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Pathophysiology Exam III: PITUITARY

Total questions: 84

Worksheet time: 47mins

Name
Class
Date
1.

Alternative names for the pituitary gland

a)

Master gland

b)

Middle manager

c)

Primary gland

d)

Secondary gland

e)

Secondary manager

2.

Posterior pituitary

a)

Neurohypophysis

b)

Adenohypophysis

c)

Neurotransmission

d)

Blood vessels

3.

Anterior pituitary

a)

Neurohypophysis

b)

Adenohypophysis

c)

Neurotransmission

d)

Blood vessels

4.

Hypothalamus is connected to pituitary gland by a stalk consisting of the axons of some hypothalamic neurons with terminal boutons composing the

a)

Anterior pituitary gland

b)

Posterior pituitary gland

c)

Both anterior and posterior pituitary glands

d)

Pituitary [hypophyseal] portal system

e)

Capillaries

5.

Pituitary [hypophyseal] portal system is blood hormones that flow directly from the median eminence to their receptors on the

a)

Anterior pituitary gland

b)

Posterior pituitary gland

c)

Capillaries

d)

Hypothalamus

e)

Both anterior and posterior pituitary glands

6.

Involved in regulating the proliferation of adrenal cells and the growth of the adrenal layers involved in glucorticoid and androgen secretion

a)

ACTH

b)

Prolactin

c)

Vasopressin

d)

Oxytocin

e)

TRH

7.

T/F androgen secretion can occur in both males and females

a)

True

b)

False

8.

Glucorticoids

a)

Induce feedback inhibition to the hypothalamus, where they inhibit CRH secretion

b)

Induce feedback inhibition to the hypothalamus, where they inhibit ACTH secretion

c)

Induce feedback inhibition to the pituitary, where they inhibit CRH secretion

d)

Induce feedback inhibition to the pituitary, where they inhibit ACTH secretion

9.

Chronic activation of the HPA axis

a)

Causes hypertrophy of the adrenal cortex

b)

Causes atrophy of the adrenal cortex

10.

Conditions that down regulate the HPA axis

a)

Causes hypertrophy of the adrenal cortex

b)

Causes atrophy of the adrenal cortex

11.

T/F HPA axis has a significant effect on mineralocorticoid-secreting tissues [aldosterone] because ACTH stimulation triggers the release of mineralocorticoids

a)

True

b)

False

12.

Milk synthesis

a)

ACTH

b)

Prolactin

c)

Vasopressin

d)

Oxytocin

e)

TRH

13.

Secretion of prolactin is mainly (1) by the neurotransmitter (2) from the (3) rather than by a (4)

a)

(1) positively regulated

(2) dopamine

(3) hypothalamus

(4) peptide

b)

(1) negatively regulated

(2) serotonin

(3) hypothalamus

(4) peptide

c)

(1) negatively regulated

(2) dopamine

(3) hypothalamus

(4) peptide

d)

(1) negatively regulated

(2) dopamine

(3) peptide

(4) hypothalamus

e)

(1) positively regulated

(2) serotonin

(3)hypothalamus

(4) peptide

14.

The (1) results in the increase in prolactin secretion

a)

(1) loss of serotonin

b)

(1) increase of serotonin

c)

(1) loss of dopamine

d)

(1) increase of dopamine

15.

Which of the following is true of TRH?

a)

Regulates the secretion of prolactin

b)

Stimulates the secretion of prolactin

c)

Increased levels cause hyperprolactinemia in primary hypothyroidism

d)

Decreased levels cause hyperprolectinemia in primary hypothyroidism

16.

In panhypopituitarism, results in the separation of the pituitary gland from the hypothalamus and the (1)

a)

(1) Loss of all pituitaries

b)

(1) Loss of all pituitaries except ACTH

c)

(1) Loss of all pituitaries except prolactin

d)

(1) Loss of all pituitaries except vasopressin

e)

(1) Loss of all pituitaries except oxytocin

17.

