Practice test PGY452 2011

Practice test PGY452 2011 - PGY452/552 Endocrinology...

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Unformatted text preview: PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. These are all my old test questions worth seeing. I have eliminated bad questions, questions that I would not ask again because they don’t reflect current material, and near duplicate questions. The key is at the back, along with the percent correct. The table of abbreviations that will be used on the exam is also in back. Refer to it often, it may help. The first 38 questions came from last year. A word about test taking: Many students do worse on my tests than they otherwise would because of poor test‐taking skills. As you go through the practice exam, please remember • • • • • Read the whole question carefully Read all the answers carefully If you know the answer, great. If you are not sure, understand that multiple choice tests are about falsification. If you’re stuck, try treating the question as a series of five true‐false questions. Some questions are hard. Others are pretty easy. Don’t over think because an answer just seems “too easy.” I am not trying to intentionally fool you. Since I don’t intentionally recycle questions and answers, there are likely to be a couple bad questions or more likely a couple of bad “distracters” (incorrect answers that really could be correct); don’t get cute. Just pick the best answer, and if there is a problem with the test, we’ll figure it out after the analysis comes in. Some questions might seem obscure and unrelated to material covered in class. These questions always refer to a larger underlying principle that was covered in class. Recognize those principles and apply them to these questions if the answer doesn’t come to you right away. really were covered in class. Instead of assuming that you have forgotten something, look hard for the general principle that is buried in that question • 1. Which tissue is the major site for gluconeogenesis? a. Adipose b. Skeletal muscle c. Liver d. Pancreatic α‐cells e. Brain Which hormone binds to a receptor that is autophosphorylated? a. Thyroid hormone b. GLP1 c. IGF1 d. CRH e. Epinephrine Which property is different between neurotransmitters of the central nervous system and hormones from the endocrine system? a. Neurotransmitters from the CNS only influence neurons b. Endocrine hormone signaling is faster than neural signaling c. Neurotransmitters recognize cell surface receptors d. Neurotransmitters are not secreted into the blood e. Hormones come from glands, neurotransmitters from neurons 2. 3. 1 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 4. Why are analogs of T4 rather than T3 generally thought to be the most appropriate treatment for hypothyroidism? a. T4 is the only form of thyroid hormone that can be transported into target cells b. The concentration of free T4 is higher than that of T3 c. T4 is not subject to feedback inhibition d. T4 is more potent e. T4 has a slower turnover rate Which property is true of hormones synthesized in the hypothalamus? a. Their levels are higher at night b. They are all releasing hormones c. Their concentration is highest in the anterior pituitary d. They respond to sensory input e. They are subject to feedback control by steroid hormones Many peptide and glycoprotein hormones bind to Gαs‐coupled receptors. Which process is NOT a common mechanism for down regulation of the signal generated by a Gαs‐coupled receptor? a. Hydrolysis of cAMP by phosphodiesterase b. Internalization of the hormone bound receptor c. Down regulation of receptor biosynthesis d. Calcium reuptake into intercellular stores e. Antagonism by Gαi‐coupled signaling To date, 37 common alleles (gene variants) have been discovered that are linked with obesity. The most common are alleles of MCR4, the hypothalamic receptor for αMSH, which is the primary neurotransmitter secreted from POMC/CART neurons. Why are individuals with these mutations likely to be obese? a. Deficiency in response to GLP1 b. Deficiency in stimulatory signaling to the "decrease energy intake/satiety" pathway c. Deficiency in inhibitory signaling between POMC/CART neurons and NPY/AgRP neurons d. Deficiency in stimulatory signaling to the "increase energy intake/hunger" pathway e. Deficiency in leptin response 5. 6. 7. 8. The half‐life of ACTH is 10 minutes, while the half life of IGF1 is 2 hours. What property accounts for this discrepancy? a. IGF1 is associated with a binding protein b. ACTH is a peptide c. ACTH is subject to negative feedback d. IGF1 is a steroid e. IGF1 is not subject to feedback control 2 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 9. Growth hormone has been used as an athletic performance enhancer. However, available evidence suggests that growth hormone does not improve performance in any sport, and abuse can lead to serious medical complications. What would be the effects on hormone levels in an individual who chronically abuses growth hormone? a. Increased leptin levels b. Increased GHRH levels c. Increased insulin levels d. Decreased IGF1 levels e. Decreased epinephrine levels Refer to the Figure 1. Which structure secretes a hormone that directly regulates thirst? a. A b. B c. C d. D e. None of the above Thyroid releasing hormone binds to a Gαq‐coupled receptor. What happens in the target cell immediately after TRH binding to its receptor? a. Decreased cytoplasmic calcium concentration b. Increased intracellular diacylglycerol c. Receptor autophosphorylation d. Activation of PKA e. Activation of hormone sensitive lipase Which property of thyroid hormone is NOT shared with most steroid hormones? 10. 11. 