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Question 1
What is the endocrine system?
A system that regulates body functions through neurotransmitters.
A system that regulates body functions through vitamins.
A system that regulates body functions through enzymes.
A system that regulates body functions through hormones
Question 2
What are the components of the endocrine system?
Pancreas, pituitary gland, hypothalamus, pineal gland, thyroid, parathyroid, adrenal glands, adrenal cortex
Pancreas, pituitary gland, hypothalamus, pineal gland, thyroid, parathyroid, adrenal glands, testes
Pancreas, pituitary gland, hypothalamus, pineal gland, thyroid, parathyroid, adrenal glands, ovaries
Pancreas, pituitary gland, hypothalamus, pineal gland, thyroid, parathyroid, adrenal glands, gonads
Question 3
What is a hormone?
chemical compounds synthesized and released in small amounts into systemic circulation to mediate a physiological function
Question 4
What forms do hormones take?
• steroids • proteins • amines
Question 5
What is the chemical structure of steroids?
Derivatives of cholesterol (hormones from gonads and adrenal) • Lipid soluble • Can cross the phospholipid bilayer • activate receptors inside cells or turn genes on/off
Derivatives of amino acids (hormones from gonads and adrenal).
Derivatives of fatty acids (hormones from gonads and adrenal).
Derivatives of glucose (hormones from gonads and adrenal).
Question 6
What are the main types of non-steroid hormones?
amines and proteins
The main types of non-steroid hormones are steroids and nucleotides.
The main types of non-steroid hormones are steroids and proteins.
The main types of non-steroid hormones are steroids and amines.
Question 7
Structure of protein nature non-steroid hormones
• Synthesized in rough ER as prohormones • packaged in vesicles till release • Most hormones have protein nature • Hydrophilic • Bind to cell surface receptors and activate secondary messengers to induce physiological function
Question 8
Structure of amines
derived from tyrosine • thyroid hormones and adrenaline/noradrenaline
Question 9
What is the predominant mechanism for hormone release regulation?
• Negative feedback mechanism (predominant) • Positive feedback mechanism
Cyclic AMP pathway
Positive feedback mechanism
Autocrine signaling
Question 10
What mechanisms are used for hormone receptor regulation?
Desensitization
Down-regulation, Up regulation
Up-regulation
Autocrine signaling
Question 11
What other mechanisms are used for hormone regulation?
duration, hormone release, transport and elimination.
Question 12
What are the two types of hormones based on their solubility?
Water-soluble and thyroid hormones
water-soluble hormones & steroid & thyroid hormone
Water-soluble and peptide hormones
Water-soluble and protein hormones
Question 13
What role does plasma protein binding play in hormone transport?
It increases hormone activity
It accelerates clearance from the plasma
It has no effect on hormone transport
It acts as a reservoir and slows clearance from the plasma
Question 14
What are cyclical variations of hormones?
variations in hormone release pattern according to developmental stage or circadian clock – Sex hormones – Growth hormone – Cortisol
Question 15
Which hormones are examples of cyclical variations in hormone release?
Insulin, glucagon, and thyroid hormone
Insulin, glucagon, and adrenaline
Sex hormones, growth hormone, and cortisol
Insulin, glucagon, and cortisol
Question 16
WHat hormone does the pineal gland secrete?
Melatonin (amine hormone)
Question 17
What is melatonin's function?
regulating the circadian rhythm and sleep pattern
Question 18
What regulates melatonin?
stimulated by darkness inhibited by daylight
Question 19
What is the pineal gland?
small gland beside the 3rd ventricle
gland located in the brainstem
gland that produces adrenaline
large gland in the pituitary
Question 20
What is the hypothalamus?
A gland that produces digestive enzymes
A neuroendocrine organ
A part of the brain responsible for memory
A muscle that controls heart rate
Question 21
What are the physiological functions of the hypothalamus?