Peptide hormones (1) are synthesized in the supraoptic and paraventricular nuclei of the hypothalamus (HINT: more than one choice is correct)

a)

(1) Vasopressin

b)

(1) ACTH

c)

(1) Oxytocin

d)

(1) Prolactin

e)

(1) TRH

18.

ADH or AVP

a)

Oxytocin

b)

Prolactin

c)

ACTH

d)

Vasopressin

19.

In response to a (1) in blood osmolarity, the hypothalamus responds by triggering the subjective sense of thirst and release of vasopressin

a)

(1) small increase

b)

(1) small decrease

c)

(1) large increase

d)

(1) large decrease

20.

(1) increases the number of active water channels in the cell membranes of renal collecting duct cells, allowing the reabsorption of free water, resulting in the (2)

a)

(1) vasopressin

(2) increase of concentration of the urine

b)

(1) vasopressin

(2) decrease of concentration of the urine

c)

(1) prolactin

(2) increase in concentration of the urine

d)

(1) prolactin

(2) decrease in concentration of the urine

e)

(1) oxytocin

(2) increase in concentration of urine

21.

V1A

a)

Found on smooth muscle

b)

Major effect is vasoconstriction

c)

Found on corticotropes

d)

Contribute to increased ACTH secretion

e)

Found in distal nephrons in the kidneys

22.

V1B

a)

Found on smooth muscle

b)

Major action is to mediate vasopressin's effects on reducing blood osmolality

c)

Found on corticotropes

d)

Contribute to increased ACTH secretion

e)

Found in distal nephrons in the kidneys

23.

V2

a)

Found on smooth muscle

b)

Major action is to mediate vasopressin's effects on reducing blood osmolality

c)

Found on corticotropes

d)

Contribute to increased ACTH secretion

e)

Found in distal nephrons in the kidneys

24.

Milk ejection

a)

Oxytocin

b)

Prolactin

c)

ACTH

d)

Vasopressin

25.

Causes uterine smooth muscle contraction

a)

Oxytocin

b)

Prolactin

c)

ACTH

d)

Vasopressin

26.

Obesity entails changes in body weight due to

a)

Amount of food ingested

b)

Central control of satiety

c)

Hormonal control of assimilation

d)

Physical activity

e)

Metabolic rate

27.

BMI is defined as

a)

Body mass [grams] divided by the body height [meters]

b)

Body mass [kg] divided by the square of the body height [m2]

c)

Body mass [kg] divided by the body height [meters]

d)

Body mass [kg] divided by the square of the body height [cm2]

28.

Normal range for BMI

a)

17.5-24

b)

17.5-25

c)

18.5-25

d)

21.5-25

29.

Obesity BMI is >

a)

29

b)

30

c)

31

d)

29.9

30.

Underweight BMI is <

a)

18.5

b)

18.9

c)

19

d)

19.5

31.

Overweight BMI is

a)

25-30

b)

25-29.5

c)

25-29.9

d)

24.9-30

32.

Drawbacks of BMI

a)

Overestimates the body fat in older persons and others who have lost muscle

b)

Underestimates the body fat in older persons and others who have lost muscle

c)

Underestimates the body fat in athletes and muscular body

d)

Overestimates the body fat in athletes and muscular body

33.

Several mutations in leptin gene or leptin receptor gene

a)

Obesity

b)

Pituitary adenoma

c)

Hypopituitarism

d)

Diabetes insipidus

e)

Diabetes mellitus

34.

Obese humans have (1) rather than (2) leptin levels

a)

(1) excessive

(2) deficient

b)

(1) deficient

(2) excessive

35.

The number of fat cells in the body is established during

a)

Infancy

b)

Childhood

c)

Adolescence

d)

Early adulthood

e)

Late adulthood

36.

Enlargement of individual fat cells

a)

Hyperplasia

b)

Hypertrophy

37.

Increased number of fat cells

a)

Hyperplasia

b)

Hypertrophy

38.