12. a. b. c. d. e. 13. Signaling through transcriptional regulation Transport through the blood in association with a binding protein Relatively long serum half lives Synthesis from a protein precursor Participation of feedback loops with hypothalamic releasing hormones A new class of drug has been developed for patients with type 2 diabetes. They work by inhibiting the DPP4 protease, which normally degrades GLP1, inactivating the hormone. Inhibition of the DPP4 protease increases the half‐life (t½) of GLP1 greatly. Why is this beneficial for many type 2 diabetes patients? a. Increased skeletal muscle insulin sensitivity b. Increased leptin secretion c. Increased insulin secretion d. Increased glucagon secretion e. Inhibition of pancreatic β cell apoptosis What is the rate limiting step in pancreatic β cell insulin release? a. Release of β cell internal calcium stores b. Conversion of glucose to glucose‐6‐phosphate by glucokinase c. Activation of PKA by Gαs coupled to the GIP receptor d. Entry of calcium through voltage‐gated channels e. Up regulation of skeletal muscle GLUT4 3 14. PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 15. Which factor determines the specificity of a hormone for its target? a. Proximity of the gland to the target tissue b. The value K in the equation [HR]=K[H][R] c. The presence of a receptor on the target tissue d. Neuroendocrine signaling e. Transcriptional control of the hormone Which property most often distinguishes type 1 and type 2 diabetics? 16. a. b. c. d. e. 17. Response to an oral glucose challenge Age Triacylglycerol levels in the blood Production of incretins Insulin resistance You are working with a pituitary cell line to study the regulation of a recently discovered peptide hormone called Gorman. Within one minute of the addition of an uncharacterized regulatory hormone, you measure Gorman release from the cells. What kind of receptor is most likely responsible for this effect? a. JAK/STAT tyrosine kinase b. Receptor tyrosine kinase c. Steroid receptor d. Gαi‐coupled e. Gαs‐coupled The synthesis of cortisol is controlled by a series of feedback loops primarily involving the hypothalamic‐ pituitary axis. Which of the following statements about control of cortisol synthesis is true? a. Cortisol stimulates synthesis and release of the CRH b. CRH inhibits release of ACTH c. ADH and CRH stimulate release of ACTH d. Cortisol promotes release but not the synthesis of ACTH e. Pulsatile release of ACTH is highest during the day, so that cortisol synthesis is highest at night Which hormone does NOT directly stimulate hormone sensitive lipase activity or synthesis? a. Cortisol b. Glucagon c. Thyroid hormone d. Growth hormone e. Insulin Prior to release, epinephrine is synthesized in the adrenal medulla in a series of enzymatic steps, similar to a steroid. What else is a feature of epinephrine synthesis and release? a. It is down regulated by feedback inhibition with acetyl choline b. Once synthesized, it passively diffuses out of the cell c. It is down regulated by cortisol d. It is up regulated by ACTH e. In sympathetic neurons, norepinephrine is synthesized from epinephrine 18. 19. 20. 4 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 21. Growth hormone secretion is influenced by many nutritional and endocrine factors. What is the most accurate description of the control of growth hormone secretion in normal individuals? a. Up regulation by IGF1 and non‐esterified fatty acids (NEFA), down regulation by glucose and GHIH b. Up regulation by leptin and amino acids, down regulation by IGF1 and glucose c. Up regulation by exercise and glucose, down regulation by amino acids and NEFA d. Up regulation by NEFA and amino acids, down regulation by leptin and glucose e. Up regulation by IGF1 and GHRH, down regulation by glucose and amino acids Cortisol and epinephrine are the two main hormones involved in the endocrine stress response. Which property is shared by these hormones? a. Up regulation of lipoprotein lipase b. Serum half‐life c. Up regulation of hormone sensitive lipase d. Signaling through cell surface receptors e. Up regulation of glycogenesis During fasting, what is the first source of stored energy to be mobilized to maintain blood glucose concentration? a. Adipose triglyceride b. Skeletal muscle glycogen c. Liver glycogen d. Skeletal muscle protein e. Liver ketone bodies 22. 23. 24. Vytorin is a drug that combines ezetimibe and simvastatin, which block both cholesterol uptake from the gastrointestinal tract and cholesterol synthesis by all cells. A confused individual accidently takes an overdose of Vytorin. After a week, she is severely hypocholesterolemic (i.e., has very low levels of circulating cholesterol). Which hormone would be present at a lower level than normal? a. Cortisol b. Thyroid hormone c. Growth hormone d. TSH e. ADH To which class does the vitamin D receptor belong? a. G protein‐coupled receptors b. Calcium‐sensing receptors c. JAK/STAT receptors d. Nuclear hormone receptors e. RTK tyrosine kinase receptors Rickets is a softening of bones in children potentially leading to fractures and deformity due to vitamin D deficiency. Which of the following is most effective for Rickets prevention? a. Consumption of fruit juices b. Consumption of at least 1000 mg/day of calcium c. Exercising at a gym d. Playing outside e. Synthetic estrogen therapy 5 25. 26. PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 27. Kallmann's syndrome is a form of hypogonadism associated with a deficiency of GnRH‐secreting neurons in the hypothalamus. What would be the effect on serum hormone concentrations in women with Kallmann's syndrome? a. High gonadotropins, low estrogens and androgens b. Normal gonadotropins and androgens, low estrogens c. Low gonadotropins, high estrogens, and normal androgens d. Low gonadotropins, high estrogens and androgens e. Low gonadotropins and estrogens, normal androgens Which of the following is NOT a mechanism for regulation of steroid hormone synthesis? a. Phosphorylation of biosynthetic enzymes b. Transcription of tropic hormone receptors c. LDL receptor endocytosis d. Proteolysis in the trans‐golgi e. Hypertrophy of the gland As long as they are regularly milked, dairy cows will always give milk, even though they are not always pregnant or nursing a calf. Assuming that regulation of lactation is the same in cows and humans, which hormonal regulation is responsible? a. Down regulation of prolactin inhibitory hormone b. Down regulation of LH & FSH c. Up regulation of progesterone d. Up regulation of prolactin inhibitory hormone e. Down regulation of oxytocin Synthetic androgens are commonly used by athletes and body builders to increase muscle mass. Androgen abuse can lead to many undesirable effects that can differ in males and females. In males, these include acne, testicular atrophy, decreased sperm count, gynecomastia (enlarged breasts in men), high blood pressure, fluid retention, abnormal liver function, and prostate enlargement. What causes the gynecomastia? a. Decreased testosterone synthesis in the testes b. Increased estrogen synthesis in the adipose tissue c. Increased FSH synthesis in the hypothalamus d. Decreased 5DHT synthesis in peripheral tissues e. Nature's love of irony What is the only pituitary tropic hormone that is under predominantly inhibitory control by the hypothalamus? a. Prolactin b. Thyroid stimulating hormone c. Growth hormone d. ACTH e. Parathyroid hormone 28. 29. 30. 31. 6 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 32. Which of the following properties are shared by luteinizing hormone and chorionic gonadotropin? a. They are nine amino acid peptides b. They activate steroidogenesis in Sertoli cells prior to ovulation c. Their release is stimulated by gonadotropin releasing hormone d. They activate the same receptor tyrosine kinase (RTK) receptor e. They up regulate steroidogenesis in the theca Swyer syndrome is a form of gonadal dysgenesis in which a phenotypic female is found to have normal female internal and external genetalia, lacks ovaries, but has an apparently normal XY karyotype (although this says nothing about point mutations and other small defects of either chromosome). A mutation in the gene for which protein would explain this disorder? a. Wolfian regression factor b. Testes determining factor c. An androgen receptor d. Oxytocin e. Aromatase Which of the following is a property of inhibin? a. It down regulates FSH secretion b. It is a steroid c. It is increased immediately prior to recruitment of 'a cohort of follicles' d. It is at its highest levels during pregnancy e. It is secreted from the Leydig cells Which of the following is part of a long feed‐back loop? 33. 34. 35. a. b. c. d. e. 36. Down regulation of PTH synthesis by 1,25 (OH)2D3 Up regulation of CRH by cortisol Down regulation of GH by GHIH Down regulation of estrogen receptor synthesis by progesterone Down regulation of LH by estrogens Which statement most accurately describes androgens in females? a. b. c. d. e. 37. They are Important for feedback inhibition of GnRH They are absent from maternal serum during pregnancy They are substrates for aromatase They are precursors of progesterone They are required for normal development of the external genetalia Which of the following hormones would have the greatest up regulation following injection of FSH into fertile adult females? a. LH b. DHEA c. Oxytocin d. Estrogen e. GnRH 7 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 38. Which of the following occurs in parathyroid chief cells when serum free [Ca2+] ≥ 1.3 mM? a. b. c. d. e. 39. Activation of preproPTH transcription Activation of 25(OH)D3‐1‐hydroxylase Activation of protein kinase A Activation of protein kinase C Inhibition of preprocalcitonin transcription Which of the following is true of the incretin effect? a. Insulin secretion is higher when stimulated by dietary glucose than by glucose administered intravenously b. It is inhibited by glucagon‐like peptide 1 (GLP1) c. Leptin activation of β cells is a key event d. A & B e. A & C Which of the following stimulates appetite? a. Cortisol b. Ghrelin c. Insulin d. non‐esterified fatty acids e. None of the above An average individual can go 8 weeks without iodine before developing thyroid deficiency. Why is this? a. Eight weeks is the length of time an average individual can survive without thyroid hormone b. Feedback inhibition of TSH by iodine reduces hormone biosynthesis c. Sufficient iodine is stored in the follicle for 8 weeks d. Because bound T4 has a very long half life in serum e. Table salt contains NaI Why is aldosterone synthesized only in the Zona glomerulosa of the adrenal cortex? a. It is the only ‘zona’ of the cortex where LDL receptors are located b. Portal circulation carries high concentrations of corticosterone to the Zona glomerulosa c. Aldosterone is synthesized in the adrenal medulla, not the Zona glomerulaosa d. The Zona glomerulosa lacks ACTH receptors, allowing aldosterone and cortisol to be regulated independently e. It is the only zone of the cortex that has aldosterone synthase, the enzyme that converts corticosterone to aldosterone If the adrenal gland is removed from a subject or the gland is non‐functional in terms of hormone production, what would be the consequence? a. Circulating ACTH (adrenocorticotropic hormone) levels and cortisol levels will be low b. Circulating ACTH levels will be low and cortisol will be high c. Circulating ACTH levels will be high and cortisol levels will be low d. Circulating ACTH and cortisol levels will be high e. None of the above 40. 41. 42. 43. 