1.
Which of these is the best answer? The adrenal gland lies:
Correct Answer
C. On the kidneys
Explanation
The adrenal gland is located on the kidneys. This is because the adrenal glands are small, triangular-shaped organs that sit on top of each kidney. They are responsible for producing hormones that regulate various bodily functions, including metabolism, stress response, and blood pressure.
2.
The adrenal cortex secretes steroid hormones. Which of these corticosteroids are mainly secreted by the adrenal cortex?
Correct Answer(s)
C. C19
D. C21
Explanation
The adrenal cortex mainly secretes corticosteroids of the C19 and C21 types. These include hormones such as cortisol, cortisone, and corticosterone, which are involved in regulating metabolism, immune response, and stress response. These hormones play important roles in maintaining homeostasis in the body and are essential for various physiological processes.
3.
The adrenal medulla is composed of modified sympathetic ganglion cells, which is nervous in nature and secretes hormone upon stimulation. Which of these hormones are secreted?
Correct Answer(s)
A. Adrenaline
C. NorepinepHrine
D. Catecholamines
Explanation
E & NE are catecholamines
4.
For the biosynthesis of steroid hormones in the adrenal cortex, adrenal cortex contain cells with large amounts of:
Correct Answer(s)
B. SER
D. Lipid
Explanation
The adrenal cortex is responsible for the biosynthesis of steroid hormones. These hormones are derived from cholesterol, which is a type of lipid. Therefore, it makes sense that the adrenal cortex contains cells with large amounts of lipids, as they are necessary for the production of steroid hormones. Additionally, the smooth endoplasmic reticulum (SER) is involved in the synthesis of lipids, including cholesterol. Therefore, the presence of SER in the adrenal cortex further supports the production of steroid hormones.
5.
The adrenal cortex is divided into 3 zones:1) Zona Glomerulosa (outermost)2) Zona Fasciculata3) Zona reticularisWhat does the Zona glomerulosa secrete?
Correct Answer
A. Mineralocorticoids (Aldosterone, deoxycorticosterone)
Explanation
GFR : Glomerulosa, Fasciculata, Reticularis
6.
The adrenal cortex is divided into 3 zones:1) Zona Glomerulosa (outermost)2) Zona Fasciculata3) Zona reticularisWhat does the Zona Fasciculata & reticularis secrete?
Correct Answer(s)
B. Glucocorticoids
C. Androgens
Explanation
Both secrete glucocorticoids & androgens
7.
What is the arrangement of the cells of the zona glomerulosa?
Correct Answer
B. Whorl of cells
Explanation
The arrangement of the cells in the zona glomerulosa is in a whorl pattern. This means that the cells are arranged in a circular or spiral shape, with each layer of cells overlapping the previous one. This arrangement allows for efficient secretion of aldosterone, which is the primary hormone produced in the zona glomerulosa. The whorl pattern ensures that the cells are closely packed together, maximizing their contact with blood vessels and facilitating the release of aldosterone into the bloodstream.
8.
What is the arrangement of the cells of the zona fasciculata?
Correct Answer
C. Linear cords
Explanation
The arrangement of the cells in the zona fasciculata is in the form of linear cords. This means that the cells are aligned in a linear pattern, forming cords or strands. This arrangement allows for efficient secretion and production of hormones, as the cells are closely packed together and organized in a specific pattern. The linear cords arrangement is characteristic of the zona fasciculata, which is one of the three distinct layers of the adrenal cortex.
9.
What is the arrangement of the zona reticularis?
Correct Answer
A. Netlike
Explanation
The arrangement of the zona reticularis is described as netlike. This suggests that the cells in this region are arranged in a network or mesh-like pattern. This arrangement may be important for the function of the zona reticularis, which is responsible for producing and secreting hormones such as androgens. The netlike arrangement may allow for efficient communication and interaction between the cells, ensuring the proper functioning of this endocrine gland.
10.
Which of these is the rate limiting step for the biosynthesis of cortisol?
Correct Answer
A. Conversion of cholesterol to pregnenolone by desmolase/SCC
Explanation
In Cytoplasm, Cholesterol + Acetate = Cheolesteryl esters stored in storage vacuoles.
