Tuesday, February 13, 2007

Endocrinology.mcq

. Steroid hormones are secreted by all except:
(a) Ovary (b) Testes
(c) Adrenal medulla (d) Placenta
2. Receptors within cell cytoplasm are specific to:
(a) Peptide hormones (b) Protein hormones
(c) Cortisol (d) Catecholamine
3. The cation essential for adenyl cyclase activity to form cAMP is:
(a) Sodium (b) Magnesium
(c) Calcium (d) Potassium
4. The weight of normal pituitary gland is:
(a) 1 gm (b) 5 gm
(c) 10 gm (d) 25 gm
5. The maximum number of hormone secreting cells of anterior pituitary are:
(a) Somatotropes (b) Thyrotropes
(c) Corticotropes (d) Gonadotropes
(a) Lactotropes
6. Which of the following is not an effect of growth hormone in glucose metabolism:
(a) Diminished glucose uptake by cell
(b) Decreased glucose utilisation
(c) Suppression of insulin secretion
(d) Decreased sensitivity to insulin
7. Chondrocytes are converted to osteogenic cells under influence of:
(a) Growth hormone (b) Testosterone
(c) Corticosteroids (d) Thyroxine
8. Normal growth hormone level in a child or adolescent is:
(a) 1 ng/ml (b) 2-3 ng/ml
(c) 6 ng/ml (d) 10-15 ng/ml
9. Which of the following is inhibited by somatostatin:
(a) Growth hormone (b) Insulin
(c) Glucagon (d) All of the above
10. Both oxytocin and vasopressin (ADH) have 9 amino acids with partial functional similarities except for amino acid structure involving:
(a) Arginine (b) Valine
(c) Histidine (d) All of the above
11. When peroxides system is blocked or congenitally absent which step of thyroid hormone synthesis is affected:
(a) Iodine trapping (b) Iodine oxidation
(a) Organification of iodine
12. Among thyroid hormones which is rapid acting:
(a) T4 (b) Reversed T3
(c) T3 (d) All equal




13. The exophthalmos in Graves' disease is due to:
(a) Increase in size of eyeball
(b) Increased blood lymph content of eye
(c) Oedema of retro-orbital tissue
(d) All of the above
14. In myxoedema, serum findings are all except:
(a) Low T3, T4 (b) High TSH
(c) Low cholesterol (d) Normal sugar
15. Cortisol is secreted from:
(a) Zona glomerulosa (b) Zona fasciculata
(c) Zona reticularis (d) B + C
16. The degraded adrenal hormones are mainly secreted in:
(a) Urine (b) Bile
(c) Sweat (d) Stool
17. Normal plasma aldosterone is:
(a) 1 ng / dl (b) 6 ng / dl
(c) 12 ng / dl (d) 18 ng / dl
18. Banting and Best, isolated insulin in:
(a) 1890 (b) 1902
(c) 1922 (d) 1942
19. Normal level of ketone bodies in plasma is:
(a) 1 mEq / L (b) 5 mEq / L
(c) 10 mEq / L (d) 20 mEq / L
20. What is asthenia:
(a) Tall lanky body (b) Lack of energy
(c) Lack of adipose tissue (d) None of the above
21. Persistent hypoglycemia is dangerous because of:
(a) Shock (b) Brain damage
(c) Renal shut down (d) Visual impairment
22. Normal daily calcium excretion in urine is:
(a) 50 mg (b) 100 mg
(c) 250 mg (d) 500 mg
23. Conversion of Vit D3 to 1-25 dihydroxycholecalciferol occurs in which part of nephron:
(a) Glomerulus (b) Proximal tubules
(a) Distal tubules
24. Which of the following conforms to hydroxyapatite:
(a) Ca8 (PO4)6 (OH)2 (b) Ca10 (PO4)6 (OH)2
(c) Ca10 (PO4)8 (OH)2 (d) Ca8 (PO4)8 (OH)2
25. The bacterium responsible for caries can be all except:
(a) Sterptococci (b) Diphtheroid
(b) Staphylococci (d) Lactobacilli