Obesity from (1) appears to be much more easily controlled than obesity from (2)

a)

(1) fat cell hypertrophy

(2) fat cell hyperplasia

b)

(1) fat cell hyperplasia

(2) fat cell hypertrophy

39.

Feedback signals from which of the following are important to the hypothalamic "lipostat"?

a)

Fat cell hypertrophy

b)

Fat cell hyperplasia

40.

T/F how much fat is deposited is more important than where fat is deposited

a)

True

b)

False

41.

(1) seems far more important as a risk factor for obesity-related morbidity and mortality than (2)

a)

(1) visceral or central obesity

(2) subcutaneous or peripheral fat

b)

(1) subcutaneous or peripheral fat

(2) visceral or central obesity

42.

Which of the following is a marker for insulin resistance?

a)

Visceral fat

b)

Peripheral fat

43.

Which of the following is true regarding pituitary adenomas?

a)

Malignant tumor of epithelial cell origin

b)

Enclosed space and very limited capacity to accommodate an expanding mass

c)

Arise from cells that secrete hormones, giving rise to hormone overproduction syndromes

d)

Headaches and vision changes

44.

What is the most common anterior pituitary disorder?

a)

Hyperprolactinemia

b)

Pathologic hyperprolactinemia

c)

Cushing disease

d)

GH secreting adenoma

e)

Hypopituitarism

45.

Tumors or drug related

a)

Hyperprolactinemia

b)

Pathologic hyperprolactinemia

c)

Cushing disease

d)

GH secreting adenoma

e)

Hypopituitarism

46.

Macroadenomas

a)

Mass effects

b)

Hormonal effects

c)

Galactorrhea

d)

Reproductive dysfunction

47.

Microadenomas

a)

Mass effects

b)

Hormonal effects

c)

Galactorrhea

d)

Reproductive dysfunction

48.

Which of the following is true regarding hyperprolactinemia?

a)

Most common posterior pituitary disorder

b)

Most common anterior pituitary disorder

c)

Common consequence is decreased bone density

d)

Common consequence is increased bone density

e)

Tumors or drug related

49.

Involves syndromes such as gigantism and acromegaly

a)

Hyperprolactinemia

b)

Pathologic hyperprolactinemia

c)

Cushing disease

d)

GH secreting adenoma

e)

Hypopituitarism

50.

Excess cortisol because of ACTH overproduction by a pituitary adenoma

a)

Hyperprolactinemia

b)

Pathologic hyperprolactinemia

c)

Cushing disease

d)

GH secreting adenoma

e)

Nelson syndrome

51.

Gigantism

a)

Children

b)

Adults

52.

Acromegaly

a)

Children

b)

Adults

53.

Rapid progression of an ACTH-secreting pituitary adenoma, which is often observed after bilateral adrenalectomy to control the symptoms of cortisol excess

a)

Hyperprolactinemia

b)

Pathologic hyperprolactinemia

c)

Cushing disease

d)

GH secreting adenoma

e)

Nelson syndrome

54.

Loss of one or more pituitary hormones

a)

Hypopituitarism

b)

Panhypopituitarism

c)

Diabetes insipidus

d)

Cushing disease

e)

Nelson disease

55.

Syndrome resulting from complete loss of all hormones secreted by the pituitary gland

a)

Hypopituitarism

b)

Panhypopituitarism

c)

Diabetes insipidus

d)

Cushing disease

e)

Nelson disease

56.

Correct order for panhypopituitarism

a)

GH deficiency, ACTH and gonadotropin deficiencies, and TSH deficiency

b)

TSH deficiency, ACTH and gonadotropin deficiencies, and GH deficiency

c)

ACTH and gonatropin deficiencies, TSH deficiency, and GH deficiency

d)

TSH deficiency, GH deficiency, and ACTH and gonadotropin deficiencies

57.

