MCQs PHARMACOLOGY: Hormones and Related Drugs

16.1 The following hypothalamic regulatory hormone is not a peptide:
A. Growth hormone release inhibitory hormone
B. Prolactin release inhibitory hormone
C. Gonadotropin releasing hormone
D. Corticotropin releasing hormone

16.2 Which hormone acts through a cytoplasmic receptor:
A. Calcitriol
B. Prolactin
C. Vasopressin
D. None of the above

16.3 Actions of growth hormone include the following except:
A. Increased protein synthesis
B. Increased fat utilization
C. Increased carbohydrate utilization
D. Glucose intolerance

16.4 Several actions of growth hormone are exerted through the elaboration of: A. Cyclic AMP B. Cyclic GMP C. Somatostatin D. Insulin like growth factor-1

ANSWER
16.1 B 16.2 A 16.3 C 16.4 D


16.5 Octreotide is a long acting synthetic analogue of: A. Prolactin B. Growth hormone C. Somatostatin D. Gonadotropin releasing hormone

16.6 Somatostatin inhibits the release of: A. Growth hormone B. Insulin C. Thyrotropin D. All of the above

16.7 Indications of somatostatin include: A. Macroprolactinoma B. Zollinger Ellison syndrome C. Bleeding esophageal varices D. Steatorrhoea

16.8 Drugs that suppress growth hormone release in acromegaly include the following except: A. Bromocriptine B. Somatostatin C. Octreotide D. Nafarelin

16.9 For therapeutic use, growth hormone is obtained from: A. Recombinant DNA technique B. Human cadaver pituitaries C. Porcine pituitaries D. Chemical synthesis

16.10 Hyperprolactinemia can cause the following except: A. Amenorrhoea B. Gynaecomastia C. Multiple ovulation D. Depressed fertility

ANSWER
16.5 C 16.6 D 16.7 C 16.8 D 16.9 A 16.10 C

16.11 Bromocriptine causes the following: A. Prolactin release B. Vomiting C. Uterine contraction D. Impotence

16.12 The most prominent action of bromocriptine is: A. Dopamine D2 agonism B. Dopamine D2 antagonism C. Dopamine D1 antagonism D. α adrenergic antagonism

16.13 Gynaecomastia can be treated with: A. Chlorpromazine B. Cimetidine C. Bromocriptine D. Metoclopramide

16.14 Menotropins is a preparation of: A. FSH + LH obtained from urine of menstrua-ting women B. LH obtained from urine of pregnant women C. FSH + LH obtained from urine of menopausal women D. LH obtained from serum of pregnant mare

16.15 The hypothalamic gonadotropin releasing hormone (GnRH) is: A. A single peptide B. A mixture of two distinct peptides FSH-RH and LH-RH C. A mixture of several peptides D. Dopamine

ANSWER
16.11 B 16.12 A 16.13 C 16.14 C 16.15 A

16.16 Gonadotropins are indicated in the following conditions except: A. Hypogonadotrophic hypogonadism in males B. Cryptorchism in a boy less than 7 years old C. Amenorrhoea and infertility in women D. Polycystic ovaries

16.17 Superactive GnRH agonists cause: A. Initial as well as sustained release of gonado-tropins B. Initial inhibition followed by stimulation of gonadotropin release after 1-2 weeks C. Initial stimulation followed by inhibition of gonadotropin release after 1-2 weeks D. Initial as well as sustained inhibition of gonadotropin release

16.18 Thyrotropin exerts the following actions on the thyroid gland except: A. Increases vascularity B. Inhibits proteolysis of thyroglobulin C. Induces hyperplasia and hypertrophy D. Promotes iodide trapping

16.19 Serum TSH levels are high in most cases of: A. Myxoedema B. Grave’s disease C. Carcinoma thyroid D. Toxic nodular goiter

16.20 Adrenocorticotropic hormone is primarily used for: A. Treatment of Addison’s disease B. Treatment of congenital adrenal hyperplasia C. Treatment of autoimmune diseases D. Diagnosis of pituitary-adrenal axis disorders

ANSWER
16.16 D 16.17 C 16.18 B 16.19 A 16.20 D

17.1 Trapping of iodide by the following organ/organs is enhanced by thyrotropin: A. Thyroid B. Salivary gland C. Placenta D. All of the above

