Endocrine Feedback Quiz: Test Your Hormone Knowledge

Answer the following multiple-choice questions. There is no time limit, and you may save and return to your work as many times as you need to before submitting the worksheet. But you may submit this worksheet only once. Flag question: Question 1 Question 1 1 pts Open-loop negative feedback refers to the phenomenon of Group of answer choices Blood flow in the hypothalamic–hypophyseal portal system Blood flow to the pituitary via dural-penetrating vessels Negative feedback involving an unvarying, fixed set point Negative feedback with a modifiable set point Flag question: Question 2 Question 2 1 pts The specific feedback effector for FSH is Group of answer choices Activin Inhibin Estradiol Progesterone Flag question: Question 3 Question 3 1 pts Which anterior pituitary hormone lacks a stimulatory hypophysiotropic hormone? Group of answer choices ACTH Prolactin Vasopressin Growth hormone

Flag question: Question 4 Question 4 1 pts The definitive suppression test to prove autonomous production of growth hormone is Group of answer choices Dexamethasone suppression Somatostatin infusion Estrogen priming Oral glucose loading Flag question: Question 5 Question 5 1 pts Which of the following is influenced by growth hormone? Group of answer choices Lipolysis All of these IGFBP-III IGF-I Flag question: Question 6 Question 6 1 pts What statement concerning vasopressin secretion is true? Group of answer choices A reduction in effective blood volume overrides the effects of plasma osmolality in regulating vasopressin secretion. Changes in blood volume also alter vasopressin secretion. All of these. Vasopressin secretion is closely tied to plasma osmolality. Flag question: Question 7 Question 7 1 pts What are the long-term sequelae of untreated or partially treated acromegaly? Group of answer choices Increased muscle strength An increased risk of colon and lung cancer Enhanced longevity A reduced risk of heart disease

Flag question: Question 8 Question 8 1 pts TRH stimulates the secretion of Group of answer choices Prolactin and TSH Growth hormone TSH Prolactin Flag question: Question 9 Question 9 1 pts Estrogen influences the secretion of which of the following hormones? Group of answer choices Prolactin All of these Luteinizing hormone Growth hormone Flag question: Question 10 Question 10 1 pts What is the difference between a tropic hormone and a direct effector hormone? Group of answer choices Tropic hormones act on endocrine glands, while direct effector hormones act on peripheral tissues. Tropic hormones act on peripheral tissue, while direct effector hormones act on endocrine glands. Tropic and direct effector hormones are both similar in that both act directly on peripheral tissue. Tropic and direct effector hormones are both similar in that both act directly on another endocrine gland. Flag question: Question 11 Question 11 1 pts A deficiency in vasopressin can lead to which of the following? Group of answer choices Euvolemic hypokalemia Diabetes insipidus Euvolemic hyponatremia Primary hypothyroidism

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Flag question: Question 12 Question 12 1 pts Which of the following hormones stimulate prolactin secretion? Group of answer choices Dopamine TSH GnRH TRH Flag question: Question 13 Question 13 1 pts Which hormone most directly stimulates testosterone secretion? Group of answer choices GnRH TRH LH FSH Flag question: Question 14 Question 14 1 pts Concerning secretion of growth hormone, which of the following is NOT true? Group of answer choices Secretion is stimulated by GHRH. The most reproducible surge is at the onset of sleep. Secretion is pulsatile, occurring usually 2 to 3 times daily. It is secreted from somatotrophs that constitute over one-third of normal pituitary weight. Flag question: Question 15 Question 15 1 pts Familial acromegaly is most likely caused by a mutation in which gene? Group of answer choices SS receptor type 5 AIP GNAS GHRH gene Flag question: Question 16

Question 16 1 pts Cosecretion of which hormone is most commonly seen with acromegaly? Group of answer choices FSH Prolactin TSH ACTH Flag question: Question 17 Question 17 1 pts Which hormone is not secreted from the anterior pituitary? Group of answer choices Oxytocin FSH Prolactin TSH Flag question: Question 18 Question 18 1 pts Which of the following is most suggestive of a diagnosis of diabetes insipidus? Group of answer choices Elevated serum osmolarity and decreased urine osmolarity with urinary hypernatremia Low sodium in a patient who reports polydipsia and polyuria. Hyponatremia after a therapeutic trial of dDAVP Persistent complaint of polydipsia and polyuria in a patient without diabetes mellitus Flag question: Question 19 Question 19 1 pts Vasopressin release is regulated by which of the following? Group of answer choices Hypothalamic osmoreceptors Hypothalamic osmoreceptors and vascular baroreceptors V2 receptors in the kidney Vascular baroreceptors

