lange _ endocrine _ physiology self-assessment study questions

Lange Endocrine Physiology Self-Assessment

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You incorrectly answered .

Which of the following statements concerning a particular hormone (hormone X) is correct?

A. It will bind to cell membrane receptors in all cell types.

B. It is lipid soluble and has an intracellular receptor.

C. It circulates bound to a protein, and this shortens its half-life.

D. It is a small peptide; therefore, its receptor localization will be in the nucleus.

The answer is B.

Question 2 of 51 < Previous question Next question >


Which of the following statements concerning hormonal regulation is correct?

A. A hormone does not inhibit its own release.

B. The substrate a hormone regulates does not affect that hormone's release.

C. Negative feedback regulation occurs only at the level of the anterior pituitary.

D. Feedback inhibition may be exerted by nutrients and hormones.

The answer is D.



The structure of a newly discovered hormone shows that it is a large peptide with a

glycosylated subunit. The hormone is likely to:

A. Bind to DNA and affect gene transcription

B. Bind to adenylate cyclase and stimulate protein kinase C

C. Bind to a cell membrane receptor

D. Be secreted intact in the urine

The answer is C.



The renal effects of arginine vasopressin (ADH) are mediated by:

A. Binding to V2 G protein–coupled receptor, protein phosphorylation, and insertion of

aquaporin 2 into luminal cell membrane in collecting duct

B. Binding to nuclear receptors, protein phosphorylation, and insertion of aquaporin 2 into

basolateral membrane of collecting duct

C. Binding to V1 G protein–coupled receptor, protein phosphorylation, and insertion of

aquaporin 1 into luminal cell membrane of collecting duct

D. Binding to nuclear receptors, protein phosphorylation, and insertion of aquaporin 2 into

luminal cell membrane of collecting duct

The answer is A.



Which of the following would be expected to alter hormone levels?

A. Changes in mineral and nutrient plasma levels

B. Pituitary tumor

C. Transatlantic flight

D. Training for the Olympics

E. All of the above

The answer is E.



Laboratory values that would be compatible with endemic goiter due to iodine deficiency

include:

A. Thyrotropin 20 IU/mL, T4 2.5 g/dL, T3 20 ng/dL

B. Free T4 3.0 ng/dL, RT3U 57%, thyroid-stimulating Ig positive

C. Thyrotropin less than 0.1 IU/mL, T4 1 g/dL, T3 50 ng/dL

D. Free T4 1.0 ng/dL, RT3U 10%, thyrotropin less than 0.1 IU/mL

E. Both A and D are correct

The answer is A.



In a patient with severe hypoglycemia (38 mg/dL), the differential diagnosis between self-

administered insulin overdose and a tumor that produces excess insulin can be made by

determining plasma levels of:

A. Insulin

B. Somatostatin

C. C-peptide

D. Gastrin

The answer is C.



A female patient presents with milky discharge from both nipples and menstrual irregularity.

The patient has no history of headache or visual abnormalities. A pregnancy test is negative,

and her mammogram and breast exam are normal. She has a list of medications that her

psychiatrist has recently prescribed. Which of the following could be responsible for the milky

discharge?

A. Levodopa

B. Dopamine antagonist

C. Dopaminergic agonist

D. Serotoninergic agonist

The answer is B.



On a hot summer day, the release of ADH occurs:

A. When plasma osmolality is 270 mOsm/kg

B. Immediately following stimulation of thirst

C. Before an 8% decrease in blood volume

D. Before stimulation of thirst

The answer is D.



Which of the following can be manifestations of the syndrome of inappropriate antidiuretic

hormone secretion?

A. Hypernatremia with high urine osmolality

B. Hyponatremia with high urine osmolality

C. Hypophosphatemia with low urine osmolality

D. Hyponatremia with low urine osmolality

The answer is B.



Oxytocin

A. Is released from the anterior pituitary during parturition

B. Is produced in the posterior pituitary and is released during parturition

C. Is produced in the magnocellular neurons of the hypothalamus and released from the

posterior pituitary during parturition

D. Is produced in the magnocellular neurons of the hypothalamus and released from the

anterior pituitary during parturition

The answer is C.



Uterine muscle responsiveness to oxytocin

A. Is enhanced by an increase in estrogen/progesterone ratio

B. Is prevented by high prostaglandin levels during pregnancy

C. Is decreased by down-regulation of oxytocin receptors during the third trimester

D. Is enhanced by decreased estrogen/progesterone ratio

The answer is A.



A patient has been taking pharmacologic doses of a steroidal anti-inflammatory drug for a

prolonged period for his asthma flareups. Laboratory values obtained would be compatible

with:

A. Low CRH and high cortisol

B. High CRH and high cortisol

C. Low CRH and low cortisol

D. High CRH and low cortisol

The answer is C.



