. Hypothyroidism due to a primary abnormality in thyroid glandC. Hypothyroidism due to a primary abnormality in pituitary blandD. Hyperthyroidism due to a primary abnormality due to a primary

abnormality in the hypothalamusKey: D

54. Amount of ionized calcium in blood fall by all of the following except:A. If sodium cirtrate is added to it

B. If the thyroid glands is perfused with a calcium rich solutionC. In hyperventilationD. When the blood phosphate levels fallsE. At high altitudeKey; D

55. Plasma half life of insulin is:A. 5 minutesB. 10 minutesC. 15 minutesD. 20 minutesE. 25 minuteskey; A

56. The likelihood of developing tetany is increased when:A. Plasma bicarbonate level decreases

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B. Plasma magnesium level risesC. The anterior pituitary is removedD. Respiratory failure developsE. One is exposed to high altitude without prior acclimatizationKey: E

57. A high plasma calcium level causes:A. Bone demineralizationB. Increased formation of 1,25 dihydroxycholecalciferol.C. Decreased secretion of calcitoninD. Decreased blood coagulabilityE. Increased formation of 24,25 dihydroxycholecalciferolKey: E

58. In diabetic ketoacidosis all of the following are likely to occur except:A. Serum osmolality may exceed 320 mOsm per kg.

B. The fluid deprivation is 5-6 L.C. The most common occurrence is in patient with juvenile onset diabetesmellitus

D. The pH of the blood is usually below 7.0E. HypoventilationKey: E

59. Metabolic rate may be estimated:A. By measuring respiratory quotientB. From carbon dioxide productionC. By measuring a persons total heat production at room temperature

D. Form oxygen consumptionE. By increasing thyroxine levels in bloodKey; D

60. During exercise following will be observed:A. Increased insulin, decreased glucagonsB. Decreased insulin, decreased glucagonsC. Increased insulin, increased glucagonsD. Decreased insulin, increased glucagonsE. None of the aboveKey: D

61. One of your diabetic patients has a blood glucose level of 200 mg/dl.Surprisingly a dipstick test is negative for urinary glucose how couldthis finding be explained:

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A. Patient is in a state of antidiuresisB. Patient has diabetes insipidusC. Patient has significantly reduced GFRD. Patient has defective tubular glucose itransportersE. Dipstick test are more sensitive for reducing sugar other than glucose

Key: C

62. The following is true regarding insulin:A. Stimulates glycogen phosphorylase in liver & musclesB. Inhibits glycogen phosphrylase in liverC. Stimulates hormone sensitive lipase (HSL) in adipose tissueD. Inhibits pyruvate kinase in all tissuesE. Inhibits pyruvate dehydrogenase in liver & muscleKey: B

63. A young man brought to the emergency dept with delirium & severe

abdominal pain. The investigation of choice is:A. Blood sugar levelB. Serum amylaseC. Serum lipaseD. Abdominal ultrasoundE. GT scanKey: A

64. cortisol deficiency is often characterized by:A. fall in eosinophils countB. rise in platelets count

C. ise in erythrocytes countD. rise in lymphocytes countE. rise in neutrophils countskey: D

65. The following is true regarding calcitonin:A. Increases the blood calcium ion conc.B. Is secreted by parafollicular cells of thyroid glandsC. Is a steroid hormonesD. Increases are the formation of new osteoclastsE. Increases osteolytic of osteo-cytic membraneKey :B

66. Following will be observed as a result of aldosterone on salivarysecretion:A. Secretion of Na+

B. Reabsorption of Na+

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C. Reabsorption of K+

D. Secretion of ClE. Reabsorption of HCO3key: B

67.The following is true regarding adrenocorticotropic hormone:A. Secretion mainly increases the aldosterone secretion

B. Is regulated by a factor from posterior pituitary glandC. Secretion is directly proportional to the cortisol level in bloodD. Is produced by neurons whose cell bodies lie in hypothalamusE. Production is controlled by a hormone form hypothalamusKey; E

68. The following is true regarding parathyroid hormone:A. Has no effect on absorption of calcium form kidneyB. Causes postmenopausal osteoporosis

