Endocrine System MCQ for RRB & SSC and other Competitive exams
31
What is diabetic ketoacidosis (DKA)?
✓ Answer:
B
A life-threatening complication mainly of Type 1 diabetes characterised by hyperglycaemia, ketosis, and metabolic acidosis
Diabetic Ketoacidosis (DKA) occurs mainly in T1DM (can occur in T2DM). Precipitated by: Missed insulin dose, infection, surgery, stress. Pathophysiology: No insulin causing cells unable to use glucose causing glucose accumulates (hyperglycaemia) causing cells use fat causing fatty acids causing ketone bodies (acetoacetate, beta-hydroxybutyrate, acetone) causing metabolic acidosis. Features: Hyperglycaemia (>11 mmol/L), Metabolic acidosis (pH <7.3, HCO3 <15), Ketonaemia/Ketonuria, Osmotic diuresis causing dehydration, Kussmaul breathing (deep, rapid - compensatory respiratory alkalosis), Fruity/acetone breath, and Nausea, vomiting, abdominal pain. Treatment: IV fluids + Insulin infusion + K+ replacement (fixed rate insulin infusion protocol).
32
What is ACTH (Adrenocorticotrophic Hormone) and what does it stimulate?
✓ Answer:
B
Produced by the anterior pituitary - stimulates the adrenal cortex to produce cortisol
ACTH (Adrenocorticotrophic Hormone / Corticotrophin) is produced by corticotroph cells of the anterior pituitary. It is a fragment of the precursor protein POMC (Pro-opiomelanocortin) - which also gives rise to MSH (Melanocyte Stimulating Hormone) - explaining hyperpigmentation in Addison's disease (excess ACTH causes excess MSH). Actions: Stimulates the zona fasciculata of adrenal cortex causing cortisol production, Also stimulates zona reticularis causing androgens (minor), and Has weak MSH-like activity causing pigmentation if grossly elevated. Regulated by: CRH (corticotrophin-releasing hormone) from hypothalamus (stimulates) and cortisol (negative feedback - suppresses). The HPA (Hypothalamo-Pituitary-Adrenal) axis is tested by: Short Synacthen test (measures cortisol response to synthetic ACTH).
33
What is a goitre?
✓ Answer:
B
Enlarged thyroid gland - can occur in both hypothyroidism and hyperthyroidism
A Goitre is simply an enlargement of the thyroid gland - it can occur with normal, low, or high thyroid hormone levels. Types: Simple/Endemic goitre (due to iodine deficiency - thyroid enlarges trying to compensate for inadequate iodine causing hypothyroidism - most common cause worldwide - iodised salt has dramatically reduced endemic goitre), Toxic goitre (Graves' disease - hyperthyroidism with goitre), Multinodular goitre (multiple nodules - may be toxic or non-toxic), Physiological goitre (during puberty or pregnancy - increased demand), and Hashimoto's thyroiditis (autoimmune hypothyroidism with goitre). A goitre can cause neck swelling, difficulty swallowing (dysphagia), and compressive symptoms.
34
What are the male sex hormones called and where are they produced?
✓ Answer:
B
Androgens (primarily testosterone) - produced mainly by Leydig cells of the testes under LH stimulation
Male sex hormones (Androgens) - primarily Testosterone - are produced by: Leydig cells (interstitial cells) of the testes (95% of testosterone) stimulated by LH from pituitary, and Adrenal cortex (zona reticularis) which produces weak androgens (DHEA, androstenedione) - 5%. Functions of Testosterone: Spermatogenesis (with FSH acting on Sertoli cells), Development of male secondary sexual characteristics (puberty) - deepened voice, facial/body hair, penile/testicular growth, muscle mass, bone density, Anabolic effects (muscle and bone growth), Libido (sex drive), and in fetal life development of male genitalia. Testosterone is converted to DHT (Dihydrotestosterone) - more potent - by 5-alpha reductase (important in prostate and hair follicles).
35
What is the menstrual cycle and which hormones control it?
✓ Answer:
B
A ~28-day cycle controlled by FSH, LH, oestrogen, and progesterone - involving follicular development, ovulation, and uterine preparation
The Menstrual Cycle (~28 days) has two phases. Follicular Phase (Days 1-14): FSH rises causing follicle development causing oestrogen rises causing uterine lining (endometrium) proliferates. Rising oestrogen causes positive feedback causing LH surge (day ~13) causing Ovulation (day 14). Luteal Phase (Days 14-28): Ruptured follicle forms Corpus luteum (under LH) which produces Progesterone + Oestrogen. Progesterone prepares endometrium (secretory phase) for implantation. If NO pregnancy: Corpus luteum degenerates causing progesterone/oestrogen fall causing menstruation (days 1-5). If PREGNANCY: HCG (from embryo) maintains corpus luteum causing progesterone maintained and no menstruation.
