[MCQ] Disorders of the Anterior Pituitary and Hypothalamus- Part 7

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Disorders of the Anterior Pituitary and Hypothalamus- Part 7

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Question 1

In treatment of Cushing’s disease, which of the following drugs is useful ?

A	Aminoglutethimide
B	Cyproheptadine
C	Etomidate
D	All of the above

Question 1 Explanation:

Aminoglutethimide, trilostane, cyproheptadine & etomidate block steroidogenesis and are useful in treatment of Cushing’s disease.

Question 2

Which out of the following clinical features of Cushing’s syndrome is most common ?

A	Hypertension
B	Purple skin striae
C	Thin skin
D	Truncal obesity

Question 3

Which out of the following clinical features of Cushing’s Syndrome is most common ?

A	Acne
B	Hirsutism
C	Hyperpigmentation
D	Bruising

Question 3 Explanation:

Clinical features of Cushing’s Syndrome in order of frequency are : Obesity, Thin skin, Moon facies, Hypertension, Purple skin striae, Hirsutism, Menstrual disorders, Plethora, Abnormal glucose tolerance, Impotence, Proximal muscle weakness, Truncal obesity, Acne, Bruising, Mental changes, Osteoporosis, Edema of lower extremities, Hyperpigmentation, Hypokalemic alkalosis, Diabetes mellitus.

Question 4

What percentage of anterior pituitary cells are gonadotrope cells ?

A	5 %
B	10 %
C	15 %
D	20 %

Question 4 Explanation:

Gonadotrope cells comprise ~10% of anterior pituitary cells and produce two gonadotropins LH & FSH.

Question 5

Specificity of gonadotropins, LH and FSH, is conferred by which subunit ?

A	α
B	β
C	γ
D	δ

Question 5 Explanation:

LH & FSH are glycoprotein hormones (like TSH & hCG) & consist of  &  subunits. The  subunit is common to these glycoprotein hormones, specificity is conferred by the  subunits, which are expressed by separate genes.

Question 6

Which of the following is the smallest amino-acid peptide ?

A	Hypothalamic GnRH
B	ACTH
C	Corticotropin releasing hormone (CRH)
D	POMC precursor protein

Question 6 Explanation:

Hypothalamic GnRH is a 10-amino-acid peptide. ACTH has 39 amino acids derived from POMC precursor protein which has 266 amino acids. CRH is a 41-amino-acid hypothalamic peptide synthesized in paraventricular nucleus

Question 7

GnRH is secreted in discrete pulses every ?

A	5 to 10 minutes
B	10 to 30 minutes
C	30 to 60 minutes
D	60 to 120 minutes

Question 7 Explanation:

Hypothalamic GnRH regulates synthesis & secretion of both LH & FSH. GnRH is secreted in discrete pulses every 60 to 120 minutes, which in turn elicit LH & FSH pulses. Pulsatile mode of GnRH release prime gonadotrope responsiveness, whereas continuous GnRH exposure induces desensitization

Question 8

FSH hormone is under control of which of the following ?

A	Inhibin
B	Activin
C	GnRH
D	All of the above

Question 8 Explanation:

Inhibin selectively suppresses FSH synthesis, whereas activin stimulates FSH synthesis. GnRH induces FSH secretion. Inhibin & activin are gonadal peptides & are members of transforming growth factor  (TGF-) family

Question 9

Which of the following statements is false ?

A	In women, FSH stimulates ovarian estrogen production
B	In women, LH helps maintain corpus luteum
C	In men, LH induces testosterone synthesis & secretion by Leydig cells
D	None of the above

Question 10

Most common presenting feature of adult hypopituitarism is ?

A	Hypothyroidism
B	Hypogonadism
C	Addison’s disease
D	Hyperprolactinemia

Question 10 Explanation:

Hypogonadism is the most common presenting feature of adult hypopituitarism, even when other pituitary hormones are also deficient

Question 11

Acquired GnRH deficiency causing hypogonadotropism can be due to ?

A	Anorexia nervosa
B	Stress
C	Starvation
D	All of the above

Question 11 Explanation:

Acquired forms of GnRH deficiency leading to hypogonadotropism are seen in association with anorexia nervosa, stress, starvation & extreme exercise, but may also be idiopathic. Hypogonadotropic hypogonadism in these disorders is reversed by removal of the stressful stimulus

Question 12

Which of the following is the characteristic skin change in hypogonadal adult males ?

A	Petechiae
B	Fine facial wrinkles
C	Coarse thickened skin
D	Skin tags

Question 12 Explanation:

In hypogonadal adult males, secondary testicular failure is associated with decreased libido & potency, infertility, decreased muscle mass with weakness, reduced beard and body hair growth, soft testes, and characteristic fine facial wrinkles.

Question 13

Most clinically nonfunctioning adenomas originate from ?

