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148 Cards in this Set
- Front
- Back
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What is the primary function of the endocrine system?
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to maintain body homeostasis through the manufacture & secretion of hormones
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When secreted into the circulation, hormones can exert their effects on ____ sites. These effects are called _____ effects.
a. distant; endocrine b. distant; paracrine c. local; autocrine d. adjacent; paracrine |
A
distant sites endocrine effects |
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When hormones are diffused through interstitial tissue, they can exert their effects on ____ sites. These effects are called _____ effects.
a. distant; endocrine b. distant; paracrine c. local; autocrine d. adjacent; paracrine |
D
adjacent sites paracrine effects |
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When hormones exert effects on their own cell of origin, the effects are called _____ effects.
a. endocrine b. paracrine c. autocrine d. self-stimulating |
C
autocrine effects |
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Polypeptide hormones are derived from what?
a. cholesterol b. amino acids c. ions d. enlarging masses |
B
amino acids |
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True or False: A single hormone will always exert the same biological effect.
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False.
Depending on the target cell, the same hormone can exert biologically different effects. |
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Steroid hormones are all derived from what?
a. cholesterol b. amino acids c. polypeptides d. prolactin |
A
cholesterol |
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Steroid hormones and thyroid hormones are
a. hydrophilic b. hydrophobic c. amphipathic d. varied in terms of polarity |
B
hydrophobic |
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Any hormone that is not a steroid or thyroid hormone is
a. hydrophilic b. hydrophobic c. amphipathic d. varied in terms of polarity |
A
hydrophilic |
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Which of the following is false regarding hydrophobic hormones (steroids and thyroid hormones)?
a. they diffuse easily through plasma membranes and bind reversibly to intracytoplasmic receptors b. they are transported in the circulation in low concentration c. they require transport proteins d. they are ultimately bound to nuclear DNA where they act to regulate transcription of certain genes |
B
hydrophobic hormones are NOT transported in the circulation in low concentration |
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Which of the following is false regarding hydrophilic hormones?
a. they require transport proteins b. they are transported in the circulation in low concentrations c. they bind to specific receptors d. they can effect cells action by induction of secondary messengers that act on the nucleus or by altering the plasma membrane permeability |
A
hydrophilic hormones do NOT require transport proteins |
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Which of the following is not a manifestation of endocrine organ abnormalities?
a. hyperfunction b. hypofunction c. local effects of an enlarging mass d. a single hormone exerting multiple effects varied by target cell |
D
It is normal for a single hormone to exert biologically different effects depending on the target cell it acts upon |
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Where does the anterior pituitary arise from?
a. the base of the skull b. the sella turcica c. the roof of the mouth d. the base of the brain |
C
anterior pituitary arises from the roof of the mouth |
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Where does the posterior pituitary arise from?
a. the base of the skull b. the sella turcica c. the roof of the mouth d. the base of the brain |
D
posterior pituitary arises from the base of the brain |
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What are the 6 hormones produced by the anterior pituitary gland?
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follicle stimulating hormone (FSH)
luteinizing hormone (LH) adrenal corticotropic hormone (ACTH) growth hormone (GH) thyroid stimulating hormone (TSH) prolactin (PL) |
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Where are the hormones of the posterior pituitary actually produced?
a. anterior pituitary b. posterior pituitary c. hypothalamus d. renal cortex What are the 2 hormones of the pituitary gland? |
C
hypothalamus hormones: antidiuretic hormone(ADH or vasopressin) oxytocin |
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In MOST cases, release of hormones from the pituitary is controlled by ____ produced/controlled in _____.
a. releasing factors; hypothalamus b. releasing factors; anterior pituitary c. stimulating hormone; hypothalamus d. positive feedback; hypothalamus |
A
In most cases, release of pituitary hormones is controlled by releasing factors that are produced in the hypothalamus of the brain |
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Once pituitary hormones have caused hormone secretion from their target organs, the increase in serum levels of the target organ hormone has a _____ effect on the pituitary and hypothalamus.
a. stimulating b. suppressive c. additive d. synergistic |
B
suppressive (negative feedback) |
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Which of the following is the most common basis of hyperpituitarism?
a. hypothalamic hypersecretion b. disruption of negative feedback loops c. genetic inheritance d. autonomous pituitary hypersecretion |
D
autonomous pituitary hypersecretion |
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Autonomous pituitary hypersecretion is usually due to
a. pituitary adenoma secreting polypeptide hormones b. genetic inheritance c. disruption of negative feedback loops d. hyperpituitarism |
A
pituitary adenoma (a functional, benign, monoclonal neoplasm) secreting polypeptide hormones |
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What is the most common secretory product of pituitary adenomas?
a. growth hormone b. ACTH c. gonadotropin d. prolactin |
D
Prolactin |
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Prolactin excess, in women, often results in what 3 things? What 2 things can it produce in men?
