Deck 12: The Modulation of Body Growth, Development and Metabolism

Question 1

The clinical effects of thionamides for hyperthyroid states do not become apparent until stores of thyroid hormones become depleted, which takes about after the start of therapy.

A) 2 to 3 days
B) 5 to 7 days
C) 7 to 14 days
D) 21 to 28 days

Answer 1

21 to 28 days

Question 2

Which one of the following drugs stimulates gonadotrophin release?

A) The follitropins.
B) Goserelin.
C) Clomiphene.
D) Tetracosactrin.

Answer 2

Goserelin.

Question 3

Which statement is true about oral hypoglycaemic drugs?

A) This group of drugs does not lower blood sugar levels directly.
B) This group of drugs alters liver function or increases effectiveness of endogenous insulin.
C) This group of drugs is always first-line treatment for type 1 diabetes mellitus.
D) Both A and B.

Answer 3

Both A and B.

Question 4

When administering somatropin produced from recombinant DNA technology in a young child, it is important to monitor:

A) urinary levels of potassium and sodium.
B) for limping.
C) serum levels of potassium and sodium.
D) Creutzfeldt-Jakob disease.

Question 5

The pathophysiology of type 1 diabetes mellitus is associated with:

A) hyperinsulinaemia.
B) an autoimmune destruction of pancreatic beta cells.
C) cellular insulin resistance.
D) pregnancy.

Question 6

Which of the following pituitary hormones is a trophic hormone?

A) Prolactin.
B) Oxytocin.
C) Luteinising hormone.
D) Growth hormone.

Question 7

In cases of growth hormone hyposecretion, therapy involves the use of:

A) a somatostatin analogue.
B) tetracosactrin.
C) somatropin.
D) the ergot alkaloids.

Question 8

A drug group that tends to raise blood glucose levels is the:

A) anabolic steroids.
B) oral contraceptives.
C) NSAIDs in high dosage.
D) monoamine oxidase inhibitors.

Question 9

Generally, L-thyroxine is preferable to liothyronine as therapy in hypothyroid states because:

A) it has a longer duration of action.
B) it is less cardiotoxic.
C) levels are easier to monitor.
D) all of the above.

Question 10

Which of the following is true about the action of iodide solutions for hyperthyroid states?

A) High doses of iodide cause an immediate reduction in the release of thyroid hormone.
B) Iodide reduces blood supply to the thyroid gland and makes it firmer.
C) Iodide has a long half-life and greatly reduces the release of thyroid hormone for up to one month.
D) Both A and B.

Question 11

Which one of the following actions is not associated with high doses of vasopressin?

A) It stimulates sodium excretion.
B) It stimulates coagulation.
C) It may lower blood pressure.
D) It reduces blood loss associated with haemorrhage.

Question 12

Which one of the following physiological responses is not associated with thyroid hormones?

A) The facilitation of normal musculoskeletal growth.
B) Glucose storage in the liver.
C) The normal development of the nervous system.
D) Normal lactation.

Question 13

A serious adverse effect associated with drugs that act like or stimulate release of endogenous gonadotrophin is:

A) low levels of oestrogens in the blood.
B) ovarian cysts that may rupture.
C) colon cancer.
D) gonadal atrophy.

Question 14

The type of insulin preparation with an onset of action around 0.5-1 hour and a duration of action of 6-8 hours is:

A) neutral insulin.
B) isophane insulin.
C) ultralente insulin.
D) an insulin analogue.

Question 15

Which of the oral hypoglycaemic drug groups acts by inducing the release of endogenous insulin?

A) The thiazolidinediones.
B) The glucosidase inhibitors.
C) The sulfonylureas
D) The biguanides.

Question 16

Which one of the following statements about oxytocin is correct?

A) There are no clinical uses for oxytocin.
B) Oxytocin is believed to have strong serotonergic and α-adrenergic activity.
C) The anterior pituitary lobe secretes oxytocin.
D) Oxytocin promotes breast milk let-down and facilitates placental delivery.

Question 17

When using desmopressin for renal function testing, effectiveness of treatment is determined by:

A) measuring blood levels of antidiuretic hormone.
B) measuring blood levels of potassium.
C) monitoring fluid balance.
D) measuring urinary levels of sodium.

Question 18

Ergot alkaloids are used to treat prolactin hypersecretion. Their mechanism of action is to:

A) activate dopamine receptors in the pituitary.
B) inhibit prolactin-releasing hormone from the pituitary.
C) increase the production of growth hormone, which is produced by the same cells in the pituitary gland.
D) act on the nipples to desensitise them to stimulation.

Question 19

An injection of glucagon would be appropriate for which of the following?

A) A person with type 1 diabetes mellitus who presents with a blood glucose reading above 18 mmol/L.
B) A person with unstable diabetes insipidus.
C) A person with drug-induced hypoglycaemia
D) A person with type 2 diabetes mellitus who has hypersensitivity reactions to metformin.

Question 20

Glycosylated haemoglobin level (HbA1c) is an indicator of:

A) insulin overdose.
B) normal growth in children with diabetes mellitus.
C) stress.
D) longer-term glycaemic control.

