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171 Cards in this Set
- Front
- Back
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1. What % of a person’s height is complete in utero?
a. 10% b. 30% c. 40% d. 15% |
30%
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2. What time period involved the most rapid growth
a. Prenatal b. Prepubertal c. Infant d. Pubertal |
A - 50cm 9mths
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3. What is/are the main regulators of prenatal growth?
a. Foetal nutrition b. Placental function c. Intrauterine infections d. Genetics e. All of the above |
E - also maternal health and env. toxins
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4. How many phases of growth are there after birth?
a. 1 b. 2 c. 3 d. 4 |
3 (0 infantile (0-3 years), pre-pubertal, pubertal)
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5. Regarding the main regulatory factors for the growth phases of a person; which of the following is INCORRECT:
a. Infantile growth depends on nutrition and genetics b. Childhood (3 YO-puberty) growth depends genetics and growth hormone. c. Pubertal growth depends on sex steroids and growth hormone d. Post-pubertal growth depends on sex/ growth hormones and genetics |
D - no phase of post pubertal growth
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6. Name 4 factors important for optimal growth.
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nutrition, general emotional health, genetic factors and hormones
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7. T/F – Males are usually taller than females by the pre-pubertal phase of growth.
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F - usually same height
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8. What is the average difference in height between males and females after puberty?
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13 cm
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9. What is the main reason for differences in heights between different people?
a. Maternal and childhood nutrition b. Infection at any stage – particularly prenatal c. Toxin exposure during utero d. Genetic factors |
D
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10. T/F – Taller people have slower growth velocity but grow for a longer period?
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F - they have faster growth velocity
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11. Which of the following regarding Growth Hormone is incorrect:
a. Secreted in a pulsatile fashion b. Release is under the influence of somatostatin and GHRH c. Stimulates the production of insulin-like growth factor I d. Its effects are mainly mitogenic and anabolic; it does not have catabolic effects. |
11. D – it has catabolic effects on fat → Lipolysis
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12. What % of weight gain occurs in the pre-natal period of life?
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12.5%
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1. Regarding which of the following statements regarding the pituitary fossa are incorrect (may be more than 1 answer):
a. It is a depression in the ethmoid bone b. Lies superior to the sphenoidal sinus c. Bounded anteriorly and posteriorly by the anterior and posterior clinoid processes d. The roof is formed by the sellar falx e. The pituitary stalk traverses the sellar diaphragm f. Immediately posterior to the pituitary fossa is the optic chiasm in which axons originate from the ganglion cells of the temporal retina. g. Anterolateraly lies the external carotid artery which supplies the ophthalmic, anterior cerebral and middle cerebral arteries. h. Laterally are the cavernous sinuses, which supplies blood into the base of the brain. |
1. A – sphenoid; D – Sella diaphragm; F – it lies anterior, and contains axons from the nasal retina; G – Internal carotid; H - drains blood, not supply
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2. What structures are present in the cavernous sinus?
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2. CN – III, IV, VI, V1, V3 + internal carotid artery with carotid plexus (SNS – from cervical SNS trunk)
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3. What problem can effect both the pituitary and cavernous sinus structures?
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3. Pituitary tumour – pressure effects on pituitary and cavernous sinus structures, also erosion of surrounding bony surfaces
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4. Regarding which of the following statements regarding the pituitary gland are INCORRECT (may be more than 1 answer):
a. Anterior pituitary = neurohypophysis; posterior pituitary = adenohypophysis b. Neurohypophysis originates from the floor of the diencephalons; adenohypophysis originates from embryonic pharynx c. Anterior pituitary contains the pars distalis, pars tuberalis, pars intermedia d. Acidophils in the Ant. Pituitary include lactotropes and gonadotropes e. Basophiles – gonadotropes, thyrotropes, adrenocorticotropes f. The posterior pituitary produces oxytocin and ADH g. The infundibulum process connects the hypothalamus to the Ant. Pituitary via hormone secreting neurons. h. Myelinated fibres connect the hypothalamus to the Post. Pituitary. |
4. A – other way around; D – they are the lactotropes (prolactin) and somatotropes (Growth hormone); G – connects the hypothalamus to the Posterior pituitary; H – non-myelinated fibre
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5. Where are the posterior pituitary hormones synthesized?
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Paraventricular nucleus and supraoptic nucleus of the hypothalamus
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6. What consists of the hypophyseal portal system?
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The venules connecting capillaries in the median eminence - with the sinusoidal capillaries - of the anterior pituitary.