Cholesteryl esters ---b/d---> Fatty acid + Cholesterol
1st step : Cholesterol enter mitochondrion –--enzyme desmolase/ SCC---> convert to Pregnenolone (RATE LIMITING STEP)
2nd step : Pregnenolone enters cytoplasm ---enzyme dehydrogenase, isomerase ---> Progesterone ----> Enter Endoplasmic reticulum
3rd step : Progesterone --- enzyme hydroxylase ---> 17 a- hydroxyprogesterone
4th step : 17a-hydroxyprogesterone --- enzyme hydroxylase ---> 11-Deoxycortisol
5th step : 11-Deoxycortisol enters mitochondrion --- enzyme hydroxylase ---> Cortisol ----> Enter cytoplasm
11.
Which of these is the most potent mineralocorticoids?
Correct Answer
A. Aldosterone
Explanation
Aldosterone is the most potent mineralocorticoid because it is primarily responsible for regulating the balance of water and electrolytes in the body. It acts on the kidneys to increase the reabsorption of sodium and the excretion of potassium, leading to increased blood volume and blood pressure. This hormone also plays a role in maintaining the balance of other ions, such as chloride and hydrogen ions. Deoxycorticosterone is also a mineralocorticoid, but it is less potent than aldosterone. Testosterone, cortisol, and adrenaline are not mineralocorticoids and do not have the same effects on electrolyte balance.
12.
Why is it that aldosterone is rapidly cleared from plasma by liver forming tetrahydroaldosterone 3-gluocronide, which is then excreted in the urine?
Correct Answer
C. No specific plasma carrier protein
Explanation
No specific plasma carrier protein, forms weak association with albumin.
Due to lack of specific plasma carrier protein, aldosterone is rapidly cleared from plasma by liver (form tetrahydroaldosterone 3-gluocronide) which will be excreted in the urine.
13.
Which part of the kidney will aldosterone act on?
Correct Answer
A. DCT & CD
Explanation
Same as ADH. It will increase no. of Na+ channels on the apical membrane. The reabsorption of Na will cause a decreased osmolality in the tubules. hence water will be reabsorbed as well via osmotic pull.
14.
Which other parts of the body does aldosterone act on beside the distal tubules of the kidney?
Correct Answer(s)
A. Tongue
B. Stomach
C. Blood vessel
Explanation
It does not only act on kidney tubules for Na+ reabsorption, but also on blood vessels (perspiration), tongue (saliva) and stomach (gastric juice).
15.
For the Na+ to be reabsorbed, Na/K pump will require ATP which will be generated by mitochondrial enzymes (mitochondrial activity increased by aldosterone), therefore Na+ will be reabsorbed, and K+ will be eliminated instead. Therefore, there will be alterations in the acid-base balance of the blood. Loss in basic content (K+) will cause blood to be more..
Correct Answer
A. Acidic
Explanation
The correct answer is acidic because the loss of K+ ions will result in an increase in H+ ions in the blood, leading to a decrease in pH and making the blood more acidic.
16.
The kidney compensate the loss of basic K+ from the reabsorption of Na+ by secreting:
Correct Answer(s)
B. K+
C. H+
E. NH+
Explanation
The kidney compensates for the loss of basic K+ from the reabsorption of Na+ by secreting K+, H+, and NH+. This helps to maintain the acid-base balance in the body. K+ is secreted to regulate potassium levels, H+ is secreted to regulate pH levels, and NH+ is secreted to help eliminate excess ammonia. By secreting these ions, the kidney helps to maintain homeostasis and ensure that the body's electrolyte and acid-base levels remain within the normal range.
17.
How is aldosterone release stimulated?
Correct Answer(s)
A. Renin-angiotensin-aldosterone system
C. Low Na+
D. High K+
Explanation
Aldosterone is needed to conserve Na & eliminate K.
Stress will cause release of corticotropin releasing hormone (CRH) from hypothalamus ----> Adrenocorticotropin (ACTH) from anterior pituitary ----> act on adrenal gland ----> produce aldosterone.
Aldosterone release will cause increase in blood volume & BP, ensuring adequate delivery of O2/CO2 and nutrients during stressful period.
