Faculty of Medicine Alexandria University Third year (IUMP) 1st Semester End Module Endocrine Exam

Date: 14/11/2012 Total marks: 24 marks Time allowed: 50 minutes All questions to be answered.

General Instruction: 1. Answer only in the provided answer sheet. Answers in the question papers will NOT be scored. 2. Questions are arranged serially from Q1 to Q48 in 9 pages. 3. Each question has ONLY ONE answer. Putting more than one answer to any question will lead to its automatic cancellation. 4. Indicate your choice by completely shading the circle containing the letter (A), (B), (C), or (D) using number 2B pencil. NO pens are allowed. 5. Make sure you have entered your ID number, your name & exam form (if present) in specific fields correctly. 6. Write your name & ID number using 2B pencil in the designated area. 7. Dont circle or mark X on your answer, otherwise it will be cancelled. 8. Half mark for each correct answer.

Histology: 1. Chief cells of the parathyroid hormone:

a) b) c) d) Are one of neuroendocrine cells. Are rich in lysosomal system. Have apical secretory granules. Decrease calcium level in blood.

2. The FALSE statement about the cells of zona fasciculata is: a) They contain numerous mitochondria and extensive rER. b) They are sensitive to ACTH stimulation. c) They form the thickest cortical zone. d) They show large number of lipid droplets.

3. The EM picture of steroid hormone secreting cell is characterized by all of the following EXCEPT: a) Numerous sER. b) Numerous mitochondria with tubular cristae. c) Numerous rER. d) Well-developed Golgi complex.

4. One statement is true in describing the basophils of the adenohypophysis: a) They are larger than acidophils and of bigger percentage. b) Their granules are smaller than the acidophils. c) They are smaller than acidophils but of bigger percentage. d) Mammotrophs are one type of the basophils.

5. Concerning the beta cells in Islet of Langerhans, the FALSE statement is: a) Their granules are soluble in alcohol but not in water. b) They are smaller than alpha cells. c) They contain granules with homogenous dense core. d) They are present in the center of islet of Langerhans.

6. The acidophilic structures known as Herring bodies represent: a) Acidophils of the adenohypophysis. b) Modified neuroglia found in neurohypophysis c) Pinealocytes d) None of the above.
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7. In the following type of thyroiditis, the thyroid is stony hard in: a) Hashimotos thyroiditis. b) Riedels thyroiditis. c) Granulomatous thyroiditis. d) Subacute lymphocytic thyroiditis.

8. Cardiovascular complications of diabetes include: a) Atherosclerosis b) Hypertension c) Myocardial Infarction d) All of the above

9. All the following is true about papillary thyroid carcinoma EXCEPT: a) Aggressive biological behavior & poor prognosis. b) Multifocality c) Psammoma bodies maybe seen microscopically. d) Strong association with external irradiation.

Physiology: 10. Vasopressin (ADH) deficiency is characterized by: a) Excretion of a large volume of urine. b) Drinking a little volume of water. c) Increased blood volume. d) Decreased plasma osmolality.

11. Prolactin: a) It is the hormone mainly responsible for the growth of breast tissue. b) Secretion increases at the time of delivery. c) Release is inhibited by TSH. d) Increases milk formation.

12. Growth hormone secretion: a) Is stimulated by somatostatin released from the hypothalamus. b) Increases when the blood glucose level increases. c) Increases the size of pituitary gland. d) Stimulates liver to form somatomedin.

13. Impaired growth hormone secretion: a) In children causes delayed puberty. b) In children leads to short stature with more effect on the limbs than the trunk. c) Is associated with red, warm and soft skin. d) In adults leads to premature senility.

14. Releasing hormones produced in the hypothalamus: a) Pass down nerve axons to reach the anterior pituitary gland. b) May control the output of only one pituitary hormone. c) Regulate the release of thyrothropic hormone. d) Regulate the release of oxytocin.

15. Patient suffering from myxedema is more likely to have: a) Sweaty hands. b) Hirsutism. c) A high serum cholesterol level. d) Hypotension.

16. Thyroid hormone, when secreted in excess, may cause an increase in the: a) Peripheral resistance. b) Frequency of urination. c) Duration of tendon reflexes. d) Pulse pressure.

17. Thyroxin: a) Is stored in the parafollicular cells as thyroglobulin. b) Decreases the rate of carbon dioxide production. c) Is essential for normal development of the brain in infants. d) Is not needed for normal red cell production.

18. Aldosterone is secreted in response to: a) Decreased blood volume. b) Increased ACTH secretion. c) Hypernatremia. d) Administration of an inhibitor of angiotensin-converting enzyme.

19. Cushing syndrome is characterized by all of the following EXCEPT: a) Excess plasma level of both cortisol and glucose. b) Muscle wasting. c) Hypotension. d) Osteoporosis

20. The secretion of cortisol is increased by: a) Stress. b) High K+ level in blood. c) Hyperglycemia. d) Increase amino acids in blood.

21. Glucocorticoid tend to decrease: a) Renal excretion of calcium. b) Protein anabolism in liver. c) Hepatic gluconeogenesis. d) Glucose utilization.