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1. which are the following are not causes of short stature:
a. deficiencies in bone metabolism b. primary bone metabolism c. unknown pathophysiology d. excess GH secretion |
d
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2. T/F regarding the short stature and social development:
a. increased concentration b. poor social skills c. lack of interest in hobbies d. GH may have a central neuroendocrine action e. increased likelihood of being ostracised |
2. a = F; b = T; c = T; d = T; e = T
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3. The best type of care for patients with short stature and their families is/are:
a. education b. tutor after class to keep child up to speed with the grade c. multidisciplinary clinics d. a + b e. a + b + c f. a + c |
f
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1. Which of the following is false regarding ADH:
a. it raises TPR and thereby BP b. secretion is under osmotic as well as volume and pressure control c. excess ADH is a likely cause of polyuria and polydypsia d. it increases CO by raising blood volume |
c
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2. Which of the following is not an action of oxytocin:
a. uterine contraction b. milk production c. milk secretion d. coitus-induced secretion |
b (PRL)
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3. Which of the following is false regarding diabetes insipidus:
a. it results in excess thirst and urine b. urine can have traces of glucose due to its hyperosmolar effect on nephrons c. it can be caused by destruction to cell bodies in the hypothalamus d. VP mutation is often underlying |
b (no glucose detected, polyuria due to def. in ADH leading to lack of water retention)
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1. Regarding Glucocorticoids (GC), which of the following may be incorrect? (more than 1 answer is possible)
a. Formed in the pancreas b. Effect mRNA production, protein expression .. c. … are fatty acid esters. d. Are synthesized from cholesterol e. Act on cell surface receptors – glucocorticoid receptors f. Formed in the adrenal cortex g. Cortisol is an example of an endogenous glucocorticoid h. Dexamethasone is an example of an endogenous glucocorticoid i. Formed in the adrenal medulla j. Causes its effects via a G protein coupled receptor k. Prednisolone, betamethasone and fluticasone are exogenous steroids, commonly used clinically l. Bind intracellular receptors and affect GREs (glucocorticoid response elements) |
F= a,c,e,h,I,j
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2. What is the main reason glucocorticoid replacement (steroids) is associated with so many unwanted side effects?
a. Cross reaction with other receptors (non-glucocorticoid) b. Large doses needed to produce a physiological response c. Unwanted mineralocorticoid effects d. Many types of GC receptors |
D
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3. Which of the following is NOT a mineralocorticoid effect of steroids?
a. Na+ retention b. Hyperglycaemia c. Calcium loss d. K+ loss |
B
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4. What is Transactivation?
a. Activation of gene response elements b. Activation of mRNA to produce proteins c. Activation of proteins via G protein coupled receptors d. Activation of Ion channels via receptors |
A
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4. What is Transactivation?
a. Activation of gene response elements b. Activation of mRNA to produce proteins c. Activation of proteins via G protein coupled receptors d. Activation of Ion channels via receptors |
A - CGR translocates to the nucleus where is binds GREs promoting synthesis of anti-inflammatory proteins and ALSO binds to transcription factors, thereby inhibiting their ability to stimulate mRNA production (such as AP-1 for inflammatory cytokines)
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6. Which is the following sentences are false?
a. DNA is tightly bound around histones in active cells b. Histone de-acetylases unwind DNA from histones c. Histone transferases are responsible for winding DNA onto histones via acetylation d. Histone transferases (HAT) unwind DNA which allow gene transcription e. Histone de-acetylases cause DNA silencing f. GCR inhibit gene transcription via recruiting histone transferases g. Acetylation = gene silencing h. Post-genomic events may be involved in producing the actions of GC – such as facilitating mRNA degradation |
a,b,c,g
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7. What are budesonide, ciclesonide and fluticasone commonly used for?
a. Asthma b. Eczema c. Immunosuppression d. CG replacement therapy |
A
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8. What is oral prednisolone NOT used to treat
a. Rheumatoid arthritis b. Inflammatory bowel disease c. Immunosuppression following organ transplant d. Long term asthma control |
D
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9. What are the actions of fludrocortisone ?
a. Glucocorticoid b. Mineralocorticoid |
B
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10. What is the normal treatment of Addison’s disease?
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Hydrocortisone + fludrocortisone
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11. T/F – IV Hydrocortisone is given for anaphylaxis and severe asthma.
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T
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12. Which treatment is more appropriate for cerebral oedema?
a. Hydrocortisone b. Fludrocortisone c. Carbamazepine d. Dexamethasone |
D
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13. T/F – Steroids usually have the same half life.
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F - hydrocortisone (8-12h), pred (12-36h), dexa (36-72h)
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14. Which of the following contains side effects that are NOT caused by steroids (in different forms including oral, IV, inhaled).
a. Diabetes, myopathy, hypertension, bruising b. Thinning of skin, infertility and Cushings syndrome (including moon face, striae and acne) c. Oral candidiasis, dysphonia and sore throat, acne rosacea, perioral dermatitis, and growth suppression in children d. Infections such as TB, fungal, or cellulites may be exacerbated, reactivate or acquired e. Adrenal Atrophy/suppression, psychiatric disturbances, osteopaenia |
C
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1. What are Steroids synthesised from?
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cholesterol
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2. What are the 5 main groups of steroids?
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2. Glucocorticoids, mineralocorticoids, androgens, estrogens, progestogens
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3. What is produced at the adrenal cortex?
a. Oestrogen b. ACTH c. Catecholamines d. Cortisol |
d
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4. Where is aldosterone produced?
a. Pituitary b. Suprarenal gland c. Hypothalamus d. Gonads e. Pancreas |
b
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5. Which of the following androgens are produced in the suprarenal gland?
a. DHEA b. Testosterone c. Oestradiol d. Androstenedione e. ACTH |
a, d
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6. What steroid hormones are produced by the placenta ?