8 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 44. What would be the consequence of removal of the thyroid gland from an adult? a. Circulating TSH (thyroid stimulating hormone) and T4 levels will be high b. Circulating TSH levels and T4 levels will be low c. Circulating TSH levels will be high and T4 levels will be low d. Circulating TSH levels will be low and T4 will be high e. None of the above Figure 1 Refer to Figure 1. Who has the greatest extent of pancreatic β cell apoptosis? a. George b. Ringo c. Paul d. Yoko e. John Which of the following is a consequence of glucocorticoid treatment for an extended period? a. Hypoglycemia (low blood glucose) b. Increased capacity to respond to stress c. Inability to secret PTH d. Inability to secret thyroid hormone e. Reduced response to ACTH Which statement about Grave’s disease is true? a. It is an auto immune disease that causes hypothyroidism b. It causes very high serum TSH levels, while T4 levels are low c. It causes very high serum T4 levels, while TSH levels are low d. It is an autoimmune condition that results in adrenal insufficiency e. It causes a deficiency of thyroid response in peripheral tissues, due to lack of conversion of T4 to reverse T3 Which of the following is NOT synthesized in the adrenal gland? a. Aldosterone b. Androgens c. Cortisol d. Estrogens e. None of the above Thyroid hormone and cortisol exert their major effects through which of the following? a. Transcription b. Tyrosine kinase c. DNA replication d. Translation e. None of the above 45. 46. 47. 48. 49. 9 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 50. Which of the following hormones has the shortest half‐life (t½) in the blood stream? a. Parathyroid hormone b. Epinephrine c. Insulin d. Thyroxine (T4) e. Cortisol Glycogen is to triglycerides as glucose is to a. Insulin b. Protein c. Non‐esterified fatty acids d. Glucagon e. Glycerol Working in a research lab, you are given what is thought to be a novel hormone about which very little is known. Previous investigators have shown that it has a very long half‐life in serum (several days), and that it is internalized by every type of cell and tissue that has been tested. It is your job to measure the response to this hormone in cultured cells. After mixing the hormone with serum albumin to keep it soluble, you add it to the cultured cells. When would you most likely expect to see a response? a. 2 milliseconds b. 2 seconds c. 2 minutes d. 2 hours or more e. Never Oxytocin stimulates contraction of smooth muscles in the breast and uterine wall. The key step in muscle contraction is release of calcium from internal cell stores. With which type of receptor does oxytocin interact to cause muscle contraction? a. cytoplasmic receptor that interacts with a hormone response element b. Gαq‐coupled receptor c. Gαi‐coupled receptor d. Gαs‐coupled receptor e. An RTK receptor Which of the following statements concerning epinephrine synthesis is correct? a. ACTH activation of PKA inhibits epinephrine synthesis through direct phosphorylation of biosynthetic enzymes b. Epinephrine has a long t½ in the blood stream because it isassociated with chromogranin c. Acetylcholine from the sympathetic nervous system stimulates release of calcium from internal stores d. Cortisol stimulates transcription of epinephrine biosynthetic enzymes e. None of the above 51. 52. 53. 54. 10 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 55. Which of the following hormones are released in pulses at regular time intervals? a. calcitonin b. leptin c. ACTH d. T4 e. epinephrine What is the role of thyroglobulin? a. Control of parathyroid hormone release in response to plasma calcium concentration b. Transport of iodine into the colloid c. Provide the tyrosine substrate for thyroid hormone synthesis d. Serve as the primary thyroid hormone binding protein in the blood stream e. Convert T4 to T3 in target tissues It what respects does epinephrine differ from peptide hormones? a. Its signaling mechanism involves cell surface receptors b. It is synthesized from tyrosine c. It is soluble in the blood stream d. It is stored in vesicles e. All of the above Which of the following statements about insulin’s effects on metabolism in the liver is FALSE? a. It increases β oxidation of non‐esterified fatty acids to provide energy for protein translation and glycogenesis b. It stimulates the expression of glucokinase to increase the rates of glycogenesis and glycolysis c. It stimulates synthesis of triacylglycerols d. It inhibits gluconeogenesis e. None of the above statements are FALSE Steroid acute regulatory protein (StAR) is a key biosynthetic regulatory enzyme for which hormone? a. thyroid hormone b. corticotrophin releasing hormone c. 1,25(OH)2D3 d. cortisol e. All of the above What do glucagon and cortisol have in common? a. They are both subject to feedback regulation by the hypothalamic/pituitary axis b. They both mobilize glucose through stimulation of glycogenolysis c. They both mobilize glucose through stimulation of liver gluconeogenesis d. They are both steroids e. All of the above 56. 57. 58. 59. 60. 