Quiz 33: Additional Factors Related to Hormones and Cardiovascular Diseases

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Question 1 of 6

1. Question
Low dehydroepiandrosterone (DHEA) and ischemic heart disease (IHD) in middle-aged men: Prospective results from the Massachusetts Male Aging Study (choose incorrect answer):
- The adrenal steroid DHEA and its sulfate (DHEA-S) have been characterized as "protective" against ischemic heart disease
- It's a random sample prospective study of 1,709 men aged 40–70 years at baseline, testing whether serum levels of DHEA or DHEA-S could predict incident IHD over a 9-year interval
- The lowest quartile at baseline (<1.6 microg/ml) were significantly more likely to incur IHD by follow-up (adjusted odds ratio = 1.60, 95% confidence interval: 1.07, 2.39; p = 0.02)
- DHEA and DHEA-S levels cannot predict ischemic heart disease
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Question 2 of 6

2. Question
Effect of Testosterone on Plaque Development and Androgen Receptor Expression in the Arterial Vessel Wall (choose correct answer):
- Study measured plaque formation in New Zealand white rabbits after trauma to the arteries
- Testosterone supplementation reduced plaque formation in a dose-dependent manner
- There was an increase in AR development associated with decreased plaque formation
- All of the above are correct
- One of the above is incorrect
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Question 3 of 6

3. Question
Testosterone inhibits early atherogenesis by conversion to estradiol: Critical role of aromatase (choose correct answer):
- Castrated animals had increases in fatty streak development that was prevented by testosterone replacement
- Anastrozole, an aromatase inhibitor, nullified the beneficial effects of testosterone replacement
- Estradiol treatment gave similar results to testosterone by inhibiting fatty streak formation
- The postulated mechanism is for aromatase localized in the arterial wall to convert testosterone into estradiol for the beneficial effects to occur
- All of the above are correct
- One of the above is incorrect
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Question 4 of 6

4. Question
Nitric oxide – control by hormones (choose correct answer):
- NO synthase is activated in selective tissues by E2 and testosterone
- eNOS increase – selective primary vasodilator in coronary, cerebral and pelvic/penile (first phase of erection) arteries
- iNOS in lymphocytes/macrophages is down-regulated by testosterone reducing pro-inflammatory cytokines: IL-6, TNFα, PGE2
- We hear a lot about NO – there are many kinds and all of them are beneficial
- All of the above are correct
- One of the above is incorrect
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Question 5 of 6

5. Question
Nitric oxide (choose correct answer):
- It's a critical substance for many cellular functions
- “Endothelium relaxing factor” now identified as NO
- Inhibition of platelet aggregation means less clots and less larger clots
- Neurotransmitter for many tissues (brain, gonads) are controlled by NO in those tissues
- Delay in thrombus formation or re-occlusion after thrombolysis
- Involved in the inflammatory cascade – increase in CRP, fibrinogen and PGE2, IL-6 and TNFα
- Co-activator of the insulin receptor
- All of the above are correct
- One of the above is incorrect
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Question 6 of 6

6. Question
Penile-Brachial Index (choose correct answer):
- Is comparing the BP in the arm and the penis
- First question a cardiologist should ask any man is, "Do you have ED?"
- If a man in his 40s has ED, he is 50 times more likely to have a coronary event between ages 40 and 50
- The Penile-Brachial Index reflects regional NO production
- Penile arteries are more dependent on testosterone for the induction of NOS than peripheral arteries
- Cerebral and coronary arteries are also more dependent on testosterone for NOS
- Impotence is associated with decreased production of NO secondary to testosterone deficiency
- In 130 impotent men, lower P-B index was associated with two- and threefold increased stroke and heart attack risk
- All of the above are correct
- One of the above is incorrect
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Quiz 33: Additional Factors Related to Hormones and Cardiovascular Diseases

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