C. Increases phosphate absorption form kidneyD. Is secreted by oxyphill cellsE. Enhances Ca2 &PO4 absorption in intestine by inc. renal formation of

1,25- dihydeoxycholecalciferolKey; E

69. Regarding calcium all of the following are true except:A. Concentration fo the serum is normally 8.5-10 mg/100 ml (2.1-2.6

mmol/l)B. Is present in the body in larger amounts than any other cationC. Is 70% ionized

D. Becomes less ionized when blood pH risesE. In the serum is characteristically raised in hyperthyroidismKey: C

70. For diagnosis of diabetes the most important test is:A. Fasting blood glucoseB. Random blood glucoseC. Glycosylated HbD. Glucose tolerance testE. Urine sugarKey: D

71. Regarding 50 gm glucose tolerance test all of the following are trueexcept:A. Blood glucose curve becomes flat by thyroid removalB. Slow rise & fall of blood glucose curve occur in normal then in diabetes

mellitus

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C. It does not cause glucose in urine in normal personsD. Slow rise of blood glucose occur in celiac diseaseE. It may be effected by drungs eg, steroidsKey; B

72.A 40 year-old woman is diagnosed as a case of adrenal insufficiency.The following is likely to found in this patient:

A. HyponatremiB. HyperphosphatemiaC. Hypopligmentat onD. Lowered blood urea nitrogenE. DehydrationKey: A

73. In ketoacidosis, the basic pathophysiology is:A. Insulin deficiency

B. Decreased enzyme production by liverC. Action of glucagonsD. Inceased ketone bodies formationE. Decreased deacylaseKey: A

74. The hormonal analysis of a 40-year-oldman shows an elevated level ofparathyroid hormone in serum. Following is likely to be true in thispatient:A. Secretion is increased by a high plasmalevel of ionized calciumB. Decreased calcium reabsorption in the kidney tubules

C. Bone cysts can developD. Plasma con. Is usually lowered in osteoporosisE. Increases the reabsorption of phosphate by the kidney tubulesKey: C

75. Regarding thyroxine all of the following are true except:A. Increases glycolysis & gluconeogenesisB. Deficiency in infants causes defective myelination & abnormal

development of synapsesC. Is carried in the blood stream mostly by albuminD. Is less active than triiodothyronineE. Has a calorigenic actionKey: C

76. The receptors for thyroid hormone are located:A. In cytoplasmB. On nuclear membraneC. Inside nucleusD. On plasma membrane

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E. On mitochondriaKey: B

77. adrenaline differs from noradrenaline in all of the following except:A. Is a more potent dilator of the bronchi

B. Causes tachycardia when injected intravenouislyC. Is the catecholamine secreted in greatest amount by the adreanalmedulla

D. Inceases the strength of myocardial contractionE. Causes vasodilation in skeletal muscle & liverKey: D

78. Regarding a patient who develops sudden parathyroid deficiency all ofthe following are true except:A. Is likely to develop skeletal muscle spasmsB. Is likely to die if no treatment is given

C. Is likely to be improved by a slow intravenous injection of calcium ions,eg calcium gluconateD. Is likely to be improved in the long term by regular doses of vitamin DE. Is likely to develop renal calculiKey; E

79. A patient with a secreting tumor of the adrenal medulla(pheochromocytoma) typically has all of the following except:A. A raised blood pressure which may be transient or constantB. A fine tremor of the extended hadC. A lowering of blood pressure when an alpha adrenoceptor atagonist is

givenD. An increase in the basal metabolic rateE. Decreased VMA and metanephrines in urineKey: E

80. The characteristics of hyperparathyroidism include all of the followingexcept:A. Demineralization of boneB. Formation of kidney stonedC. HypercalcemiaD. HypercalciuriaE. HyperphosphatemiaKey: E

81. A 34-year-old woman has undergone total thyroidectomy formultinodiular goiter. During a postoperative follow-up 2 monthslater, following is likely to be found:A. A low blood cholesterol levelB. Exaggerated stretch reflexes

