Nokea
Which hormone stimulates gluconeogenesis in the liver?
- A. Insulin
- B. Growth Hormone
- C. Glucagon
- D. Estrogen
Correct Answer: C
Rationale: The correct answer is C: Glucagon. Glucagon stimulates gluconeogenesis in the liver by promoting the breakdown of glycogen stores into glucose. Insulin, choice A, actually inhibits gluconeogenesis by promoting glucose uptake and storage. Growth hormone, choice B, primarily affects protein synthesis and growth rather than directly stimulating gluconeogenesis. Estrogen, choice D, is not directly involved in regulating gluconeogenesis in the liver. Therefore, based on its specific function in promoting glucose production in the liver, glucagon is the correct answer.
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What is a cause of primary hypothyroidism in adults?
- A. Malignant or benign thyroid nodules
- B. Surgical removal or failure of the pituitary gland
- C. Surgical removal or radiation of the thyroid gland
- D. Autoimmune-induced atrophy of the thyroid gland
Correct Answer: D
Rationale: Primary hypothyroidism in adults is commonly caused by autoimmune diseases such as Hashimoto's thyroiditis, which leads to thyroid tissue destruction.
You are a resident in a hospital in a very poor part of the world. Their drug selection is limited. A patient presents with acute cardiac failure, for which your preferred drug is dobutamine, given intravenously. However, there is none available. Which of the following other drugs, or combination of drugs, would be a suitable alternative?
- A. Dopamine (at a very high dose)
- B. Ephedrine
- C. Ephedrine plus propranolol
- D. Norepinephrine plus phentolamine
Correct Answer: D
Rationale: The correct answer is D: Norepinephrine plus phentolamine. Norepinephrine is a potent vasopressor that can increase blood pressure and cardiac output in acute cardiac failure. Phentolamine is an alpha-blocker that can help counteract the vasoconstrictive effects of norepinephrine.
Rationale:
1. Norepinephrine: Increases blood pressure and cardiac output, improving perfusion to vital organs in acute cardiac failure.
2. Phentolamine: Counteracts the vasoconstrictive effects of norepinephrine, preventing excessive vasoconstriction.
Summary:
A: Dopamine at a very high dose may not be as effective as norepinephrine in acute cardiac failure.
B: Ephedrine is a less potent vasopressor compared to norepinephrine.
C: Ephedrine plus propranolol combination may lead to conflicting effects on blood pressure and heart rate
Which hormone is responsible for milk production in the mammary glands?
- A. somatotropin
- B. prolactin
- C. luteinizing hormone
- D. follicle-stimulating hormone
Correct Answer: B
Rationale: Prolactin is the correct answer because it is the hormone responsible for milk production in the mammary glands. It is secreted by the pituitary gland in response to the suckling stimulus from the baby. Prolactin stimulates the alveoli in the mammary glands to produce milk. Somatotropin (A), luteinizing hormone (C), and follicle-stimulating hormone (D) do not play a direct role in milk production. Somatotropin is involved in growth, luteinizing hormone is involved in ovulation, and follicle-stimulating hormone is involved in the development of ovarian follicles.
Regarding iron:
- A. it is more readily absorbed in the ferric form
- B. men lose about 0.6mg/d
- C. average daily iron intake is 40mg
- D. ascorbic acid reduces iron absorption
Correct Answer: B
Rationale: The correct answer is B because men lose about 0.6mg of iron per day through various physiological processes like shedding skin cells and hair. This loss must be replenished through dietary intake to maintain iron balance. Choice A is incorrect as iron is more readily absorbed in the ferrous form. Choice C is incorrect as the average daily iron intake is around 18mg. Choice D is incorrect ascorbic acid enhances iron absorption rather than reducing it.
Which of the following has no muscarinic blocking activity:
- A. Amitriptyline
- B. Meperidine
- C. Ipratropium
- D. Edrophonium
Correct Answer: D
Rationale: The correct answer is D, Edrophonium. Edrophonium is a short-acting cholinesterase inhibitor used in the diagnosis of myasthenia gravis. It does not possess muscarinic blocking activity, as its mechanism of action involves inhibition of acetylcholinesterase leading to increased acetylcholine levels at the neuromuscular junction. The other choices, Amitriptyline (A) is a tricyclic antidepressant with anticholinergic properties, Meperidine (B) has weak antimuscarinic effects, and Ipratropium (C) is an anticholinergic medication used in respiratory conditions. These choices exhibit muscarinic blocking activity, unlike Edrophonium.