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Question 1
Incorrect
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Which of the following statements regarding prolactin is true?
Your Answer: Prolactin levels decrease shortly after sleep
Correct Answer: Prolactin levels increase during stress
Explanation:Causes of Hyperprolactinemia: Prolactinomas, Medication (phenothiazines, metoclopramide, risperidone, selective serotonin reuptake inhibitors, oestrogens, verapamil), Stress, Pregnancy, Hypothyroidism, Kidney disease, Chest trauma
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This question is part of the following fields:
- Endocrinology
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Question 2
Incorrect
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What is the definition of puberty in girls?
Your Answer: Development of secondary sexual characteristics
Correct Answer: Becoming capable of sexual reproduction
Explanation:Puberty is the process of reproductive and sexual development and the maturation which changes a child into an adult.
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This question is part of the following fields:
- Endocrinology
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Question 3
Correct
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What percentage of children does delayed puberty occur in?
Your Answer: 3%
Explanation:Delayed puberty is defined as the absence of breast development in girls beyond the age of 13, and the absence of testicular development in boys beyond the age of 14. The incidence of delayed puberty is 3%, with the condition being more common in boys.
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This question is part of the following fields:
- Endocrinology
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Question 4
Correct
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What is the definition of premature menopause?
Your Answer: Menopause at or before 40 years of age
Explanation:Menopause is defined as the cessation of menstruation for a period of 12 months. Premature menopause is defined as cessation of menstruation before the age of 40.
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This question is part of the following fields:
- Endocrinology
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Question 5
Incorrect
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Regarding placental anatomy:
Your Answer: The fetal side of the placenta is divided into 30-40 cotyledons
Correct Answer: Fetal blood vessels develop in the mesenchymal core of the chorionic villi
Explanation:The chorionic plate represents the fetal surface of the placenta, which in turn is covered by the amnion. The amnion is composed of a single layered epithelium and the amnionic mesenchyme, an avascular connective tissue. The amnionic mesenchyme is only weakly attached to the chorionic mesenchyme and can easily be removed from the delivered placenta. The chorionic mesenchyme contains the chorionic vessels that are continuous with the vessels of the umbilical cord. Within the mesoderm of secondary villi, haematopoietic progenitor cells develop and start to differentiate. At about day 20 post-conception, first placental blood cells and endothelial cells develop independent of the vascular system of the embryo proper.13 14 The development of first placental vessels transforms the respective villi into tertiary villi.
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This question is part of the following fields:
- Endocrinology
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Question 6
Correct
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Which of the following is the primary source of oestrogen ?
Your Answer: Granulosa cells
Explanation:Ovarian granulosa cells (GC) are the major source of oestradiol synthesis. Induced by the preovulatory luteinizing hormone (LH) surge, cells of the theca and, in particular, of the granulosa cell layer profoundly change their morphological, physiological, and molecular characteristics and form the progesterone-producing corpus luteum that is responsible for maintaining pregnancy.Â
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This question is part of the following fields:
- Endocrinology
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Question 7
Correct
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During the menstrual cycle which hormone typically reaches its peak level on day 21 (assuming a 28 day cycle)?
Your Answer: Progesterone
Explanation:LH, FSH and Oestrogen have their peaks just before ovulation on day 14 whereas progesterone peaks around day 21.
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This question is part of the following fields:
- Endocrinology
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Question 8
Incorrect
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Raised FSH levels are found in all of the following conditions, EXCEPT:
Your Answer: Postmenopausal women
Correct Answer: Women on combined oral contraceptive pills
Explanation:Oestrogen- and progesterone-containing oral contraceptives inhibit LH, which suppresses the FSH and LH levels, preventing follicular development and ovulation. Combined pills suppress FSH and LH throughout the cycle, inhibit endometrial proliferation, and produce a scanty cervical mucus.Â
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This question is part of the following fields:
- Endocrinology
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Question 9
Incorrect
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Which of the following statements regarding progesterone production in the ovary is true?
Your Answer: Synthesised from androgen by Theca cells
Correct Answer: Synthesised from cholesterol by Luteal cells
Explanation:After the release of the oocyte, the theca and the granulosa cells form the corpus luteum which undergoes extensive vascularization for continued steroidogenesis. Progesterone is secreted by the luteal cells and is synthesized from cholesterol.
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This question is part of the following fields:
- Endocrinology
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Question 10
Incorrect
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Prognathism and macroglossia are features of which of the following?
Your Answer: Down's syndrome
Correct Answer: Acromegaly
Explanation:These are features of excess growth hormone i.e. Acromegaly. Down’s and Cri du chat typically cause Micrognathia (small jaw)
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This question is part of the following fields:
- Endocrinology
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Question 11
Incorrect
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In relation to ovulation, when does the LH surge occur?
Your Answer: 8-16 hours before ovulation
Correct Answer: 24-36 hours before ovulation
Explanation:Ovulation usually occurs on day 14 in a typical 28-day cycle. Luteinizing hormone levels spike as a result of increased oestrogen levels secreted from maturing follicles. This LH spike occurs about 24-36 hours before the release of the oocyte from the mature follicle.
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This question is part of the following fields:
- Endocrinology
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Question 12
Correct
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Gonadotropin-releasing hormone (GnRH) stimulates the release of:
Your Answer: Luteinizing hormone
Explanation:Gonadotropin-releasing hormone (GnRH) is the hormone responsible for the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary gland.