Facilitates learning and memory
Temperature regulation, neuroendocrine control, regulating thirst, hunger, and satiety, and controlling the circadian rhythm
Controls the immune system
Regulates blood pressure and heart rate
Question 22
What is the pituitary gland?
A small pea-sized gland located in the hypophyseal fossa.
A small gland located in the spinal cord
A large gland located in the stomach
A large gland located in the brain
Question 23
What are the two parts of the pituitary gland?
Medulla and corpus
Anterior pituitary and posterior pituitary
Cerebellum and cerebrum
Adenohypophysis and neurohypophysis.
Question 24
How is the pituitary gland attached to the hypothalamus?
By a blood vessel
By a nerve pathway
By a direct connection
By an infundibular stalk.
Question 25
What develops in the third week of embryonic development from the roof of the oral cavity (oral ectoderm)?
The notochord
the anterior pituitary
The mesoderm
The neural tube
Question 26
Where does the posterior pituitary develop from?
The ectoderm
The neural tube
From neurohypophyseal bud from diencephalon
The mesoderm
Question 27
adenohypophysis includes five distinct cell populations
1. somatotrophs 2. lactotrophs 3. gonadotrophs 4. corticotrophs 5. thyrotrophs
Question 28
What are the categories of chromophils?
Basophils
(gonadotrophs, corticotrophs, thyrotrophs)
Acidophils
(somatotrophs, lactotrophs)
Question 29
What is the function of acidophils in the adenohypophysis?
Acidophils secrete follicle-stimulating hormone (FSH)
Acidophils secrete thyroid-stimulating hormone (TSH)
Acidophils secrete growth hormone (GH) and prolactin (PRL).
Acidophils secrete adrenocorticotropic hormone (ACTH)
Question 30
Which hormone is produced by somatotrophs in the adenohypophysis?
Somatotrophs secrete growth hormone (GH).
Somatotrophs secrete thyroid-stimulating hormone (TSH)
Somatotrophs secrete follicle-stimulating hormone (FSH)
Somatotrophs secrete adrenocorticotropic hormone (ACTH)
Question 31
Lactotrophs, aka lactotropes, produce what hormone
prolactin (PRL)
Question 32
What hormone does a gonadotroph produce?
Adrenocorticotropic hormone (ACTH)
Insulin-like growth factor (IGF)
Growth hormone (GH)
Follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
Question 33
Which hormone is produced by corticotrophs?
Insulin
Adrenocorticotropic hormone (ACTH)
Thyroid-stimulating hormone (TSH)
Gonadotropin-releasing hormone (GnRH)
Question 34
What hormone does a thyrotroph produce?
Insulin-like growth factor (IGF)
Gonadotropin-releasing hormone (GnRH)
Adrenocorticotropic hormone (ACTH)
Thyroid-stimulating hormone (TSH)
Question 35
What are chromophobes?
Cells with darker staining that contain no secretory granules
Cells with lighter staining that contain no secretory granules
Cells with lighter staining that contain some secretory granules.
Cells with darker staining that contain secretory granules
Question 36
Which cells are chromophobes?
Melanotrophs and chromophils
Chromophils and folliculo-stellate cells
1.
melanotrophs
→ melanocyte stimulating hormone (MSH) 2.
stem cells
→ hormone producing cells + older chromophil cells that lost their secretory function 3.
folliculo-stellate cells
: have phagocytic and paracrine function
Melanotrophs and stem cells
Question 37
What is in the neurohypophysis?
Myelinated neurons
1. unmyelinated axons 2. blood capillaries 3. pituicytes
Myelinated axons
Myelinated dendrites
Question 38
What hormones are carried by the unmyelinated axons in the neurohypophysis?