18.
What is the signs & symptoms of aldosteronism? (hypersecretion of aldosterone)
Correct Answer(s)
B. Hypernatremia
C. Hypokalemia
D. Alkalosis
Explanation
Hypernatremia, hypokalemia, and alkalosis are signs and symptoms of aldosteronism, which is the hypersecretion of aldosterone. Hypernatremia refers to an elevated level of sodium in the blood, which can occur due to aldosterone causing increased reabsorption of sodium in the kidneys. Hypokalemia is a condition characterized by low levels of potassium in the blood, which can also result from aldosterone's effect on the kidneys, leading to increased excretion of potassium. Alkalosis refers to an elevated pH level in the blood, which can be caused by aldosterone promoting the excretion of hydrogen ions in the kidneys. These symptoms collectively indicate the presence of aldosteronism.
19.
Glucocorticoids circulates in plasma in protein bouund/free form. Which of these is the plasma binding protein of glucocorticoids?
Correct Answer(s)
A. A-globulin
C. Albumin
Explanation
Plasma binding protein : α-globulin/ transcortin/corticosteroid-binding globulin (CBG) produced in the liver (increased synthesis by estrogens)
Only small amounts bound to albumin (weak association)
Unbound: 8% of total cortisol (biologically active)
20.
Which of these are effect of cortisol?
Correct Answer(s)
A. Increase blood glucose
C. Promote protein metabolisme
D. Weaken immune system
E. Increase blood pressure via aldosterone release
Explanation
Cortisol is a hormone released by the adrenal glands in response to stress. It has several effects on the body. Firstly, it increases blood glucose levels by promoting gluconeogenesis, which is the production of glucose from non-carbohydrate sources such as amino acids and fats. Secondly, cortisol promotes protein metabolism by stimulating protein breakdown in muscles and inhibiting protein synthesis in other tissues. Thirdly, it weakens the immune system by suppressing inflammation and reducing the activity of immune cells. Lastly, cortisol increases blood pressure indirectly by stimulating the release of aldosterone, a hormone that promotes sodium and water retention, leading to increased blood volume and subsequently higher blood pressure.
21.
Does aldosterone inhibit ADH release?
Correct Answer
A. Yes
Explanation
Inhibit ADH release
Binds to cortisol receptors ---> inhibit ADH release ---> increase in free water loss ---> polyuria.
22.
Which of these are signs & symptoms of Cushing's syndrome?
Correct Answer(s)
A. Water & salt retention (aldosterone)
B. Polyuria (inhibit ADH)
C. Tendency to bruising
D. Pendulous abdomen
Explanation
persistent hyperglycemia (high glucose)
loss in muscle & bone protein
water & salt retention (hypertension, oedema) – aldosterone action
swollen ‘moon’ face
buffalo hump
tendency to bruising
poor wound gealing
enhanced anti-inflammatory effects (lack of inflammatory cells)
polyuria, polydipsia – Low ADH
striae
pendulous abdomen
23.
In Addison's disease, we will be able to see:
Correct Answer(s)
A. Deficiency in both glucocorticoids & mineralocorticoids
C. Plasma glucose decrease
D. Dehydration
E. Hypotension
Explanation
Always remember, when there is increase in cortisol, there will be increase in aldosterone but decrease in ADH.
24.
The gonadocorticoids are sex hormones. Which of these are precursors to the sex hormones?
Correct Answer(s)
A. Androsterotenedione
C. DHEA
Explanation
Androsterotenedione and DHEA are precursors to the sex hormones. Androsterotenedione is converted into testosterone and estrogen, while DHEA can be converted into both testosterone and estrogen as well. These precursors play a crucial role in the synthesis of sex hormones and are essential for the proper functioning of the reproductive system.
25.
Which of these are active androgens?
Correct Answer(s)
A. DHT
C. Testosterone
Explanation
DHT (dihydrotestosterone) and testosterone are active androgens because they both play a crucial role in male sexual development and function. They are responsible for the development of male secondary sexual characteristics such as facial hair, deepening of the voice, and muscle growth. On the other hand, progesterone, DHEA, and estrogen are not active androgens. Progesterone is a female hormone involved in the menstrual cycle and pregnancy, DHEA is a precursor to testosterone and estrogen, and estrogen is the primary female sex hormone.
