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Pituitary/Adrenal

BOC Pages 107-112

QuestionAnswer
217. The recommended initial thyroid function test for either a healthy, asymptomatic patient or a patient with symptoms which may be related to a thyroid disorder is: A) Free thyroxine(free T4) B) Thyroid-stimulating hormone(TSH) C) Total Thyroxine( B) TSH is the American Thyroid Association's recommended screening test.
218. The screening test for congenital hypothyroidism is based upon: A) TSH level in newborn B) Thyroid-binding globulin level in the newborn C) iodine level in the newborn D) total thyroxine(T4) level in the newborn D) Neonates are screened using total thyroxine(T4)
219. Which of the following sets are consistent with primary hypothyroidism(Hashimoto thyroiditis) A) decreased TSH, decreased T4, positive antimicrosomal antibody B) increased TSH, increased T4, positive antimicrosomal antibody C) normal TSH, decrea D) in Hashimoto thyroiditis or primary hypothyroidism; TSH levels are increased, T4 levels are decreased, and antimicrosomal antibodies are positive.
224. In amniotic fluid, the procedure used to detect hemolytic disease of the newborn is: A) measurement of absorbance at 450nm B) creatinine C) lecithin/sphingomyelin ratio D) estriol A) The procedure, "change in absorbance of amniotic fluid at 450nm" is used to detect hemolytic disease of newborns(HDN)
225. During a normal pregnancy, quantitative human chorionic gonadotropin (HCG) level peaks how many weeks after the last menstrual period? A) 2-4 B) 8-10 C) 14-16 D) 18-20 B) Serum HCG levels peak at 8-10 weeks
227. Which of the following steroids is an adrenal cortical hormone? A) angiotensinogen B) aldosterone C) epinephrine D) growth hormone B) Aldosterone is a hormone produced by the adrenal cortex.
228. What common substrate is used in the biosynthesis of adrenal steroids, including androgens and estrogens? A) cortisol B) catecholamines C) progesterone D) cholesterol D) All adrenal steroid hormones are enzymatically derived from cholesterol.
230. Plasma for cortisol determinations were collected at 7AM, after waking the patient, and at 10PM that evening, the cortisol level of the morning sample was higher than the evening sample. This is consistent with: A) a normal finding B) Cushing syn A) the normal variation of serum cortisol is higher at 8AM than 4PM.
231. Night blindness is associated with the deficiency of which of the following vitamins? A) A B) C C) niacin D) thiamine A) A deficiency of vitamin A leads to night blindness and if prolonged, total blindness.
232. Berberi is associated with deficiency of vitamin: A) A B) C C) niacin D) thiamine D) A deficiency of thiamine(vitamin B1) known as berberi, may be seen with chronic alcoholism in the U.S.
233. Scurvy is associated with deficiency of which of the following vitamins? A) A B) C C) niacin D) thiamine B) A deficiency of ascorbic acid(vitamin C) is called scurvy.
234. Rickets is associated to deficiency of which of the following vitamins? A) B1 B) C C) niacin D) D D) a deficiency in vitamin D leads to rickets in children.
235. Pellagra is associated with deficiency of which of the following vitamins? A) A B) B1 C) thiamine D) niacin D) a deficiency of niacin may be seen with chronic alcoholism, and is known pellagra.
236. The major action of angiotensin II is: A) increased pituitary secretion of vasopressin B) increased vasoconstriction C) increased parathormone secretion by the parathyroid D) decreased adrenal secretion of aldosterone B) Angiotensin II is a vasoconstrictor and stimulates the adrenal cortex to produce aldosterone.
237. The urinary excretion product measured as an indicator of epinephrine production is: A) dopamine B) dihydroxyphenylalanine (DOPA) C) homovanillic acid D) vanillylmandelic acid (VMA) D) Vanillylmandelic acid (VMA) is the major metabolite of epinephrine and norepinephrine. VMA is measured in a 24 hour urine.
238. Which of the following hormones regulates normal blood calcium levels? A) thyroxine B) estriol C) parathyroid hormone D) growth hormone C) Parathyroid hormone(PTH) and the hormone vitamin D play a dominant role in calcium regulation.
240. A diagnosis of primary adrenal insufficiency requires demonstration of: A) decreased urinary 17-keto- and 17-hydroxysteroids B) decreased cortisol production C) impaired response to ACTH stimulation D) increased urinary cortisol excretion after C) ACTH stimulation tests, using synthetic ACTH, will differentiate primary from secondary adrenal insufficiency. Synthetic ACTH will not cause the adrenal gland to respond in primary insufficiency.
