A4M EXAM 2026 TEST BANK QUESTIONS AND
SOLUTIONS
◉ What is the prevalence of Hashimoto's disease in the US
population? Answer: 13%
◉ What are the secondary lymphoid tissues? Answer: Spleen, lymph
nodes, tonsils, Peyer's patches (gut)
◉ What are signs / symptoms of low T3 in cardiovascular disease?
Answer: Bradycardia, narrowed pulse pressure, diastolic
hypertension, elevated CRP, inflammatory markers and
homocysteine
◉ T or F: T3 therapy is antiarrhythmic Answer: T
◉ What is the strongest independent predictor of death in cardiac
patients Answer: Low fT3
◉ What enzyme(s) does progesterone act on in hormonal pathway?
Answer: Progesterone has actions as both an aromatase inhibitor as
well as a 5-alpha-reductase inhibitor
,◉ Mechanisms of action of melatonin on inflammation Answer: -
Inhibits COX-2 & Nuclar Factor Kappa Beta
- Reduces expression of inflammatory cytokines
- Most effective scavenger of hydroxyl radical
- Endogenously protects mitochondria and nuclear DNA from injury
and oxidation
- Stimulates superoxide dismutase, glutathione peroxidase
- Increases free radical scavenging and antioxidant efficacy of
glutathione, Vit E, Vit C
- Protects against cellular and DNA damage from ionizing radiation
and reperfusion injury
◉ T or F: growth hormone peaks at puberty and starts to decline at
age 21 Answer: True
◉ Main estrogen produced in the post-menpausal woman Answer:
Estrone
◉ T or F: obese women have higher estrone: estradiol ratio than
non-obese women Answer: True
◉ Strongest estrogen in body Answer: Estradiol
,◉ T or F: 16-hydroxyestrone does not stimulate cells to divide
Answer: False. 16-OHE bind strongly to special receptors inside of
cells and increase rate of DNA synthesis
◉ How much of a female's total testosterone level is free? Answer:
1%
◉ What conditions are associated with high levels of 16-OHE?
Answer: Obesity, hypothyroidism, pesticide exposure, omega-6 FA
excess, inflammatory cytokines
◉ T or F: Testosterone, when given without estradiol in a woman,
increases the risk of MI by increasing plaque formation in heart
vessels Answer: T
◉ What is the central killing mechanism of neutrophils? Answer:
NADPH oxidase, which generates high levels of superoxide, a ROS.
Superoxide combines with NO to form peroxynitrite and hydrogen
peroxide.
◉ How do activated macrophages contribute to tissue damage
during prolonged immune activation? Answer: Macrophages contain
surface glutamate receptors that, when activated, cause tissue
damage. Macrophages readily enter the brain and spinal cord,
transform into microglia, and release cytokines, chemokines,
interferons and other ecitotoxic molecules.
, ◉ T or F: mast cells can enter the brain from the blood during brain
injury Answer: T
◉ What cell line constitutes the first line of defense against invading
organisms? Answer: Macrophages
◉ T or F: plasma cells are highly present in circulation Answer:
False. Plasma cells reside in secondary lymphoid organs. They will
accumulate in areas of high antigen presence.
◉ what is the purpose of T-regulatory cells? Answer: T-regulatory
cells reduce inflammatory responses and are connected to IL-4 and
IL-10, the anti-inflammatory cytokines.
◉ What are the 5 R's of gut rebalancing? Answer: Remove, Replace,
Reinoculate, Repair, Rebalance
◉ T or F: LDL can become oxidized from pathogen exposure Answer:
T. This is due to LPS activating foam cells (inflammatory response)
◉ T or F: High plasma renin activity (PRA) will respond more
effectively to ACE-I and CCB Answer: T. High PRA > 0.65 will respond
to ACE-I
SOLUTIONS
◉ What is the prevalence of Hashimoto's disease in the US
population? Answer: 13%
◉ What are the secondary lymphoid tissues? Answer: Spleen, lymph
nodes, tonsils, Peyer's patches (gut)
◉ What are signs / symptoms of low T3 in cardiovascular disease?
Answer: Bradycardia, narrowed pulse pressure, diastolic
hypertension, elevated CRP, inflammatory markers and
homocysteine
◉ T or F: T3 therapy is antiarrhythmic Answer: T
◉ What is the strongest independent predictor of death in cardiac
patients Answer: Low fT3
◉ What enzyme(s) does progesterone act on in hormonal pathway?
Answer: Progesterone has actions as both an aromatase inhibitor as
well as a 5-alpha-reductase inhibitor
,◉ Mechanisms of action of melatonin on inflammation Answer: -
Inhibits COX-2 & Nuclar Factor Kappa Beta
- Reduces expression of inflammatory cytokines
- Most effective scavenger of hydroxyl radical
- Endogenously protects mitochondria and nuclear DNA from injury
and oxidation
- Stimulates superoxide dismutase, glutathione peroxidase
- Increases free radical scavenging and antioxidant efficacy of
glutathione, Vit E, Vit C
- Protects against cellular and DNA damage from ionizing radiation
and reperfusion injury
◉ T or F: growth hormone peaks at puberty and starts to decline at
age 21 Answer: True
◉ Main estrogen produced in the post-menpausal woman Answer:
Estrone
◉ T or F: obese women have higher estrone: estradiol ratio than
non-obese women Answer: True
◉ Strongest estrogen in body Answer: Estradiol
,◉ T or F: 16-hydroxyestrone does not stimulate cells to divide
Answer: False. 16-OHE bind strongly to special receptors inside of
cells and increase rate of DNA synthesis
◉ How much of a female's total testosterone level is free? Answer:
1%
◉ What conditions are associated with high levels of 16-OHE?
Answer: Obesity, hypothyroidism, pesticide exposure, omega-6 FA
excess, inflammatory cytokines
◉ T or F: Testosterone, when given without estradiol in a woman,
increases the risk of MI by increasing plaque formation in heart
vessels Answer: T
◉ What is the central killing mechanism of neutrophils? Answer:
NADPH oxidase, which generates high levels of superoxide, a ROS.
Superoxide combines with NO to form peroxynitrite and hydrogen
peroxide.
◉ How do activated macrophages contribute to tissue damage
during prolonged immune activation? Answer: Macrophages contain
surface glutamate receptors that, when activated, cause tissue
damage. Macrophages readily enter the brain and spinal cord,
transform into microglia, and release cytokines, chemokines,
interferons and other ecitotoxic molecules.
, ◉ T or F: mast cells can enter the brain from the blood during brain
injury Answer: T
◉ What cell line constitutes the first line of defense against invading
organisms? Answer: Macrophages
◉ T or F: plasma cells are highly present in circulation Answer:
False. Plasma cells reside in secondary lymphoid organs. They will
accumulate in areas of high antigen presence.
◉ what is the purpose of T-regulatory cells? Answer: T-regulatory
cells reduce inflammatory responses and are connected to IL-4 and
IL-10, the anti-inflammatory cytokines.
◉ What are the 5 R's of gut rebalancing? Answer: Remove, Replace,
Reinoculate, Repair, Rebalance
◉ T or F: LDL can become oxidized from pathogen exposure Answer:
T. This is due to LPS activating foam cells (inflammatory response)
◉ T or F: High plasma renin activity (PRA) will respond more
effectively to ACE-I and CCB Answer: T. High PRA > 0.65 will respond
to ACE-I