26.
In post-menopausal women, the ovaries will be regressed and will be unable to produce oestrogens. However, there are hormones that will try to compensate for the lack of oestrogen production. Which of these are important precursors of oestrogens for post-menopausal woman?
Correct Answer
B. Androgen
Explanation
Post-menopausal women experience a decline in estrogen production due to the regression of the ovaries. However, other hormones, such as androgens, can act as important precursors for estrogen synthesis in these women. Androgens can be converted into estrogens through a process called aromatization, which occurs in various tissues including adipose tissue, liver, and the brain. Therefore, androgens play a crucial role in compensating for the lack of estrogen production in post-menopausal women.
27.
Gonadocorticoids hypersecretion will cause rapid maturation of reproductive organs & appearance of secondary sex characteristics earlier than most boys. Hypersecretion of gonadocorticoids also will affect females. Which of these are related to hypersecretion in woman?
Correct Answer
B. Androgenital syndrome
Explanation
Develop beard
Masculine pattern of body hair distribution
Clitoris grows to resemble small penis
Also linked to Polycystic Ovarian Syndrome (another post)
28.
Which of these are physiological stressors?
Correct Answer
A. Pregnancy
Explanation
Physiological stressors are factors that cause stress on the body's physical systems. Pregnancy can be considered a physiological stressor because it involves significant changes in hormone levels, physical discomfort, and increased demands on the body. These changes can put stress on various physiological systems, such as the cardiovascular and endocrine systems. Acidosis, trauma, and anger can also be considered physiological stressors as they can have direct physical effects on the body. Peer pressure, on the other hand, is more of a psychological stressor as it primarily affects one's emotional well-being rather than directly impacting the body's physiological systems.
29.
Which of these are physical stressors?
Correct Answer
C. Orthostasis
Explanation
Orthostasis is a physical stressor because it refers to the body's response to changes in posture, particularly when standing up from a sitting or lying position. This change in position can cause a temporary drop in blood pressure, leading to symptoms such as dizziness, lightheadedness, and even fainting. These physical changes and the body's response to them can be considered physical stressors as they put strain on the cardiovascular system.
30.
Which of these are receptors of pain?
Correct Answer
A. Nocireceptor
Explanation
Receptors:
Nocireceptor: pain
Thermo: temperature
Mechano: physical
Baro: blood pressure
Chemo: glucose, acid, O2
In Special senses: sight, smell
31.
During perception of stress, the action potential goes to which ascending pathways?
Correct Answer
B. Somatic sensory cortex
Explanation
Action potential go to..
-> hypothalamus (neuroendocrine response)
-> somatic sensory cortex (perception/stress)
-> motor cortex (voluntary action response)
-> limbic cortex (emotions)
32.
During emotional stress, the action potential goes to which ascending pathways?
Correct Answer
D. Limbic cortex
Explanation
Action potential go to..
-> hypothalamus (neuroendocrine response)
-> somatic sensory cortex (perception/stress)
-> motor cortex (voluntary action response)
-> limbic cortex (emotions)
33.
During stress, which of these hormones will increase?
Correct Answer(s)
A. CRH, ACTH
B. GHRH
Explanation
Increase in CRH – ACTH
Increase in GHRH, Decrease in somatostatin– Growth Hormone
Decrease in PIH – Increase in Prolactin
Decrease in TRH – TSH
Decrease in GnRH – Gonadotropin
34.
Physical stress: Cold pressor test (immersion of hand in cold water for 3 minutes). What is the effect on blood pressure & heart rate according to the graph?
Correct Answer
A. Increase
Explanation
According to the graph, the effect of the cold pressor test on blood pressure and heart rate is an increase. This means that when the hand is immersed in cold water for 3 minutes, both blood pressure and heart rate will go up.
35.