Oxytocin and cortisol
Oxytocin and insulin
Oxytocin and adrenaline
Oxytocin and anti-diuretic hormone
from hypothalamus to nerve terminals to axonal distension (herring bodies)
Question 39
What are herring bodies
axonal distensions that store and release the hormones
Question 40
What are pituicytes
glial cells that provide supportive function to the axons
Question 41
how do hormones go from the hypothalamus to the pituitary
Anterior Pituitary - Portal System
→ Hypothalamic releasing/inhibiting hormones are released into a capillary plexus → travel down through portal veins → stimulate anterior pituitary hormone release
Posterior Pituitary - Nerve Tract
→ hormones sent down axon terminals in the pituitary stalk → directly to the posterior lobe for storage (Herring) and release
Question 42
What is the hypothalamic–hypophysial portal system?
transmission of hypothalamic peptides directly to anterior pituitary without systemic dilution
Question 43
Which artery supplies blood to the posterior pituitary gland?
The superior hypophyseal artery.
The inferior hypophyseal artery.
The portal vein.
The carotid artery.
Question 44
What is the hypothalamus-pituitary-peripheral gland axis?
A system for neural control over endocrine function
• hierarchical system for endocrine function regulation • organization allows central control over endocrine function
A system for immune function regulation
A system for digestive function regulation
Question 45
Functions of hypothalamus-pituitary-peripheral gland axis?
untitled answer
Question 46
How does the Hypothalamus control the anterior pituitary?
through releasing/inhibitory hormones via hypothalamic-hypophysial portal system
Question 47
Which hormones are released by the hypothalamus?
Specific hormones
– TRH, thyrotropin-releasing hormone – CRH, corticotropin-releasing hormone – GnRH, gonadotropin-releasing hormone – GHRH, growth hormone-releasing hormone – GH-inhibiting hormone (Somatostatin) – Prolactin-inhibiting hormone (Dopamine)
Tropic hormones
Inhibiting hormones
Question 48
Which hormones does the pituitary gland release in response to hypothalamic hormones?
The pituitary gland releases TSH, LH, FSH, ACTH, growth hormone, and prolactin.
Luteinizing hormone (LH)
Thyroid stimulating hormone (TSH)
Follicle stimulating hormone (FSH)
Question 49
Relationship between TRH and TSH
TRH inhibits the synthesis and release of TSH by thyrotropes in response to TSH.
TRH stimulates the synthesis and release of TSH by thyrotropes in response to TSH.
TRH stimulates the synthesis and release of TSH by thyrotropes in response to TRH.
TSH synthesized in response to TRH
Question 50
What is TSH?
Thyroid stimulating hormone
• glycoprotein hormone • synthesized by thyrotropes
Question 51
What is TRH?
Thyrotropin releasing hormone
• released according to a diurnal rhythm • inhibited by stress, starvation, infection, T3 and somatostatin
Question 52
What factors inhibit the secretion of TRH?
TRH secretion is inhibited by stress, starvation, infection, and thyroid hormones, T4 and somatostatin (ss).
• stress • starvation • infection • thyroid hormones - T3 and somatostatin
TRH secretion is inhibited by stress, starvation, infection, and thyroid hormones, T3 and somatostatin (ss).
TRH secretion is inhibited by stress, starvation, infection, and thyroid hormones, T3 and somatostatin (ss).
Question 53
What is the effect of T3/T4 on the secretion of TSH?
T3/T4 has no effect on TSH secretion.
T3/T4 increases its secretion.
T3/T4 decreases its secretion.
T3/T4 stimulates TSH secretion.
Question 54
What activates TRH and hence TSH secretion?
Cold temperature activates TRH and hence TSH secretion.
Nutrient deficiency activates TRH and hence TSH secretion.
Hot temperature activates TRH and hence TSH secretion.
Stress activates TRH and hence TSH secretion.
Question 55
What is the first function of TSH?
TSH has no effect on thyroid hormone synthesis and release.
TSH stimulates the growth factor for cells of the thyroid gland.
TSH inhibits the synthesis and release of thyroid hormones.
TSH stimulates synthesis/release of thyroid hormones (T4 & T3) • activating synthetic pathway (starting material: iodide and thyroglobulin)
Question 56
What is the second function of TSH?