11 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 61. Which of the following hormones result in enhanced glucose mobilization? a. epinephrine, leptin, insulin b. cortisol, insulin, growth hormone c. insulin, IGF1, growth hormone d. glucagon, cortisol, epinephrine e. all of the above Which of the following statements is true? a. Increased nutrient intake results in decreased energy expenditure b. Increased voluntary movement results in increased energy intake in order to “defend the highest weight achieved” c. Because energy homeostasis is regulated to defend the highest weight achieved, it is impossible to reduce energy stored in the adipose tissue d. Unconscious movement, thermogenesis, and efficiency of nutrient absorption are all components of energy expenditure e. Decreased nutrient intake results in decreased energy expenditure Which of the following are considered adipokines? a. Glucose‐dependent insulinotropic peptide b. insulin c. ghrelin d. epinephrine e. none of the above Which of the following are involved in a long feedback loop? a. cortisol & ACTH b. IGF1 & growth hormone c. cortisol & CRH d. T3 & TRH e. All of the above Which of the following statements concerning leptin is true? a. It stimulates secretion of insulin b. It activates Gαs‐coupled receptors in the muscle, which leads to increased glycogen storage c. It is secreted primarily from the visceral adipose (belly fat) d. Its concentration in the blood stream is a reflection of the adipose mass e. None of the above Which of the following are involved in a short feedback loop? a. TSH & growth hormone b. insulin & glucagon c. ACTH & CRH d. parathyroid hormone & calcitonin e. epinephrine & cortisol 62. 63. 64. 65. 66. 12 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 67. Which of the following hormones is converted to an active form in its target tissue? a. cortisol b. glucagon c. thyroid hormone d. insulin e. none of the above Which of the following is a characteristic of skeletal muscles that are becoming resistant to insulin? a. Decreased glucose uptake b. Decreased glycogen synthesis c. Decreased β oxidation of non‐esterified fatty acids d. Secretion of inflammatory factors e. none of the above Please refer to the figure. Which patient is most likely to have fasting glucose greater than 6.0 mM, but not be classified as diabetic? a. Bruce b. Max Note: 6.0 mM=108 mg/dL c. Roy d. Clarence e. Steven Hormone X is a peptide that inhibits insulin release from pancreatic β cells. What is the most likely explanation of the mechanism of Hormone X? a. It inhibits the GLUT4 transporter, resulting in decreased cellular ATP concentration, which inhibits the ATP‐sensitive K+ channel b. It binds to a Gαs‐coupled receptor, activating PKA which increases transcription of glucokinase, thus increasing cellular ATP concentration c. It activates the NMDA receptor; the subsequent membrane depolarization inhibits a voltage‐gated calcium channel, depriving the cell of the calcium need to stimulate release d. It binds to a Gαq‐coupled receptor, causing loss of calcium‐stimulated secretion e. It binds to a Gαi‐coupled receptor, causing loss of PKA‐stimulated secretion Which of the following is NOT an effect of epinephrine? a. Inhibition of liver glycogen breakdown b. Inhibition of muscle glucose transport c. Stimulation of glucagon secretion d. Activation of adipose hormone sensitive lipase e. Inhibition of adipose glucose transport Which of the following statements about liver metabolism is true? a. It is the major target of IGF1 b. Its response to insulin is regulated by the ATP‐sensitive K+ channel c. It contains the GLUT2 glucose transporter, glucokinase, & responds to insulin d. It uses ketones for energy during prolonged fasting e. None of the above 13 68. 69. 70. 71. 72. PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 73. Which of the following statements about glucagon is FALSE? a. It increases glycogen storage in the liver b. It stimulates non‐esterified fatty acid synthesis in liver & adipose c. It increases blood glucose concentration d. It increases β oxidation of non‐esterified fatty acids in the liver e. All of the above statements are FALSE Why does glucagon‐like peptide 1 stimulate insulin secretion? a. It binds to a Gαs‐coupled receptor on pancreatic β cells which results in PKA‐mediated stimulation of insulin gene transcription. b. It inhibits calcium entry into the β cells c. It mobilizes β cell glucose through stimulation of gluconeogenesis d. It binds to a Gαs‐coupled receptor on pancreatic β cells which results in PKA‐mediated stimulation of secretion. e. None of the above Which is NOT typical of G protein coupled receptor activation? a. Stimulation of hormone exocytosis b. Activation of the JAK/STAT pathway c. Release of internal cellular calcium stores d. Hydrolysis of GTP e. Receptor internalization after hormone binding Which of the following hormones DOES NOT show a pattern of pulsed release? a. Thyroid stimulating hormone b. Growth hormone c. Thyroid hormone d. Gonadotrophin releasing hormone e. Adrenocorticotropic hormone Which of the following is secreted from the hypothalamus? a. Follicle stimulating hormone b. Antidiuretic hormone c. Corticotrophin releasing hormone d. Leptin e. Melatonin Substances that are diabetogenic are capable of causing or exacerbating diabetes, especially in excess. Which hormone is LEAST likely to be diabetogenic in excess? a. Insulin b. Cortisol c. Glucagon d. Growth Hormone e. Epinephrine 74. 75. 76. 77. 78. 14 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 79. What is the most important stimulator of insulin release? a. Glucagon b. Ghrelin c. Non‐esterified fatty acids d. Glucagon‐like peptide 1 e. Glucose Epinephrine down regulates insulin secretion through interaction with the α2 adrenergic receptor. What is its mechanism? a. Activation of a tyrosine kinase b. Suppression of transcription c. Suppression of apoptosis d. Activation of Gαq e. Activation of Gαi Which of these processes is up regulated by insulin in the liver? a. GLUT4 transport b. Glycolysis c. Export of pyruvate from the mitochondria d. Lipolysis e. β oxidation of non‐esterified fatty acids Which hormone decreases appetite through direct interaction with αMSH expressing neurons? a. Ghrelin b. Leptin c. Gastric inhibitory peptide d. Adrenocorticotropic hormone e. Epinephrine Which of the following has no known role in cortisol signaling? a. A hormone response element b. Histone acetyltransferase c. RNA polymerase II d. Tyrosine kinase e. HSP90 Which hormones stimulate glucose mobilization? a. Cortisol, epinephrine, & glucagon b. Aldosterone, epinephrine & glucagon c. Epinephrine, glucagon & insulin d. Aldosterone, epinephrine & insulin e. Cortisol, epinephrine & insulin 80. 