During stress, there are 2 pathways. One of it is the hypothalamo-sympatho-adrenalmedullary axis activation (Flight/fight response)The afferent sensory pathway is the limbic cortex (perception of stress), and the afferent sensory pathways are the sympathetic nervous system (hypothalamus) releasing NA and the adrenal medualla releasing A, NA, dopamine & opioid peptides. What is the role of the adrenal medulla in flight./fight response?
Correct Answer
C. Prolong effects of hypothalamus
Explanation
Efferent Sensory Pathway:
sympathetic nervous system -->Hypothalamus (release noradrenaline)
Adrenal medulla (release A, NA, dopamine & opioid peptides) prolong effects of hypothalamus (EMERGENCY FUNCTION)
Target organs: Skeletal muscles
Increased energy demands by skeletal muscles
more fuel & O2 needed for aerobic production of ATP
More blood flow to skeletal msucles (supply o2, fuels, elimination of products of metabolism & heat)
36.
During stress, there are 2 pathways. One of it is the hypothalamo-pituitary-adrenocortical axis activation (General adaptation syndrome)Based on the graph, there are 3 phases involved:1) Alarm state/Compensation phase2) Resistance phase 3) Exhaustion/Decompensation phaseWhich of these phases where both the sympatho-adrenal & hypothalamo-pituitary-adrenocortical axis are activated?
Correct Answer
A. Compensation pHase
Explanation
Alarm state/Compensation phase:
When the stressor is noticed, there will be onset of shock and decreased resistance.
During this time, both sympatho-adrenal & hypothalamo-pituitary-adrenocortical axis are activated.
Resistance phase:
Resistance to the stressor increased as animal adapted & coped with it
Lasts for as long as the animal can support this heightened resistance.
Exhaustion/Decompensation phase:
Resistance has exhausted
37.
Both adrenaline and noradernaline are secreted during stress. Which of these hormones are secreted when a known familiar stress is encountered?
Correct Answer
B. Noradrenaline
Explanation
Noradrenalin & Adrenaline
equally potent in increasing alertness (adrenaline evokes more anxiety & fear)
Known familiar stress –> more Noradrenaline
Unknown stress – > more Adrenaline
38.
Cortisol secreted during stress allows permissive effects on catecholamines & glucagon. Why is this important?
Correct Answer
A. Essential for survival when stress is severe
Explanation
Glucocorticoids (Cortisol)
Stimulate protein catabolism –> liver uptake of amino acids –> conversion to glucose (gluconeogenesis)
**Anti-insulin action on muscle (own local supply) & adipose tissue (inhibit uptake of glucose)
Increase glucose supply to brain
TG breakdown –> glycerol + FA (fuel for muscle activity)
Increase plasma AA, glucose, glycerol & FA
Permissive effects (gives permission) for:
-Catecholamines (vasoconstriction, bronchodilation, lipolysis)
-Glucagon (gluconeogenesis)
Antiallergic effect
Increase RBC count
Increase neutrophil count
Due to the permissive actions for catecholamines & glucagon, secretion of ACTH & glucocorticoids (cortisol) are essential for survival when stress is severe.
39.
Which of these are effect of prolonged stress on health?
Correct Answer(s)
B. Cardiovascular disease
C. Glucocorticoids in large amount can suppress immune system
D. Glucocorticoids in large amount can increase protein catabolisme (muscle loss)
Explanation
Prolonged stress can have various effects on health, including cardiovascular disease. This is because stress can contribute to high blood pressure, inflammation, and the development of plaque in the arteries, all of which can increase the risk of cardiovascular problems. Additionally, prolonged stress can lead to the release of glucocorticoids in large amounts, which can suppress the immune system. This can make individuals more susceptible to infections and illnesses. Furthermore, excessive glucocorticoid production can also increase protein catabolism, leading to muscle loss.
40.
What is the effect of short term stressors?
Correct Answer
A. Boost immune system
Explanation
Instead, long term stressors will suppress immune system. Effects are more serious on the elderly & those that are already ill.
HIV +ve patients will experience rapid decline in T-helper cells if only provided with low social support.
41.
Negative emotional states will bring about these effects:
Correct Answer(s)
A. Decrease lympHocyte proliferation & reactivity
B. Decrease T-cell function
C. Decrease NK activity
Explanation
IgA will decrease.