Growth factor for cells of thyroid gland
i.e increase the size, number and increased secretory activity of thyroid cells
Question 57
What is the role of T3 in the body?
Regulates blood sugar levels
Promotes bone growth
Controls immune system function
maintains the basal metabolism • energy consumption and weight • affect the heart rate • stimulate the response to sympathetic nervous system
Question 58
How is T3/T4 transported in the blood?
Bound to thyroxine-binding globulin
Free in the blood
Bound to hemoglobin
Bound to albumin
Question 59
What happens to T4 in the cell?
Converted to T2
Converted to T5
Enzymatically de-iodinated to T3 → enters nucleus and attaches to specific receptors
Converted to T6
Question 60
Effect of different frequencies of GnRH on LH secretion?
High GnRH: stimulates LH secretion Low GnRH: preferentially stimulate FSH release
Stimulates FSH secretion
No effect on LH secretion
Inhibits LH secretion
Question 61
What is the effect of puberty on GnRH function?
No change in GnRH function
Downregulates the GnRH function
Upregulates the GnRH function
Stimulates FSH release
Question 62
What do sufficient sex steroid hormones do to FSH?
LH
Inhibits its release
FSH
GnRH
Question 63
What do sufficient sex steroid hormones do to LH?
LH release is stimulated by high estrogen levels during ovulation positive feedback mechanism
Question 64
What is the function of gonadotropins?
Inhibit ovulation
promote testosterone secretion in males promotes estrogen and progesterone secretion in females
Stimulate the growth of the uterine lining
Promote the release of estrogen from the ovaries
Question 65
Which hormone stimulates ovulation in females?
FSH =growth of the ovarian follicles + regulate the ovulatory cycle LH = ovulation, progesterone from corpus luteum, steroid release from ovaries
Estrogen
Follicle-stimulating hormone
Progesterone
Question 66
What do FSH and LH do in males?
FSH = spermatogenesis LH = testosterone release
Question 67
What hormone aids in spermatogenesis in males?
Follicle-stimulating hormone
Testosterone
Estrogen
Luteinizing hormone
Question 68
What is the role of CRH in the synthesis of ACTH?
CRH stimulates the adrenal cortex to produce ACTH.
CRH inhibits the release of ACTH.
CRH is released by the posterior pituitary.
CRH is synthesized by the adrenal cortex.
Question 69
How is ACTH synthesized?
In response to corticotropin-releasing hormone (CRH)
• synthesized by corticotropes (POMC cells) • from the prohormone precursor: proopiomelanocortin (POMC)
Question 70
What is the diurnal rhythm of CRH and ACTH release?
CRH and ACTH are released in pulses in the late afternoon.
CRH and ACTH are released in pulses at night.
released in pulses following the diurnal rhythm highest levels in the early morning
CRH and ACTH are released continuously throughout the day.
Question 71
What are the functions of ACTH?
ACTH stimulates the production and release of thyroid hormones and adrenaline.
ACTH stimulates the production and release of growth hormone and prolactin.
1. binds to adrenal receptors + stimulates glucocorticoids. mineralocorticoids • Aldosterone = regulating salt and water metabolism • Glucocorticoids = metabolism and stress response 2. Growth/survival of cells in adrenal cortex 3. glucose metabolism and immune function
ACTH stimulates the production and release of insulin and glucagon.
Question 72
What are glucocorticoids?
Glucocorticoids are hormones produced by the pancreas that regulate metabolism and response to stress.
hormones produced by adrenal cortex regulate metabolism and response to stress
Glucocorticoids are hormones produced by the thyroid gland that regulate metabolism and response to stress.
Glucocorticoids are hormones produced by the pituitary gland that regulate metabolism and response to stress.
Question 73
What is the role of ACTH in the HPA axis?
ACTH stimulates the release of adrenaline from the adrenal medulla.
ACTH stimulates the release of cortisol from the adrenal cortex.