81. 82. 83. 84. 15 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 85. Which hormone stimulates catecholamine synthesis in the adrenal medulla by activation of tyrosine hydroxylase? a. Norepinephrine b. Leptin c. Acetylcholine d. Cortisol e. Epinephrine Throughout the 20th century in the United States, children generally grew to be taller than their same‐sex parent. This trend was obvious from the steady increases in average adult height from 1900 to 1974. However, this trend has reversed in recent years, so that individuals born between 1975‐1984 will be on average 1.5 cm shorter than those born between 1965‐1974. Many hypotheses about changing lifestyles have been advanced to explain this trend. Which hypothesis is the LEAST plausible (i.e. least likely to be true)? HINT: Concentrate on the endocrinological consequences of each of these possibilities. a. Lack of physical activity b. High protein diets c. High carbohydrate diets d. High stress e. Lack of sleep Use the figure to answer this question. Acromegaly is a hormonal disorder that results from too much growth hormone (GH) in the body. Which patient has been diagnosed with acromegaly? a. John b. Robby c. Mike d. Brad e. Korel Which factor does NOT directly regulate aldosterone synthesis? a. Cortisol b. Antidiuretic hormone c. ACTH d. plasma [K+] e. Angiotensin II Which of the following does NOT increase ADH secretion? a. Decreased blood pressure b. Angiotensin II c. Aldosterone d. Thirst e. Increased plasma osmolarity 86. 87. 88. 89. 16 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 90. Central diabetes insipidous is a serious condition characterized by over‐production of urine and extreme thirst. Which endocrine tissue is defective in this disease? a. Seminiferous tubules b. Posterior pituitary c. Pancreatic β cells d. Adipose tissue e. Thyroid Which of the following IS NOT directly involved in G protein signaling? a. Inositol triphosphate b. Calcium c. Diacylglycerol d. cAMP e. Glucose Which hormone interacts with a Gαs ‐coupled receptor? a. Prolactin b. Follicle stimulating hormone c. Leptin d. Insulin e. Testosterone Which of the following occurs in a long feedback loop? a. Epinephrine stimulation of progesterone synthesis b. Growth hormone inhibiting hormone inhibition of GH release c. Adrenocorticotropic hormone inhibition of corticotropin releasing hormone secretion d. Gonadotropin releasing hormone inhibition of thyroid releasing hormone secretion e. Cortisol inhibition of adrenocorticotropic hormone synthesis Which of the following occurs in a short feedback loop? a. Gonadotropin releasing hormone inhibition of thyroid releasing hormone secretion b. Epinephrine stimulation of progesterone synthesis c. Ghrelin stimulation of growth hormone releasing hormone secretion d. Cortisol inhibition of adrenocorticotropic hormone synthesis e. Adrenocorticotropic hormone inhibition of corticotropin releasing hormone secretion Which of the following is NOT synthesized from progesterone? a. Aldosterone b. 1,25(OH)2 vitamin D3 c. Estrogens d. Cortisol e. Testosterone 91. 92. 93. 94. 95. 17 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 96. Which of the following events IS NOT a regulatory point for peptide hormone action? a. Transcription of the preprohormone b. Secretion of the hormone c. Internalization of the hormone receptor d. Activation in the target cells e. Association of the hormone with a plasma binding protein Body builders and athletes to promote skeletal muscle development sometimes use direct injection of testosterone. In males, one side effect of this behavior is very low sperm production. Why is this? a. Injected testosterone inhibits Leydig cell production of testosterone b. Injected testosterone increases androgen binding protein synthesis, reducing free testosterone c. Injected testosterone increases circulating estrogen d. Injected testosterone must first be converted to dihydrotestosterone (DHT) in the testis e. He's too stupid to reproduce. Nature knows this, and reduces his sperm production accordingly The existence of prolactin releasing hormone is controversial. If it does exist, which property would it most likely have? a. Binding to a JAK/STAT tyrosine kinase associated receptor b. Binding to Gαs coupled receptor c. Secretion from the posterior pituitary d. A long t½ in the blood stream e. Binding to a Gαi coupled receptor After ovulation, which of the following events occurs first? a. Menses b. Recruitment of a cohort of follicles c. Entry into the endometrial secretory phase d. Peak progesterone levels e. Peak LH levels 97. 98. 99. 