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women:
anovulation amenorrhea galactorrhea men: infertility impotence |
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What does giantism refer to?
a. exaggerated skeletal growth b. enlarged tumor c. a distended stomach 2-5 inches more than normal d. a height of more than 6'5 |
A
exaggerated skeletal growth (*reflects an increase in growth hormone before puberty) |
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Giantism is often accompanied by problems with
a. nerves b. muscle c. joints d. all of the above |
D
all - nerves, muscles, and joints |
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After puberty, a hypersecretion of growth hormone produces
a. giantism b. acromegaly c. galactorrhea d. amenorrhea |
B
acromegaly |
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What are the 8 features associated with acromegaly?
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-enlargement and coarsening of the face, hands, and feet
-prominent forehead -protruding jaw -thick lips -enlarged tongue -hypertension -glucose intolerance -osteoporosis |
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An excess of ACTH results in
a. acromegaly b. Cushing disease c. Sheehan syndrome d. there are no problems associated with excess ACTH |
B
Cushing disease |
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Hypopituitarism most commonly results from what?
a. extensive destruction of anterior lobe tissue b. GH deficiency c. Simmond disease d. ACTH excess |
A
extensive destruction of anterior lobe tissue **syllabus also later says "non-functioning adenoma is the most frequent cause of hypopituitarism" --neoplasm enlarges in size and compresses gland to result in gradual loss of function |
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Hypopituitarism leads to
a. pituitary adenoma b. giantism c. autonomous pituitary hypersecretion d. panhypopituitarism (Simmond disease) |
D
panhypopituitarism (Simmond disease) |
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Which of the following is the correct sequence of deficiencies related to hypopituitarism.
a. GH, gonadotropin, FSH, LH b. ACTH, TSH, GH, gonadotropin c. FSH, LH, TSH, GH d. GH, gonadotropin, TSH, ACTH |
D
GH (growth hormone), gonadotropin, TSH (thyroid stimulating hormone), ACTH (adrenal corticotropic hormone hormone) **gonadotropin hormones are FSH and LH |
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If a growth hormone deficiency is present before puberty, it can cause
a. delayed sexual maturity b. pituitary dwarfism c. hypothyroidism d. A and B e. none of the above |
D
both A and B - delayed sexual maturity and pituitary dwarfism |
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A patient with pituitary dwarfism would appear
a. short stature and abnormal proportions b. short stature but with normal proportions c. average height but with abnormal proportions d. shortened limbs but with a normal torso |
B
short stature with normal proportions |
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What can a gonadotropin deficiency cause in children? In adult females? In adult males?
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children - delayed puberty
adult females - amenorrhea loss of secondary sex characteristics atrophy of the ovaries and external genitalia adult males - aspermia loss of secondary sex characteristics testicular atrophy |
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TSH deficiency produces symptoms of
a. hyperemia b. hypoadrenalism c. hypothyroidism d. amenorrhea |
C
hypothyroidism |
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ACTH deficiency produces symptoms of
a. hyperemia b. hypoadrenalism c. hypothyroidism d. amenorrhea |
B
hypoadrenalism |
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Classically, Sheehan syndrome is due to
a. TSH deficiency b. GH deficiency c. obstetric hemorrhage and hypotension d. increase in osmolarity of body water What is this called? |
C
obstetric hemorrhage and hypotension this is called postpartum pituitary necrosis |
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Sheehan syndrome results from
a. varicose veins entangling in lymphatic vessels b. pulmonary hypertension c. non functioning adenoma d. an infarct of the anterior pituitary secondary to hypotension or shock |
D
an infarct of the anterior pituitary secondary to hypotension or shock |
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A female patient returns two months after having delivered her baby. She reports being unable to lactate and that she has yet to resume menses. She is lacking energy and appears to have lost muscle strength as well. What do you suspect?
a. gonadotropin deficiency b. Sheehan syndrome c. oxytocin excess d. Simmond disease |
B
Sheehan syndrome |
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True or False: Neither excessive nor deficient production of oxytocin has recognizable associated clinical effects.
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True.