ACTH stimulates the release of insulin from the pancreas.
ACTH inhibits the release of cortisol from the adrenal cortex.
Question 74
What is the negative feedback mechanism of CRH and ACTH?
Cortisol inhibits CRH and ACTH secretion Negative feedback mechanism
Cortisol stimulates the release of insulin.
Cortisol stimulates the release of adrenaline.
Cortisol stimulates CRH and ACTH secretion.
Question 75
Which part of the brain controls the setpoint of the HPA axis?
The thyroid gland controls the setpoint of the HPA axis.
The hypothalamus
The pituitary gland controls the setpoint of the HPA axis.
The adrenal cortex controls the setpoint of the HPA axis.
Question 76
What is GH (somatotropin) synthesized by?
Somatotrophs, released by hypothalamus
Question 77
What is the primary hormone responsible for stimulating growth in humans?
Growth Hormone
Prolactin
Somatostatin
GHRH
Question 78
Regulation of GH via hormones?
Balance between GHRH and Somatostatin
stimulatory: growth hormone-releasing hormone (more dominant) inhibitory: somatostatin
Neutral
Promoting
Stimulatory
Question 79
What is the endocrine axis?
hypothalamic-pituitary-adrenal axis
hypothalamic-pituitary-gonadal axis
hypothalamic-pituitary-thyroid axis
hypothalamic-pituitary-liver axis
Question 80
When is GH released?
at sleep and during exercise in pulsatile manner
at 4 pm
at midnight
at noon
Question 81
What stimulates the production of IGF-1 in the liver?
GH
insulin
cortisol
glucagon
Question 82
What stimulates the secretion of growth hormone?
Sleep, stress, hormones related to puberty, starvation, exercise, and hypoglycemia
Decreased blood free fatty acids
Increased blood glucose
Increased blood amino acids (arginine)
Question 83
What inhibits the secretion of growth hormone?
Decreased blood glucose
Increased blood free fatty acids
Aging
• Somatostatin, somatomedins (IGF-1), obesity, hyperglycemia, and aging • inhibits its secretion by stimulating somatostatin from the hypothalamus
Question 84
Inhibition of GHRH
inhibits its own secretion from the hypothalamus
Question 85
What is the direct effect of growth hormone on adipose tissue?
Lipolysis and lipogenesis
Lipolysis - for energy
fuels higher metabolism for other cells
Lipogenesis
Lipolysis and lipolysis
Question 86
What is the direct effect of growth hormone on the liver?
Promotes gluconeogenesis and glycogenolysis
Promotes glycogenolysis and gluconeogenesis
Promotes glycogenolysis and glycogen synthesis
Promotes glycogen synthesis and gluconeogenesis
Question 87
Effect of growth hormone on tissues?
GH induced insulin resistance
• resistance increased in tissues • less effective in moving glucose into cells
Question 88
What is the indirect effect of insulin-like growth factor 1 (IGF-1)?
Stimulates steady release of somatomedin C
Increases linear growth via action on osteoblasts
• Promotes cellular metabolism • Prevents cell death • ↑ Rate of cell division / differentiation • Promotes protein, RNA and DNA synthesis • Increases linear growth via action on chondrocytes and osteoblasts
Prevents cell death
Question 89
What is prolactin?
A hormone synthesized by pituitary cells in response to thyrotropin-releasing hormone (TRH)
A hormone synthesized by hypothalamic cells in response to thyrotropin-releasing hormone (TRH)
A hormone synthesized by adrenal cells in response to thyrotropin-releasing hormone (TRH)
hormone synthesized by lactotrophs in response to thyrotropin-releasing hormone (TRH)
Question 90
What are the factors that increase prolactin secretion?
Estrogen (pregnancy), breast-feeding, sleep, stress, TRH, prolactin
Estrogen (pregnancy), breast-feeding, sleep, stress, TRH, somatostatin
Estrogen (pregnancy), breast-feeding, sleep, stress, TRH, dopamine agonists
Estrogen (pregnancy), breast-feeding, sleep, stress, TRH, dopamine antagonists.