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C. A fine tremor of the fingersD. Flattening of the oral glucose tolerance curveE. ExophthalmosKey; D

82.The biochemical changes associated with inadequately controlled IDDMinclude :

A. Abnormally rapid fall of blood glucose following a mealB. Abnormally low conc. of fatty acids in bloodC. High level of ketones in bloodD. High rate of glycogen synthesis in liverE. Low plasma lipoprotein levelKey: C

83. Regarding somatostatin all of the following are true except:A. Is secreted by the D cells of the pancreatic islets.

B. Has a plasma life of 3 minutesC. Is the substance thru which growth hormone exerts much of its effectD. May exerts its effects in close proximity to site of releaseE. Inhibits secretion of growth hormone & glucagonsKey: C

84. After removal of ACTH producing cells of anterior pituitary, all of thefollowing will be observed except:A. Atrophy of zona fasciculateB. Atrophy of zona glomerulosaC. Atrophy of zona reticularis

D. Los of cortisol productionE. Loss of androgen productionKey; B

85. After infusion of small amount of TRH, TSH is raised but level of T3 & T4remain unaffected; which of the following explain this condition:A. Primary thyroid diseaseB. Secondary thyroid diseaseC. Tertiary thyroid diseaseD. THS receptor antibodiesE. Hashimotos diseaseKey: A

86. Muscles are not contributors to blood glucose level between of theabsence of:A. GlucokinaseB. HexokinaaseC. G6PO4-DHGD. Glucose -6-phosphatase

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E. Glucose -1-phosphataseKey: D

87. The following is true regarding somatostain:A. Is secreted by alpha cells of pancreas

B. Is a mucopolysaccharideC. Has extremely long half-lifeD. Secretion is inhibited by increased blood glucose levelE. Secretion is stimulated by increased blood amino acids levelKey: E

88.Regarding growth hormone all of the following are true exceptA. Bovine growth hormone if injected in humans, produce no effect on

growthB. Growth hormone from monkeys has diabetogenic effect, as well as

stimulates growth in humansC.

Humans growth hormone has intrinsic latogenic activityD. Basal growth hormone level in humans less than 3 mg/ml of plasmaE. It is metabolized partly in liverKey: D

89.Regarding effects of growth hormone all of the following are true exceptA. It causes decrease in Na & K excretion from kidneysB. It synergises with androgens, to inc. size of accessory reproductive

organsC. It decreases fat contents of bodyD. It causes rise in plasm a phosphorus levels

E. It causes rise in plasma phosphorus levelsF. It stimulates erythropoiesisKey: E

90. A 56-year-old male is noted to have episodic hypertension , a mass inhis adrenal gland & elevated catecholamines. The most likelydiagnosis is:A. PheochromocytomaB. GanglioneuromaC. NeuroblastomaD. Adrenal cortical carcinomaE. Adrenal cortical hyperplasiakey: A

91. Regarding adrenal glands all of the following are true except:A. Blood supply is form phrenic artery alsoB. After hypophyscetomy all three layers of adrenal cortex degenerateC. Human adrenal gland is larger in size in fetal life as compared after

birthD. Extra adrenal sites are found along aortaapart form its usual site

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E. Aldosterone is secreted by zona glomerulaosa, & is partly undercontrol of ACTH

Key; B

92. Regarding hormones of adrenal medulla all of the following are true

except:A. After hypophysectomy epinephrine synthesis fallsB. 50% of catecholamines are excreted in urine as metanephrine &

normetanephrineC. 50% is exreted in urine as VMAD. dopamine is recommended in cardiogenci shockE. dopamine acts as vasodilator of mesenteric vesselskey: C

93. impaired glucose tolerance is associated with all of the followingexcept:A. cushing syndrome

B. pheochromocytomaC. acidophilic adenomaD. gravs diseaseE. chronic panreatitiskey: B

94. Regarding anterior pituitary gland the following is true:A. Whole -MSH is identical to a part of ACTHB. Gamma MSH is present in sufficient con. In intermediate & anterior

lobes, and is adrenal insufficiencyC. POMC (pro-opimelanocortin) forms a no of hormonesD. POMC is synthesized in anterior pituitary onlyE.