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Increases in osmolality of body water or a decrease in blood volume will stimulate the release of
a. oxytocin b. ADH c. GH d. ACTH |
B
ADH |
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Thirst, which promotes water ingestion, works with ____ to regulate water balance to maintain steady state solute concentrations within tissue.
a. ADH b. oxytocin c. parafollicular c-cells d. coagulation factors |
A
ADH |
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What are 3 results of the syndrome of inappropriate ADH? Why?
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hypervolemia
hemodilution inability to dilute urine because SIADH results in renal retention of water |
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The classic cause of the syndrome of inappropriate ADH (SIADH) is
a. nephrogenic diabetes insipidus b. hypervolemia c. bitemporal hemianopsia d. oat cell carcinoma of the lung |
D
oat cell carcinoma of the lung (ectopic production of ADH by a neoplasm) |
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What are 2 symptoms that are common to both diabetes insipidus and diabetes mellitus?
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polyuria
polydipsia |
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Of the following, diabetes insipidus is generally due to
a. anterior pituitary tissue destruction b. expanding pituitary masses c. posterior pituitary tissue damage d. polydipsia |
C
posterior pituitary tissue destruction |
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Of the following, which is diabetes insipidus generally due to
a. polydipsia b. disruption of hypothalamic-pituitary connections c. parafollicular c-cells secreting calcitonin d. in response to stimulation by excess TSH from the pituitary |
B
disruption of hypothalamic pituitary connections |
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End-organ unresponsiveness to ADH is referred to as
a. syndrome of inappropriate ADH b. hyperthyroidism c. posterior pituitary syndrome d. nephrogenic diabetes insipidus |
D
nephrogenic diabetes insipidus |
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Bitemporal hemianopsia is a visual impairment that can be produced by
a. expanding pituitary masses b. severe headaches c. excess calcitonin d. TSH deficiency Why? |
A
expanding pituitary masses due to its location at the base of the brain it impinges on the optic chiasm or compresses the oculomotor nerves |
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The adult thyroid is composed of follicles in a fibrovascular stroma which contains _____ that secrete ____.
a. parafollicular cells; parathyroid hormone b. C-cells; calcitonin c. T3; T4 d. iodine; TSH |
B
C-cells that secrete calcitonin *C-cells are aka parafollicular cells |
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Calcitonin opposes the effects of
a. follicle stimulating hormone b. gonadotropin c. parathyroid hormone e. luteinizing hormone |
C
parathyroid hormone |
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_____ is a hypermetabolic state produced by ______.
a. hyperthyroidism; increased T4 and/or T3 b. hyperthyroidism; decreased calcitonin c. hypothyroidism; decreased TSH d. hypothyroidism; increased TSH |
A
hyperthyroidism produced by increased T4 and/or T3 |
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What are the 9 clinical manifestations of hyperthyroidism?
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-nervousness
-hyperkinesia -sweating -heat intolerance -tachycardia -cardiac arrhythmias -weight loss despite increased appetite -muscle weakness and fatigue -tremors -warm, moist skin -fine oily hair -emotional lability -hyperdefecation |
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Which of the following is not a major cause of hyperthyroidism?
a. Graves' disease b. bitemporal hemianopsia c. toxic multinodular goiter d. toxic adenoma |
B
bitemporal hemianopsia is NOT a cause of hyperthyroidism |
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Hyperthyroidism is also called
a. myxedema b. cretinism c. Simmonds disease d. thyrotoxicosis |
D
thyrotoxicosis |
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Hypothyroidism which results from intrinsic thyroid disease is referred to as
a. primary hypothyroidism b. secondary hypothyroidism c. thyrotoxicosis d. Hashimoto thyroiditis |
A
primary hypothyroidism |
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Secondary hypothyroidism is hypothyroidism which results from
a. intrinsic thyroid disease b. deficiency of TSH because of pituitary or hypothalamic disease c. nutritional deficiencies d. birth problems associated with a high maternal age |
B
TSH deficiency because of pituitary or hypothalamic disease |
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What is the most sensitive indicator of primary hypothyroidism?
a. excess T3 and T4 b. excess T3 and deficiency in T4 c. increased TSH serum levels d. decreased TSH serum levels |
C
increased TSH serum levels (thyroid failure = nonresponsive to TSH = no negative feedback to stop production of TSH) |
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Which of the following is true regarding secondary hypothyroidism?
a. it is a hypermetabolic state produced by increased T4 b. its features are significantly different than primary hypothyroidism c. it results from intrinsic thyroid disease d. TSH serum level will not be elevated in patients with secondary hypothyroidism |
D
TSH serum level will not be elevated in patients with secondary hypothyroidism (**secondary hypothyroidism results from DEFICIENCY of TSH due to pituitary or hypothalamic disease) |
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What is myxedema?
a. late childhood/adult hypothyroidism b. congenital hypothyroidism c. primary hyperthyroidism d. secondary hyperthyroidism |
A
late childhood/adult hypothyroidism |
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Myxedema is manifested by what 10 things?