100. Levels of which hormone DOES NOT increase throughout pregnancy? a. Chorionic gonadotropin b. Estriol (E3) c. Progesterone d. Estradiol (E2) e. All of the above increase throughout pregnancy 101. "Lactational amenorrhea" is a natural method of birth control where the period of breast feeding an infant is extended. Infertility during this period is caused by elevated levels of which hormone? a. Progesterone b. Chorionic gonadotropin c. Prolactin inhibiting hormone d. Estradiol (E2) e. Prolactin 18 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 102. What is the most significant source of serum testosterone in the normal woman? a. Ovarian granulosa cell production from luteal dehydroepiandrosterone b. Luteal cell production from granulosa progesterone c. Peripheral production from adrenal dehydroepiandrosterone d. Adipose production from ovarian estradiol e. None of the above 103. In males, which hormones participate in negative feedback inhibition of luteinizing hormone secretion? a. Dihydrotestosterone and estradiol b. Testosterone and dihydrotestosterone only c. Testosterone, dihydrotestosterone and estradiol d. Testosterone, dihydrotestosterone and follicle stimulating hormone e. Testosterone only 104. One mechanism proposed for the hourly pulses of GnRH seen in adult females is that secreted GnRH inhibits further GnRH release. This would be an example of which type of regulation? a. Transcriptional regulation b. Long loop negative feedback c. Ultrashort loop negative feedback d. Osmoregulation e. Short loop positive feedback 105. What is the major difference in steroid biosynthesis between males and females? a. Males do not synthesize adrenal androgens b. Males do not produce estrogen c. Males do not produce progesterone d. Females do not synthesize gonadal androgens e. None of the above 106. In old movies, when the heroine becomes pregnant, a doctor bursts into the room and announces “the rabbit died,” because “pregnant” was considered an obscene word. The rabbit test was an old fashioned pregnancy test conducted immediately after a woman’s second missed menstrual period. A sample of the woman’s urine was injected into a female rabbit, and its ovaries were examined for signs of pregnancy (which of course meant that the rabbit died no matter what), such as unusually large corpus luteum. What would have been in the woman’s urine that would have caused the earliest signs of pregnancy? a. Prolactin b. Chorionic gonadotropin c. GnRH d. Estradione e. Progesterone 107. What property is shared by Leydig cells and theca cells? a. They are found in the seminiferous tubules b. They secrete large amounts of estrogens c. They express aromatase d. They are stimulated primarily by LH e. They secrete large amounts of progesterone 19 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 108. If a fetus has not expressed testes determining factor (TDF) by the 9th week of gestation a. It will develop as a female b. The Wolffian duct will develop into ovaries and other female‐specific organs c. It will not express androgens d. It will develop Gonadal dysgenesis e. All of the above 109. What property is shared by Sertoli cells and follicular granulosa cells a. The presence of aromatase b. The presence of FSH receptors c. They secrete inhibin d. A & B only e. All of the above 110. One month after gestation, a fetus could be called “indifferent” because: a. It lacks the SRY gene b. It has an XXY genotype c. It has no gender phenotype d. It secretes anti‐Müllerian hormone e. Sigh, it just doesn’t care anymore 111. Which of the following statements about testosterone are true? a. Inhibits synthesis of estrogens in Sertoli cells b. Is not synthesized in females c. Is a precursor of glucocorticoids d. Is converted to DHT in target tissues e. All of the above 112. Which of the following statements about testosterone is true? a. It is a substrate of aromatase b. It is responsible for expression of testes determining factor c. It is necessary for proliferation of Leydig cells d. It is inactivated by 5 α‐dehydroxysteroid dehydrogenase in target tissues e. It is synthesized only in males 113. Which of the following properties of the granulosa distinguishes the follicular phase of the ovarian cycle from the luteal phase? a. Increased synthesis of androstenedione b. Decreased synthesis of gonadotropin releasing hormone receptors c. Increased aromatase activity d. The presence of LH receptors e. The presence of FSH receptors 20 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 114. A pregnant woman was unable to have a normal delivery due to lack of uterine wall contraction. After surgical delivery, she finds she is unable to breast feed, although her breasts are full of milk. She also complains that she's always thirsty. An MRI showed that she has a tumor at the base of her brain that is pressing on the inferior hypophyseal artery, which supplies blood to the posterior pituitary. This woman has a deficiency in which of the following hormones? a. Gonadotropin releasing hormone & Oxytocin b. Parathyroid hormone & Antidiuretic hormone c. Corticotropin releasing hormone & Parathyroid hormone d. Corticotropin releasing hormone & Gonadotropin releasing hormone e. Antidiuretic hormone & Oxytocin 115. Individuals afflicted with congenital adrenal hyperplasia have a mutation which leads to a deficiency of the steroidogenic cytochrome P450 21‐α‐hydroxylase in the adrenal gland. In males, this condition may not be apparent at birth. However females with this condition are born with ambiguous genitalia due to excess androgen production during development. Which of the following hormones would be found at abnormally LOW levels in this condition? a. ACTH b. Estradiol c. Angiotensin II d. Aldosterone e. 5‐dihydrotestosterone 116. Which of the following properties are shared by luteinizing hormone and follicle stimulating hormone? a. They are nine amino acid peptides b. Neither is secreted prior to puberty c. Their release is stimulated by gonadotropin releasing hormone d. They activate of tyrosine kinase coupled receptors e. They activate steroidogenesis in Sertoli cells prior to ovulation 117. Which hormone has a receptor that is structurally similar to the estrogen receptor? a. Insulin b. Growth hormone c. Thyroid hormone d. Parathyroid hormone e. Epinephrine 118. A form of the peptide hormone somatostatin is secreted by pancreatic δ (delta) cells and inhibits secretion of glucagon, although the physiological role is unclear. This is an example of which type of communication? a. Exocrine b. Neuroendocrine c. Paracrine d. Autocrine e. Paranormal 21 PGY452/552 Endocrinology previous EXAMquestions; Dr. Morales, Spring 2011. 