Which of the following is true regarding sudden onset panhypopituitarism?

a)

Due to trauma or infarction

b)

Decreased bone density

c)

Galactorrhea in women and men

d)

Reproductive dysfunction

e)

Headaches and vision changes can occur

58.

Affecting the synthesis and secretion of vasopressin

a)

Central DI

b)

Nephrogenic DI

c)

Pregnancy

59.

Loss of the kidney's ability to respond to circulating vasopressin

a)

Central DI

b)

Nephrogenic DI

c)

Pregnancy

60.

Caused by head trauma or intracranial tumor

a)

Central DI

b)

Nephrogenic DI

c)

Pregnancy

61.

Variety of drugs may cause this

a)

Central DI

b)

Nephrogenic DI

c)

Pregnancy

62.

Increased metabolic clearance of vasopressin due to presence of excessive vasopressinase in plasma

a)

Central DI

b)

Nephrogenic DI

c)

Pregnancy

63.

Resistant to vasopressin injection

a)

Nephrogenic DI

b)

Central DI

64.

Plasma vasopressin is high

a)

Nephrogenic DI

b)

Central DI

65.

T/F SIADH is hyponatremia with edema

a)

True

b)

False

66.

Which of the following is true regarding SIADH?

a)

Lack of vasopressin secretion

b)

Excess of vasopressin secretion

c)

Caused by tumors and a side effect of many drugs

d)

Watch carefully for fluid intake

67.

Secreted by the Anterior pituitary

a)

GH

b)

TSH

c)

ACTH

d)

LH and FSH

e)

PRL

68.

CRH stimulated which of the following?

a)

GH

b)

TSH

c)

ACTH

d)

LH

e)

FSH

69.

GnRH stimulates which of the following?

a)

GH

b)

TSH

c)

ACTH

d)

LH and FSH

e)

PRL

70.

Which of the following is secreted alone to target cells?

a)

GH

b)

TSH

c)

ACTH

d)

LH and FSH

e)

PRL

71.

Which of the following are secreted by the posterior pituitary?

a)

ADH

b)

Oxytocin

c)

PRL

d)

GH

e)

TSH

72.

-20 mOsm/kg

a)

Hypovolemia

b)

High plasma vasopressin

c)

Low plasma vasopressin

d)

Hypervolemia

73.

+20 mOsm/kg

a)

Hypovolemia

b)

High plasma vasopressin

c)

Low plasma vasopressin

d)

Hypervolemia

74.

T/F plasma vasopressin and plasma osmolality have an indirect relationship

a)

True

b)

False

75.

As plasma osmolality increases, the slope is

a)

Steep

b)

Shallow

76.

Prolactin is released by which hormone?

a)

CRH

b)

GHRH

c)

TRH

d)

GnRH

77.

The hypothalamic inhibiting factor of GH is

a)

Somatostatin

b)

Dopamine

c)

Somatostatin and dopamine

78.

The hypothalamic inhibiting factor of prolactin is

a)

Somatostatin

b)

Dopamine

c)

Somatostatin and dopamine

79.

The hypothalamic inhibiting factor of TSH is

a)

Somatostatin

b)

Dopamine

c)

Somatostatin and dopamine

80.

The target of ACTH is

a)

Adrenal gland

b)

Liver and peripheral tissue

c)

Mammary gland

d)

Thyroid gland

e)

Ovary

81.

The target of GH is

a)

Adrenal gland

b)

Liver and peripheral tissue

c)

Mammary gland

d)

Thyroid gland

e)

Ovary

82.

The target of prolactin is

a)

Adrenal gland

b)

Liver and peripheral tissue

c)

Mammary gland

d)

Thyroid gland

e)

Ovary

83.

The target of TSH is

a)

Adrenal gland

b)

Liver and peripheral tissue

c)

Mammary gland

d)

Thyroid gland

e)

Ovary

84.

The target of LH and FSH is

a)

Adrenal gland

b)

Liver and peripheral tissue

c)

Mammary gland

d)

Thyroid gland

e)

Ovary

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