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-tiredness
-apathy -lethargy -slow speech -rough skin -coarse/dry hair -puffy periorbital soft tissue -enlarged tongue -flabby heart -dilated heart |
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What is cretinism?
a. late childhood/adult hypothyroidism b. gestational or early infancy hypothyroidism c. primary hyperthyroidism d. secondary hyperthyroidism |
B
gestational or early infancy hypothyroidism |
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Cretinism can arise from which of the following
a. lack of iodine b. excess iodine c. defects in thyroid hormone synthesis d. all of the above e. A and C f. B and C |
E - both A and C
lack of iodine defects in thyroid hormone synthesis |
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Neurologic cretinism is manifested by what 3 things?
It is caused by a. iodine deficiency in early fetal life which retards brain development b. iodine deficiency late in pregnancy or early infancy c. primary idiopathic myxedema d. impaired skeletal growth limiting brain development |
manifestations:
mental retardation spasticity deaf-mutism cause: A iodine deficiency in early fetal life which retards brain development |
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An iodine deficiency late in pregnancy or early infancy leads to hypothyroidism that usually becomes manifested by what
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-feeding difficulty
-somnolence -hoarse, low pitched cry -failure to thrive -impaired skeletal growth -dry skin -protuberant abdomen -wide set eyes -broad flat nose -enlarged tongue -periorbital puffiness |
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_______ is an autoimmune disease that characteristically presents in middle aged women as a gradual thyroid enlargement (usually painless) and is associated with insidious onset of hypothyroidism.
a. Graves' disease b. goiters c. Hashimoto thyroiditis d. myxedema |
C
Hashimoto thyroiditis |
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On inspection you note the thyroid gland is symmetrically enlarged, firm, and rubbery. Histologically you find that there is lymphoid infiltrate. What do you suspect?
a. Graves' disease b. goiters c. Hashimoto thyroiditis d. myxedema |
C
Hashmoto thyroiditis |
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Graves' disease is characterized by what 4 things?
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hyperthyroidism
moderate thyroid enlargement ocular changes localized thickening of the skin over the dorsum of the feet and legs |
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Proptosis, muscle weakness, diplopia, periorbital edema, and lid lag are all _____ associated with _____.
a. ocular changes; Hashimoto thyroiditis b. ocular changes; Graves' disease c. orbital changes; primary hypothyroidism d. orbital changes; secondary hypothyroidism |
B
ocular changes associated with Graves' disease |
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Goiters refers to
a. enlargement of the thyroid gland b. enlargement of the parathyroid glands c. a benign neoplasm of the thyroid gland d. papillary adenocarcinoma |
A
enlargement of the thyroid gland |
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____ refers to gradual painless enlargement of the thyroid due to compensatory hyperplasia secondary to defect in production/secretion of thyroid hormone.
a. diffuse non-toxic goiter b. simple goiter c. colloid goiter d. all of the above e. A and B f. B and C |
D
diffuse nontoxic goiter is the same as simple goiter or colloid goiter! |
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True or False: At the time of diagnosis of diffuse non toxic goiter, most patients thyroid function is beyond repair.
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False.
At the time of diagnosis most patients have normal thyroid function (euthyroid) |
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________ is the end result of a long-standing diffuse nontoxic goiter. It can cause thyromegaly.
a. pretibial myxedema b. Hashimoto thyroiditis c. Graves disease d. multinodular goiter |
D
multinodular goiter |
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The vast majority of benign neoplasms of the thyroid are _____ which arise from follicular epithelial cells.
a. adenomas b. papillary adenocarcinomas c. follicular carcinomas d. none of the above |
A
adenomas |
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The risk of thyroid carcinomas (malignancies) is increased by
a. goiter b. adenoma c. Hashimoto thyroiditis d. Graves' disease e. previous radiation exposure |
E
previous radiation exposure All other options are other thyroid diseases but do not appear to increase the risk. |
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The most common thyroid malignancy is
a. follicular carcinoma b. papillary adenocarcinoma c. adenomas d. none of the above |
B
papillary adenocarcinoma |
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True or False: Treatment of a papillary adenocarcinoma includes surgical removal of the entire thyroid gland even if the tumor is only identified in one lobe.
