14. A 72-year-old man is suffering from nocturia, difficulty with urination, inc

Question

14. A 72-year-old man is suffering from nocturia, difficulty with urination, including decreased flow, and inability to completely empty the bladder. The prostate is symmetrically enlarged, nontender, and smooth. The predominant androgen associated with this enlargement is:

DHEA

androstenediole

testosterone

DHT

androsterone

a and c

15. Which of the following cause-and-effect relationships is correct?

a. weight gain in Cushing’s syndrome is a result of the lipogenic action of cortisol.

b. a person with adrenal insufficiency has difficulty excreting a water load in a normal period of time because of the actions of aldosterone on sodium and hence water reabsorption.

c. anemia occurs in Addison’s disease because of the action of cortisol on GI iron absorption and on erythropoetin release.

d. skin darkening in Addison’s disease individuals indicates that the site of the disorder is in the pituitary rather than the adrenal.

e. synthetic glucocorticoids are useful in the treatment of arthritis because they stimulate bone growth.

16. In humans, total adrenalectomy is fatal without replacement therapy whereas hypophysectomy is not. This is because after hypophysectomy:

a. the adrenal cortex undergoes compensatory hypertrophy

b. the adrenal catecholamines compensate for the metabolic actions of cortisol

c. the secretion of aldosterone is not markedly decreased.

d. tissue requirements for corticosteroids decrease markedly. e. all of the above

17. Factors that increase serum cortisol concentrations include all of the following except:

a. stress

b. eating a high-carbohydrate meal

c. pregnancy d. exercise

e. all of the above

Explanation / Answer

14. DHT

Testosterone is converted to dihydrotestosterone (DHT) which is critical mediator of prostatic growth. However DHEA has also been implicated to contribute to prostate enlargement but it is believed that it is a precursor for testosterone which is further converted to DHT. For the given, DHT will be the suitable answer.

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