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estradiol and progesterone
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7. Which of the following statements about the suprarenal gland are INCORRECT (may be more than 1):
a. It has 3 zones and are located on the outside of the medulla. b. Zona glomerulosa produces aldosterone which is regulated by ACTH c. Zona reticulatum produces androgens (androstenedione and DEHA) which is regulated by ATCH d. Zona fasciculata produces cortisol and is controlled by hypothalamic ACTH e. Lack of ACTH will cause atrophy of the Zona fasciculata and reticulatum |
7. B (renin system), D (pituitary ACTH)
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8. Which of the following are INCORRECT statements (more than 1 may be incorrect)
a. Sertoli cells of the testis produce testosterone b. The follicular cells of the ovaries is the major site for estradiol production c. Orchidectomy is a surgery than can only be conducted on the female sex d. LH and FSH stimulate the production of Human chorionic gonadotrophin hormone (HCG) in the human placenta e. Testosterone production is stimulated by LH from the anterior pituitary under the control of GNRH (gonadotrophin releasing hormone) f. Estradiol can be produced by men by conversion of testosterone to estradiol in fat cells g. The corpus luteum synthesizes progesterone after stimulation by TSH |
8. A (Leydig cells), C (males only), D (HCG stimulates oestradiol and progesterone production by the placenta), G (LH stimulates release)
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9. What is the Renin-angiotensin pathway?
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9. Renin from juxtaglomerular apparatus in kidneys is secreted when low salt → converts angiotensinogen (liver) to angiotensin-I → AT-I is then converted to AT-II by ACE → AT-II activates aldosterone release
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10. Cushing’s disease is due to?
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10. elevated cortisol due to excess ACTH
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11. What is Addison’s Disease?
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Reduced cortisol, androgens and aldosterone due to autoimmune attack on the suprarenal gland
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12. What is Congenital Adrenal Hyperplasia due to?
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12. a deficiency of one of several enzymes (such as 21 hydroxylase) → reduced circulating cortisol, and increased androgens.
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1. primary adrenal insufficiency can be due to all except:
a. autoimmune disease b. Cushing’s disease c. granulomatosis d. a and b |
1. b (caused by increased ACTH)
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2. T/F:
a. detection of insufficiency is best undertaken by the synacthen test b. insulin-induced hyperglycaemia is diagnostic of primary adrenal insufficiency c. Cushing’s syndrome falls under the larger category of Cushing’s disease d. a major cause of temporary adrenal insufficiency a destructive lesion |
2. a = T; b = F (used to Dx secondary adrenal insufficiency); c = F (Cushing’s disease falls under syndrome); d = F (destructive lesions cause permanent insufficiency)
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3. primary, secondary, and tertiary levels of adrenal insufficiency affect respectively:
a. hypothalamus, adrenal gland, anterior pituitary b. hypothalamus, anterior pituitary, adrenal gland c. adrenal hormone production, ACTH production, CRH production d. adrenal hormone production, CRH production, ACTH production |
c
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1. which of the following is true regarding blood supply to the adrenal gland:
a. the middle adrenal artery is a branch of the renal artery b. the superior adrenal artery is a branch off the aorta c. the inferior adrenal artery is a branch off the aorta d. the superior adrenal artery is a branch of the inferior phrenic artery |
d
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2. T/F:
a. the cortex is derived from the mesoderm, while the medulla is derived from the neural crest b. both the parenchyma of the cortex and medulla are arranged in ovoid clusters c. catecholamine production can be induced by the ANS and glucocorticoid production d. catecholamines are found in cytoplasmic granules e. the zona fasciculata comprises both lipid droplets and smooth ER |
2. a = T; b = T; c = T; d = T = e = T
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3. what is the predominant hormone found in each of the layers of the adrenal cortex:
a. glucocorticoids = zona reticularis b. mineralocorticoids = zona fasciculata c. androgens = zona fasciculata d. none of the above |
3. d (ZG = mineralocorticoids, ZF = glucocorticoids; ZR = androgens; mnemonic = Go Find Rex. Make Good Sex)
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1. Which of the following statements are INCORRECT:
a. Insulin is produced as a large polypeptide that has 3 modifications before release. b. Insulin is released from pre-formed secretory granules c. Insulin is secreted due to stimuli such as BLG>5mM d. Is produced in the alpha islet cells of the pancreas |
1. A (2 modifications; pre proinsulin is cleaved to → proinsulin, which is hydrolysed to insulin + C-peptide which are both released), D – Beta Cells
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2. Which glucose transporters are present in beta cells?
a. GLUT1 b. GLUT2 c. GLUT3 d. GLUT4 |
b
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3. What is the main way that glucose and insulin secretion stimulating drugs (sulphonylureas) work?
a. Activating Ca channels b. Inhibiting Ca channels c. Activating K channels d. Inhibiting K channels e. Activating Cl channels |
3. D – glucose and these drugs inhibit k channels which prevent K efflux → disrupting membrane potential → voltage gated Ca channels are activated (not the 1st step) → release of vesicles
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4. Which of the following factors potentiate or inhibit insulin release:
a. Glucose b. Glucagon c. SNS activity d. PNS activity e. Glucagon like polypeptide I f. Gastric inhibitory polypeptide |
4. Potentiators (beta cell requires these compounds to respond to glucose) – glucagon, glucagon like polypeptide I, gastric inhibitory polypeptide, PNS; inhibitors – SNS
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5. T/F – insulin release can occur with sight or smell of food without a rise in BGL (pre-absorptive).