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True.
because some of these tumors are multifocal within the thyroid |
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Papillary adenocarcinomas mostly spread via _____.
a. arterial vessels b. venous vessels c. lymphatic vessels d. A or B is most common |
C
lymphatic vessels **up to 20% of patients have cervical lymph node metastases **can be hematogenous spread to the LUNGS and BONE |
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True or False: Papillary adenocarcinomas are non-tender and very slow growing.
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True.
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As a rule, papillary adenocarcinomas are mostly
a. functional b. nonfunctional c. diagnosed with poor prognosis d. benign |
B
nonfunctional |
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_______ are firm, irregular, nodular masses which grow relatively slowly.
a. papillary adenocarcinomas b. adenomas c. follicular carcinomas d. C-cell masses |
C
follicular carcinomas |
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Follicular carcinomas tend to spread ______ to distant organs (lung, bone, liver).
a. hematogenously b. through lymphatic dissemination c. by traumatic seeding d. through transcoelomic seeding |
A
hematogenously |
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The parathyroid glands function to regulate
a. calcium metabolism b. sodium metabolism c. potassium reabsorption d. all of the above |
A
calcium metabolism |
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____ causes the release of parathormone (PTH)
a. high serum levels of calcium b. low serum levels of calcium c. high serum levels of potassium d. low serum levels of sodium |
B
low serum levels of calcium |
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What are the 3 ways in which parathormone (PTH) acts to oppose low serum levels of calcium?
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increase absorption from the GI tract by activating vitamin D in the kidney
increase reabsorption of calcium from the urine increase reabsorption of calcium from bone stores |
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The C cells of the thyroid secrete _____ which opposes the activity of ______.
a. parathormone; calcitonin b. calcitonin, parathormone c. mineralocorticoids; aldosterone d. cortisol; glucocorticoids |
B
C cells secrete CALCITONIN which opposes action of PARATHORMONE (PTH) |
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______ is a condition reflected by elevated parathormone (PTH) levels even in the face of hypercalcemia and increased urine calcium excretion.
a. goiters b. hyperadrenalism c. hypoparathyroidism d. hyperparathyroidism |
D
hyperparathyroidism |
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A patient is asymptomatic but an incidental finding of an abnormal serum calcium level is identified. You suspect
a. hyperadrenalism b. hyperparathyroidism c. hyperthyroidism d. diabetes insipidus |
B
hyperparathyroidism |
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______ will lead to "stones, bones, moans, and groans" if left untreated.
a. diabetes insipidus b. hyperthyroidism c. hyperparathyroidism d. Simmond's disease What does "stones, bones, moans, and groans" imply |
C
hyperparathyroidism stones = renal stones bones = bone demineralization/osteomalacia moans = psychiatric disturbances/neurological abnormalities/muscle weakness groans = peptic ulcers/pancreatitis/abdominal pain |
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The most frequent cause of primary hyperparathyroidism is
a. parathyroid adenoma b. parathyroid hyperplasia c. ectopic production of parathormone d. hypocalcemia |
A
parathyroid adenoma (B and C - parathyroid hyperplasia and ectopic production of parathormone -can also lead to hyperparathyroidism) |
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_____ is characterized by low parathormone (PTH) and hypocalcemia.
a. diabetes insipidus b. Graves' disease c. hypothyroidism d. hypoparathyroidism |
D
hypoparathyroidism |
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What are the 6 clinical symptoms of hypoparathyroidism?
|
weakness
paresthesias tetany (muscle cramps) cataracts headache abdominal pain |
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The outer zone of the adrenal cortex produces _______.
a. androgenic steroids (testosterone) b. androgenic steroids (aldosterone) c. glucocorticoids (cortisol) d. mineralocorticoids (aldosterone) |
D
mineralocorticoids (aldosterone) |
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The mineralocorticoid aldosterone acts to
a. regulate extracellular fluid volume and metabolism b. increase appetite and promote fat deposition c. increase protein breakdown and promote masculinization d. all of the above What effects does this have on the kidney? (2) |
A
regulate extracellular fluid volume and potassium metabolism effects on kidney: -retention of sodium and water -secretion of potassium |
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The inner zone of the adrenal cortex produces
a. mineralocorticodes (aldosterone) b. glucocorticoids (cortisol) c. androgenic steroids (testosterone) d. A and B e. A and C f. B and C |
F - B and C
glucocorticoids (cortisol) and androgenic steroids (testosterone) |
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The glucocorticoid cortisol
a. acts to regulate potassium metabolism b. increases appetite and promotes fat deposition c. increases protein breakdown d. impairs the inflammatory and immunologic responses e. A and C only f. B, C, and D g. all of the above |
F - B, C, and D
increase appetite and promote fat deposition in the face, neck, and trunk; increase protein breakdown; and impair the inflammatory and immunologic responses. |
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The androgenic steroid testosterone
a. promotes potassium metabolism b. promotes masculinization c. decreases calcium retention d. B and C e. all of the above |
B
promotes masculinization |
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Cortisol and androgens are secreted
a. in response to pituitary ACTH b. in response to increasing serum cortisol c. in response to excess potassium d. cyclically throughout the day |
A
in response to pituitary ACTH |
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If a patient has excess mineralocorticoids, glucocorticoids, or androgens then they can be diagnosed with
a. Graves' disease b. hyperadrenalism c. papillary adenocarcinoma d. diffuse nontoxic goiter |
B
hyperadrenalism |
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Primary hyperaldosteronism is an excess of ______ and is known as ______.