119. Which hormone is under control of an inhibitory trophic hormone? a. 1,25(OH)2D3 b. Thyroid stimulating hormone c. Angiotensin II d. Thyroid releasing hormone e. Growth hormone 120. In which tissue does down regulation of vitamin D occur? a. Liver b. Skin c. Kidney d. Thyroid gland e. Small intestine 121. What happens at plasma calcium concentrations greater than 1.3 mM? a. Increase of phosphate concentration in the blood b. Stimulation of osteoclast activity c. Synthesis of 24,25(OH)2D3 d. Increased calcium reabsorption in the kidney e. None of the above 122. Which of the following properties is NOT true of 1,25(OH)2D3? a. It inhibits PTH transcription b. It stimulates absorption of calcium in the gut c. It has a long plasma half‐life d. It is activated by conversion of 24,25(OH)2D3 in the liver e. It is structurally related to steroids 123. The term for cutting the stalk between the pituitary & the hypothalamus is hypophysectomy. Which of the following would NOT be a result of such a procedure? a. Hyperkalemia (high plasma potassium concentration) b. Interruption of the menstrual cycle c. Inhibition of growth and development in the a young individual d. Atrophy of the thyroid gland e. Loss of the incretin effect 124. What organ or tissue is the primary pool for phosphorus in humans? a. soft tissues (liver, brain, heart, etc.) b. gut c. extra cellular fluid, including blood d. kidney e. bone 22 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. 125. Which of the following is true about steroids? a. They are lipophilic b. They are always involved in positive feedback loops c. They are synthesized exclusively in the mitochondria d. They are stored in vesicles e. They all have cell surface receptors 126. Which of the following is a property of parathyroid hormone? a. It acts directly on the follicle to promote absorption of dietary Ca2+ into the colloid b. It influences all cells that it contacts to release or take up Ca2+ c. It is released by parafollicular cells d. It is released at a higher rate when [Ca2+ ] concentration is low e. It stimulates conversion of 7‐deoxycholesterol into Vitamin D3 in the skin 127. Which of the following hormones is synthesized from a cholesterol precursor? a. Insulin‐like growth factor 1 (IGF1) b. Epinephrine c. 1,25(OH)2D3 d. Leptin e. Calcitonin 128. During lactation, touch‐sensitive mechano‐receptors in the nipple are activated by the infant's suckling. These receptors send a signal to the hypothalamus which results in the release of oxytocin from the pituitary. Oxytocin stimulates smooth muscle contraction in the breast, inducing the infant to suck more as milk is expelled. This is an example of which type of regulation? a. An ultrashort positive feedback loop b. A long negative feedback loop c. A long positive feedback loop d. A short negative feedback loop e. A short positive feedback loop 129. Which of the following is NOT true of protein kinase C? a. When active, it can regulate transcription a. It controls parathyroid hormone release b. It phosphorylates target proteins c. It requires diacylglycerol for activation d. It is inhibited by hormones that bind to a Gαi‐coupled receptor 130. What percentage of the body's calcium is present in the bones? a. less than 1% b. 1%‐50% c. 50‐85% d. 85‐99% e. greater than 99% 23 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. Abbreviations Full name Adrenocorticotropic hormone Antidiuretic hormone Anti‐Müllarian hormone Calcitrol Chorionic gonadotrophin (human) Corticotrophin releasing hormone Dehydroepiandosterone Diacylglycerol Dihydrotestosterone Estradiol Estriol Estrogens Estrone Follicle stimulating hormone Gastric inhibitory peptide Glucagon‐like peptide 1 Glucose‐dependent insulinotropic peptide Gonadotropin releasing hormone Growth hormone Growth hormone inhibiting hormone (somatostatin) Growth hormone releasing hormone Insulin‐like growth factor 1 Luteinizing hormone Parathyroid hormone Prolactin inhibiting hormone (dopamine) Protein kinase A Protein kinase C Triiodothyronine Thyroid hormone Thyroxine Thyrotropin releasing hormone Thyroid stimulating hormone Vitamin D Abbreviation ACTH ADH AMH 1,25(OH)2D3 or 1,25(OH)2 vitamin D3 hCG CRH DHEA DAG DHT E2 E3 E1+E2+E3 E1 FSH GIP GLP1 GIP GnRH GH GHIH GHRH IGF1 LH PTH PIH PKA PKC T3 T4+T3 T4 TRH TSH 25(OH)D3 24 PGY452/552 Endocrinology previous EXAM questions; Dr. Morales, Spring 2011. Key # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 Answer % correct C C D E D D B A C D B D C B C E E C E D B C C A D D E D A B A E B 92% 70% 49% 51% 41% 59% 64% 78% 42% 71% 46% 71% 78% 72% 72% 72% 63% 60% 57% 58% 64% 57% 77% 81% 67% 52% 73% 62% 83% 51% 59% 36% 58% # 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 Answer A E C D D A B C E C C B E C D A B C D B D C C B A D C D E E E D C % correct 88% 29% 48% 73% 38% 55% 87% 59% 71% 58% 69% 90% 67% 62% 52% 76% 61% 72% 68% 77% 62% 67% 72% 64% 52% 63% 76% 82% 68% 34% 62% 48% 85% # 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 Answer C A A E A C A D B C C A E E B B D A D B B A C B E B E E B D A B C % correct 81% 73% 43% 44% 63% 68% 76% 65% 65% 52% 83% 35% 91% 58% 52% 76% 67% 78% 50% 49% 80% 45% 43% 59% 75% 84% 64% 68% 68% 63% 62% 43% 59% # 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 Answer A E C C C E B D A E C D A D E D C C C E C C D E E A D C C E E % correct 72% 67% 67% 56% 88% 52% 43% 70% 59% 32% 72% 68% 56% 42% 91% 31% 96% 50% 80% 74% 58% 27% 57% 63% 73% 86% 86% 71% 95% 59% 56% 25 ...
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This note was uploaded on 02/22/2011 for the course PGY 452 taught by Professor Dr.baizer during the Spring '11 term at SUNY Buffalo.

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