A	Somatotrophe cells
B	Corticotrope cells
C	Gonadotrope cells
D	Lactotrophe cells

Question 13 Explanation:

Most clinically nonfunctioning adenomas originate from gonadotrope cells. These tumors typically produce small amounts of intact gonadotropins (usually FSH) as well as uncombined  and LH  and FSH  subunits. Tumor secretion may lead to elevated  & FSH  subunits and, rarely, to increased LH  subunit levels. Some adenomas express  subunits without FSH or LH.

Question 14

In patients with gonadotrope adenomas, administration of which of the following stimulates LH  subunit secretion ?

A	TRH
B	TSH
C	ACTH
D	CRH

Question 14 Explanation:

In majority of patients with gonadotrope adenomas, TRH administration stimulates LH  subunit secretion. This response is not seen in normal individuals

Question 15

Which of the following is false in men with gonadotropin-secreting tumors ?

A	Increased gonadotropins (LH > FSH)
B	Pituitary mass
C	Low testosterone levels
D	None of the above

Question 15 Explanation:

In men, gonadotropin-secreting tumors may be diagnosed because of slightly increased gonadotropins (FSH > LH) in the setting of a pituitary mass. Testosterone levels are usually low, despite the normal or increased LH level, perhaps reflecting reduced LH bioactivity or the loss of normal LH pulsatility.

Question 16

Clinically inapparent somatotrope adenoma is best excluded by ?

A	Normal IGF-I value
B	Normal IGF-II value
C	Normal GH value
D	All of the above

Question 16 Explanation:

Clinically inapparent somatotrope or corticotrope adenomas can be excluded by a normal IGF-I value and normal 24-hour urinary free cortisol levels. If PRL levels are <100 g/L in a patient with pituitary mass, a nonfunctioning adenoma causing pituitary stalk compression should be considered.

Question 17

In the treatment of nonfunctioning pituitary tumors, which of the following reduces adenoma size ?

A	Dopamine agonists
B	Octreotide
C	Nal-Glu GnRH
D	None of the above

Question 17 Explanation:

Nonfunctioning pituitary tumors respond poorly to dopamine agonists, octreotide and selective GnRH antagonist, Nal-Glu GnRH.

Question 18

TSH-secreting thyrotrope cells comprise what percentage of anterior pituitary cell population ?

A	2 %
B	5 %
C	8 %
D	12 %

Question 18 Explanation:

TSH-secreting thyrotrope cells comprise 5% of the anterior pituitary cell population. Gonadotrope cells comprise about 10% of anterior pituitary cells. GH-secreting somatotrope cells constitute up to 50% of the total anterior pituitary cells. Lactotropes comprise about 20% of anterior pituitary cells.

Question 19

TSH is structurally related to ?

A	GH
B	PRL
C	FSH
D	ACTH

Question 19 Explanation:

TSH is structurally related to LH & FSH. It shares a common  subunit with these hormones but contains a specific TSH  subunit.

Question 20

Hypothalamic tripeptide - TRH is also called ?

A	Pyroglutamyl histidylprolinamide
B	Proglutamyl histidylprolinamide
C	Pentaglutamyl histidylprolinamide
D	Preglutamyl histidylprolinamide

Question 20 Explanation:

TRH is a hypothalamic tripeptide (pyroglutamyl histidylprolinamide) that acts through a GPCR to stimulate TSH synthesis & secretion

Question 21

Besides TSH, TRH also stimulates secretion of ?

A	PRL
B	GH
C	ACTH
D	Vasopressin

Question 21 Explanation:

TRH also stimulates the lactotrope cell to secrete PRL.

Question 22

TSH secretion is suppressed by ?

A	Dopamine
B	SRIF
C	Glucocorticoids
D	All of the above

Question 22 Explanation:

TSH secretion is stimulated by TRH, whereas thyroid hormones, dopamine, SRIF & glucocorticoids suppress TSH by overriding TRH induction.

Question 23

Which of the following is secreted in pulses ?

A	GnRH
B	ACTH
C	GH
D	All of the above

Question 23 Explanation:

Like TSH, GnRH, ACTH, GH, LH & FSH are secreted in pulses.

Question 24

Which of the following has the longest half life ?

A	TSH
B	ACTH
C	GH
D	Prolactin (PRL)

Question 24 Explanation:

TSH has a prolonged half-life with relatively constant serum levels, even though it is secreted in discrete pulses. ACTH, GH, prolactin, PTH, LH have relatively short half-lives (<20 min) with sharp peaks of secretion & decay.

Question 25

Which of the following is not useful in suppressing TSH secretion in TSH-producing macroadenomas ?

A	Dopamine agonists
B	Octreotide
C	Lanreotide
D	All of the above

Question 25 Explanation:

Dopamine agonists are rarely effective for suppressing TSH secretion from TSH-secreting adenomas. Octreotide markedly suppresses TSH, causing biochemical hypothyroidism that requires concomitant thyroid hormone replacement. Lanreotide, a long acting somatostatin analogue, effectively suppresses TSH.

