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A patient presents with Addison's disease.

Serum The test for adrenal cortical hyperfunction that has the
sodium and potassium analyses are done. The results greatest diagnostic sensitivity is measurement of:
would reveal:
Urinary free cortisol
Normal sodium, low potassium levels
Plasma cortisol
Low sodium, low potassium levels
Urinary 17-hydroxycorticosteroids
Low sodium, high potassium levels
Plasma corticosterone
High sodium, low potassium levels Urinary free cortisol
Low sodium, high potassium levels As a screening test for Cushing's syndrome, the
Hyponatremia (low serum sodium level) may be found in physician wishes to see whether a patient exhibits
all of the following conditions EXCEPT: normal diurnal rhythm of his cortisol secretion. At what
time should the specimens be drawn for plasma cortisol
Addison's disease determination? (Assume a daytime work schedule for
Diarrhea the patient.)
Renal tubular disease
6 AM, noon
Conn's syndrome 8 AM, 2 PM
8 AM, 8 PM
Congestive heart failure
Conn's syndrome Noon, 6 PM
A low-salt diet, low blood pressure, and diuretics would
cause the following results: Noon, midnight
8 AM, 8 PM
Increased renin, increased aldosterone, hypernatremia, A patient is suspected of having Addison's disease. His
hypokalemia laboratory tests show low serum sodium and chloride,
elevated serum potassium, and elevated urine sodium
Increased renin, decreased aldosterone, hypernatremia, and chloride levels. The aldosterone cortisol levels are
hypokalemia decreased. To make a definitive diagnosis, the physician
orders an ACTH stimulation test, and the cortisol level is
Decreased renin, decreased aldosterone, hyponatremia, measured again. If the patient has Addison's disease,
hyperkalemia the cortisol level would ________. If the patient has
hypopituitarism, the levels would _______.
Decreased renin, increased aldosterone, hyponatremia,
hyperkalemia Increase; decrease
Increased renin, increased aldosterone, hypernatremia,
hypokalemia Decrease; increase
The FINAL metabolite of epinephrine that is measured in
urine is: Increase; remain the same

Dopamine Remain the same; increase

Metanephrines Decrease; decrease


Remain the same; increase
Homovanillic acid In a patient who is suspected of having
pheochromocytoma, measurement of which of the
Vanillylmandelic acid following nary compounds would be the most useful?
Vanillylmandelic acid
The definitive diagnosis of primary adrenal insufficiency Vanillylmandelic acid
requires demonstration of:
Homovanillic acid
Decreased urinary 17-keto- and 17-hydroxysteroids
Catecholamines
Decreased cortisol production
Dopamine
Impaired response to ACTH stimulation
Metanephrines
Increased urinary cortisol excretion after metyrapone Metanephrines
Impaired response to ACTH stimulation A genetic disorder causing a deficiency of certain
enzymes in the synthetic pathways leading to cortisol
and aldosterone production is referred to as:
Degraded rapidly in nonneuronal cells by monamine
Congenital adrenal hyperplasia reductase.

Cushing's syndrome Have long half-lives.

Conn's syndrome Circulating blood catecholamines are 99% bound to


albumin.
Addison's disease
Congenital adrenal hyperplasia None of the above accurately describes catecholamines.
A primary hyperaldosteronemic state is characterized by: None of the above accurately describes catecholamines.
The collection of a 24-hour urine is used for measuring:
A urine potassium of 35 mmol/d.
Creatinine clearance
A urine potassium of 21 mmol/d.
Norepinephrine
A spot urine test where the sodium levels are greater
than potassium levels. Dopamine

Within 3 hours of taking 50 mg of captopril, plasma All of the above may be measured in a 24-hour urine
aldosterone was low. All but one of the above may be measured in a 24-hour
urine
All of the above are characteristic of hypoaldosteronism. All of the above may be measured in a 24-hour urine
All of the above are characteristic of hypoaldosteronism. Cushing's syndrome is characterized by which of the
During a low dose (1 mg) dexamethasone suppres-sion following?
test, total cortisol levels measured in a patient at 8:35
am was 2.8 ug/dL. How is this interpreted? Excess secretion of pituitary ACTH

The patient is normal. Adrenal insufficiency

The patient has Cushings syndrome. Corticosteroid excess (in blood)


Low plasma levels of cortisol
The patient has a nonpituitary tumor causing ectopic Corticosteroid excess (in blood)
ACTH syndrome. Which statement below about patients with Addison's
disease is true?
The patient has an ACTH-secreting pituitary adenoma.
The patient is normal. Serum levels of ACTH are high
The most biologically active androgen in this list is:
DHEA Serum levels of cortisol high