Flag question: Question 20 Question 20 1 pts Replacement of thyroxine is potentially dangerous in the setting of which other hormonal abnormality? Group of answer choices ACTH deficiency Hyperprolactinemia GH deficiency Perimenopausal state Flag question: Question 21 Question 21 1 pts Which of the following is NOT generally considered to be a function of oxytocin? Group of answer choices Enhancement of mother–infant bonding Uterine contraction during labor Enhancement of insulin sensitivity in smooth muscle Milk "letdown" for breast-feeding Flag question: Question 22 Question 22 1 pts Which clinical presentation is consistent with Kallmann's syndrome? Group of answer choices Hypogonadism with the absence of smell Hypothyroidism and intermittent severe weakness or paralysis ACTH deficiency together with GH excess Hyperprolactinemia in the setting of pregnancy Flag question: Question 23 Question 23 1 pts Which drug may cause panhypopituitarism? Group of answer choices Pitocin Risperdal Ipilimumab Cabergoline

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Flag question: Question 24 Question 24 1 pts Which of the following is unlikely to be a cause of hyperprolactinemia? Group of answer choices Pituitary stalk interruption Primary hypothyroidism Primary hypogonadism Metoclopramide Flag question: Question 25 Question 25 1 pts When considering an endocrine cause for a patient's hypertension, the ______ is the usual suspect. Group of answer choices Liver Parathyroid Gland Lungs Adrenal gland Flag question: Question 26 Question 26 1 pts When hypertension results from an endocrine disorder, what hormonal state is usually found? Group of answer choices hormone underproduction hormone overproduction Flag question: Question 27 Question 27 1 pts True or false? Major warning signs of adrenal disease include abnormal blood pressure, abnormal electrolytes (potassium, acid–base status, urine dilution), and unexplained weight change. Group of answer choices True False

Flag question: Question 28 Question 28 1 pts ___________ is the common substrate from which all adrenal steroids are produced. Group of answer choices Cortisol Testosterone Glucose Cholesterol Flag question: Question 29 Question 29 1 pts True or false? When produced, free catecholamines (NE and EPI) are short- lived. They are best measured in the urine, though catecholamine metabolites are best measured in the serum. Group of answer choices True False Flag question: Question 30 Question 30 1 pts Catecholamines are produced in the adrenal____________ . Group of answer choices Zona Reticularis Medulla Zona Fasciculata Zona Glomerulosa Flag question: Question 31 Question 31 1 pts A primary hyperaldosteronemic state is characterized by: Group of answer choices A spot urine test where the sodium levels are greater than potassium levels A urine potassium of 35 mmol/d Within 3 hours of taking 50 mg of captopril, plasma aldosterone was low A urine potassium of 21 mmol/d All of these reasons are characteristic of hypoaldosteronism

Flag question: Question 32 Question 32 1 pts During a low-dose (1 mg) dexamethasone suppression test, total cortisol levels measured in a patient at 8:35 a.m. was 1.7 µg/dL. How is this interpreted? Group of answer choices The patient has Cushing's syndrome. The patient has a nonpituitary tumor causing ectopic ACTH syndrome. The patient has an ACTH-secreting pituitary adenoma. The patient is normal. Flag question: Question 33 Question 33 1 pts The most biologically active androgen in this list is: Group of answer choices LH FSH Estrone DHEA Testosterone Flag question: Question 34 Question 34 1 pts Which amino acid is needed for the biosynthesis of norepinephrine and epinephrine? Group of answer choices Serine Leucine Phenylalanine Alanine Isoleucine Flag question: Question 35 Question 35 1 pts Which of the following describes catecholamines? Group of answer choices Circulating blood catecholamines are 99% bound to albumin. Degraded rapidly in nonneuronal cells by monoamine reductase None of these answers accurately describes catecholamines. Have long half-lives Hydrophobic

