2) Remembering the anatomic relationships,
you can predict that an enlarged pituitary gland will cause all of the following
symptoms, EXCEPT:
a)
Headache, because the upward extension of the enlarged gland stretches
the diaphragma sellae, which is innervated
b)
Visual field defects (typically bitemporal hemianopsia) because the upward
extension of the gland compresses, once the diaphragma is passed, the optic
chiasma
c)
Exophthalmia because the enlarged pituitary blocks the lymphatic drainage
from the orbit, and thus pushes the eye globe forward
d)
Impaired mobility of the eye globes. In fact a pituitary mass can expand
laterally into the cavernous sinus where it can compress the oculomotor
nerve (III cranial nerve that controls medial glaze), more rarely the trochlear
(VI) and abducent (VI) cranial nerves
e)
Hypopituitarism because the pituitary mass when compresses the normal
adjacent cells of the pituitary. The first normal cells to be affected are
the lactotropes and the somatotropes, but their loss of function does not
cause clear symptoms in the adult. Next are affected the gonadotropes (thus
hypogonadism appears), then the thyreotropes (hypothyroidism), and finally
the corticotropes (adrenal insufficiency).
3) Somatostatin has all of the following
effects, EXCEPT:
a)
inhibits gastric secretion from the parietal cells of the stomach
b)
inhibits TSH release
c)
inhibits insulin release
d)
increases glucagon secretion
e)
inhibits gallbladder contractility
4)A 60-years old man, heavy smoker, presents
with fatigue, slight weight increase, and hemophtysis (spotting of blood
derived from the lungs). Physical exam shows edema around the ankles, enlargement
of the liver, and enlargement of supraclavicular lymph nodes. A chest X-ray
shows a large mass around the right hilus.
Analysis of the patient's serum
shows:
sodium 115 mEq/L (vn 135-154)
potassium 2.3 mEq/L (vn 3.5-5.0)
chloride 70 mEq/L (vn 95-110)
osmolality: 230 mOsm/L (vn 285-295).
The
urine osmolality was 500 mOsm/L (vn 400-800). Which of the following hormones
would you expect to see increased in this patient's serum?
a)
ADH
b)
GH
c)
PRL
d)
aldosterone
e)
cortisol
5) The adrenocortical insufficiency can
cause decreased blood levels of sodium (hyponatremia). Which of the following
mechanisms DOES NOT contribute to the hyponatremia?
a)
the aldosterone deficit causes urinary loss of sodium
b)
the cortisol deficit decreases the clearance of free water (by antagonizing
the action of ADH on the renal tubuli). The end-result is that more water
is absorbed
c)
the cortisol deficit decreases ADH release from the neurohypophysis
d)
the aldosterone and cortisol deficits cause reduced blood volume (hypovolemia),
and thus reduced blood pressure and cardiac output
6) All of the following hormones share their
alpha subunit with TSH, EXCEPT:
a)
LH
b)
GH
c)
FSH
d)
hCG
7) Which of the following statements describing
the actions of GnRH and estradiol on the gonadotropes in women is/are CORRECT?
a)
GnRH induces synthesis and storage of gonadotropins (reserve pool)
b)
estradiol induces synthesis of gonadotropins, but inhibits their release
c)
GnRH stimulates the synthesis of its own receptors from the gonadotropes
(self-priming). Thus the response of gonadotropes to identical pulses of
GnRH increases over time
d)
at midcycle, GnRH has induced sufficient number of its own receptors
that GnRH stimulatory actions overcome the inhibition that estradiol exerts
on gonadotropins release, thus causing the mid-cycle gonadotropin peak
e)
none of these
f)
all of these
8) ONLY ONE of the following statements
regarding the secretion of hormones produced by the anterior hypophysis
is correct:
a)
The main hypothalamic factor that controls prolactin secretion is stimulatory
in nature
b)
A single blood sample is sufficient to study and assess the function
of the anterior hypophysis
c)
A lesion that interrupts the pituitary stalk causes an increase in the
serum concentrations of ACTH, TSH and GH
d)
The main hypothalamic factor that control prolactin secretion is dopamine,
which has an inhibitory effect on prolactin
9) After a very severe decrease in the extracellular
volume, without a change in osmolality, the body responds by increasing:
a)
Aldosterone and atrial natriuretic factor
b)
Calcitonin and antidiuretic hormone
c)
Aldosterone and renin
d)
Aldosterone and anti-diuretic hormone
10) Indicate which of the following statements
are TRUE (T) and which are FALSE (F):
T
F
a) Tanycytes may transport substances between
the third ventricle and the gomitoli
T
F
b) The testosterone surge that human males experience
at about 2 months of age is thought to "organize" the androgen-dependent
tissues
T
F
c) Human chorionic gonadotropin (hCG), but not
luteinizing hormone (LH), prevents the lysis of the corpus luteum during
the menstrual cycle
T
F
d) Both the male and female pituitaries respond
to inhibin
T
F
e) The hypothalamic neurons that produce gonadotropin-releasing
hormone (GnRH) in females and males respond identically to their respective
main steroid, estradiol and testosterone
11-A) During
pregnancy prolactin levels raise beginning at about 8 weeks and peaking
at term. Prolactin is the major hormone in milk synthesis, however, during
pregnancy lactation is inhibited by:
a)
Estrogen
b)
Progesterone
c)
hCG
d)
all of these
11-B) Then, after
delivery, the hormonal trigger for milk production is the rapid decline
in the circulation of:
a)
Estrogen
b)
Progesterone
c)
both of these
d)
none of these
11-C) During
puerperium, breast suckling stimulates the release of:
