This document contains a presentation on physiology by Magda El-Dakhakhni along with a series of multiple choice questions and their answers related to thyroid function and disorders. Specifically, it covers topics like myxedema, cretinism, gigantism, Graves' disease, hypothyroidism, hyperthyroidism, the roles of TSH, TRH, and thyroid hormones. The questions assess understanding of the causes, characteristics, and diagnostic markers of various thyroid conditions.

1. Presented By:
Magda El-Dakhakhni
Professor of Physiology
Prepared by staff of Physiology department

3. 1. A patient suffering from Myxedema is more
likely to have:
a. Sweaty hands
b. Hirsutism
c. A high serum cholesterol level
d. Hypertension

4. 2. The nuclear receptors are specific binding sites for:
a. GH
b. Glucocorticoides
c. Thyroid hormones
d. Catecholamines

5. 3. Gigantism is:
a. Due to over secretion of GH after puberty
b. Associated with normal gonads
c. A manifestation of hypothyroidism
d. Associated with hyperglycemia

6. 4. Cretinism is characterized by:
a. An increased secretion of Thyroid hormones.
b. Disproportionate retarded physical growth
c. Normal mentality
d. Increased basal metabolic rate

7. 5. A woman came to her physician suffering from loss
of appetite, weight gain & somnolence. The most likely
diagnosis for this condition is:
a. Diabetes mellitus.
b. Cushing disease.
c. Myxedema.
d. Acromegaly.

8. 6. Myxedema is characterized by:
a. Low serum cholesterol.
b. Nervousness and irritability.
c. Poor tolerance to cold.
d. Loss of weight.

9. 7. All the following hormones are
synthesized in the Hypothalamus EXCEPT:
a. Anti diuretic hormone.
b. Thyrotropin releasing hormone.
c. Leutinizing hormone.
d. Prolactin inhibitory hormone

10. 8. Growth hormone:
a. Promotes bone growth by direct action.
b. Increases protein synthesis.
c. Inhibits Somatomedines production by the liver.
d. Increases Glucose uptake by the muscles.

11. 9. Pituitary dwarfs have:
a. Disproportionate retarded physical growth.
b. High metabolic rate.
c. Hypogonadism in two thirds of them.
d. Mental retardation.

12. 10. In hyperthyroidism, exophthalmos
is due to:
a. Activation of reticular activating system.
b. Loss of weight.
c. Edematous swelling of the retro-orbital tissues
d. Increased secretion of thyroid stimulating hormone
( TSH).

13. 11. Cretinism manifests by:
a. Physical and mental growth retardation.
b. Vasodilatation of cutaneous blood vessels.
c. Increased metabolic rate.
d. Nervousness, anxiety and irritability.

14. 12. Hypothalamus releases All the
following hormones EXCEPT:
a. ACTH.
b. Oxytocin
c. Leutinizing hormone releasing hormone.
d. Somatostatin

15. 13. Which of the following is not related to
Thyroid hormones functions:
a. Increased heart rate.
b. Myelination of nerve fibers.
c. Anti-inflammatory, anti- allergic.
d. Increased intestinal activity.

16. 14. As regards myxedema:
a. Is due to abnormal secretion of Insulin.
b. Patient has cold dry skin.
c. Patient loses weight and has a good appetite.
d. Metabolic rate and oxygen consumption are
increased.

17. 15. Thyroxine-receptor complex..
a. activates adenyl cyclase enzyme.
b. elevates CGMP level.
c. diffuses into the nucleus.
d. is located at the cell membrane.

18. 16. Which hormone is a derivative of
amino acid:
a. Thyroxine.
b. Testosterone
c. Aldosterone.
d. Vitamine D3.

19. 17. TRH (thyrotrophic hormone) :
a. Stimulates TSH secretion by the adenohypophysis
b. Stimulates prolactin secretion by the
adenohypophysis
c. Inhibits GH secretion by the adenohypophysis
d. Stimulates Thyroxin secretion by the Thyroid gland.

20. 18. Thyroid hormones, when secreted in
excess, may cause an increase in the:
a. Peripheral resistance
b. Duration of sleep
c. Energy expenditure required for a given
workload
d. Duration of tendon reflexes.

21. 19. Graves’ disease is characterized by :
a. a. Apathy and mental retardation
b. Poor tolerance to heat and frequently exophthalmos
c. Bradycardia and increased serum cholesterol level
d. Hypercarotenamia and yellow coloration of the skin.