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Flag question: Question 36 Question 36 1 pts The collection of a 24-hour urine is used for measuring: Group of answer choices All of these answers may be measured in a 24-hour urine Norepinephrine Dopamine Creatinine clearance All but one of these answers may be measured in a 24-hour urine Flag question: Question 37 Question 37 1 pts If serum levels of estradiol do not increase after injection of hCG, the patient has Group of answer choices Pituitary failure Secondary ovarian failure Primary ovarian failure Tertiary ovarian failure Flag question: Question 38 Question 38 1 pts If a patient had a luteal phase defect, which hormone would most likely be deficient? Group of answer choices FSH hCG Prolactin Estrogen Progesterone Flag question: Question 39 Question 39 1 pts Which of the following is the precursor for estradiol formation in the placenta? Group of answer choices Fetal adrenal DHEAS Maternal testosterone Placental hCG Maternal progesterone

Fetal adrenal cholesterol Flag question: Question 40 Question 40 1 pts Which of the following target tissues is incapable of producing steroidal hormones? Group of answer choices Ovary Adrenal medulla Testis Placenta Adrenal cortex Flag question: Question 41 Question 41 1 pts The parent substance in the biosynthesis of androgens and estrogens is Group of answer choices Progesterone Cholesterol Cortisol Catecholamines Flag question: Question 42 Question 42 1 pts The biologically most active, naturally occurring androgen is Group of answer choices Testosterone DHT Epiandrosterone Androstenedione Flag question: Question 43 Question 43 1 pts For the past 3 weeks, serum estriol levels in a pregnant woman have been steadily increasing. This is consistent with Group of answer choices Fetal death A normal pregnancy Hemolytic disease of the newborn Congenital cytomegalovirus infection

Flag question: Question 44 Question 44 1 pts Which of the following is secreted by the placenta and used for the early detection of pregnancy? Group of answer choices FSH LH Progesterone hCG Flag question: Question 45 Question 45 1 pts Androgen secretion by the testes is stimulated by Group of answer choices LH FSH Testosterone Gonadotropins Flag question: Question 46 Question 46 1 pts A deficiency in estrogen during the follicular phase will result in Group of answer choices An incomplete development of the endrometrium A lack of graafian follicle release from the ovary An increased length of the menstrual cycle A failure of embryo implantation Flag question: Question 47 Question 47 1 pts Which hormone is responsible for an increase in body temperature at the time of ovulation? Group of answer choices LH FSH Progesterone Estradiol Estrogen

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Flag question: Question 48 Question 48 1 pts A midcycle LH surge will stimulate which series of events? Group of answer choices Anovulation An increase in FSH A decrease in progesterone production A decrease in FSH Amenorrhea Flag question: Question 49 Question 49 1 pts All of the following statements about iodine are true EXCEPT Group of answer choices RAIU is often useful in determining the cause of thyrotoxicosis. Iodine deficiency is one of the most common causes of hypothyroidism in the world. Radioactive iodine treatment of Graves' disease is effective in less than 40% of patients treated with this agent. T 4 has four iodine atoms. Flag question: Question 50 Question 50 1 pts The fetus Group of answer choices Is dependent on thyroid hormone for normal neurologic development Is not susceptible to damage from radioactive iodine therapy given to the mother Does not develop a thyroid gland until the third trimester Will be born with hypothyroidism in approximately 1 of 400 births in developed countries Flag question: Question 51 Question 51 1 pts The thyroid gland Group of answer choices Depends on TPO to permit the joining of two DIT residues to form T3 Depends on TPO to permit iodination of the tyrosyl residues to make MIT and DIT Is an ineffective iodine trap Usually functions independent of TSH levels

Flag question: Question 52 Question 52 1 pts The thyroid gland produces all of the following EXCEPT Group of answer choices T 4 Thyroglobulin T 3 TSH Flag question: Question 53 Question 53 1 pts Hypothyroidism is generally associated with all of the following EXCEPT Group of answer choices TPO antibodies Depression TSH receptor antibodies An elevation of TSH levels Flag question: Question 54 Question 54 1 pts A 34-year-old woman presents with goiter, tachycardia, and weight loss of 2 months duration. TSH is undetectable and free T 4 is high. All of the following tests are useful in diagnosing the cause of the hyperthyroidism EXCEPT Group of answer choices RAIU FNA biopsy of the thyroid gland TSH TSH receptor antibodies Flag question: Question 55 Question 55 1 pts A 65-year-old woman presents with fatigue, hypothermia, pericardial effusions, and hair loss. Her thyroid function tests show a significantly elevated TSH and a low free T 4 . All of the following laboratory test abnormalities may be associated with her underlying condition EXCEPT Group of answer choices Elevated WBC An elevated cholesterol level Anemia