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5. T – due to hormonal and neural potentiators
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6. What is the characteristic insulin release like?
a. Biphasic – rapid incline, drop off and then steady build up again b. Monophasic – slowly reaching a peak and steadily reducing over the next few hours c. Monophasic – rapidly coming to the peak and then plateauing and maintaining this until BGL has dropped again d. Circadian – alternated depending on day night cycle |
6. A – initial increase is due to preformed vesicles close to cell surface, attached to sensory apparatus, the second is a slower release group of vesicles located deeper within the cells
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7. Loss of the initial phase of insulin release is characteristic of which type of diabetes?
a. T1D b. T2D c. Gestational diabetes d. Secondary diabetes |
b
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8. Which of the following is not one of the 3 key target tissues of insulin
a. Liver b. Skeletal muscle c. Pancreas d. Adipose tissue |
c
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9. Which of the following are NOT actions of insulin:
a. Increasing glucose transport to skeletal muscle b. Increasing glucose storage c. Increasing glucose utilization d. Increasing glucose formation by gluconeogenesis e. Inhibiting ketone formation f. Promoting lipolysis g. Promoting TAG formation |
c, d, f
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1. Which of the following occurs during starvation:
a. Insulin is low b. Insulin is high c. BGL is low d. Increases GLUT4 expression in fat cells and skeletal muscle e. Increases glycogenolysis via cAMP activation of glycogen phosphorylase f. AA are high g. Glucose utilization and storage is facilitated h. FA are low i. Triacylglycerol lipase is inhibited (converts TAG → glycerol + FA) j. FAs are used by muscle, brain and liver to produce energy k. Lipolysis occurs l. Ketone bodies may be formed |
1. A, C, E, F, K, L
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2. What is the minimum BGL level needed for brain function
a. 1 mM b. 100mM c. 45mM d. 4mM |
d
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3. Why can the brain not use FAs as a source of energy?
a. The cannot cross the BBB b. Neurons do not have the molecular machinery to utilize this energy source c. FAs become hydrolysed on entry in CSF and are no longer suited as the appropriate enzyme substrate d. They are used up be the peripheral cells first |
a
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4. Which of the following regarding amino acids is incorrect:
a. AA can stimulate insulin release b. AA can be used as a substrate for gluconeogenesis c. Starvation leads to reduced AA in the blood d. AA can be used to form ketone bodies |
c
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5. Which of the following regarding diabetes is INCORRECT:
a. Reduced insulin can result in a lower BGL via reducing glucose uptake into tissues b. At a level of 10mM, glycosuria occurs c. During persistent hypoinsulinaemia lipolysis and proteolysis occur, resulting in increased blood FAs and AA concentrations d. During persistent hypoinsulinaemia increased gluconeogenesis and ketone body production occurs e. Hyperglycaemia leads to polyuria and polydypsia f. Hyperglycaemia leads to cellular dehydration by drawing water into the intracellular space g. The combination of acidic lactate, ketone bodies and FAs leads to an acidosis in the body h. Hyperglycaemia/dehydration leads to influx of K out of cells and due to reduced ability to excrete K via the kidneys – hyperkalaemia occurs (can reach dangerous levels) |
A –higher BGL, F – extracellular space, H – efflux of K
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6. T/F enormous and rapid weight loss is associated with T2D Dx.
