[MCQ] Disorders of the Adrenal Cortex- Part 4

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Disorders of the Adrenal Cortex- Part 4

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Question 1

Which of the following is false about macula densa cells ?

A	DCT epithelial cells
B	Directly opposed to juxtaglomerular cells
C	Chemoreceptors
D	Monitor potassium load

Question 1 Explanation:

Macula densa cells are a group of distal convoluted tubular epithelial cells directly opposed to juxtaglomerular cells. They function as chemoreceptors, monitoring sodium (or chloride) load presented to the distal tubule.

Question 2

Factor that decreases renin release is ?

A	Atrial natriuretic peptide
B	Increased dietary potassium
C	Angiotensin II
D	All of the above

Question 2 Explanation:

Increased dietary intake of potassium decreases renin release, whereas decreased potassium intake increases it. Angiotensin II exerts negative feedback control on renin release that is independent of alterations in renal blood flow, blood pressure, or aldosterone secretion. Atrial natriuretic peptides also inhibit renin release.

Question 3

Glucocorticoids raise the blood glucose level by ?

A	Suppressing secretion of insulin
B	Inhibiting peripheral glucose uptake
C	Gluconeogenesis
D	All of the above

Question 3 Explanation:

Glucocorticoids raise blood glucose level by antagonizing secretion & actions of insulin, thereby inhibiting peripheral glucose uptake, which promotes hepatic glucose synthesis (gluconeogenesis) & hepatic glycogen content.

Question 4

Glucocorticoids deplete ?

A	T lymphocytes
B	B lymphocytes
C	Eosinophils
D	All of the above

Question 5

Glucocorticoids inhibit all of the following except ?

A	Lymphokines
B	Prostaglandins
C	IL-1 & IL-6
D	Angiotensin convertig enzyme

Question 5 Explanation:

Glucocorticoids inhibit production & action of mediators of inflammation (lymphokines & prostaglandins), interferon by T lymphocytes, IL-1 & IL-6 by macrophages. IL-1 is an endogenous pyrogen.

Question 6

Glucocorticoids inhibit all of the following except ?

A	Bradykinin
B	Vasopressin
C	Serotonin
D	Renin

Question 6 Explanation:

Glucocorticoids inhibit production & inflammatory effects of bradykinin, platelet-activating factor, serotonin, T cell growth factor (IL-2) by T lymphocytes, reverse macrophage activation & antagonize action of migration-inhibiting factor (MIF), prostaglandin & leukotriene

Question 7

Cortisol suppresses which of the following ?

A	Pituitary POMC
B	Hypothalamic CRH
C	Vasopressin
D	All of the above

Question 8

Mineralocorticoids major determinants of the metabolism of ?

A	Sodium
B	Potassium
C	Chloride
D	All of the above

Question 8 Explanation:

Mineralocorticoids are the major determinants of potassium metabolism mediated by the binding of aldosterone to MR in epithelial cells (principal cells in renal cortical collecting duct).

Question 9

Mineralocorticoids act on the epithelium of ?

A	Salivary ducts
B	Sweat glands
C	Gastrointestinal tract
D	All of the above

Question 9 Explanation:

Mineralocorticoids act on epithelium of the salivary ducts, sweat glands & gastrointestinal tract to cause reabsorption of sodium in exchange for potassium.

Question 10

Mineralocorticoids cause reabsorption of sodium in exchange for potassium in ?

A	Gastrointestinal tract
B	Epithelium of salivary ducts
C	Sweat glands
D	All of the above

Question 11

Escape phenomenon in kidneys pertains to which hormone ?

A	Aldosterone
B	Renin
C	Angiotensin II
D	Potassium

Question 11 Explanation:

Aldosterone initially causes sodium retention followed by natriuresis to reestablish sodium balance in 3 - 5 days preventing edema. This process is called escape phenomenon. It signifies an “escape” by renal tubules from the sodium-retaining action of aldosterone. There is no escape from the potassium-losing effects of mineralocorticoids.

Question 12

Mineralocorticoid receptor is found in ?

A	Neurons in brain
B	Myocytes
C	Endothelial cells
D	All of the above

Question 12 Explanation:

MR is found in nonepithelial cells like neurons in brain, myocytes, endothelial cells & vascular smooth-muscle cells.