a. glucocorticoids; Cushing syndrome b. androgens; adrenogenital syndromes c. mineralocorticoids; Conn syndrome d. mineralocorticoids; Addison disease |
C
mineralocorticoids; Conn syndrome |
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A 40 year old female patient presents with moderate hypertension and reports chronic fatigue and weakness. She came in with cardiac arrhythmia and you suspect it is due to hypokalemia. What does this patient have?
a. Addison disease b. Graves' disease c. Conn syndrome d. Cushing syndrome |
C
Conn syndrome |
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The most common cause of Conn syndrome is
a. an aldosterone-secreting cortical adenoma b. overstimulation by the pituitary c. deficiency in potassium d. low serum ACTH |
A
an aldosterone-secreting cortical adenoma |
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An excess of glucocorticoids is known as ____ and is a type of _____.
a. Addison disease; hypoadrenalism b. Diabetes mellitus; pancreas abnormality c. Diabetes insipidus; hyperparathyroidism d. Cushing syndrome; hyperadrenalism |
D
Cushing syndrome; hyperadrenalism |
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________ is characterized by moon facies, buffalo hump, truncal obesity, purple abdominal stria, hirsutism, menstrual disorders, emotional lability, easy bruisability, susceptibility to infection, impaired glucose tolerance, muscle weakness, osteoporosis, etc.
a. Simmond's disease b. Graves' disease c. Conn syndrome d. Cushing syndrome |
D
Cushing syndrome |
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Primary hypercortisolism (Cushing syndrome) is associated with
a. a low serum ACTH b. a high serum GH c. a low serum TSH d. a low serum PTH |
A
a low serum ACTH |
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Secondary hypercortisolism (Cushing disease) is associated with
a. low serum calcium b. high serum ACTH c. high serum PTH d. low serum calcitonin |
B
high serum ACTH |
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Cushing syndrome (NOT Cushing disease) is due to either _____ or ______.
a. an autosomal recessive disorder or excessive calcitonin b. untreated diabetes mellitus or untreated diabetes insipidus c. a cortisol secreting cortical neoplasm or bilateral nodular hyperplasia d. an ACTH producing pituitary adenoma or ectopic production of calcitonin |
C
can be due to either a cortisol secreting cortical neoplasm or bilateral nodular hyperplasia |
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Cushing disease (NOT Cushing syndrome) is due to _____ or _____.
a. an autosomal recessive disorder or excessive calcitonin b. untreated diabetes mellitus or untreated diabetes insipidus c. a cortisol secreting cortical neoplasm or bilateral nodular hyperplasia d. an ACTH producing pituitary adenoma or ectopic production of ACTH |
D
can be due to either an ACTH producing pituitary adenoma or ectopic production of ACTH |
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Cushing disease generally leads to either ____ or ____.
a. bilateral diffuse or nodular adrenal cortical hyperplasia b. a cortisol secreting cortical neoplasm or bilateral nodular hyperplasia c. an autosomal recessive disorder or excessive calcitonin d. Addison disease or Addisonian crisis |
A
bilateral diffuse or nodular adrenal cortical hyperplasia |
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_________ are inherited autosomal recessive disorders which affect the activity of enzymes in the steroidogenesis pathway.
a. adrenogenital syndromes b. Conn syndromes c. diabetes syndromes d. hypoadrenalism syndromes |
A
adrenogenital syndromes |
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Adrenogenital syndromes affect the activity of various enzymes in the steroidogenesis pathway and result in
a. Conn syndrome b. Simmond's disease c. congenital adrenal hyperplasia d. secondary adrenocortical insufficiency |
C
congenital adrenal hyperplasia |
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Metabolic defects associated with adrenogenital syndromes block the production of _____ . This eliminates the negative feedback on the pituitary to increase the serum _____.
