Chemistry 6.7 Clinical Endocrinology

Which of the following hormones is often decreased by approximately 25% in the serum of pregnant women who have a fetus with Down syndrome? A. Estriol (E3) B. Human chorionic gonadotropin (hCG) C. Progesterone D. Estradiol (E2)

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) causes: A. Low serum vasopressin B. Hypernatremia C. Urine osmolality to be lower than plasma D. Low serum electrolytes

Select the hormone which when elevated is associated with galactorrhea, pituitary adenoma, and amenorrhea. A. Estradiol B. Progesterone C. Follicle-stimulating hormone (FSH) D. Prolactin

Zollinger-Ellison (Z-E) syndrome is characterized by great (e.g., 20-fold) elevation of: A. Gastrin B. Cholecystokinin C. Pepsin D. Glucagon

Which statement about multiple endocrine neoplasia (MEN) is true? A. It is associated with hyperplasia or neoplasia of at least two endocrine organs B. Insulinoma is always present when the pituitary is involved C. It is inherited as an autosomal recessive disorder D. Plasma hormone levels from affected organs are elevated at least 10-fold

Select the main estrogen produced by the ovaries and used to evaluate ovarian function. A. E3 B. E2 C. Epiestriol D. Hydroxyestrone

Which statement best describes the relationship between luteinizing hormone (LH) and FSH in cases of dysmenorrhea? A. Both are usually increased when there is pituitary adenoma B. Increases in both hormones and a decrease in estrogen signal a pituitary cause of ovarian failure C. Both hormones normally peak 1 to 2 days before ovulation D. In menopause, the LH level at the midcycle peak is higher than the level of FSH

When pituitary adenoma is the cause of decreased estrogen production, an increase of which hormone is most frequently responsible? A. Prolactin B. FSH C. LH D. Thyroid-stimulating hormone (TSH)

Which set of results is most likely in an adult male with primary testicular failure? A. Increased LH, FSH, and decreased testosterone B. Decreased LH, FSH, and testosterone C. Decreased testosterone, androstenedione, and FSH D. Increased androstenedione, decreased testosterone, and normal FSH

When should progesterone be measured when evaluating an adult female for anovulation? A. At the onset of menses B. During the first 7 days of the menstrual cycle C. At the midcycle just after LH peaks D. At the end of the menstrual cycle

A female with severe excessive pubic and facial hair growth (hirsutism) should be tested for which of the following hormones? A. Estrogen and progesterone B. Chorionic gonadotropin C. Growth hormone D. Testosterone and dehydroepiandrosterone sulfate

Which set of results is most likely in a female with hypogonadotropic ovarian failure? A. Increased LH, FSH, and estrogen B. Decreased LH, FSH, and estrogen C. Decreased prolactin and estrogen D. Increased LH and FSH, and decreased estrogen

The onset of menopause is usually associated with what hormonal changes? A. Decreased estrogen, testosterone, and androgens B. Decreased estrogen, FSH, LH, and progesterone C. Decreased estrogen and progesterone, and increased LH and FSH D. Decreased estrogen and progesterone, normal LH and FSH

Which of the following statements is correct in assessing GH deficiency? A. Pituitary failure may involve one, several, or all adenohypophyseal hormones; but GH deficiency is usually found B. A normal random serum level of GH in a child under 6 years old rules out GH deficiency C. Administration of arginine, insulin, or glucagon will suppress GH release D. GH levels in the blood show little variation within a 24-hour period

Which statement best describes the level of GH in patients with pituitary adenoma associated with acromegaly? A. The fasting GH level is always elevated at least twofold B. Some patients will require a glucose suppression test to establish a diagnosis C. A normal fasting GH level rules out acromegaly D. Patients produce a lower concentration of insulin-like growth factor I (IGF-1) than expected from their GH level

Hyperparathyroidism is most consistently associated with: A. Hypocalcemia B. Hypocalciuria C. Hypophosphatemia D. Metabolic alkalosis

Which statement regarding the use of PTH is true? A. Determination of serum PTH level is the best screening test for disorders of calcium metabolism B. PTH levels differentiate primary and secondary causes of hypoparathyroidism C. PTH levels differentiate primary and secondary causes of hypocalcemia D. PTH levels are low in patients with pseudohypoparathyroidism

The best method of analysis for serum PTH involves using antibodies that react with: A. The amino-terminal fragment of PTH B. The carboxy-terminal end of PTH C. The amino-terminal and either C-middle or C-terminal fragment D. All fragments of PTH as well as intact hormone

Which of the following is most often elevated in hypercalcemia associated with malignancy? A. Parathyroid-derived PTH B. Ectopic PTH C. PTHRP D. Calcitonin

Which is normally the most abundant corticosteroid hormone secreted by the adrenal cortex? A. Cortisol B. Dehydroepiandrosterone C. Aldosterone D. Corticosterone

Which of the following statements regarding adrenal cortical dysfunction is true? A. Patients with Cushing syndrome usually have hyperkalemia B. Cushing syndrome is associated with glucose intolerance C. Addison disease is associated with hypernatremia D. Addison disease is caused by elevated levels of cortisol

Which of the following statements about cortisol in Cushing syndrome is true? A. Twenty-four–hour urinary free cortisol is a more sensitive test than plasma total cortisol B. Patients with Cushing disease show pronounced diurnal variation in serum cortisol C. Free cortisol is increased by a high-serum cortisol-binding protein concentration D. An elevated serum total cortisol level is diagnostic of Cushing syndrome

Which of the following conditions is characterized by primary hyperaldosteronism caused by adrenal adenoma, carcinoma, or hyperplasia? A. Cushing syndrome B. Addison disease C. Conn syndrome D. Pheochromocytoma

Which of the following is the most common cause of Cushing syndrome? A. Pituitary adenoma B. Adrenal hyperplasia C. Overuse of corticosteroids D. Ectopic adrenocorticotropic hormone (ACTH) production by tumors