Question 13

Primary mechanism that controls aldosterone release is ?

A	Renin-angiotensin system
B	Potassium
C	ACTH
D	All of the above

Question 14

Which of the following does not stimulate aldosterone secretion ?

A	Potassium ion
B	ACTH
C	Serotonin
D	Dopamine

Question 15

Which of the following does not stimulate aldosterone biosynthesis ?

A	β-endorphin
B	Endothelin
C	Atrial natriuretic peptide
D	Serotonin

Question 16

Which of the following inhibit aldosterone biosynthesis ?

A	Dopamine
B	Atrial natriuretic peptide
C	Ouabain-like factors
D	All of the above

Question 16 Explanation:

Potassium, serotonin, ACTH, -endorphin and endothelin stimulate aldosterone biosynthesis. Sodium, dopamine, atrial natriuretic peptide and Ouabain-like factors inhibit aldosterone biosynthesis

Question 17

Adrenal androgen formation is regulated by ?

A	ACTH
B	Gonadotropins
C	γ-melanocyte-stimulating hormone
D	β-endorphin

Question 17 Explanation:

Adrenal androgen formation is regulated by ACTH, not by gonadotropins. Adrenal androgens are suppressed by exogenous glucocorticoids

Question 18

Which of the following is the most potent androgen ?

A	DHEA
B	Androstenedione
C	11-hydroxyandrostenedione
D	Testosterone

Question 18 Explanation:

The principal adrenal androgens are DHEA, androstenedione, and 11-hydroxyandrostenedione. Testosterone is a gonadal steroid. DHEA & androstenedione are weak androgens & exert their effects via conversion to potent androgen testosterone in extraglandular tissues.

Question 19

Angiotensin II plasma levels are influenced by ?

A	Dietary sodium intake
B	Dietary potassium intake
C	Posture
D	All of the above

Question 19 Explanation:

Angiotensin II levels are influenced by dietary sodium, potassium intakes & posture. Upright posture & sodium restriction elevate angiotensin II levels.

Question 20

Peripheral plasma renin activity (PRA) is gauged by generation of which of the followinng during a standardized incubation period ?

A	Angiotensin I
B	Angiotensin II
C	Angiotensin III
D	All of the above

Question 20 Explanation:

In Plasma renin activity (PRA), renin activity is gauged by the generation of angiotensin I during a standardized incubation period. Plasma angiotensinogen acts as substrate.

Question 21

PRA and active renin correlate less well on ?

A	Low-sodium diets
B	High-sodium diets
C	Low-potassium diets
D	High-potassium diets

Question 21 Explanation:

PRA depends on dietary sodium intake patient’s ambulatory status. PRA has a diurnal rhythm with peak values in morning & a nadir in afternoon. PRA & active renin correlate very well on low-sodium diets but less well on high-sodium diets.

Question 22

The plasma level of aldosterone is increased by ?

A	Dietary potassium loading
B	Sodium restriction
C	Upright posture
D	All of the above

Question 23

The plasma level of cortisol is increased by ?

A	Dietary potassium loading
B	Sodium restriction
C	Upright posture
D	None of the above

Question 23 Explanation:

Plasma level of aldosterone, but not of cortisol, is increased by dietary potassium loading, sodium restriction or by assumption of upright posture.

Question 24

Which compound of DHEA is a useful index of adrenal androgen secretion ?

A	Sulfate
B	Phosphate
C	Chloride
D	None of the above

Question 24 Explanation:

Measurement of the sulfate conjugate of DHEA is a useful index of adrenal androgen secretion, as little DHEA sulfate is formed in gonads.

Question 25

Urine 17-ketosteroid values are highest in ?

A	Infants
B	Young adults
C	Middle age
D	Old age

Question 25 Explanation:

Urinary 17-KS originate in adrenal gland or gonad. In normal women, 90% of urinary 17-KS is derived from adrenal while in men 60 - 70% is of adrenal origin. Urine 17-KS is highest in young adults & decline with age.