Elevated CPK levels Flag question: Question 56 Question 56 1 pts A 26-year-old man presents with a 3-cm, right lobe, thyroid nodule and a normal TSH. What is the next test that should be performed? Group of answer choices Thyroid scan Free T 4 level Thyroid ultrasound FNA of the nodule Flag question: Question 57 Question 57 1 pts The following are treatment options for hyperthyroidism associated with Graves' disease EXCEPT Group of answer choices Radioactive iodine PTU Thyroid hormone Beta-blockers Flag question: Question 58 Question 58 1 pts All of the following abnormalities might be expected in a severely ill patient EXCEPT Group of answer choices Low TSH Low rT 3 Low T 3 Low T 4 Flag question: Question 59 Question 59 1 pts Of the following thyroid hormones, which is considered the most biologically active? Group of answer choices Free T 3 T 3 bound to TBG Free T 4

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T 4 bound to TBG rT 3 Flag question: Question 60 Question 60 1 pts The primary serum test to screen for thyroid disease is Group of answer choices rT 3 Total T 4 TSH Free T 4 Autoimmune antibodies to thyroid tissue Flag question: Question 61 Question 61 1 pts Of the following, which will MOST likely interfere with quantitation of thyroglobulin? Group of answer choices Thyroid peroxidase antibodies Thyroid-stimulating antibodies Antithyroglobulin autoantibodies TSH receptor antibodies Flag question: Question 62 Question 62 1 pts True or false? PTH and 1,25(OH) 2 D (vitamin D) are the principal hormones involved in the normal physiologic regulation of calcium homeostasis. Group of answer choices True False Flag question: Question 63 Question 63 1 pts The primary organs involved in the maintenance of calcium homeostasis are the intestine, __________, and kidney. Group of answer choices Pancreas Bone Skin Liver

Flag question: Question 64 Question 64 1 pts Skin, _________, and kidneys are involved in the production of the active metabolite of vitamin D. Group of answer choices Pancreas Bone Liver Skin Flag question: Question 65 Question 65 1 pts True or false? Cod liver oil is a source of vitamin D. Group of answer choices True False Flag question: Question 66 Question 66 1 pts True or false? 1,25(OH) 2 D is the best blood test for determining adequacy of vitamin D stores in the body. Group of answer choices True False Flag question: Question 67 Question 67 1 pts True or false? PTHrP is produced by some cancers and often leads to cancer- associated hypercalcemia. Group of answer choices True False

Flag question: Question 68 Question 68 1 pts Hypervitaminosis may result from aberrant production of 1,25(OH) 2 D due to extrarenal 1-alpha-hydroxylase activity, leading to hypercalcemia. Group of answer choices True False Flag question: Question 69 Question 69 1 pts In primary hyperparathyroidism, the defect primarily lies in ___________. In secondary hyperparathyroidism, the defect primarily lies with the thread of _________ to the body. Group of answer choices Pituitary; hypercalcemia Parathyroids; hypercalcemia Pituitary; hypocalcemia Parathyroids; hypocalcemia Flag question: Question 70 Question 70 1 pts Development of ____________ is the primary complication of hypercalciuria (increased urinary excretion of calcium). Group of answer choices Kidney stones Urinary tract infection Gallbladder stones Reduced GFR Flag question: Question 71 Question 71 1 pts ________________ is the most common cause of hypoparathyroidism. Group of answer choices Head trauma Hypopituitarism Neck surgery Osteoporosis

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Flag question: Question 72 Question 72 1 pts ____________ is a type of bone most rapidly lost in response to hypogonadism and glucocorticoid therapy. Group of answer choices Trabecular bone Flat bones Long bones Short bones Flag question: Question 73 Question 73 1 pts ______________ cells in bone are responsible for bone resorption, and __________ cells are responsible for bone formation. Group of answer choices Osteoblast; osteoclast Osteoclast; osteoblast Flag question: Question 74 Question 74 1 pts ____________ is the most prevalent metabolic bone disease in the United States. Group of answer choices Vitamin D deficiency Hypocalcemia Osteoporosis Hypoparathyroidism Flag question: Question 75 Question 75 1 pts True or false? Hormone replacement does not inhibit bone resorption in osteoporotic patients. Group of answer choices True False

Flag question: Question 76 Question 76 1 pts True or false? Teriparatide is the only drug currently approved by the FDA for the treatment of osteoporosis that directly stimulates bone formation (i.e., it is not an antiresorptive drug). Group of answer choices True False

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