a. ACTH; calcitonin b. cortisol; ACTH c. glucagon; somatostatin d. insulin; glucagon |
B
blocks cortisol increasing serum ACTH by eliminating negative feedback on pituitary |
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Metabolic defects associated with adrenogenital syndromes lead to
a. Addison disease b. hypotension c. bilateral diffuse or nodular hyperplasia d. an ACTH producing pituitary adenoma |
C
bilateral diffuse or nodular hyperplasia |
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Androgen secreting cortical tumors can arise from _____ and can lead to precocious puberty in boys or masculinization in girls.
a. primary chronic adrenocortical deficiency b. acute adrenal insufficiency c. diabetes insipidus d. adrenogenital syndromes |
D
adrenogenital syndromes |
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Primary chronic adrenocortical insufficiency is called ______ and is a type of _____.
a. Cushing syndrome; hyperadrenalism b. Addisonian crisis; diabetes c. Gastrinoma; hypoparathyroidism d. Addison disease; hypoadrenalism |
D
called Addison disease type of hypoadrenalism |
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_________ results from any chronic destructive process that destroys more than 90% of the adrenal cortex.
a. diabetes insipidus b. Addison disease c. Graves' disease d. Conn syndrome |
B
Addison disease |
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Clinically, _____ involves a slow onset of weakness and fatigue, anorexia, weight loss, nausea and vomiting, diarrhea/constipation, hypotension, and hyperpigmentation of skin.
a. Addison disease b. Cushing disease c. Diabetes mellitus d. Conn syndrome |
A
Addison disease |
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______ is the result of decreased ACTH secretion from the pituitary.
a. Sheehan syndrome b. secondary adrenocortical insufficiency c. bitemporal hemianopsia d. neurologic cretinism |
B
secondary adrenocortical insufficiency |
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The differences in symptoms between primary and secondary adrenocortical insufficiency are that patients with secondary _______ and the other clinical features are _____.
a. lack hypotension; more striking b. lack constipation/diarrhea; more striking c. lack hyperpigmentation; less striking d. lack weight loss; less striking |
C
lack hyperpigmentation other features are less striking |
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______ is a life threatening situation which may be the result of sudden stress in patients with Addison disease.
a. acute adrenal insufficiency b. secondary adrenocortical insufficiency c. Addison disease d. A and C When this condition is caused in this manner, it is called what? |
A
acute adrenal insufficiency **acute adrenal insufficiency caused by this is known as Addisonian crisis |
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The abrupt withdrawal of exogenous steroids may result in
a. diabetes mellitus b. Sheehan syndrome c. Graves' disease d. acute adrenal insufficiency |
D
acute adrenal insufficiency |
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A patient presents to the ER with symptoms of hypotension, shock, and vascular collapse. You diagnose the patient with
a. gastrinoma b. diabetes insipidus c. secondary adrenocortical insufficiency d. acute adrenal insufficiency |
D
acute adrenal insufficiency |
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The islets of Langherhans are made up of
a. alpha cells b. beta cells c. delta cells d. all of the above e. A and B only |
D
all of the above |
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Alpha cells of the islets of Langerhans secrete
a. somatostatin b. glucagon c. insulin d. calcitonin |
B
glucagon |
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Which of the following is true regarding the function of glucagon?
a. inhibits utilization of glucose by body tissues b. promotes utilization of glucose by body tissues c. inhibits insulin and glucose release d. stimulates reuptake of seritonin |
A
inhibits utilization of glucose by body tissues |
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Beta cells of the islets of Langerhans secrete
a. somatostatin b. glucagon c. insulin d. calcitonin |
C
insulin |
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Which of the following is true regarding the function of insulin?
a. inhibits utilization of glucose by body tissues b. promotes utilization of glucose by body tissues c. inhibits insulin and glucose release d. stimulates reuptake of seritonin |
B
promotes utilization of glucose by body tissues |
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Delta cells of the islets of Langerhans secrete
a. glucagon b. seritonin c. insulin d. somatostatin |
D
somatostatin |
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Which of the following is true regarding the function of somatostatin?
a. inhibits utilization of glucose by body tissues b. promotes utilization of glucose by body tissues c. inhibits insulin and glucose release d. stimulates reuptake of seritonin |
C
inhibits insulin and glucose release |
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The most common endocrine disease in the US is
a. diabetes mellitus b. diffuse nontoxic goiter c. human papilloma virus d. acute adrenal insufficiency |
A
diabetes mellitus |
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Which of the following is false regarding insulin.