Question 91
What is the function of prolactin?
• mammary gland development + milk production. • Inhibit ovulation + spermatogenesis via ↓ GnRH • development of breast and mammary glands • modulates reproductive and parental behavior
Promotes bone growth and strength
Regulates blood sugar levels
Increases heart rate
Question 92
How does prolactin inhibit ovulation and spermatogenesis?
By increasing the synthesis and release of GnRH
By directly stimulating ovulation
By decreasing synthesis/release of GnRH
By decreasing estrogen levels
Question 93
What is the effect of prolactin deficiency on milk production in the breast?
Milk production is unaffected
Disruption of milk production in the breast
Increased milk production in the breast
No effect on milk production
Question 94
What are the effects of prolactin abundance?
Galactorrhea, decreased libido, decreased fertility (inhibits GnRH)
No effects on non-lactating females
Prolactin abundance has no effect
Increased libido and fertility
Question 95
How is melanocortin synthesized?
small amounts of MSH is produced by melanotrophs (from POMC) following dopamine stimulation
Question 96
What is the role of Melanocortin in skin pigmentation?
Stimulates melanin synthesis in melanocytes
Promotes hair growth
Inhibits melanin synthesis
Regulates skin temperature
Question 97
What happens when cortisol production decreases in Addison's disease?
Decreases melanin release
Supraphysiological levels of ACTH increase melanin release
No change in melanin release
Increases cortisol release
Question 98
What is the function of the posterior pituitary gland?
Secretes hormones
Controls digestion
Regulates body temperature
Facilitates blood clotting
Question 99
Which hormones are released by the posterior pituitary gland?
Insulin and Glucagon
Estrogen and Progesterone
ADH and Oxytocin
Cortisol and Aldosterone
Question 100
When is ADH released
• In response to nerve stimulation • released in the nerve endings by exocytosis • Acts on the collecting ducts in the nephrons
Question 101
What is the main regulator for ADH release?
Blood pressure
Temperature
Heart rate
Serum osmolarity
Question 102
Which factors increase ADH secretion?
α-Agonists
Ethanol
Serum osmolarity, volume contraction, pain, nausea, hypoglycemia, nicotine, opiate, antineoplastic drugs
ANP
Question 103
What is the antidiuretic effect of ADH?
It increases blood pressure directly.
It decreases water excretion by the kidneys.
It has no effect on water excretion.
It increases water excretion by the kidneys.
Question 104
What happens to blood pressure when ADH is in higher concentration?
It increases venous pressure.
It increases arterial pressure vis vasoconstriction
It decreases arterial pressure.
It has no effect on arterial pressure.
Question 105
Function of oxytocin?
Promotes maternal and social bonding behavior
Stimulate uterine contraction and cervical dilation
• milk ejection • uterine contraction + cervical dilation • maternal and social bonding
Regulates blood pressure
Question 106
Where is oxytocin synthesized and regulated?
From the paraventricular nuclei of the hypothalamus
From the thyroid gland
From the pituitary gland
From the adrenal cortex
Question 107
What stimulates the release of oxytocin
suckling action during lactation and during labor via a positive feedback mechanism
Question 108
Levels of endocrine disorders
Primary - Target gland Secondary - pituitary gland Tertiary - hypothalamus
Tertiary
Secondary
Hypothalamic
Question 109
What is Hypopituitarism?
Hypopituitarism is an increase in pituitary hormones.
decreased secretion of 1+ pituitary hormones
Hypopituitarism is a condition characterized by decreased secretion of all pituitary hormones.
Hypopituitarism is a condition characterized by increased secretion of one or more pituitary hormones.
Question 110
What is Panhypopituitarism
decreased secretion of
all
pituitary hormones
Question 111
What are the causes of Hypopituitarism?
Hypopituitarism can occur secondary to genetic mutations.