DHEAS Adrenal glands produce excessive amounts of


testosterone
LH
It is not a disease of the adrenal glands
FSH Serum levels of ACTH are high
Which of the following classes of compounds are derived
Estrone from tyrosine and includes epinephrine, norepinephrine,
Estrone and dopamine?
Which amino acid is needed for the biosynthesis of
norepinephrine and epinephrine? Steroids
Alanine
Androgens
Phenylalanine
Catecholamines
Isoleucine
Estrogens
Leucine Catecholamines
Pheochromocytoma is a benign or malignant tumor
Serine arising from which of the following?
Phenylalanine
Which of the following describes catecholamines? Bile caniculi
Hydrophobic.
Trophoblastic cells
Maternal ovarian function
Neurochromaffin cells in the adrenal medulla
Fetal and placental function
Follicular cells of the thyroid
Neurochromaffin cells in the adrenal medulla Fetal adrenal function
Which metabolite is most often increased in carcinoid
tumors? Maternal liver function
Fetal and placental function
5-Hydroxyindolacetic acid (5-HIAA) For the past 3 weeks, serum estriol levels in a pregnant
woman have been steadily increasing. This is consistent
3-Methoxy-4-hydroxyphenylglycol (MHPG) with:
3-Methoxydopamine
A normal pregnancy
Homovanillic acid
5-Hydroxyindolacetic acid (5-HIAA) Hemolytic disease of the newborn
Which of the following is NOT a metabolite of
catecholamines? Fetal death

Methoxyhydroxyphenylglycol (MHPG) Congenital cytomegalovirus infection


A normal pregnancy
Vanillylmandelic acid (VMA) Which of the following is secreted by the placenta and
used for the early detection of pregnancy?
Homovanillic acid (HMA)
Follicle-stimulating hormone (FSH)
Monoiodothyronine
Monoiodothyronine Human chorionic gonadotropin (HCG)
Which of the following is described as a smooth muscle
stimulant and vasoconstrictor? Luteinizing hormone (LH)

Aldosterone Progesterone
Human chorionic gonadotropin (HCG)
Cortisol Chronic fetal metabolic distress is demonstrated by:

Serotonin Decreased estrogen in maternal plasma and increased


estriol in amniotic fluid
Deoxycorticosterone
Deoxycorticosterone Increased estradiol in maternal plasma with a
The parent substance in the biosynthesis of androgens corresponding increase of estriol in amniotic fluid
and estrogens is:
Increased urinary estriol excretion and increased
Cortisol maternal serum estriol

Catecholamines Decreased urinary estriol excretion and decreased


maternal serum estriol
Progesterone Decreased urinary estriol excretion and decreased
maternal serum estriol
Cholesterol Androgen secretion by the testes is stimulated by:
Cholesterol
The biologically most active, naturally occurring Luteinizing hormone (LH)
androgen is:
Follicle-stimulating hormone (FSH)
Androstenedione
Testosterone
Dehydroepiandrosterone
Gonadotropins
Epiandrosterone Luteinizing hormone (LH)
Progesterone:
Testosterone
Dehydroepiandrosterone Is produced in adult testes and is responsible for genital
The formation of estriol in a pregnant woman is development, beard growth, muscle development, and
dependent on: sexual drive
Is produced by the placenta during pregnancy, with Prolactin
highest levels seen at conception and then steadily Progesterone
decreasing to non-detectable levels at term Which of the following is the precursor for estradiol
formation in the placenta?
Is lowest is serum during the luteal phase of the
menstrual cycle and highest during the follicular phase Fetal adrenal DHEAS

Parallels activity of the corpus luteum by rapidly Maternal testosterone


increasing following ovulation and then abruptly falling to
initial low concentrations prior to the onset of Maternal progesterone
menstruation
Parallels activity of the corpus luteum by rapidly Placental hCG
increasing following ovulation and then abruptly falling to
initial low concentrations prior to the onset of Fetal adrenal cholesterol
menstruation Fetal adrenal DHEAS
The most potent estrogen, and the substance Which of the following target tissues is incapable of
considered to be the true ovarian hormone, is: producing steroidal hormones?
Estriol
Adrenal medulla
Estrone Placenta
Ovary
Estradiol Testis

Epiestriol Adrenal cortex


Estradiol Adrenal medulla
The placenta secretes numerous hormones, both protein A deficiency in estrogen during the follicular phase will
and steroid. Which of the following hormones is not result in:
secreted by the placenta?
A failure of embryo implantation.
Human chorionic gonadotropin (HCG)
An increased length of the menstrual cycle.
Estrogen
A lack of Graafian follicle release from the ovary.
Human placental lactogen (HPL)
An incomplete development of the endometrium.
Progesterone An incomplete development of the endometrium.
Which hormone is responsible for an increase in body
Luteinizing hormone (LH) temperature at the time of ovulation?
Luteinizing hormone (LH)
If serum levels of estradiol do not increase after injection Progesterone
of hCG, the patient has Estrogen
LH
Primary ovarian failure FSH
Estradiol
Pituitary failure Progesterone
A midcycle LH surge will stimulate which series of
Tertiary ovarian failure events?

Secondary ovarian failure An increase in FSH


Primary ovarian failure
If a patient had a luteal phase defect, which hormone A decrease in FSH
would most likely be deficient?
Anovulation
Progesterone
Amenorrhea
Estrogen
A decrease in progesterone production
hCG A decrease in FSH

FSH Doc booc will get 60 items.from.repro and 30


from.pancreatic. dunno sa adrena