Question 21

Women treated with oestrogen-only preparations may be at an increased risk of developing:

A) colon cancer.
B) Alzheimer's disease.
C) osteoporosis.
D) breast cancer.

Question 22

The glucocorticoids have a role in the therapy associated with:

A) diabetes mellitus.
B) osteoporosis.
C) hypovolaemic shock.
D) hypertension.

Question 23

Which one of the following effects is not associated with adrenocorticoid hormones?

A) An increase in blood glucose levels.
B) Sodium and water retention.
C) The enhancement of immune processes.
D) The distribution of body hair.

Question 24

During spironolactone therapy, the blood levels of should be monitored.

A) sodium
B) potassium
C) urea
D) calcium

Question 25

Which one of the following statements about uric acid is true?

A) It is a product of pyrimidine-based nucleic acid metabolism.
B) It tends to crystallise at relatively low physiological temperatures.
C) Hyperuricaemia always results in gout.
D) Uric acid is very water soluble in kidney filtrate.

Question 26

Stimulant anorectics are only recommended for short-term treatment of obesity for a period of up to:

A) 2 weeks.
B) 6 weeks.
C) 12 weeks.
D) 24 weeks.

Question 27

Prior to commencing probenecid for gout, it is important to inform the person that:

A) probenecid is inactivated by pigments in red food colouring, so they must abstain from foods containing red dye three days prior to commencement of therapy and throughout the course of therapy.
B) probenecid is likely to cause constipation.
C) ceasing oral analgesics is the best way to gauge the effect of a course of probenecid.
D) probenecid is a preventative treatment so should not be commenced while they have acute symptoms of gout.

Question 28

An adverse effect not associated with androgenic drug use is:

A) increased libido.
B) increased aggressiveness.
C) testicular hypertrophy.
D) liver disorders.

Question 29

To minimise the increased incidence of acute gouty attacks at the start of allopurinol treatment, should be given concurrently for the first two months of treatment.

A) colchicine or an NSAID
B) probenecid
C) an intra-articular injection of methylprednisolone
D) a urinary alkaliser such as sodium bicarbonate

Question 30

When commencing a uricosuric agent such as probenecid, the person should be advised to:

A) cease all other medications to reduce drug interactions.
B) ensure adequate fluid intake to reduce kidney stone formation.
C) avoid direct sunlight.
D) avoid urine alkalising preparations.

Question 31

A major consideration associated with the progestogen-only contraceptive pill is:

A) that it cannot be used in breastfeeding women.
B) it increases the risk of breast cancer.
C) it has an increased failure rate compared to the oestrogen-progestogen combinations.
D) if you are intolerant to an oestrogen-progestogen combination you cannot use this preparation either.

Question 32

Which one of the gonadal hormones induces effects that include increased libido, enhanced red blood cell production and raised basal metabolic rate?

A) Oestrogen.
B) Testosterone.
C) Progesterone.
D) Inhibin.

Question 33

Which one of the following drugs or drug groups acts to increase the excretion of uric acid?

A) The corticosteroids.
B) Colchicine.
C) Probenecid.
D) Allopurinol.

Question 34

Colchicine has NSAID properties, but also has specific mechanisms including to treat gout.

A) stimulating prostaglandin synthesis and secretion
B) disruption of leukocyte microtubule function, which inhibits cell migration to the site of inflammation
C) activation of xanthine oxidase
D) creating more acidic urine, which increases excretion of uric acid

Question 35

Hormone replacement therapy comprising an oestrogen-progestogen combination for menopausal and post-menopausal women has been found to:

A) be inappropriate for the short-term relief associated with the clinical manifestations of the menopause.
B) lower the risk of cardiovascular disease in post-menopausal women.
C) reduce the relative risk of osteoporosis and colon cancer but increase the risk of breast cancer and thromboembolism for post-menopausal women receiving therapy.
D) be safer than the use of a selective oestrogen receptor modulator in the management of osteoporosis.

Question 36

When the oral dose exceeds mg daily of prednisolone or equivalent dose, the person will benefit from receiving gastric acid suppressive therapy.

A) 4
B) 6
C) 10
D) 15

Question 37

A characteristic of gout is that:

A) it manifests as a form of arthritis.
B) it is more prevalent in women.
C) the risk of developing it can be reduced by eating foods such as sardines or offal.
D) it is not associated with any genetic predisposition.

Question 38

A typical adverse effect profile of systemic corticosteroid therapy includes:

A) hyperkalaemia, gynaecomastia, skin rashes and menstrual disruption.
B) hot flushes, thromboembolism, leg cramps and gastrointestinal disturbances.
C) nausea, breast tenderness, hypotension and hypoglycaemia.
D) fluid retention, altered mood, altered blood pressure, hypokalaemia, hyperglycaemia and impaired wound healing.

Question 39

In the treatment of type 2 diabetes, a sulfonylurea agent is administered with food to:

A) reduce the incidence of diarrhoea.
B) reduce the incidence of hypoglycaemia.
C) reduce the incidence of vomiting.
D) reduce the drug's metabolism.