POMC is hydrolyzed into alpha and beta MSH in adultsKey: A95. Regarding pigment abnormalities the following is true:

A. Black pigmentation is a feature of adrenal insufficiency due to anycause

B. Hypopituitarism manifest as hyperpigmentationC. Albinos have a congenital inability to synthesize melaninD. Piebaldism is characterized by patches of skn, that are

hyperpigmented. And is a congenital defectE. Vitiligo show patchy loss of pigmentation and is a hereditary condition

present at birthKey: C

96. The following is true regarding thyroglobulin:A. Is found in RBCB. Level in blood is decreased in hyperthyroidismC. Level in blood is increased in some types of thyroidD. Contain lipidsE. Is very active component acting on tissues

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Key: C

97. all of the following hormones act by negative feedback mechanismexcept :A. cortisol ACTH

B. thyroxine TSHC. calcium PTHD. testosterone LU & FSHE. suckling Proiactinkey: E

98. Regarding the islets of langerhans all of the following are true except:A. Contain beta cells whose granules fix anti- insulin antibodiesB. Contain alpha cells which secrete glucagonsC. Have a high zina content relative to other tissuesD. Contains granular gamma cells which are thought to secrete a

hormone which controls the blood glucose levelE. Contain F cells that secrete pancreatic polypeptideKey :D

99. The following is true regarding hypoglycemia:A. Is associated with acinar cell tumors of the pancreaseB. Occurs when a normal person fasts for 48 hoursC. Characteristically occur 2 hours after meals in untreated

hyperthyroidismD. Is a charachteristic feature of induced hypothermiaE. Is associated with a fall in catecholamines

Key: C

100. Regarding parathyroid hormone all of the following are true except:A. Increases the plasma phosphate levelB. Secretion is regulated by serum calcium levelC. Enhances resorption of calcium form boneD. Is a polypeptideE. Increases the urinary output of phosphatesKey; B

101. Administration of glucocorticoids in high doses for prolongedperiods results in:A. Loss of hairB. Increased dlugconeogenesisC. Mineralization of boneD. Thickening of skinE. Virilizing effects in womenKey: B

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102. Which of the following areas of the adrenal gland would be expectedto increase in activity in a patient subjected to salt restriction:A. Adrenal medullaB. Zona fasciculate of the adrenal cortex

C. Zona reticularis of the adrenal cortexD. Zona glomerulosa of the adrenal cortexKey; D

103. Cortisol is produced:A. During sleepB. In traumaC. In addisions diseaseD. In eveningE. In hypopituitarisimKey: B

104. Following help to investigate a patient suffering from gravesdisease:A. T3 levelB. T4 levelC. TSH levelD. TRH levelE. TSH receptor antibodiesKey: C

105. The presence of 3+ urinary ketones in a patient is due to:

A. StarvationB. Insulin deficiencyC. Diabetes insipidusD. HyperglyeemiaE. Impaired metabolism of ketonesKey: B

106. A series of photographs taken of a middle aged man over a period oftwo decades demonstrates gradual coarsening of facial features andprogressive protrusion of the brows. Upon questioning the patientreports having to wear larger shoes than he did as a young manwhich of the following pair of hormones normally regulates thehormone responsible for these changesA. TSH & ACTHB. LH & HCG

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C. Prolactin & FSHD. Somatostatin & GHRHE. Dopamine & norepinephrineKey; D

107.A 46-year-old man with weakness and a 10-lb increase in weight hasa blood pressure of 160/100 mmHg. His lab data shows Na- 155mmol/L, K+ 2.3 mmol/L & low plasma rennin the diagnosis is:A. Cushings syndromeB. Diabetes mellitusC. Primary hyperaldosteronismD. Secondary hyperaldosteronismE. PheochromocytomaKey: C

108. Immediately postpartum there may be a decrease in insulin

requirements of diabetic patients. This can be partly explained by:A. Increased food intakeB. Decreased activityC. Decrease in plasma estrogenD. Decrease in plasma progesteroneE. Decrease in plasma chorionic somatomammotropinKey: E

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