The physiologic mechanisms affected by medical strategies for the management of

osteoporosis include:

A. Decreased apoptosis of osteoclasts by bisphosphonates

B. Increased activation of osteoclast activity by calcitonin

C. Increased osteoblast differentiation by selective estrogen receptor modulators

D. Decreased intestinal Ca2+ secretion by vitamin D

The answer is C.



Laceration of the pituitary stalk during an automobile accident could be expected to result in

any of the following with the exception of:

A. Decreased prolactin release

B. Decreased TSH release

C. Decreased LH and FSH release

D. Decreased GH release

The answer is A.



A 73-year-old woman is admitted to the hospital following a bout of severe vomiting and

generalized weakness. Initial laboratory values reveal elevated Ca2+ levels. The referring

physician tells you that she has breast cancer and her bone scan indicates metastasis to bone.

Clinical evaluation is positive for dehydration. Your initial recommendation is to:

A. Prescribe nasal calcitonin spray

B. Administer high doses of vitamin D

C. Inject Ca2+-binding proteins

D. Hydrate with normal saline solution

The answer is D.



Growth hormone excess in an adult male can present with:

A. Longitudinal growth of the extremities

B. Thickening of cartilaginous tissue

C. Hypoglycemia

D. Low IGFBP-3

The answer is B.






Which of the following laboratory values would be compatible with this clinical scenario?

A. PTH 5 pg/mL, phosphate 6 mg/dL, alkaline phosphatase 600 U/L

B. PTH 90 pg/mL, phosphate 6 mg/dL, alkaline phosphatase 30 U/L

C. PTH 5 pg/mL, phosphate 2 mg/dL, alkaline phosphatase 20 U/L

D. PTH 3 pg/mL, phosphate 2 mg/dL, alkaline phosphatase 100 U/L

The answer is A.



A 30-year-old man reports a 12-month history of progressive restlessness. He reports

irritability and nervousness. Clinical evaluation reveals violent palpitations, unbounded energy,

prominent stare, tachycardia, tremor, exophthalmos, warm moist palms, and enlarged thyroid

(goiter). Which of the following laboratory values would be compatible with hyperthyroidism

due to Graves disease?

The normal values for the hospital's laboratory are:

Thyrotropin (TSH): 0.4–4.7 IU/mL

T4: 4.8–11.2 g/dL

T3: 45–137 ng/dL

Free T4: 0.9–2.0 ng/dL

Resin T3 uptake (RT3U): 24–37%

Thyroid-stimulating immunoglobulin: negative

Anti-thyroid peroxidase antibody: negative

A. TSH level less than 3 IU/mL, T4 of 21 g/dL, RT3U 48%

B. TSH level 4.7 IU/mL, T4 of 5 g/dL, RT3U 28%

C. TSH level less than 0.1 IU/mL, T3 400 ng/dL, T4 18 g/dL

D. T4 of 8 g/dL, RT3U 48%, negative titers of thyroid-stimulating Ig

The answer is C.



A deficiency in 21-hydroxylase activity would be associated with the following:

A. Central obesity, increased cortisol levels, and decreased androstenedione

B. Virilization, increased ACTH, and decreased cortisol levels

C. Decreased ACTH levels and decreased cortisol levels

D. Hypertension, decreased ACTH, and increased cortisol levels

E. Virilization, hypertension, increased ACTH, and increased cortisol levels

The answer is B.



The following lab results are available before physical examination of a new patient: TSH less

than 0.08 IU/mL, T4 of 18 g/dL, T3 of 368 ng/dL, and RT3U of 35%. Which of the following

signs and symptoms would you expect to find?

A. Heart rate 45 beats/min, diarrhea, weight gain

B. Sweaty hands, 40-g goiter, and constipation

C. Heat intolerance, irritability, and weight loss

D. Insomnia, delayed muscle relaxation, diarrhea

The answer is C.



See Figure. In a normal individual, line A represents the changes in plasma ________ and line

B represents the changes in plasma ________ for the given plasma Ca2+ levels.

Figure 5–8.

A. PTH and calcitonin

B. PTHrP and calcitonin

C. Calcitonin and PTH

D. Calcitonin and vitamin D

The answer is A.



Physiologic responses to insulin include:

A. Stimulation of glucose transport in skeletal muscle red blood cells and the brain

B. Inhibition of triglyceride synthesis in adipose tissue

C. Stimulation of amino acid uptake by skeletal muscle

D. Stimulation of glucose reabsorption in the kidney

The answer is C.