Question 40

A specific immune-related effect associated with the glucocorticoid action is:

A) destabilisation of T lymphocytes.
B) increased protein synthesis.
C) increase in neutrophil and macrophage response.
D) reduction in the size and substance of lymph nodes and spleen.

Question 41

Which of the following tests is undertaken before using colchicine for gout prophylaxis?

A) A complete blood count.
B) A liver function test.
C) An electrocardiogram.
D) An exercise tolerance test.

Question 42

Which of the following medications should not be used with the stimulant anorectic phentermine?

A) Amoxycillin.
B) Tramadol.
C) Paracetamol.
D) Metformin.

Question 43

The AAS nandrolone may be used in the treatment of:

A) menopausal symptoms.
B) osteoporosis.
C) enhanced healing after surgery.
D) breast cancer.

Question 44

An overweight individual will have a BMI of:

A) 20-25.
B) 25-30.
C) 30-35.
D) 35-40.

Question 45

Which if the following is an example of a long-acting corticosteroid?

A) Dexamethasone.
B) Cortisone.
C) Prednisone.
D) Budesonide.

Question 46

The SERM tamoxifen is used in the treatment of:

A) menopausal symptoms.
B) osteoporosis.
C) enhanced healing after surgery.
D) breast cancer.

Question 47

Acromegaly is treated using:

A) lanreotide.
B) somatropin.
C) lisuride.
D) domperidone.

Question 48

Which of the following is not true about vitamin D?

A) Deficiency in the vitamin leads to an increase in bone mineralisation.
B) It is absorbed via the gastrointestinal system from vegetable products and some fish.
C) It is essential in the regulation of calcium and phosphorous in the body.
D) It can be 'made' as long as the client has enough exposure to UV rays.

Question 49

Which of the following adverse effects would not be expected during treatment with a stimulant anorectic?

A) Bradycardia.
B) Elevated blood pressure.
C) Euphoria.
D) Psychological dependence.

Question 50

Vitamin D deficiency may occur due to:

A) hypercalcaemia.
B) use of selective oestrogen receptor modulators.
C) inadequate sun exposure.
D) use of calcipotriol.

Question 51

Radioactive iodide may be used to treat hyperthyroidism because:

A) it inhibits conversion of L-thyroxine to L-triiodothyronine.
B) it reduces synthesis of thyroid hormones.
C) it destroys functional thyroid tissue.
D) it depletes thyroid hormone stores.

Question 52

Somatropin is administered by daily subcutaneous injections to stimulate skeletal and cellular growth. What is a major reason why some individuals fail to respond to treatment?

A) The development of somatropin antibodies by the individual taking the somatropin.
B) Use of somatropin extracted from the pituitary glands of human cadavers.
C) Lack of rotation of injection sites.
D) Use of different brands during a treatment regimen.

Question 53

Which of the following corticosteroids is classified as an intermediate-acting agent?

A) Hydrocortisone.
B) Dexamethasone.
C) Prednisolone.
D) Betamethasone.

Question 54

For maximum benefit from the anorectic agent orlistat, the dose should be taken:

A) with three main meals daily.
B) with the morning meal.
C) with the evening meal.
D) at bedtime.

Question 55

Which drug (or drugs) used in the management of hyperthyroidism does not alter the circulating levels of the thyroid hormones?

A) β-blockers.
B) Radioactive iodine.
C) The thionamides.
D) L-thyroxine.

Question 56

Which group of drugs that act on the pituitary are given to prevent premature ovulation associated with assisted reproduction?

A) Gonadotrophin-releasing hormone antagonists.
B) Partial oestrogen agonists.
C) Dopamine agonists.
D) Gonadotrophins.

Question 57

The use of hCG in prepubertal boys can cause:

A) epilepsy.
B) stunted long bone growth.
C) fluid retention.
D) asthma.

Question 58

Which of the following foods inhibit absorption of calcium due to high phytic acid content?

A) Unrefined cereals.
B) Green vegetables.
C) Strawberries.
D) Cow's milk.

Question 59

An ideal glycosylated haemoglobin (HbA1c) level is:

A) 7.0 per cent or less.
B) 8.0 per cent or less.
C) 9.0 per cent or less.
D) 10.0 per cent or less.

Question 60

The mechanism of action of the bisphosphonates is to:

A) release calcium from bones.
B) inhibit bone breakdown and resorption.
C) increase the sensitivity of the calcium-sensing receptor on parathyroid gland cells.
D) raise the blood levels of oestrogen.

Question 61

To ensure maximum efficacy for post-coital contraception, it needs to be administered within 12 hours of sexual intercourse.

Question 62

Which of the following chemical mediators stimulates feeding?

A) Serotonin.
B) Noradrenaline.
C) Peptide YY.
D) Neuropeptide Y.

Question 63

In humans, the two feeding centres are located in the:

A) brain stem.
B) thalamus.
C) hypothalamus.
D) pons.