Epstein-Barr virus will increase. (DAMAGING!)
42.
What is Cushing's syndrome?
Correct Answer
B. High cortisol
Explanation
Cushing's syndrome is a condition characterized by an excessive production of cortisol, a hormone produced by the adrenal glands. High cortisol levels can lead to a variety of symptoms such as weight gain, high blood pressure, and muscle weakness. It is caused by various factors such as long-term use of corticosteroid medications or tumors in the adrenal glands or pituitary gland. Therefore, the correct answer is "High cortisol" as it accurately reflects the hormonal imbalance associated with Cushing's syndrome.
43.
Pituitary Cushing's Syndrome is not due to hypercortisolism, but due to hyper-ACTH.Which of these are the likely causes of hyper-ACTH?
Correct Answer(s)
A. Pituitary corticotropH adenoma
C. Excessive CRH secretion from hypothalamus
Explanation
Overactivity of pituitary alone is not enough to cause Cushing's, as it is not specific and constant in duration and volume.
44.
Adrenal Cushing's Syndrome is due to hypercortisolism (without high levels of ACTH) due to the hypersecretion which originates in the adrenal gland. Which of these are the likely cause of Adrenal Cushing's Syndrome?
Correct Answer(s)
A. Adrenal cortical adenoma
B. Adrenal cortical carcinoma
D. Adrenal cortical hyperplasia
Explanation
Adrenal Cushing's is not indfluenced by hormonal stimulation of ACTH/CRH. If ACTH level is high, it is known as Pituitary Cushing's Syndrome.
45.
What will happen to the Adrenal Cortex if there is hypersecretion of ACTH from the pituitary?
Correct Answer
C. Bilateral cortical hyperplasia
Explanation
If there is hypersecretion of ACTH from the pituitary, it will lead to an excessive production of cortisol by the adrenal cortex. This can result in bilateral cortical hyperplasia, which is the enlargement of both adrenal cortices. This occurs as a compensatory response to the increased stimulation from ACTH.
46.
What is the treatment for Pituitary Cushing's Syndrome?
Correct Answer
A. Dexamethasone
Explanation
Dexamethasone is the treatment for Pituitary Cushing's Syndrome. Dexamethasone is a glucocorticoid, which is a type of medication that mimics the effects of cortisol, a hormone produced by the adrenal glands. In Pituitary Cushing's Syndrome, there is an overproduction of adrenocorticotropic hormone (ACTH) by the pituitary gland, leading to excessive cortisol production. Dexamethasone works by suppressing the production of ACTH, thereby reducing cortisol levels and alleviating the symptoms of Cushing's Syndrome.
47.
For Adrenal Cushing's Syndrome, does it respond to high dose of glucocorticoid?
Correct Answer
B. No
Explanation
Probably because glucocorticoid will stimulate the hypothalamus. In this case, adrenal cushing's is specifically due to an adrenal cortical lesion.
48.
Cushing's Syndrome can also be caused by an ectopic lesion. Which hormone will be in high levels?
Correct Answer
B. ACTH
Explanation
Cushing's Syndrome is a condition characterized by excessive levels of cortisol in the body. It can be caused by various factors, including an ectopic lesion. In this case, the hormone that will be in high levels is ACTH (adrenocorticotropic hormone). ACTH is produced by the pituitary gland and stimulates the production and release of cortisol from the adrenal glands. When there is an ectopic lesion causing Cushing's Syndrome, it leads to excessive production of ACTH, which in turn increases cortisol levels in the body.
49.
In Pituitary Cushing's syndrome, Dexamethasone can be used as a treatment to suppress the ACTH secretion. In the case of an Ectopic Cushing's syndrome which also hypersecretes ACTH, does Dexamethasone work as a treatment?
Correct Answer
B. No
Explanation
Why?
Dexamethasone acts on Pituitary alone.
50.
In organ transplant patients or with autoimmune diseases, glucocorticoids/ACTH is administered for therapeutic purposes. However, with prolonged administration of glucocorticoids/ACTH, what problems will the patient develop?
Correct Answer
B. Cushing's syndrome
Explanation
This is a Iatrogenic Cushing's Syndrome