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T - T1D
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1. Which of the following is true regarding good glycaemic control and diabetic complications:
a. good control is linked with prevention of macrovascular complications b. good control is not linked with any form prevention for complications c. good control is linked with prevention of microvascular complications d. good control is linked with prevention of both microvascular and microvascular complications |
c
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2. T/F:
a. clinical manifestations of non-proliferative retinopathy include microaneurysms, hard and soft exudates, and formation of new vessels b. vision threatening retinopathy refers to proliferative retinopathy with macular oedema c. 30% of type 1 diabetics have diabetic nephropathy d. one sample of ASR is required to Dx microalbuminuria e. most cases of diabetic neuropathy present early with pain, paraesthesia, and numbness |
2. a = F (formation of new vessels in proliferative retinopathy only); b = T; c = T; d = F (requires 2 or 3 samples before treatment given); e = F (most cases present later, or are asymptomatic early)
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3. Which of the following is false regarding treatment for diabetic complications:
a. laser photocoagulation is one strategy to treat diabetic neuropathy b. treatment of hypertension should be targeted when proteinuria is detected in diabetics c. mainstay treatment for nephropathy includes renal dialysis and transplantation d. VEGF antagonists are a form of treatment for retinopathy |
a (used to treat retinopathy, not neuropathy)
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4. Which of the following is false regarding macrovascular complications:
a. there is a higher chance of cardiovascular complications in diabetics with a previous vascular incident b. diabetes is an independent risk factor for cardiovascular disease c. prevention of macrovascular complications relies more on glycaemic control than other risk factors d. targeted structures include the coronary arteries, cerebral and peripheral vessels |
4. c (more important to control HT and hypercholesterolaemia)
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1. The normal blood glucose range is:
a. 2.5-6.5 mM/L b. 3.0-7 mM/L c. 3.5-7.5 mM/L d. 4-8 mM/L |
c
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2. Which of the following is false regarding the use of insulin:
a. 25% of diabetics are on insulin therapy b. all type 1 diabetics require insulin c. the majority of type 2 diabetics require insulin d. type 2 diabetics are on insulin if previous therapy has failed e. insulin is most often given subcutaneously |
2. c (type 2 diabetics are only on insulin therapy if their conditions has digressed or current management is not working)
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3. Which of the following is not an action of insulin:
a. prevent ketoacidosis b. reduce gluconeogenesis c. relieve hypoglycaemia d. prevent microvascular complications |
3. c (relieves hyperglycaemia)
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4. Which of the following is true regarding the administration of insulin:
a. conventionally it is given immediately before a meal b. insulin pump therapy is the mainstay for management c. diabetics prone to fluctuations of BGLs should revert back to injection therapy d. short and rapid acting insulin should no be given too long before or after a meal c |
4. d (should be given immediately before a meal)
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1. Which of the following regarding Weight Gain are TRUE or FALSE?
a. Weight gain may be due to increase in lean body mass b. Weight gain is only due to increase in adiposity c. Weight gain can be due to increase in fluid retention d. Weight gain and loss is a natural part of development e. Adiposity rebound occurs during adulthood f. Adiposity rebound is where fat is gained, lost and gained again (and lost again in preadolescence) g. Weight gain during childhood should generally follow sex specific growth charts |
1. True = a,c,d,f,g; False = b,d,e
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2. Causes of weight gain can include which of the following:
a. Altered osmotic pressure of the plasma due to protein loss usually through the bowel or kidney is a further cause. b. Acromegaly c. Aging d. General factors such as ischaemic cardiac failure or cardiomyopathy, renal failure e. Genetics leading to increased adiposity f. Increase energy intake g. Endocrine disorders such as hyperinsulinaemia, Cushing's Syndrome, hypothyroidism, raised prolactin levels and Type 2 diabetes h. Liver Failure i. Reduced energy expenditure j. Menopause k. Local factors such as varicose veins, groin constriction, removal of lymphatics etc. |
2. ALL – but for different mechanisms → Fluid retention = a,d,h,k; Increased Fat = c, e,f,g,I,j; Increased muscle mass = acromegaly
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1. Which of the following is NOT true about insulin:
a. Is secreted when BGL <5mmol b. Generally has catabolic functions c. Stimulates storage of CHO by promoting synthesis of glycogen and lipids (CHO storage macromolecules) d. Is necessary for the liver to take up glucose |
1. a (>5mM), b (Usually anabolic), d (liver usually has many GLUT at the surface – does NOT need insulin)
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2. Which of the following statements are incorrect?
a. Stimulates lipid formation, via enzyme activation b. Is secreted following meals from the pancreatic beta islet cells c. Is secreted by hormonal, metabolic and neuronal signals d. Effects mainly the liver, skeletal muscle and adipose tissue e. Its major stimulus for release is hyperglycaemia (>5mM) f. Promotes catabolism of protein |
2. J (anabolic)
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3. Which of the following statements regarding insulin are incorrect?
a. Increases AA in the blood b. Inactivates enzymes important for the production of glycogen (such as glycogen synthase) c. Insulin action occurs via binding of insulin to the insulin receptor and a sequence of phosphorylation steps to modulate the activity of key enzymes/processes d. Prevents glycogen breakdown via a reduction in cAMP, which usually is an activator for glycogen and lipid mobilizing enzymes |
3. a (reduces AA in blood by increasing uptake into muscle), b (activates these enzymes)
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4. Which of the following are incorrect?
a. Stimulates mitosis of cells b. It has pleiotropic effects on cells (diverse effects) c. Increases GLUT-4 on skeletal muscle cell surface d. A drop in insulin leads to massive lipid production |
4. d (leads to massive lipolysis)
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5. What BGL is normal?
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5. 5mM
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6. What BGL is associated with insufficient glucose supply to the brain
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6. 3-4mM
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7. At which above what BGL can cellular damage be done if held at this level for extended periods of time?