Hypopituitarism can occur secondary to a lack of pituitary hormones.
1. Congenital 2. Secondary to: • head trauma/thrombus • radiation, autoimmune disorders/infections • pituitary tumors that compress the pituitary gland
Hypopituitarism can occur secondary to hormonal imbalances.
Question 112
ACTH in adult hypopituitarism?
Increased aldosterone production
Decreased aldosterone production
Increased aldosterone secretion
deficiency leading to adrenal insufficiency
Question 113
TSH in adult hypopituitarism?
Decreased thyroid hormone secretion
Increased thyroid hormone secretion
Decreased thyroid hormone production
Increased thyroid hormone production
Question 114
Gonadotropin in adult hypopituitarism?
Decreased sex hormone secretion
Increased sex hormone secretion
deficiency leading to hypogonadism and declining sexual functions
Increased sex hormone production
Question 115
GH in adult hypopituitarism?
Decreased GH = decrease fat mobilization, weaker muscles and lower bone density
Question 116
ADH in adult hypopituitarism?
ADH deficiency leading to diabetes insipidus
Question 117
Melanocortin in adult hypopituitarism?
Melanocortin deficiency leading to abnormal pallor
Question 118
Causes of dwarfism relating to hormones
1. Panhypopituitarism during childhood - 70% 2. Deficiency of GH - 30 % 3. Deficiency of somatomedin C
Question 119
Effects of Panhypopituitarism during childhood
• Decreased rate of body development • appropriate proportions to each other. • lack adult sexual functions due to gonadotropins deficiency
Question 120
What is the primary cause of dwarfism due to deficiency of growth hormone?
normal growth rate
lack of sexual maturity
slower growth rate but attain sexual maturity and can reproduce
increased rate of body development
Question 121
What is the effect of somatomedin C deficiency on individuals?
normal stature and slower growth
short stature and slower growth
short stature and normal growth
normal stature and faster growth
Question 122
What are the dental complications of hypopituitarism?
Delayed exfoliation of permanent teeth
– Maxilla and mandible are smaller than the normal – delayed exfoliation of primary teeth – delayed eruption of permanent teeth – shorter roots and crowding of permanent teeth
Shorter roots and crowding of primary teeth
Delayed eruption of primary teeth
Question 123
Management of GH deficiency?
Synthetic human somatotropin
Humulin R®
Humulin®
Humalog®
Question 124
Indications for using synthetic human somatotropin?
GH deficiency in children only
GH deficiency in adults with confirmed deficiency only
GH deficiency in adults only
GH deficiency in children with growth retardation + adults with confirmed deficiency
Question 125
Adverse effects of synthetic human somatotropin?
Increased risk of hypertension, edema, and pain at injection site
Increased risk of hypoglycemia, edema, and pain at injection site
Increased risk of diabetes, edema, and pain at injection site
Increased risk of hyperglycemia, edema, and pain at injection site
Question 126
What is hyperpituitarism?
Hyposecretion of thyroid hormones
Hyposecretion of pituitary hormones
Hypersecretion of pituitary hormones
Hypersecretion of thyroid hormones
Question 127
Causes of Hyperpituitarism
1. Pituitary adenoma (common) 2. Congenital • genetic mutation in single cell yielding hormone-secreting tumor
Question 128
Clinical presentations of hyperpituitarism?
Addison's disease
Adulthood: Acromegaly. Childhood: Gigantism
Cushing's syndrome
Gigantism
Question 129
What are the clinical presentations of hyperpituitarism in childhood?
Cushing's syndrome
Gigantism
Addison's disease
Acromegaly
Question 130
What is the primary cause of acromegaly?
Addison's disease
GH-secreting pituitary adenoma
multiple due to high levels of IGF-1
Cushing's syndrome
Diabetes mellitus
Question 131
What are the clinical manifestations of acromegaly?