22. High levels of PTH are consistent with: a) Low serum calcium level. b) Increased muscle tone. c) Frequent occurrence of spontaneous fracture. d) Decrease activity of anterior pituitary gland.

23. Which is true about Ca++ : a) The normal plasma Ca++ is 9-11 microgram/100ml. b) Its level in blood is maintained constant by the PTH only. c) Hypocalcemia causes hyperexcitability at the neuromuscular junction. d) Exchangeable Ca is a stable Ca salts present only in the bone.

24. Insulin: a) Inhibits protein synthesis. b) Increase glucose uptake by the satiety center. c) Increase lipolysis. d) Facilitates both glycogenolysis and gluconeogenesis.

25. Insulin secretion can be stimulated by: a) Hypoglycemia. b) Sympathetic stimulation. c) Pancreatic SS. d) Hyperkalemia.

26. Which of the following is true about glucagon hormone? a) Increase glycogenesis. b) Increase lipolysis. c) Stimulated by hyperglycemia. d) Somastatin increases its secretion.

27. Hyperparathyroidism is associated with all of the following EXCEPT: a) Ostitisfibrosacystica. b) Increased muscle tone. c) Recurrent formation of renal stone. d) Constipation.

Pharmacology: 28. Vasopressin can be utilized in the treatment of: a) Hyperprolactinemia. b) Bleeding esophageal varices. c) Short stature. d) Addisons disease.

29. The most rapid efficient therapy of Myxedema coma is: a) Thyroxin ; T4 (orally) b) Thyroxin sodium (IV) c) Liothyronine ; T3 (IV) d) Liotrix (orally)

30. The most serious side effect of carbimazole is a) Papular skin rash. b) Lymphadenopathy. c) Bone marrow depression. d) Thyroid enlargement with increased vascularity.

31. One common important clinical utilization of Calcitonin and Alendronate is: a) Hypocalcemic tetany. b) Long term management of hypoparathyroidism. c) Rickets in children. d) Osteoporosis.

32. The following disease is a relative contraindication to use adrenal corticosteroids: a) Diabetes mellitus. b) Organ transplantation. c) Rheumatic fever. d) Nephrotic syndrome.

33. The following condition requires increasing the dose of insulin: a) Increase physical exercise. b) Weight reduction. c) Surgery. d) Hypothyroidism,

34. The statement following the name of the drug corresponds correctly with its mechanism of action: a) Gliclazide: Binding to its receptor inhibits potassium efflux causing depolarization of the cell. b) Acarbose: decrease hepatic gluconeogenesis. c) Metformin: Inhibits alpha-glucosidase enzyme. d) Repaglinide: causes transcription of genes regulated by peroxisome proliferatoractivated receptor gamma. (PPAR

Anatomy: 35. The nerve which may be cut during ligation of the inferior thyroid artery in thyroidectomy is: a) External laryngeal nerve. b) Sympathetic trunk. c) Recurrent laryngeal nerve. d) Lingual nerve.

36. The pituitary gland is developed from: a) Mesoderm. b) Somatic and neural ectoderm. c) Neural ectoderm. d) Endoderm.

37. As regard the left supra-renal gland, all are true EXCEPT: a) It is semilunar in shape. b) The left supra-renal vein drains into the IVC. c) It is covered by the peritoneum of lesser sac and forming part of the stomach bed. d) It is related posteriorly to the diaphragm.

38. Persistence of the thyroglossal duct leads to the formation of: a) Thyroglossal cyst. b) Thyroglossal fistula. c) Foramen caecum. d) All of the above.

Biochemistry: 39. subunit in G-protein in its active state is bound to: a) CTP. b) CDP. c) GDP. d) GTP.

40. The following characters are specific for group I hormones EXCEPT: a) Lipophilic. b) Short plasma life span. c) Intracellular receptors. d) Need carrier proteins.

41. Insulin stimulates all the following pathway EXCEPT: a) Glycolysis. b) Gluconeogenesis. c) Liver glycogenesis. d) Muscle glycogenesis.
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42. Elevation of cytosolic calcium from intracellular stores for smooth muscle contraction can be caused by: a) Inositol 1,4,5-triphosphate (IP3). b) Diacylglycerol (DAG). c) Phosphatidyl 4,5-biphosphate. d) cAMP.

43. All of the following hormones use cAMP as second messenger EXCEPT: a) Glucagon. b) Calcitonin. c) Corticosteroid. d) Epinephrine.

44. All of the following conditions are accompanied by hypoglycemic EXCEPT: a) Insulinoma b) Leucine-sensitive child c) Hyperparathyroidism d) Overdosage of insulin

45. Intestinal absorption of calcium is increased by: a) Calcitriol. b) Calcitonin. c) Corticosteroids. d) Parathyroid hormone.

Pathology: II. State whether each of the following statement is true or false by shading A for true or B for false, opposite the number of the question in your answer sheet.

46. Adrenocortical carcinomas are more likely to be functional than adenomas. 47. Graves Disease is usually caused by toxic nodular goiter. 48. A thyroid adenoma is usually seen as solitary thyroid nodule.

GOOD LUCK
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