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See all quizzes of Disorders of the Anterior Pituitary and Hypothalamus at here:

Disorders of the Anterior Pituitary and Hypothalamus- Part 1| Disorders of the Anterior Pituitary and Hypothalamus- Part 2| Disorders of the Anterior Pituitary and Hypothalamus- Part 3| Disorders of the Anterior Pituitary and Hypothalamus- Part 4|Disorders of the Anterior Pituitary and Hypothalamus- Part 5 |Disorders of the Anterior Pituitary and Hypothalamus- Part 6| Disorders of the Anterior Pituitary and Hypothalamus- Part 7

1 In treatment of Cushing’s disease, which of the following drugs
is useful ?
A. Aminoglutethimide
B. Cyproheptadine
C. Etomidate
D. All of the above

2 Which out of the following clinical features of Cushing’s syndrome
is most common ?
A. Hypertension
B. Purple skin striae
C. Thin skin
D. Truncal obesity
3 Which out of the following clinical features of Cushing’s Syndrome
is most common ?
A. Acne
B. Hirsutism
C. Hyperpigmentation
D. Bruising

4 What percentage of anterior pituitary cells are gonadotrope
cells ?
A. 5 %
B. 10 %
C. 15 %
D. 20 %

5 Specificity of gonadotropins, LH and FSH, is conferred by which
subunit ?
A. 
B. 
C. 
D. 

6 Which of the following is the smallest amino-acid peptide ?
A. Hypothalamic GnRH
B. ACTH
C. Corticotropin releasing hormone (CRH)
D. POMC precursor protein

7 GnRH is secreted in discrete pulses every ?
A. 5 to 10 minutes
B. 10 to 30 minutes
C. 30 to 60 minutes
D. 60 to 120 minutes

8 FSH hormone is under control of which of the following ?
A. Inhibin
B. Activin
C. GnRH
D. All of the above

9 Which of the following statements is false ?
A. In women, FSH stimulates ovarian estrogen production
B. In women, LH helps maintain corpus luteum
C. In men, LH induces testosterone synthesis & secretion by
Leydig cells
D. None of the above

10 Most common presenting feature of adult hypopituitarism is ?
A. Hypothyroidism
B. Hypogonadism
C. Addison’s disease
D. Hyperprolactinemia

11 Acquired GnRH deficiency causing hypogonadotropism can be
due to ?
A. Anorexia nervosa
B. Stress
C. Starvation
D. All of the above

12 Which of the following is the characteristic skin change in
hypogonadal adult males ?
A. Petechiae
B. Fine facial wrinkles
C. Coarse thickened skin
D. Skin tags

13 Most clinically nonfunctioning adenomas originate from ?
A. Somatotrophe cells
B. Corticotrope cells
C. Gonadotrope cells
D. Lactotrophe cells

14 In patients with gonadotrope adenomas, administration of which
of the following stimulates LH  subunit secretion ?
A. TRH
B. TSH
C. ACTH
D. CRH

15 Which of the following is false in men with gonadotropin-secreting
tumors ?
A. Increased gonadotropins (LH > FSH)
B. Pituitary mass
C. Low testosterone levels

D. None of the above

16 Clinically inapparent somatotrope adenoma is best excluded
by ?
A. Normal IGF-I value
B. Normal IGF-II value
C. Normal GH value
D. All of the above

17 In the treatment of nonfunctioning pituitary tumors, which of the
following reduces adenoma size ?
A. Dopamine agonists
B. Octreotide
C. Nal-Glu GnRH
D. None of the above

18 TSH-secreting thyrotrope cells comprise what percentage of
anterior pituitary cell population ?
A. 2 %
B. 5 %
C. 8 %
D. 12 %

19 TSH is structurally related to ?
A. GH
B. PRL
C. FSH
D. ACTH

20 Hypothalamic tripeptide – TRH is also called ?
A. Pyroglutamyl histidylprolinamide
B. Proglutamyl histidylprolinamide
C. Pentaglutamyl histidylprolinamide
D. Preglutamyl histidylprolinamide

21 Besides TSH, TRH also stimulates secretion of ?
A. PRL

B. GH
C. ACTH
D. Vasopressin
22 TSH secretion is suppressed by ?
A. Dopamine
B. SRIF
C. Glucocorticoids
D. All of the above

23 Which of the following is secreted in pulses ?
A. GnRH
B. ACTH
C. GH
D. All of the above

24 Which of the following has the longest half life ?
A. TSH
B. ACTH
C. GH
D. Prolactin (PRL)

25 Which of the following is not useful in suppressing TSH secretion
in TSH-producing macroadenomas ?
Harrison’s 16th Ed. 2096
A. Dopamine agonists
B. Octreotide
C. Lanreotide
D. All of the above

Disorders of the Anterior Pituitary and Hypothalamus

[MCQ] Disorders of the Anterior Pituitary and Hypothalamus- Part 7

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Disorders of the Anterior Pituitary and Hypothalamus- Part 7

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