17.2 Triiodothyronine differs from thyroxine in that: A. It is more avidly bound to plasma proteins B. It has a shorter plasma half life C. It is less potent D. It has a longer latency of action

17.3 Metabolic rate of the following organ is not signifi-cantly affected by thyroxine: A. Brain B. Heart C. Liver D. Skeletal muscle

17.4 The most reliable guide to adjustment of thyroxine dose in a patient of hypothyroidism is: A. Pulse rate B. Body weight C. Serum thyroxine level D. Serum TSH level

17.5 Actions of thyroxine include the following except: A. Induction of negative nitrogen balance B. Reduction in plasma cholesterol level C. Fall in plasma free fatty acid level D. Rise in blood sugar level

17.6 Complications of over treatment with thyroxine include the following except: A. Auricular fibrillation B. Angina pectoris C. Congestive heart failure D. Acceleration of atherosclerosis

17.1 A 17.2 B 17.3 A 17.4 D 17.5 C 17.6 D

17.7 Thyroxine therapy is indicated in the following conditions except: A. Euthyroid status with raised TSH level B. Diffuse nontoxic goiter C. Nonfunctional thyroid nodule D. Benign functioning thyroid nodule

17.8 Triiodothyronine is preferred over thyroxine in the treatment of: A. Endemic goiter B. Cretinism C. Papillary carcinoma of thyroid D. Myxoedema coma

17.9 The following thyroid inhibitor does not produce goiter when given in over dose: A. Propyl thiouracil B. Carbimazole C. Radioactive iodine D. Sodium thiocyanate

17.10 Carbimazole acts by inhibiting: A. Iodide trapping B. Oxidation of iodide C. Proteolysis of thyroglobulin D. Synthesis of thyroglobulin protein

17.11 Antithyroid drugs exert the following action: A. Inhibit thyroxine synthesis B. Block the action of thyroxine on pituitary C. Block the action of TSH on thyroid D. Block the action of thyroxine on peripheral tissues
ANSWERS
17.7 C 17.8 D 17.9 C 17.10 B 17.11 A

17.12 The following thyroid inhibitor interferes with peripheral conversion of thyroxine to triiodothyronine: A. Propyl thiouracil B. Methimazole C. Carbimazole D. Radioactive iodine

17.13 Overtreatment with the following thyroid inhibitor results in enlargement of the thyroid: A. Lugol’s iodine B. Radioactive iodine C. Carbimazole D. All of the above

17.14 A 60-year-old male presents with severe hyperthy-roidism and multinodular goiter. It was decided to treat him with 131I. The most appropriate course of treatment would be: A. Immediate 131I dosing with no other drug before or after B. Propranolol for 1 week followed by 131I C. Propranolol + carbimazole till severe thyro-toxicosis is controlled—1 week gap—131I— resume carbimazole after 1 week for 2-3 months D. Propranolol + Lugol’s iodine for 2 weeks— 131I—continue Lugol’s iodine for 2-3 months

17.15 Carbimazole differs from propylthiouracil in that: A. It is dose to dose less potent B. It has a shorter plasma half life C. It does not produce an active metabolite D. It does not inhibit peripheral conversion of thyroxine to triiodothyronine
ANSWERS
17.12 A 17.13 C 17.14 C 17.15D

17.16 The thyroid inhibitor which produces the fastest response is: A. Lugol’s iodine B. Radioactive iodine C. Propylthiouracil D. Lithium carbonate

17.17 Choose the correct statement about carbimazole: A. It induces improvement in thyrotoxic symp-toms afer 1-4 weeks therapy B. Control of thyrotoxic symptoms with carbi-mazole is accompanied by enlargement of thyroid gland C. Its long term use in Grave's disease leads to ‘thyroid escape’ D. It mitigates thyrotoxic symptoms without lowering serum thyroxine levels

17.18 In the treatment of hyperthyroidism, carbimazole has the following advantage over radioactive iodine: A. Cost of treatment is lower B. It is preferable in uncooperative patient C. It is better tolerated by the patients D. Hypothyroidism when induced is reversible

17.19 Lugol’s iodine is used in hyperthyroidism: A. As long term definitive monotherapy B. Preoperatively for 10-15 days C. Postoperatively for 10-15 days D. As adjuvant to carbimazole for long term therapy