The rise in PTH in chronic renal failure is due to:

A. Decreased parathyroid gland responsiveness to Ca2+ and vitamin D negative feedback

inhibition

B. Decreased circulating Ca2+ and Pi levels

C. Increased intestinal Ca2+ absorption and renal Pi excretion

D. Increased circulating Ca2+ and calcitonin levels

The answer is A.



Physiologic effects of cortisol include:

A. Hypoglycemia, increased fatty acid mobilization, and decreased central fat deposition

B. Increased amino acid–derived gluconeogenesis, increased glucose utilization, and

hypoglycemia

C. Hyperglycemia, decreased fatty acid mobilization, and decreased central fat deposition

D. Decreased glucose utilization, hyperglycemia, and lipolysis

The answer is D.






The most likely cause of hypercalcemia is:

A. Increased PTH production

B. Increased responsiveness of the PTH receptor 1

C. Increased PTHrP production

D. Decreased responsiveness to calcitonin

The answer is C.



A chronic alcoholic patient presents to the emergency room with distended abdomen,

confusion, and fever. Alcoholic cirrhosis with ascites is diagnosed. Among the underlying

mechanisms for her fluid alterations are:

A. Decreased effective circulating blood volume, high renin-angiotensin activity, and

increased aldosterone release

B. Increased blood volume, high renin-angiotensin activity with effective inhibition of

aldosterone release

C. Increased interstitial fluid volume, decreased renin-angiotensin system activity with

increased aldosterone release

D. Dilutional hyponatremia, decreased renin-angiotensin system activity, and decreased

aldosterone release

The answer is A.



Secondary hyperparathyroidism in patients with impaired renal function can be prevented by:

A. Surgical resection of the parathyroid glands

B. Limited dietary phosphate ingestion

C. Increased fluid intake

D. Decreased exposure to UV light

The answer is B.



Regulation of steroid hormone production by the adrenals involves all of the following steps:

A. ACTH binding to a G protein–coupled receptor, stimulation of cholesterol transfer to

inner mitochondrial membrane, and formation of pregnenolone

B. ACTH binding to a nuclear receptor, stimulation of pregnenolone transfer to inner

mitochondrial membrane, and formation of DHEA

C. Hydrolysis of cholesterol ester, stimulation of pregnenolone transfer to inner

mitochondrial membrane, and formation of androstenedione

D. ACTH binding to a G protein–coupled receptor, increased cholesterol ester hydrolysis,

and pregnenolone transfer to inner mitochondrial membrane

The answer is A.



Which of the following statements is true regarding catecholamine synthesis and release from

the adrenals?

A. Epinephrine accounts for 20% of total adrenal catecholamine release.

B. Norepinephrine is derived from epinephrine through the action of the enzyme

phenylethanolamine N-methyltransferase.

C. Catecholamine synthesis is regulated by tyrosine hydroxylase.

D. 35% of catecholamines released are excreted intact in the urine.

The answer is C.



Regarding the production and release of aldosterone from the adrenals, which of the following

statements is correct?

A. Aldosterone production in the zona glomerulosa is mainly under ACTH control.

B. Aldosterone production in the zona glomerulosa is mainly under angiotensin II control.

C. Aldosterone production in the adrenal medulla is mainly under angiotensin II control.

D. Aldosterone production in the zona glomerulosa is mainly under K+ control.

The answer is B.



Regarding cortisol production and transport, the following statements are true:

A. Daily production averages 15 mg, with peak plasma levels occurring before 9 AM, and

most of it is free in the circulation.

B. Daily production averages 5 mg, with peak plasma levels around 12:00 noon, and most

of it circulates bound to albumin.

C. Daily production averages 10 mg, peak plasma levels occur before 9 AM, and most of

the plasma cortisol is bound to transcortin.

D. Daily production averages 5 mg, with peak plasma levels occurring before 9 AM, and

most of it circulates bound to transcortin.

The answer is C.



When would plasma insulin levels be expected to be higher?

A. Following a carbohydrate-rich meal

B. After intravenous administration of somatostatin

C. During a surgical procedure

D. Following vigorous exercise

The answer is A.



Which of the following can contribute to infertility in a young male body builder taking anabolic

steroids?

A. Decreasing circulating levels of DHT

B. Suppression of LH release from the pituitary

C. Decreasing testicular testosterone concentrations

D. Increasing muscle mass

E. A and C

F. B and C

The answer is F.



Anabolic effects of androgens in bone are mediated by:

A. Testosterone-mediated increase in osteoblast apoptosis

B. Estradiol-mediated osteoblast proliferation

C. DHT-mediated osteoclast activation

D. Testosterone-mediated decrease in osteoblast proliferation

The answer is B.