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7. 9-10mM
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1. Which of the following is not a cause of high LDLs:
a. saturated fats b. trans fatty acids c. polyunsaturated fats d. monounsaturated fats |
d
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2. What is the recommended proportion of fat consumption in the diet (from lowest to highest)?
a. polyunsaturated, monounsaturated, saturated b. saturated, monounsaturated, polyunsaturated c. polyunsaturated, saturated, monounsaturated d. monounsaturated, polyunsaturated, saturated |
c
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3. what are the effects of trans fatty acids?
a. ↓ HDL and LDL b. ↑ HDL and LDL c. ↓ HDL, ↑ LDL d. ↑HDL, ↓ LDL |
c
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4. lauric acid is an example of a:
a. saturated fat b. monounsaturated fat c. polyunsaturated fat d. trans fatty acid |
a
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1. The most common genetic lipid disorder is:
a. remnant hyperlipidaemia b. chylomicronaemia c. familial hypercholesterolaemia d. common hypercholesterolaemia e. familial combined hyperlipidaemia |
e
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2. tendon xanthomas is a feature of:
a. chylomicronaemia b. familial combined hyperlipidaemia c. familial hypercholesterolaemia d. remnant hyperlipidaemia |
c
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3. common hypercholesterolaemia is recognised with cholesterol over which level?
a. 4.8 mM b. 5.0 mM c. 5.2 mM d. 6.0 mM |
c
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4. ApoB is associated with:
a. common hypercholesterolaemia b. familial hypercholesterolaemia c. familial combined hyperlipidaemia d. chylomicronaemia |
c
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5. ApoE is associated with:
a. familial hypercholesterolaemia b. familial combined hyperlipidaemia c. familial hypertriacylglycerolaemia d. remnant hyperlipidaemia |
d
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1. Which of the following are not usually stimuli for sexual intercourse:
a. Visual input b. Auditory input c. Tactile input d. Gustatory input e. Olfactory input |
1. D (Taste, usually the others are more important)
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2. Input from out senses generally converge within the …… and influence the output via the …. . (Fill in the blanks)
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CNS; PNS
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3. There are 4 phases of intercourse, which of the following is not one?
a. Emission b. Excitement c. Orgasmic d. Plateau e. Resolution |
3. A – Excitement, plateau, orgasmic, resolution
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4. What are the main features of the 4 phases of intercourse?
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4. excitement: erection and vasocongestion of penis or clitoris, mucus secretion, heightened sexual awareness, skin flushing due to vasodilation. B) plateau: intensification of these responses, increased heart rate, blood pressure, respiratory rate and muscle tension. C) orgasmic: ejaculation in the male and rhythmic pelvic muscle contraction in the female. D) resolution: subsidence of vasocongestion and systemic manifestations followed by relaxation to return the genitalia and body systems to their prearoused state
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5. Which of the following are TRUE differences in intercourse between males and females?
a. Ejaculation in males which fills the urethra with semen, which is then expelled b. Male orgasm involves rhythmic contraction of skeletal muscles c. Males undergo a refractory period post orgasm lasting from minutes to hours (even days) d. The female does not produce secretions as the male does |
A + C
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6. What is the average volume of ejaculate a male produces/ejaculation and how many sperm are contained within this?
a. 3ml; 3-400 mil b. 4ml; 3-400 mil c. 2ml; 2-300 mil d. 2ml; 3-400 mil |
B
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7. Which of the following characteristics of sperm are not generally used to determine the fertility potential of a semen sample?
a. Number (>20 mil) b. Motility c. Shape d. No. of dead sperm |
D
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8. Is smooth muscle of skeletal muscle important during the emission phase of the movement of semen?
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8. Smooth muscle – this is the phase where secretions from glands and sperm are moved into the urethra; Skeletal muscle at the base of the penis are involved in expulsion phase
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9. T/F – Sexual intercourse is controlled by the Parasympathetic NS
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9. FALSE – SNS is involved during ejaculation
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10. Secretions produced by the female come from where?
a. Vestibular glands b. A transudate due to vasocongestion of vaginal capillaries c. Are secreted by glands of the cervix, stimulated by the parasympathetic NS d. Are not produced from the female, but are due to ejaculate from the male |
10. A + B are correct
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1. What are the main functions of the testis
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spermatogenesis, steroidgenesis
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2. Where is testosterone produced?
a. Cells of the epididymis b. Leydig cells c. Sertoli cells d. Gonadotrophin cells e. Seminiferous tubules |
B
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3. Where are sperm produced?
a. Cells of the epididymis b. Leydig cells c. Sertoli cells d. Gonadotrophin cells e. Seminiferous tubules |
E
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4. What Hormone regulates testosterone production?
a. GnRH b. LH c. FSH d. E2 |
LH (+ GnRH indirectly + hCG [long acting analogue])
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5. Where does LH have is effects and how?
a. Leydig cells of the testis, via adenylyl cyclase linked receptor b. Sertoli cells of the testis, via adenylyl cyclase linked receptor c. Leydig cells of the testis, via IP3 linked receptor d. Sertoli cells of the testis, via IP3 linked receptor |
A
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6. Which of the following does NOT control LH secretion:
a. Testosterone b. Estradiol c. GnRH d. GH |
D
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7. Once bound, how does testosterone exert its effects?
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receptor-testosterone complex -> shedding of inactivating chaperone molecules -> binds ligan activated transcription factors in DNA
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8. Androgen receptor mutations can result in development of a female with XY DNA – T/F
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T (but there is a spectrum and the male also only appears to be mildly under-masculinised)
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9. T/F – Testosterone can have effects via Estradiol receptors and also as a compound called DHT?