22. 20. The diagnostic agent useful in identifying
both hypo and hyperthyroidism is:
a. thyroxine
b. tri-iodothyrosine
c. thyroid stimulating hormone
d. thyrotropine – releasing hormone
e. long acting thyroid stimulators.

23. 21. A young woman has puffy skin and a hoarse voice.
Her plasma TSH concentration is low but increases
markedly when she is given TRH. She probably has:
a. A) hyperthyroidism due to a thyroid tumor.
b. B) hypothyroidism due to a primary abnormality in
the thyroid gland.
c. C) hypothyroidism due to a primary abnormality in
the pituitary gland.
d. D) hypothyroidism due to a primary abnormality in
the hypothalamus.

24. 22. Delayed closure of the fontanels is a
manifestation of:
a. Grave's disease
b. Myxedema
c. Cretinism
d. Struma ovarii

25. 23. Thyroxine produces all the following
effects Except:
a. Increased pulse pressure and heart palpitation
b. A marked increase in both O2 consumption and
the BMR.
c. A decrease in the plasma cholesterol level.
d. A decrease in the rate of lipolysis.

26. 24. Goitre occurs as a sequence of all
the following Except:
a. Graves’ disease.
b. Iodine deficiency.
c. A pituitary basophil adenoma.
d. Excessive intake of exogenous thyroxine.

27. 25. With increased thyroid gland activity, all the
following occurs Except:
a. The vascularity of the gland markedly increases.
b. The follicular cells become columnar.
c. The follicles enlarge and fill with colloid.
d. The gland takes up iodine from the blood at a
faster rate.

28. 26. All of the following effects of The thyroid
hormones are correct except:
a. increase rate of blood flow to the skin
b. increase the no. of β adrenergic receptors in the
heart
c. increase Haemoglobin affinity to oxygen
d. increase milk secretion in lactating women

29. 27. Write true or false on each statement:
The thyroid gland:
a. Takes up iodide against its electrochemical gradient.
b. Decreases in size when dietary iodine is deficient.
c. Is relatively avascular.
d. Contains enzymes which oxidize iodide to iodine.
e. Contains enzymes which iodinate tyrosine.

30. 28. Write true or false on each statement:
Thyroxine
a. Is stored in the follicular cells as thyroglobulin.
b. Increases the resting rate of carbon dioxide production.
c. Is essential for normal development of the brain.
d. Is needed for normal red cell production.
e. Acts more rapidly than triiodothyronine (T3).

31. 29. Write true or false on each statement
a. In cretin, skeletal and soft tissue growth is inhibited.
b. TSH level is increased in hypothyroidism due to
hypothalamus and pituitary disorders

32. ANSWERS

33. 1. A patient suffering from Myxedema is
more likely to have:
A.Sweaty hands
B.Hirsutism
C.A high serum cholesterol level
D.Hypertension

34. 2. The nuclear receptors are specific binding
sites for:
A. GH
B. Glucocorticoides
C. Thyroid hormones
D. Catecholamines

35. 3. Gigantism is:
A. Due to over secretion of GH after puberty
B. Associated with normal gonads
C. A manifestation of hypothyroidism
D. Associated with hyperglycemia

36. 4. Cretinism is characterized by:
A. An increased secretion of Thyroid
hormones.
B. Disproportionate retarded physical growth.
C. Normal mentality.
D. Increased basal metabolic rate.

37. 5. A woman came to her physician suffering from
loss of appetite, weight gain & somnolence. The
most likely diagnosis for this condition is:
A. Diabetes mellitus.
B. Cushing disease.
C. Myxedema.
D. Acromegaly.

38. 6. Myxedema is characterized by:
A. Low serum cholesterol.
B. Nervousness and irritability.
C. Poor tolerance to cold.
D. Loss of weight.

39. 7. All the following hormones are
synthesized in the Hypothalamus EXCEPT:
A. Anti diuretic hormone.
B. Thyrotropin releasing hormone.
C. Leutinizing hormone.
D. Prolactin inhibitory hormone

40. 8. Growth hormone:
A. Promotes bone growth by direct action.
B. Increases protein synthesis.
C. Inhibits Somatomedines production by the
liver.
D. Increases Glucose uptake by the muscles.

41. 9. Pituitary dwarfs have:
A. Disproportionate retarded physical growth.
B. High metabolic rate.
C. Hypogonadism in two thirds of them.
D. Mental retardation.

42. 10. In hyperthyroidism, exophthalmos
is due to:
A. Activation of reticular activating system.
B. Loss of weight.
C. Edematous swelling of the retro-orbital
tissues
D. Increased secretion of thyroid stimulating
hormone ( TSH).