a. it is an anabolic hormone involved in carbohydrate metabolism b. it is involved in protein and lipid metabolism c. its primary role is to increase the rate of glucagon transport into fibroblasts, adipose cells, and striated muscle d. it is involved in the re-uptake of seritonin by the islets of Langerhans |
D
it is NOT involved in re-uptake of seritonin (at least the syllabus don't say so!) |
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Which of the following is false regarding insulin?
a. it functions to promote glycogen formation in the liver and skeletal muscle b. it inhibits the utilization of somatostatin c. it functions to convert glucose to triglycerides d. it promotes nucleic acid and protein synthesis which stimulates cell growth and differentiation |
B
it does NOT inhibit the utilization of somatostatin (at least the syllabus don't say so!) |
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The primary stimulus for the synthesis and release of insulin is
a. hyperglycemia b. adrenal insufficiency c. ACTH promotion d. low serum glucagon |
A
hyperglycemia |
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True or False: Hyperglycemia is a COMMON feature of diabetes mellitus.
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True
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Type I diabetes mellitus is also known as which of the following? (Pick 2)
a. adult onset b. insulin dependent c. juvenile onset d. non-insulin dependent |
B and C
Type I diabetes mellitus is juvenile onset and is insulin dependent |
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Type I diabetes is the result of
a. end organ resistance to the effect of insulin b. kidney disease c. excess insulin production d. inadequate production of insulin |
D
inadequate production of insulin |
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You've been working with a patient who has retinal damage, kidney damage, vascular disease, and often suffers from infections. You note that he also has ketoacidosis. This patient has
a. acute adrenal insufficiency b. type I diabetes c. hypothyroidism d. Sheehan syndrome |
B
type I diabetes |
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A patient has a genetic predisposition to developing cytotoxic T cells and autoantibodies of beta cells. You examine his pancreas and note that the mass of and number of his beta cells in the pancreatic islets are reduced. This patient has
a. diabetes mellitus type I b. diabetes mellitus type II c. diabetes insipidus d. any of the above are possible |
A
diabetes mellitus type I |
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The most frequent cause of death in patients with type I diabetes mellitus is
a. ketoacidosis b. vascular disease c. kidney damage d. infection |
C
kidney damage (all are health problems associated with type I) |
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Type II diabetes mellitus is
(pick 2) a. juvenile onset b. adult onset c. non-insulin dependent d. insulin dependent |
B and C
adult onset and non-insulin dependent |
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Type II diabetes mellitus is ______ (by far) than type I.
(more or less common?) |
more common
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Type II diabetes patients
a. likely had no genetic predisposition to the disease b. are generally average weight c. never exhibit a delay in insulin secretion from beta cells d. exhibit an end-organ resistance to the effects of insulin |
D
exhibit an end-organ resistance to the effects of insulin |
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True or False: Obesity hampers insulin action only in diabetics.
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False
Obesity hampers insulin action EVEN in non-diabetics. |
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Which of the following is not a major problem associated with type II diabetes mellitus?
a. cardiovascular disease b. kidney disease c. nerve damage d. cataracts e. all of the above are associated problems |
E
all are associated problems |
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The most common islet cell tumor is
a. gastrinoma b. adenoma c. insulinoma d. zeta cell tumor |
C
insulinoma (this is a beta cell tumor) |
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Which of the following is false regarding an insulinoma?
a. symptoms are related to hypoglycemic episodes that are temporally related to periods of high glucose utilization b. patients develop fluid and electrolyte disturbances c. they cause stupor and loss of consciousness d. they can be aborted by administration of glucose |
B is NOT TRUE
patients who develop fluid and electrolyte disturbances are those with a gastrinoma |
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____ are tumors which are associated with gastric acid hypersecretion and resultant intractable peptic ulceration of the duodenum, stomach, and jejunum.
a. insulinoma b. adenoma c. acromeganoma d. gastrinoma |
D
gastrinoma |
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Patients with a gastrinoma may have gastric acid hypersecretion and resultant intractable peptic ulceration of duodenum, stomach, and jejunum. These symptoms may be diagnosed as
a. Zollinger-Ellison syndrome b. Sheehan syndrome c. pituitary dwarfism d. diabetes insipidus |
A
Zollinger-Ellison syndrome |
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A patient presents with fluid and electrolyte disturbance secondary to diarrhea and malabsorption. He also has peptic ulcers in his stomach. This patient has
a. a gastrinoma b. an insulinoma c. diabetes insipidus d. type II diabetes |
A
a gastrinoma |