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See all quizzes of Disorders of the Adrenal Cortex at here:

1.Neuropeptide ‘Urocortin’ is related to ?
A. ACTH
B. CRH
C. Leptin
D. FSH

2. Which of the following is released in equimolar concentrations
with ACTH ?
A. -Lipotropin
B. -endorphin
C. Corticotropin-like intermediate lobe protein (CLIP)
D. All of the above

3. The plasma level of ACTH peak ?
A. Just prior to waking up
B. Just after waking up
C. Before sleeping
D. After meals
4. The plasma level of ACTH are lowest at ?
A. Just prior to waking up
B. Just after waking up
C. Before sleeping
D. After meals

5. Normal pulsatile, circadian pattern of ACTH release is regulated by ?
A. Corticotropin-releasing hormone
B. Free plasma cortisol concentration
C. Sleep-wake cycle
D. All of the above

6. Stress causes which of the following ?
A. Release of CRH
B. Release of AVP
C. Activation of sympathetic nervous system
D. All of the above

7. Factors increasing ACTH release include ?
A. Response to eating
B. Vasopressin
C. Angiotensin II
D. All of the above

8. Factors decreasing ACTH release include ?
A. -endorphin
B. Enkephalin
C. Inflammatory cytokines
D. All of the above
9. The biologic half-life of ACTH in the circulation is ?
A. < 10 minutes
B. < 15 minutes
C. < 30 minutes
D. < 60 minutes

10. During critical illness, levels of corticosteroid-binding
globulin ?
A. Decrease
B. Increase
C. Remain same
D. All of the above
11. Suppression of the hypothalamic-pituitary-adrenal axis has been
reported with ?
A. Exogenous corticosteroid therapy for > 3 weeks
B. Medroxyprogesterone
C. Megestrol acetate
D. All of the above
12. What level of cortisol level best identifies persons with clinical
features of corticosteroid insufficiency ?
A. <15 μg per deciliter
B. <25 μg per deciliter
C. <35 μg per deciliter
D. <45 μg per deciliter
13. Synthetic peptide consisting of the first 24 amino acids of
corticotropin and used in corticotropin stimulation test is ?
A. Cosyntropin
B. Syntropin
C. Adrenomedulin
D. All of the above
14. Insulin-tolerance test should not be performed in patients with ?
A. Ischemic heart disease
B. Epilepsy
C. Severe cortisol deficiency
D. All of the above
15. Which of the following is an angiotensin receptor ?
A. AT1
B. AT1
C. AT2
D. All of the above

16. Most effects of angiotensin II are mediated by ?
A. AT1 receptor
B. AT2 receptor
C. AT3 receptor
D. AT4 receptor

17. Renin is a ?
A. Proteolytic enzyme
B. Hormone
C. Prohormone
D. Cytokine

18. Renin acts on ?
A. Angiotensinogen
B. Angiotensin I
C. Angiotensin II
D. All of the above
19. Angiotensinogen is made in ?
A. Liver
B. Kidney
C. Lung
D. Intestines

20. Half-life of renin is ?
A. 2 – 4 minutes
B. 5 – 10 minutes
C. 10 – 20 minutes
D. 30 – 45 minutes

21. Tissues that have a local renin-angiotensin system & produce
angiotensin II include all except ?
A. Uterus
B. Placenta
C. Vascular tissue
D. Ovaries
22. Tissues that have a local renin-angiotensin system and produce
angiotensin II include all except ?
A. Heart
B. Brain
C. Adrenal cortex
D. Pancreas

23.Angiotensin-converting enzyme (ACE) is present mostly in ?
A. Pulmonary vascular endothelium
B. Liver
C. Kidneys
D. Intestines

24. Which of the following is false ?
A. Angiotensin I is a decapeptide
B. Angiotensin II is an octapeptide
C. Angiotensin III is a heptapeptide
D. None of the above

25. Which of the following is false about ‘juxtaglomerular cells’ ?
A. Specialized myoepithelial cells
B. Cuff efferent arterioles
C. Act as pressure transducers
D. Release renin

Disorders of the Adrenal Cortex

[MCQ] Disorders of the Adrenal Cortex- Part 4

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Disorders of the Adrenal Cortex- Part 4

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