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This question is part of the following fields:
- Endocrinology
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Question 13
Correct
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A 32 year old woman with a 6 month history of fatigue and some weight gain reports to clinic for a review. Her medical records show evidence of hypothyroidism. On examination, a non tender, hard goitre is palpated. Further tests reveal elevated anti TPO (anti thyroid peroxidase) and anti -Tg (anti thyroglobulin). Which of the following conditions is most likely to present like this?
Your Answer: Hashimoto's
Explanation:The case presented points to a diagnosis of an autoimmune thyroiditis leading to hypothyroidism. The most common form of autoimmune hypothyroidism, Hashimoto’s, often presents with a goitre, positive for antibody tests against thyroid components i.e. anti-TPO and anti-thyroglobulin. Graves disease and toxic diffuse goitre are more likely to cause hyperthyroidism. While De-Quervain’s and endemic goitre may cause hypothyroidism, they don’t result in positive antibody tests.
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This question is part of the following fields:
- Endocrinology
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Question 14
Correct
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Adult Polycystic Kidney Disease (PKD) typically follows which pattern of inheritance
Your Answer: Autosomal Dominant
Explanation:PKD can follow either Autosomal dominant or recessive inheritance. Autosomal dominant is however the most common inheritance pattern and is seen in adult PKD. Infantile PKD is recessive
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This question is part of the following fields:
- Endocrinology
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Question 15
Correct
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Oestrogen have all of the following actions, EXCEPT:
Your Answer: Prevention of thrombosis
Explanation:The properties of oestrogen:
Structure: Stimulates endometrial growth, maintenance of vessels and skin,
reduces bone resorption, increases bone formation, increases uterine growth
Protein synthesis: Increases hepatic synthesis of binding proteins
Coagulation: Increases circulating levels of factors II, VII, IX, X, antithrombin III and plasminogen; increases platelet adhesiveness
Lipid: Increases HDL and reduces LDL,increases triglycerides, reduces
ketone formation, increases fat deposition
Fluid balance: Salt and water retention
Gastrointestinal: Reduces bowel motility, increases cholesterol in bile -
This question is part of the following fields:
- Endocrinology
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Question 16
Incorrect
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Which of the following causes an increase in Sex Hormone Binding Globulin (SHBG)?
Your Answer: PCOS
Correct Answer: Liver cirrhosis
Explanation:Liver cirrhosis is known to lead to decreased levels of SHBG. Other causes of high SHBG are:
Oestrogens e.g. oral contraceptives
Pregnancy
Hyperthyroidism
Liver cirrhosis
Anorexia nervosa
Drugs e.g. anticonvulsants -
This question is part of the following fields:
- Endocrinology
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Question 17
Correct
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Question 18
Incorrect
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What percentage of testosterone is bound to SHBG?
Your Answer: 97%
Correct Answer: 70%
Explanation:About 97% of the testosterone that is secreted loosely binds to the SHBG and circulates in the blood for several hours in this bound state until it is transported to the target organs.
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This question is part of the following fields:
- Endocrinology
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Question 19
Correct
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Hirsutism can be found in all of the following conditions, EXCEPT:
Your Answer: Patient on oral contraceptive pills
Explanation:Classically, hirsutism has been considered a marker of increased androgen levels in females from increased production of androgens (i.e. testosterone) either by the adrenals or due to an ovarian disease. The ovarian causes for hyperandrogenism are polycystic ovarian syndrome (PCOS) and ovarian tumours. Adrenal causes include Cushing’s syndrome, androgen-producing tumours, and congenital adrenal hyperplasia (CAH), most commonly due to 21-hydroxylase deficiency. Less common causes include the hyperandrogenic-insulin resistant-acanthosis nigricans syndrome (HAIRAN). Hyperprolactinemia by increasing adrenal dehydroepiandrosterone sulphate (DHEA-S) production may cause hirsutism. Androgenic drugs are also an important cause of hirsutism. About 20% of the patients may present with idiopathic hirsutism (IH) with normal androgen levels and ovarian function. The cause of increased hair in these women is thought to be related to disorders in peripheral androgen activity. Onset of IH occurs shortly after puberty with slow progression. PCOS and IH account for 90% of the hirsutism in women. Hirsutism can also occur in some premenopausal women and continue for a few years after menopause. This is due to decrease in ovarian oestrogen secretion with continuous androgen production.
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This question is part of the following fields:
- Endocrinology
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Question 20
Correct
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A patient with amenorrhoea is seen in clinic. History and examination reveal the patient runs 10-20 miles every day and her BMI is 17.8. Which of the following is likely to explain her symptoms?
Your Answer: WHO type I Ovulation Disorders
Explanation:World Health Organization (WHO) Group I ovulation disorder is due to hypothalamic pituitary failure. This is sometimes termed hypothalamic amenorrhoea or hypogonadotropic hypogonadism. Women can improve frequency of ovulation, conception and an uncomplicated pregnancy by increasing their body weight (if BMI of <19) and/or moderating their exercise levels (if they undertake high levels of exercise). GnRH and LH may be administered in these patients. PCOS falls under type II ovulation disorders. WHO Group III ovulation disorder is due to ovarian failure.
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This question is part of the following fields:
- Endocrinology
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SESSION STATS - PERFORMANCE PER SPECIALTY