241. The screen for adrenal cortical hyperfunction with the greatest sensitivity and specificity is: A) 24 hour urine free cortisol B) plasma cortisol C) urinary 17-hydroxycorticosteroids D) plasma costicosterone A) the 24 hour urine free cortisol is the most sensitive and specific screen for hypercorticolism.
244. Which of the following sample collections would give an accurate assessment of potential excess cortisol production(hypercorticolism)? A) Collect a plasma sample as a baseline, and another one hour after administration of metyrapone B) collect a C) Due to circadian variation, the 24 hour UFC is an accurate measurement of active forms of cortisol.
246. Aldosterone is released by the adrenal cortex upon stimulation by: A) renin B) angiotensinogen C) angiotensin I D) angiotensin II D) Angiotensin II directly stimulates the adrenal cortex to release aldosterone.
248. Clinical assays for tumor markers are most important for: A) screening for the presence of cancer B) monitoring the course of a known cancer C) confirming the absence of disease D) identifying patients at risk for cancer B) Tumor markers are useful for monitoring therapy, detecting recurrence and aiding in prognosis of tumors, but are not useful for screening the general public for cancer.
249. Detection of which of the following substances is most useful to monitor the course of a patient with testicular cancer? A) alpha-fetoprotein B) carcinoembryonic antigen C) prolactin D)testosterone A) Most testicular tumors are germ cell tumors which are characterized by elevated serum levels of alpha-fetoprotein(AFP). Measurement of serum AFP is used in diagnosis, therapy, and follow-up of testicular cancer. The carcinoembryonic antigen is a marker
250. Increased concentrations of alpha-fetoprotein(AFP) in adults are most characteristically associated with: A) hepatocullular carcinoma B) alcoholic cirrhosis C) chronic active hepatitis D) multiple myeloma A) Alpha-fetoprotein(AFP) is an oncofetal glycoprotein marker for hepatocellular carcinoma. Elevated levels of AFP(<200ug/L) are seen in hepatitis and cirrhosis. However in hepatocellular carcinoma, the levels can be greater than 1,000ug/L.
251. Carcinoembryonic antigen (CEA) is most likely to be produced in a malignancy involving the: A) bone B) testes C) bone) D) colon D) the carcinoembryonic antigen (CEA) is a marker for colon, gastrointestinal and lung cancer. Elevated serum levels of CEA are primarily seen with colon cancer. Although the levels may be increased in individuals with benign conditions, the level of CEA
252. Which of the following is useful in the detection and management of carcinoma of the prostate? A) total prostate-specific antigen B) prostatic acid phosphatase C) human chorionic gonadotropin D) alpha-fetoprotein 252. tPSA along with DRE is the recommended screen for prostate cancer in males over 50 years of age.
253. Which of the following statement most correctly describes the utility of clinical laboratory assays for tumor markers? A) Useful to screen asymptomatic patients for tumors B) highly specific C) indicate the likelyhood of an individual developing a D) Tumor markers are good for monitoring therapy(tracking the efficacy of treatment) and recurrence of tumors.
254. Cancer antigen 125 (CA 125) is a tumor marker associated with: A) breast carcinoma B) colon cancer C) lung cancer D) ovarian and endometrial carcinoma D) CA 125 is elevated in 80% of epithelial cell ovarian cancer.
255. In addition to carcinoma of the prostate, elevated prostate-specific antigen (PSA) can occur due to: A) aspirin therapy B) exogenous steroid use C) benign prostatic hyperplasia D) statin therapy(cholesterol lowering drug) C) PSA can be elevated due to benign prostatic hyperplasia (BPH)
134. Urobilinogen is formed in the: A) kidney B) spleen C) liver D) intestine D) intestine
142. Kernicterus is an abnormal accumulation of bilirubin in: A) heart tissue B) brain tissue C) liver tissue D) kidney tissue B) brain tissue
ch22 #11. A deficiency in estrogen during the follicular phase will result in: An incomplete development of the endometrium.
ch22 #12. Which hormone is responsible for an increase in body temperature at the time of ovulation? ESTRADIOL
ch22 #13. A mid-cycle LH surge will stimulate which series of events? An increase in FSH.
ch21 #11. Which amino acid is needed for the biosynthesis of epinephrine and norepinephrine? Phenylalanine
ch20 #10. What is the difference between a tropic hormone and a direct effector hormone? Tropic hormones act on endocrine glands while direct effector hormones act on peripheral tissues.
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