Endocrinology:ans:mcq
1.c 2.c 3.b 4.a 5.a 6.c 7.a 8.c 9.d 10.a 11.b 12.c 13.c 14.c 15.d 16.a 17.b 18.c 19.a 20.b 21.b 22.b 23.b 24.b 25.c

Endocrinology:M.C.Q&TRUE/FALSE

Second Messengers:

(a) Phosphodiesterase (PDE) convert cAMP to AMP + inorganic phosphate.
(b) PDE inhibiors augment the effects of cAMP by slowing down its degradation.
(c) The cGMP pathway is atleast as widespread as the cAMP pathway.
(d) Phosphatidyl inositol bisphosphate (PIP2) is a second messenger.
(e) IP3/Ca2+ is a very widespread chemical transduction system.

(2) Intracellular signalling:

(a) Inositol is a lipid.
(b) Inositol normally occurs in a bound form in the body.
(c) Cortisol combines with a specific protein receptor on an intracellular organelle.
(d) G proteins couple cell surface receptors with intracellular effectors.
(e) Increased G protein activity is typical of generalized resistance to hormone action, e.g. resistance to PTH (parathyroid hormone), thyrotrophin, and gonadotrophins.

(3) Concerning iodine and the thyroid:
(a) Iodine is converted to iodide before absorption in GIT.
(b) Iodide trapping is helped by an electrical gradient into the follicle cell.
(c) Iodide trapping is a primary active process.
(d) TSH stimulates iodide uptake at all iodide trapping sites in the body.
(e) Perchlorate is a competitive inhibitor for iodide trapping.

(4) In the hormonal control of calcium:
(a) Calcitonin comes from cells of neuroectodermal origin.
(b) Calcitonin is an important physiological regulator of plasma calcium.
(c) Hypocalcaemia is the main stimulus for calcitonin release.
(d) Parathyroid hormone (PTH) is essential for life.
(e) PTH is stored in granules in the parathyroid.

(5) Atrial natriuretic factor (ANF):
(a) type A is chiefly found in the myocytes of the right atrium.
(b) type A is released in hypovolaemia.
(c) inhibits the renin-angiotensin-aldosterone axis.
(d) causes natriuresis and vasodilation.
(e) has its actions potentiated by neutral endopeptidase inhibitors.


(6) In the normal function of the adrenal medulla:
(a) The basal secretion of catecholamines is important for maintaining vascular tone.
(b) Adrenaline causes vasoconstriction in the skin.
(c) Basal NA secretion has a significant biological effect.
(d) Significant secretion is only stimulated by sympathetic activity.
(e) Adrenaline inhibits lipase in adipose tissue.


(7) Cortisol:
(a) is the only glucocorticoid secreted in significant amounts in humans.
(b) acts at cell level by directly stimulating/inhibiting enzymes.
(c) increases liver glycogen stores.
(d) stimulates the use of glucose in peripheral tissues.
(e) helps to mineralize bone.

(8) Concerning aldosterone formation and secretion:
(a) Aldosterone is formed only in the zona glomerulosa.
(b) Angiotensin II is the most important regulator of aldosterone.
(c) The renin-angiotensin system is found in the adrenal cortex.
(d) ACTH has no effect on aldosterone secretion.
(e) Potassium sitmulates aldosterone release.

(9) Insulin:
(a) is the most powerful hypoglycaemic agent in the body.
(b) inhibits free fatty acid (FFA) release from tissues.
(c) inhibits lipoprotein lipase (LPL).
(d) inhibits hormone-sensitive lipase.
(e) facilities transport of amino acids secondary to glucose.

(10) Glucagon:
(a) consists of a double polypeptide chain similar to insulin.
(b) stimulates the secretion of somatostatin.
(c) stimulates gluconeogenesis at physiological levels.
(d) is the most important hormone in preventing fasting hypoglycaemia.
(e) is a strong lipolytic agent in adipose tissue.

(11) Prolactin (PRL):
(a) is synthesized in the same cells as GH.
(b) plasma levels are only slightly higher in females than in males.
(c) inhibiting factor (PIF) is tonically released from the hypothalamus.
(d) release is stimulated by cortisol.
(e) excess in hyperprolactinaemia is treated with 5-HT or 5-HT agonists.

(12) Posterior pituitary hormones:
(a) Oxytocin and arginine vasopressin (AVP) are formed in the pars nervosa of the pituitary (posterior pituitary).
(b) Oxytocin and AVP are stored with specific proteins in the pituitary.
(c) Oxytocin effects are inhibited by progesterone.
(d) Oxytocin secretion is stimulated by the enlarging uterus in pregnancy.
(e) Oxytocin is a strong lactogenic hormone.
Endocrinology:ans.True or false
1.a.True.b.True.c.false.d.False.e.True
2.a.False.b.True.c.True.d.True.e.False
3.a.True.b.False.c.false.d.False.e.True.
4.a.True.b.False.c.False.d.True.e.False.
5.a.True.b.False.c.True.d.True.e.True.
6.a.false.B.True.c.False.d.True.e.False.
7.a.True.b.False.c.True.d.False.e.False
8.a.True.b.True.c.True.d.False.e.True.
9.a.True.b.True.c.False.d.True.e.False.
10.a.False.b.True.c.True.d.True.e.True.
11.a.False.b.True.c.Teue.d.False.e.False.
12.a.False.b.True.c.True.d.False.e.False

Sunday, February 4, 2007

BIOFEEDBACK

BIOFEEDBACK

BIOFEEDBACK

You’re stressed! Your heart races, your muscles tense up, your mind blurs, your head pounds. Is it possible to calm yourself down by controlling these physical effects? Using biofeedback, you may be able to.

Biofeedback is training technique that enables an individual to gain some element of voluntary control over autonomic body function.

Biofeedback operates on the notion that we have the innate ability and potential to influence the anatomic function of our bodies through the exertion of will and mind.

Biofeedback is used in many different environment including schools (improving concentration), in sports (for optimizing functioning), in clinical environment (to learn to recognize when psychological systems are not behaving normally and to learn to correct their functioning) and by the clinicians as part of treatment for may disorders including anxiety, urinary incontinence, fecal incontinence and constipation, migraine headaches, pain from improperly functioning muscles in the jaws, shoulders, back, etc., irritable bowel syndrome and may others.

How is it done?
Biofeedback is the process of recording psychological signals (such as muscle tension and brain waves) and displaying them to the person being recorded. Recording is non-invasive and painless utilizing electrodes and specialized sensors placed on the skin with non-allergic conductive gel or paste. During Biofeedback subjects are “feedback” information with reinforcing properties about their neuromuscular and anatomic activity both normal and abnormal, on one form of analog or binary, auditory and/or visual feedback signals. Common physiology monitored through the use of Biofeedback includes EEG (brainwave activity), skin conductance and temperature, heart rate, breathing pattern and SEMG.

COMPONENTS OF BIOFEEDBACK
Biofeedback does not need to involve the use of electronic devices, computes etc., for example, a mirror is a perfectly good biofeedback device for may aspects of gait retraining. Electronic biofeedback devices are designed to record physiological function non-invasively most record from the surface of the skin. The information recorded by surface sensors is frequently sent to a computer for processing and then displayed on the monitor and/or through speaker. The person being recorded and any therapist or coach who may be present can attend to the display of information and incorporate it into whatever process they are attempting to perform.

APPLICATION IN SPORTS
Regular physical activity lowers the risks of cardiovascular and lung diseases, diabetes and osteoporosis. It also enhances life by reducing stress, increasing energy elevating mood, bettering self – image, improving appearance, stimulating creativity and reinforcing such health lifestyle changes as eating right and quitting smoking. Sports are not one – size – fits – all. For certain individuals, some sports are not recommended while others may be particularly beneficial.

Here are some examples

 If you are overweight : avoid running or high impact aerobics, they
May overstress joints. Instead, try
swimming or cycling.
 If you have arthritis : even golf with its motion and impact can be
hard on the back, elbows, wrists and knees.
So try water aerobics.

PEAK PERFORMANCE TRAINING
Even though athletes report that during competition their mental, attitudes account for 80% or more of their success, few training programs systematically train athletes to control their mental altitudes.