36
What are the parathyroid glands and what hormone do they produce?
✓ Answer:
B
Four small glands located on the posterior thyroid that produce PTH to regulate calcium
The Parathyroid Glands are 4 small glands (each the size of a grain of rice, ~50 mg each) located on the posterior surface of the thyroid gland. They produce Parathyroid Hormone (PTH) - the primary regulator of blood calcium levels. PTH is released when blood calcium falls. Actions of PTH (raises calcium): Bone (stimulates osteoclasts - bone resorption - releases Ca2+ into blood), Kidney (increases Ca2+ reabsorption in DCT, increases phosphate excretion, activates Vitamin D via 1-alpha hydroxylase), and Gut (indirectly increases calcium absorption via activated Vitamin D). Calcitonin (from thyroid C-cells) has the OPPOSITE effect - lowers calcium.
37
What are the female sex hormones and where are they produced?
✓ Answer:
B
Oestrogen and Progesterone - produced mainly by the ovaries (follicles and corpus luteum)
Female sex hormones are primarily: Oestrogen (Oestradiol - E2 most potent) = Produced by ovarian follicles (granulosa cells), corpus luteum, adrenal cortex, and placenta (in pregnancy). Functions: Development of female secondary sex characteristics (puberty), breast development, uterine growth, menstrual cycle regulation, bone maintenance, cardiovascular protection. Progesterone = Produced mainly by the corpus luteum (after ovulation) and placenta (in pregnancy). Functions: Prepares and maintains uterus for pregnancy (thickens endometrium), maintains pregnancy, inhibits uterine contractions, thickens cervical mucus. Both hormones are regulated by FSH and LH from the pituitary and are essential for the menstrual cycle and pregnancy.
38
What is the role of HCG (Human Chorionic Gonadotrophin) in pregnancy?
✓ Answer:
B
Produced by the developing placenta - maintains the corpus luteum early in pregnancy to sustain progesterone production
HCG (Human Chorionic Gonadotrophin) is produced by the trophoblast cells of the developing placenta (begins immediately after implantation). HCG structure is similar to LH - it acts on the LH receptor on the corpus luteum. Functions: Maintains the corpus luteum (prevents its regression) causing corpus luteum to continue producing progesterone causing sustained uterine lining and pregnancy maintained. Until the placenta takes over progesterone production (at ~8-10 weeks). HCG levels: Peak at ~8-10 weeks, then decline. Doubles every 48-72 hours in early normal pregnancy (slow rise suggests ectopic or failing pregnancy). Pregnancy tests detect HCG in urine (from ~10 days after conception). Elevated in Down syndrome (triple test), gestational trophoblastic disease (hydatidiform mole - very high HCG), and testicular germ cell tumours (tumour marker).
39
What is hyperparathyroidism?
✓ Answer:
B
Excess PTH secretion causing high blood calcium (hypercalcaemia), bone resorption, and kidney stones
Hyperparathyroidism is excess PTH secretion leading to hypercalcaemia. Types: Primary (parathyroid adenoma - most common 85%, hyperplasia, carcinoma rare), Secondary (chronic hypocalcaemia from CKD or Vitamin D deficiency causing parathyroid hyperplasia - appropriate response), and Tertiary (long-standing secondary causing autonomous parathyroid). Features of hypercalcaemia - mnemonic Bones, Stones, Groans, Psychic Moans: Bones (bone pain, fractures, Osteitis Fibrosa Cystica - brown tumours), Stones (kidney stones - calcium oxalate/phosphate, nephrocalcinosis), Groans (nausea, vomiting, constipation, pancreatitis, peptic ulcer), and Psychic Moans (depression, confusion, lethargy, coma).
40
What is oxytocin and what are its functions?
✓ Answer:
C
A neuropeptide produced by the hypothalamus (released by posterior pituitary) that stimulates uterine contractions and milk ejection
Oxytocin is a neuropeptide produced in the hypothalamus (paraventricular nucleus) and released by the posterior pituitary. Functions: Uterine contractions during labour - creates positive feedback loop (Ferguson's reflex): Cervical stretching causes oxytocin release causing more contractions causing more cervical stretching. Milk ejection (let-down) reflex during breastfeeding - baby suckling causes oxytocin release causing myoepithelial cells in mammary gland to contract causing milk ejected. Love hormone - promotes bonding (mother-infant, pair bonding), trust, empathy, social behaviour. Clinical use: Syntocinon (synthetic oxytocin) - to induce or augment labour and prevent postpartum haemorrhage.