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T (E2 conversion occurs via aromatisation (i.e. in adipose tissue), and DHT is a more potent androgen formed via 5-alpha reductase enzyme in certain tissues)
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10. Control of FSH includes which of the following:
a. Inhibin B b. FSH c. GnRH d. Testosterone |
all
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11. Which of the following is not a function of the Sertoli cell in spermatozoa development?
a. Formation of the blood testis barrier b. Support and nourishment via tight junctions c. Secretion and absorption of fluid, ions, metabolites and proteins d. Allow development of mature spermatozoa |
D (occurs in epididymis)
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12. T/F – Mature sperm at diploid cells.
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F (haploid)
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13. T/F – Disorders of spermatogenesis are usually symptomatic.
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F (usually asymptomatic)
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14. What are some known causes of dysfunctional spermatogenesis?
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14. Klinefelter’s syndrome (47 XXY & variants), cytotoxic drugs, irradiation, heat or infective damage.
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1. in order to achieve a successful pregnancy, which of the following must occur:
a. high monthly chance of fertility b. continuous attempt for 1 year c. continuous attempt for 2 years d. a + b e. a + c |
e
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2. fecundability can be defined as the:
a. chance of falling pregnant without contraception b. chance of falling pregnant when attempting for every month for a year c. chance of falling pregnant in any given month d. chance of falling pregnant if both partners are fertile |
c
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3. which of the following is not a cause of absolute infertility:
a. blockage of the fallopian tubes b. endometriosis c. anovulation d. globozoospermia e. azoospermia f. female age |
d (cause of relative infertility)
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4. Which is not a common test used to investigate absolute fertility
a. sperm count b. progesterone levels c. sperm morphology d. hysterosalpingogram |
c (not routinely used)
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1. a positive gestogen test points to:
a. high FSH b. high LH c. chronic anovulation d. hypothalamic-pituitary cause of anovulation |
c
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2. a negative gestogen test indicates:
a. low FSH, high LH b. hypothalamic-pituitary cause of anovulation c. PCOS d. low progesterone |
b
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3. findings for oligomenorrhoea in the investigation of anovulation include:
a. high LH b. low LH c. high androgens d. low androgens e. a + c f. a + d g. b + c h. b + d |
e
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4. which is not a test used to confirm anatomic interference:
a. laparoscopy b. progesterone levels c. ultrasound hysterosalpingography d. endocervical swabs |
b (progesterone levels used in the confirmation of anovulation)
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1. Which of the following is true regarding menstrual bleeding:
a. it is abnormal for the cycle to progress longer than 30 days b. the heaviest stage of the cycle is around the 2nd day c. abnormally heavy menstrual flow is greater than 60 mL d. mean bleeding time of 7-8 days |
b
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2. menstrual abnormalities causes due to hypothalamic dysfunction, surface lesions of the genital trace or PCOS is related to:
a. heavy bleeding b. postmenopausal bleeding c. irregular bleeding d. postcoital bleeding |
c
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3. Which of the following is not a test used to investigate abnormal menstrual bleeding:
a. menstrual charting b. cervical pap smear c. hysterostopy d. transvaginal ultrasound e. FBC |
c (sonohysterography and hysteroscopy)
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4. bleeding of undefined endometrial origin is called:
a. dysfunctional uterine bleeding b. precocious menstrual bleeding c. idiopathic irregular bleeding d. idiopathic heavy bleeding e. postmenopausal bleeding |
d
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1. Which hormonal therapy works by inhibiting endometrial proliferation and pituitary-derived gonadotropin release
a. COCP b. GnRH agonist c. danazol d. antifibrinolytic drugs |
c
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2. Which of the following is not a hormonal replacement drug:
a. prostaglandin synthetase inhibitor b. danazol c. GnRH d. COCP |
a (non-hormonal)
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3. Which of the following is not a surgical form of treatment for abnormal uterine bleeding:
a. endometrial ablation b. hysteroscopy c. myomectomy d. hysteroscopic cervectomy |
d
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4. Which drug works by inhibiting tissue plasminogen activator:
a. danazol b. ethinyl estradiol c. tranexamic acid d. nafarelin |
c
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1. Which drug works by inhibiting tissue plasminogen activator:
a. danazol b. ethinyl estradiol c. tranexamic acid d. nafarelin |
1. Fertilization - depends on presence or absence of Y chromosome in spermatozoa
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2. What are primordial germ cells
a. The cells that allow fertilization (spermatozoa + ova) b. Cells producing the testes and ovaries c. Cells producing future spermatozoa and ova d. Cells of the blastocyst forming the inner cell mass |
c
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3. The presence of a X chromosome forces development of the gonads into testes with Sertoli and Leydig cells – with the development or internal and external genitalia due to hormones secreted from these cells, anti-Mullerian hormone (AMH) and testosterone, respectively. T/F
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3. FALSE - All true, except it is the presence of a Y chromosome
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4. T/F – It is the absence of anti-Mullerian hormone and testosterone that directs development of the ovaries and internal + external female genitalia
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True
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5. T/F – The presence of mesonephric and paramesonephric ducts at 6 weeks indicates the development of a male.