43. 11. Cretinism manifests by:
A. Physical and mental growth retardation.
B. Vasodilatation of cutaneous blood vessels.
C. Increased metabolic rate.
D. Nervousness, anxiety and irritability.

44. 12. Hypothalamus releases all the
following hormones EXCEPT:
A. ACTH
B. Oxytocin
C. Leutinizing hormone releasing hormone.
D. Somatostatin

45. 13. Which of the following is not related to
Thyroid hormones functions:
A. Increased heart rate
B. Myelination of nerve fibers
C. Anti-inflammatory, anti- allergic
D. Increased intestinal activity

46. 14. As regards myxedema:
A. It is due to abnormal secretion of Insulin.
B. Patient has cold dry skin
C. Patient loses weight and has a good
appetite.
D. Metabolic rate and oxygen consumption are
increased.

47. 15. Thyroxine-receptor complex
A. Activates adenyl cyclase enzyme
B. Elevates cGMP level
C. Diffuses into the nucleus
D. Is located at the cell membrane

48. 16. Which hormone is a derivative
of amino acid:
A. Thyroxine
B. Testosterone
C. Aldosterone
D. Vitamine D3

49. 17. TRH (thyrotrophic hormone) :
A. Stimulates TSH secretion by the adenohypophysis
B. Stimulates prolactin secretion by adenohypophysis
C. Inhibits GH secretion by the adenohypophysis
D. Stimulates Thyroxin secretion by the Thyroid gland

50. 18. Thyroid hormones, when secreted in
excess, may cause an increase in :
a. Peripheral resistance.
b. Duration of sleep.
c. Energy expenditure required for a given
workload.
d. Duration of tendon reflexes.

51. 19. Graves’ disease is characterized by :
a. Apathy and mental retardation
b. Poor tolerance to heat and frequently
exophthalmos.
c. Bradycardia and increased serum cholesrterol
level.
d. Hypercarotenamia and yellow colouration of the
skin.

52. 20. The diagnostic agent useful in identifying
both hypo and hyper thyroidism is:
a. thyroxine
b. tri-iodothyrosine
c. thyroid stimulating hormone
d. thyrotropine – releasing hormone
e. long acting thyroid stimulators.

53. 21. A young woman has puffy skin and a hoarse voice.
Her plasma TSH concentration is low but increases
markedly when she is given TRH. She probably has:
A) hyperthyroidism due to a thyroid tumor
B) hypothyroidism due to a primary abnormality in the
thyroid gland
C) hypothyroidism due to a primary abnormality in the
pituitary gland
D) hypothyroidism due to a primary abnormality in the
hypothalamus

54. 22. Delayed closure of the fontanels is
a manifestation of:
a. Grave's disease
b. Myxedema
c. Cretinism
d. Struma ovarii

55. 23. Thyroxine produces all the following
effects Except:
a. increased pulse pressure and heart palpitation.
b. marked increase in both O2 consumption and
the BMR.
c. a decrease in the plasma cholesterol level.
d. a decrease in the rate of lipolysis

56. 24. Goitre occurs as a sequence of
all the following Except:
a. Graves’ disease.
b. Iodine deficiency.
c. A pituitary basophil adenoma.
d. Excessive intake of exogenous thyroxine.

57. 25. With increased thyroid gland activity, all
the following occurs Except:
a. The vascularity of the gland markedly increases
b. The follicular cells become columnar
c. The follicles enlarge and fill with colloid
d. The gland takes up iodine from the blood at a
faster rate

58. 26. All of the following effects of The thyroid
hormones are correct except:
a. increase rate of blood flow to the skin
b. increase the no. of β adrenergic receptors in
the heart
c. increase Haemoglobin affinity to oxygen
d. increase milk secretion in lactating women

59. 27. Write true or false on each statement
The thyroid gland:
a. takes up iodide against its electrochemical
gradient.
T
b. decreases in size when dietary iodine is deficient.
F
c. is relatively avascular
F
d. contains enzymes which oxidize iodide to iodine
T
e. contains enzymes which iodinate tyrosine
T

60. 28. Write true or false on each statement
thyroxine
a. is stored in the follicular cells as thyroglobulin
F
b. increases the resting rate of carbon dioxide production
T
c. is essential for normal development of the brain
T
d. is needed for normal red cell production
T
e. acts more rapidly than triiodothyronine (t3)
F

61. 29. Write true or false on each statement
a. In cretin, skeletal and soft tissue growth is
inhibited
F
b. TSH level is increased in hypothyroidism due
to hypothalamus and pituitary disorders.
F

62. THANK YOU