ANSWERS
17.16 A 17.17 A 17.18D 17.19 B

17.20 The aim of iodine therapy before subtotal thyroid-ectomy in Grave’s disease is: A. To render the patient euthyroid B. To restore the iodine content of the thyroid gland C. To inhibit peripheral conversion of thyroxine into triiodothyronine D. To reduce friability and vascularity of the thyroid gland

17.21 The uses of sodium/potassium iodide include the following except: A. Preoperative preparation of Grave’s disease patient B. Prophylaxis of endemic goiter C. As antiseptic D. As expectorant

17.22 The physical half life of radioactive 131I is: A. 8 hours B. 8 days C. 16 days D. 60 days

17.23 The most important drawback of radioactive iodine treatment of Grave’s disease is: A. Subsequent hypothyroidism in many patients B. Marked side effect for 1-2 weeks after treat-ment C. High cost D. Permanent cure cannot be achieved

17.24 Propranolol is used in hyperthyroidism: A. As short-term symptomatic therapy till effect of carbimazole develops B. As long-term therapy after subtotal thyroid-ectomy C. In patients not responding to carbimazole D. To potentiate the effect of radioactive iodine
ANSWERS
17.20D 17.21 C 17.22 B 17.23 A 17.24 A

17.25 Radioactive iodine is the treatment of choice for the following category of thyrotoxic patients: A. Children B. Young adults with recent oneset of Grave’s disease C. Elderly patients with ischaemic heart disease D. Pregnant women

18.1 Insulin release from pancreatic β cells is augmented by the following except: A. Ketone bodies B. Glucagon C. Vagal stimulation D. Alfa adrenergic agonists

18.2 Action of Insulin does not include the following: A. Facilitation of glucose transport into cells B. Facilitation of glycogen synthesis by liver C. Facilitation of neoglucogenesis by liver D. Inhibition of lipolysis in adipose tissue

18.3 The major limitation of the thiazolidinediones in the treatment of type 2 diabetes mellitus is: A. Frequent hypoglycaemic episodes B. Hyperinsulinemia C. Lactic acidosis D. Low hypoglycaemic efficacy in moderate to severe cases

18.4 Glucose entry into the cells of the following organ/ tissue is highly dependent on the presence of insulin: A. Brain B. Liver C. Adipose tissue D. Kidney tubules
ANSWERS
17.25 C 1 8 . 1D 1 8 . 2 C 1 8 . 3D 1 8 . 4 C

18.5 Choose the correct statement(s) about actions of insulin: A. It favours translocation of glucose trans-porters from intracellular site to the plasma membrane B. It enhances transcription of lipoprotein lipase in vascular endothelium C. It increases production of the enzyme gluco-kinase D. All of the above

18.6 The insulin receptor is a: A. Ion channel regulating receptor B. Tyrosine protein kinase receptor C. G-protein coupled receptor D. None of the above

18.7 The primary route of administration of insulin is: A. Intradermal B. Subcutaneous C. Intramuscular D. Intravenous

18.8 The duration of action of insulin-zinc suspension (lente insulin) is: A. 2–4 hours B. 8–10 hours C. 20–24 hours D. 30–36 hours

18.9 The most common adverse reaction to insulin is: A. Hypoglycaemia B. Lipodystrophy C. Urticaria D. Angioedema
ANSWERS
1 8 . 5D 1 8 . 6 B 1 8 . 7 B 1 8 . 8 C 1 8 . 9 A


18.10 Which of the following is true of counterregulatory symptoms of insulin hypoglycaemia: A. They generally appear before neurogluco-penic symptoms B. They are accentuated after long-term insulin treatment C. They result from parasympathetic activation D. They manifest as hunger and fatigue

18.11 Which of the following is a neuroglucopenic symp-tom of hypoglycaemia: A. Sweating B. Palpitation C. Tremor D. Abnormal behaviour

18.12 There is no alternative to insulin therapy for: A. All type 1 diabetes mellitus patients B. All type 2 diabetes mellitus patients C. Type 2 diabetes patients not controlled by a sulfonylurea drug D. Type 2 diabetes patients not controlled by a biguanide drug

18.13 In diabetic patients, round the clock tight control of hyperglycaemia achieved by multiple daily insulin injections or insulin pumps: A. Prevents macrovascular disease more effectively B. Is recommended in all type 2 diabetes patients C. Is associated with higher incidence of hypo-glycaemic reactions D. Both A and C are correct
ANSWERS
18.10 A 18.11 D 18.12 A 18.13 D