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5. False – at this stage females and males are appear identical and these ducts appear in both females and males at this stage
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6. Which ducts are lost in the female?
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6. Mesonephric ducts → will disappear without testosterone and AMH in the female (paramesonephric ducts remain)
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7. What does the fallopian tubes form from?
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Upper parts of the paramesonephric ducts (lower part → uterus and upper vagina)
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8. What hormones induce the formation of the female external genitalia?
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Maternal and placental estrogens (after 12 weeks)
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9. What does the genital tubercle become in the female?
a. Clitoris b. Labia Majora c. Labia minora d. urethral folds e. urethral opening |
A – urethral folds become the labia majora and minora
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10. What does the genital tubercle become in the male?
a. Testes b. Scrotum c. Penis d. Penile urethra |
Penis (urethral folds fuse → penile urethra and the genital folds → scrotum).
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12. What are the ligaments of the ovaries (2-4cm)?
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suspensory (lateral pelvic wall) + ovarian (uterus) + Broad ligament (double layer of peritoneum)
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13. How long is the uterine tube?
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10cm
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14. What lies anterior to the uterus?
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bladder
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15. What lies posterior to the uterus?
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rectum
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16. What are the parts of the uterus?
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fundus (muscular; top), body (upper 2/3rd), isthmus (between body and cervix), cervix (inferior 1/3rd, opens to vagina)
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17. T/F – peritoneum covers the internal genitalia of the female?
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true – ovaries, uterine tube and uterus
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18. What are the pouches formed by the peritoneum in the abdominopelvic cavity of the female?
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uterovesical, rectouterine (rectovesicle in males)
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19. Between what structures does the vagina open out to?
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paired labia minora (space between them is called the vestibule – and also contains the opening of the urethra anteriorly)
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1. T/F - Vaginal discharge and genital symptoms are a common reason for presentation to a general practitioner.
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T
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2. Which of the following may no be necessary in a complete sexual Hx:
a. Specimen collection b. Contraceptive history c. Gynaecological history d. A history of HIV risk taking behaviour e. A history of recent sexual activity overseas f. General medical history |
A (part of P.E)
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T/F – The requirement of an examination of the Pt depends on the Hx given during consultation.
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3. False – examination should always be conducted
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4. Vaginal discharge may be due to infection of:
a. Vagina b. Uterus c. Cervix d. Ovaries |
4. A and C (uterus is correct but cervix is more correct)
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5. Categorise the following infections into vaginal or cervical infections:
a. Trichomonas vaginalis b. Chlamydia trachomatis c. Neisseria gonorrhoeae d. Candida albicans |
5. A, D = Vaginal; B, C = Cervical
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6. Which of the following can cause vaginal discharge:
a. Neisseria gonorrhoeae b. Scabies c. Candida albicans (non-sexually transmitted) d. Bacterial vaginosis (non-sexually transmitted) e. HSV-1 f. Trichomonas vaginalis g. HIV h. HPV i. Chlamydia trachomatis |
6. A, C, D, F, I
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7. What is the most important complication of infections associated with vaginal discharge?
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7. PID (also pregnancy complications)
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8. What is the most common cause of PID?
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8. Chlamydia (>60%)
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9. What are the long term consequences of PID?
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9. Tubal scarring → tubal factor in infertility + ectopic pregnancy
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1. Which of the following is not a consideration when ordering a test for an STI:
a. the microbial behaviour b. individual behaviour c. family history of STIs d. test reliability |
1. c (family history not a determinant when ordering tests)
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2. Which of the following diseases is not equally common to both sexes when presenting asymptomatically:
a. syphilis b. candidiasis c. HIV d. HSV |
2. b (more common in females)
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3. The best test for the suspicion of HSV (presenting as genital warts):
a. gram staining and culture b. microscopy and PCR c. biopsy and PCR d. culture and PCR |
d
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4. T/F:
a. gram staining and culture are only investigations used with presenting urethral discharge b. vaginal pH and ‘whiff’ often provides evidence for candidiasis and bacterial vaginosis c. NAA testing of arthritis may reveal Reiter’s disease d. testing for genital ulcerations includes gram staining, culture, PCR or microscopy |
4. a = F (NAA also essential); b = T; c = T; d = T
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1. T/F:
a. contact tracing is only used to identify contacts of a person with an STI b. genital warts has a high priority for contact tracing c. HIV/AIDS may be high priority for some groups, but lower for others d. strategies for tracing involves patient referral or provider referral |
1. a = F (also used to make them aware); b = F (low priority); c = T (med for homosexuals, high for rest); d = T
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2. An index case is:
a. a person who presents with an STI b. a person of whom the tracing is made to c. the person diagnosed before tracing d. the person most at risk of developing an STI |
c
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3. Which of the following is not a high priority tracing disease:
a. chlamydia b. PID c. syphilis d. gonorrhoea e. genital herpes f. HBV |
e
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