USE OF ELECTRODERMAL BIOFEEDBACK
Electrodermal biofeedback unit measures and feedback changes in skin conductance. Skin conductance measures the changes in sympathetic arousal as produces in the perspiration of the palmer surface of the hand and correlates highly with fight/flight response. This is often called Galvanic Skin Response (GSR). Usually increase in arousal results in increase in skin conductivity.

MONITORING PHYSIOLOGICAL RELAXATION
Learning relaxation is important since it can allow athletes:
• To modulate their level of arousal necessary for performance
• To facilitate the skill to regenerate
• To build the foundation that is needed to practices imagery rehearsal.

To observe the efficacy of the relaxation training, rapid relaxation strategy known as auotgenic training is performed. As the athletes rapidly relaxed, the skin conductance, as measured from the non – dominant palmar surface, decreased. The decrease in the skin conductance demonstrates that the athletes have learned to relax. This psychological feedback is a powerful reinforces to facilitate learning – it continuously tells athletes how well they are doing. Eventhough the Electrodermal response is a useful feedback with most athletes, some don’t response with this systems. They may respond cardiovascularly, gastrointestinally or muscularly.

HEART MONITOR
Heart rate monitors are really just biofeedback unit. It became evident that using the heart rate to objectively measure body function was simple, accurate and useful. And its application in sports was obvious. The use of heart rate monitor for effective training entails two important aspects. The first is that all endurance athletes must build a good aerobic base, Second consideration has to do with the specific hear rate used during training and how a runner determines that important number.

What heart rate do you use for aerobic training?
The 180 formula, which established the best heart rate for building an aerobic base.
THE 180 FORMULA

To find your maximum aerobic heart rate

 Subtract your age from (180 - age)
 Modify this number by selecting one of the following categories
a. If you have or are recovering from a major illness (heart disease, any operation, any hospital stay) or on any regular medication, subtract 10.
b. If you have not exercised before, you have exercised but have been injured or are regressing in your running, or you often get colds or flu or have allergies, subtract. 5.
c. If you have been exercising for up to two years with not real problems and have not had colds or flu more that once or twice a year, subject 0.
d. If you have been exercising for more than two years without any problems, making progress in competition without injury add 5.
For example, if you are 30 years old and fit into category b: 180 – 30 = 150 and 150 – 5 = 145. This is your maximum aerobic heart rate. For efficient base building, you should train at or below this level throughout your base period.

Initially, training at this heart rate induces emotional stress in many athletes, “I just can’t train that slow!” is a common comment. But after a short time, not only you will feel better, but also your pace will quicken at that same training heart rate. The significant benefit of applying the 180 formula to your training is the chemical response by body. Production of free radicals is minimal compared to running at heart rates even a little higher. These chemicals can contribute to degenerative problems, inflammation, heart diseases, cancer and speeding the ageing process. By using the 180 formula, you can run more miles without risking chemical stress.

SELF ASSESSMENT
A significant benefic of aerobic base building is the ability to run faster at the same effort, that is, at the same aerobic heart rate. And an advantage of using a heart monitor is the ability to objectively measure these improvements using the maximum aerobic function (MAF) test.

Aerobic speed means you can run faster at the same aerobic heart rate. You perform the MAF test on a track with your monitor, running at your maximum aerobic heart rate. Three to five miles provides good data, although a one – mile test still has value. The test is done following an easy warm up.

Below is an actual example of a runner performing the MAF test at a heart rate of 150;

Mile 1 8:21
Mile 2 8:27
Mile 3 8:38
Mile 4 8:44
Mile 5 8:49
During any one of MAF test, it’s normal for your times to get slower; the first mile should always be the faster and the last the slowest. If that’s not the case, it usually means you have not warmed up enough.

In addition, the test should show faster times as the weeks pass. For example, over four months, we can see the endurance progress in this actual case:

April May June July
Mile 1 8:21 8:11 7:57 7:44
Mile 2 8:27 8:18 8:05 7:52
Mile 3 8:38 8:26 8:10 7:59
Mile 4 8:44 8:33 8:17 8:09
Mile 5 8:49 8:39 8:24 8:15

This improvement usually in only recognized during the aerobic base.

Another important aspect of the heart monitor and MAF test is that the test is predictive of performance. A direct relationship exists between your aerobic pace and your race effort. In other words, as your MAF test improves, so will your racing ability.