Hypogonadism
Hypothyroidism
1. Organomegaly: heart, tongue, kidney and vocal cords 2. Joint pain and hunched back 3. onset of insulin resistance
Hyperthyroidism
Question 132
Orofacial presentation of acromegaly
• Thick lips • mandibular overgrowth • prognathism • jaw thickening • maxillary widening, • drifting of teeth/malocclusion. • enlargement of forehead bones and nose
Question 133
What is prognathism?
The protrusion of the chin forward
The protrusion of the upper and lower jaws forward
The protrusion of the lower jaw forward
The protrusion of the upper jaw forward
Question 134
Which bones are thickened in acromegaly?
Frontal bones
Temporal bones
Maxillary bones
Mandibular bones
Question 135
What is the primary characteristic of gigantism?
Rapid growth of all body tissues that can occur before adolescence
Excessive weight gain
Increased bone density
Accelerated heart rate
Question 136
What are the orofacial symptoms of gigantism?
Enlarged liver
Increased muscle mass
• Macroglossia • mandibular protrusion • longer roots • hypercementosis
Hyperthyroidism
Question 137
Hyperglycemia and gigantism?
Hypertension
Hypothyroidism
Hyperglycemia that can lead to destruction of beta cells and diabetes
Hypoglycemia
Question 138
Management of GH over-production?
A) Surgical B) Pharmacological: Somatostatin = growth hormone-inhibiting hormone
Question 139
Indication of Somatostatin as growth hormone-inhibiting hormone
treatment of acromegaly
Question 140
What are the adverse effects of pharmacological management of GH over-production?
Orthostatic hypotension
Bradycardia
GI symptoms (abdominal pain, diarrhea, nausea and vomiting)
Hypertension
Question 141
What is the etiology of central diabetes insipidus?
Damage to the hypothalamus/pituitary gland, congenital defect leading to decreased ADH level.
Damage to the adrenal gland, congenital defect leading to decreased ADH level.
Damage to the thyroid gland, congenital defect leading to decreased ADH level.
Damage to the pancreas, congenital defect leading to decreased ADH level.
Question 142
What gland is responsible for producing ADH in central diabetes insipidus?
Pancreas
Thyroid gland
Hypothalamus
Pituitary gland
Question 143
What are synthetic analogues of ADH?
Vasopressin & Desmopressin
Question 144
What is the indication for the use of Vasopressin and Desmopressin?
Treatment for hypertension
Management of diabetes mellitus
Treatment for hyperthyroidism
Management of central diabetes insipidus
Question 145
What is the adverse effect of Desmopressin?
Desmopressin may cause hypoglycemia
Desmopressin may cause hypothyroidism
Desmopressin may cause xerostomia
Desmopressin may cause hyperglycemia
Question 146
What is the toxicity associated with Desmopressin?
Toxicity is associated with hypokalemia
Toxicity is associated with hypernatremia
Toxicity is associated with hyponatremia
Toxicity is associated with hyperkalemia
Question 147
Causes of Syndrome of Inappropriate Anti-diuretic Hormone Secretion (SIADH)?
Increased ADH release due to thyroid disorders, hyperparathyroidism, and hypothyroidism
Increased ADH release
• CNS disorders, head trauma, injury • ectopic production of ADH in lung malignancies • drugs: carbamazepine and cyclophosphamide
Increased ADH release due to kidney failure, liver failure, and sepsis
Increased ADH release due to diabetes, heart failure, and hypertension
Question 148
Pathophysiology of SIADH?
Increased ADH release due to diabetes, heart failure, and hypertension
excessive free water retention + continued urinary Na+ excretion = hyponatremia and expansion of plasma volume
Increased ADH release due to kidney failure, liver failure, and sepsis
Increased ADH release due to thyroid disorders, hyperparathyroidism, and hypothyroidism
Question 149
Treatment of SIADH?
Eleventh Edition
Twelfth Edition
Fourteenth Edition
Fluid restriction (first line), salt tablets and ADH antagonists