Which of the following can be present in hyperosmolar coma in a diabetic patient?

A. Low plasma glucose

B. Low plasma potassium

C. High plasma pH

D. High plasma ketones

The answer is D.



Delay in the onset of puberty in an undernourished child can be due to:

A. Decreased aromatase activity

B. Increased DHT production

C. Decreased leptin production

D. Cryptorchidism

The answer is C.



The hyperglycemia of diabetes mellitus is not the result of:

A. Decreased excretion of glucose in the urine

B. Decreased postprandial uptake of glucose by muscle

C. Exaggerated release of glucose from the liver during the fasting state

D. Increased hepatic gluconeogenesis

E. Increased hepatic glycogen breakdown

The answer is A.



A 20-year-old male patient presents to the doctor's office complaining about continuous

growth, lack of facial hair development, and smaller penis and testicles than his college

friends. Laboratory values include total testosterone 125 ng/dL and LH less than 2 mU/mL.

Thyroid-stimulating hormone and prolactin levels are normal. He has no history of

medications, drug use, or disease. GnRH stimulation test over a 7-day period produces

elevations in circulating levels of LH. Continued growth in this case is due to:

A. Increased estrogen production

B. Decreased inhibin release

C. Decreased testosterone production

D. Decreased sensitivity to LH stimulation

The answer is C.



Elevated fasting plasma glucose levels in pregnant women with no history of diabetes may be

related to:

A. Increased estrogen production

B. Decreased progesterone clearance

C. Increased hPL/GH-V production

D. Increased insulin degradation

The answer is C.



The effects of progesterone on the myometrium during pregnancy include:

A. Down-regulation of voltage-dependent calcium channel subunit expression

B. Increased estradiol-induced -adrenergic receptor expression

C. Decreased prostaglandin inactivation

D. Increased prostaglandin synthase activity

The answer is A.



Impaired activity of type 2 5 -reductase will affect:

A. Sexual differentiation and development

B. Male-pattern hair growth

C. Feedback regulation of GnRH release

D. Deepening of the voice

The answer is A.



A 30-year-old female patient arrives at your office because of missed menstrual periods for 2

months. Her history indicates regular menstrual periods in the past. During physical

examination, you suspect that she may be pregnant. Which laboratory values would be

compatible with your diagnosis?

A. Low plasma progesterone and high LH

B. High prolactin, low LH, and low progesterone

C. High urinary estradiol and low progesterone

D. High urinary hCG and high plasma progesterone

The answer is D.



A 5-month pregnant woman is referred to your office with newly diagnosed hypertension. You

are concerned that the fetus and placenta may be compromised. To assess fetal and placental

health, which of the following hormone measurements would be most informative?

A. Urinary estriol and serum hCG

B. Serum progesterone and prolactin

C. Serum LH and hPL

D. Urinary estriol and serum progesterone

The answer is A.



Which of the following neuroendocrine responses contributes to meeting the enhanced energy

demands during exercise?

A. Glucagon stimulation of hepatic glycogen synthesis

B. Epinephrine stimulation of hepatic glycogenolysis

C. Norepinephrine-induced stimulation of insulin release

D. Cortisol inhibition of gluconeogenesis

The answer is B.



Systemic and hepatic effects of estrogen include:

A. Increased serum concentrations of total cholesterol and LDL

B. Increased lipoprotein receptor expression

C. Increased plasma concentrations of fibrinogen and antithrombin III

D. Decreased synthesis of thyroxine-binding globulin and transcortin

The answer is B.



Which of the following processes takes place immediately after a balanced meal?

A. Pancreatic insulin is suppressed

B. Muscle and fat glucose uptake is increased

C. Hepatic glycogenolysis is increased

D. Lipolysis is increased

The answer is B.



Which of the following effects of leptin is involved in the regulation of body weight?

A. Leptin suppression of neuropeptide Y

B. Leptin suppression of -melanocyte-stimulating hormone

C. Meal-induced rises in circulating leptin levels

D. Rise of leptin levels during fasting and dieting

The answer is A.



Activation of the renin-angiotensin-aldosterone system during loss of effective intravascular

volume results in all of the following except:

A. Increased renal sodium and fluid retention

B. Potentiation of the activity of the sympathetic nervous system

C. Peripheral venodilatation

D. Enhanced ADH release

The answer is C.



Regulation of body K+ content and distribution can be affected by all of the following except:

A. Aldosterone-induced increase in K+ excretion

B. Insulin stimulation of intracellular K+ efflux

C. -Adrenergic stimulation of cell membrane Na+/K+-ATPase

D. Sudden changes in plasma osmolarity

The answer is B.

lange _ endocrine _ physiology self-assessment study questions

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