a.    Peptide YYN
b.    Ghrelin
c.    Oxyntomodulin
d.    Glucagon-Like Peptide 1

2.    The greater effectiveness of roux-en-Y than gastric banding obesity surgery may involve differential effect on which of the following peptides?

a.    Peptide YY and Oxyntomodulin
b.    Peptide YY, Ghrelin and Glucagon-Like Peptide 1
c.    Peptide YY, Oxyntomodulin and Glucagon-Like Peptide 1
d.    Any of the above may be involved.

3.    Weight loss from a variety of causes has what effect on circulating ghrelin levels?

a.    increased
b.    decreased
c.    no effect

4.    The disease Prader Willi syndrome is associated with:

a.    increased ghrelin levels
b.    decreased ghrelin levels
c.    reduction in the secretory products of L-cells: PYY, GLP-1, and oxyntomodulin
d.    no effect on gastrointestinal peptides

5.    All of the following adversely affect prognosis of a malignancy EXCEPT:

a.    Obesity
b.    Exercise
c.    Weight gain of at least 5 kg
d.    Newly diagnosed diabetes

6.    What is the association between the presence of insulin resistance and weight gain?

a.    persons with lower insulin sensitivity are more likely to gain weight
b.    persons with greater insulin sensitivity are more likely to gain weight
c.    insulin sensitivity per se is not associated with increased or decreased likelihood of weight gain

7.    It is clear that visceral fat causes insulin resistance, and subcutaneous fat is not associated with insulin resistance, and may actually improve insulin sensitivity.

a.    True
b.    False

8.    The PCOS is associated with increased androgens derived from increased ovarian production.     What is the relationship between insulin and ovarian androgen production in the condition?

a.    Insulin resistance in women with PCOS does not include resistance to the ovarian effect of insulin, so that hyperinsulinemia causes increased ovarian androgen production.
b.    Women with PCOS may have increased ovarian sensitivity to insulin, leading to increased androgen production without insulin resistance.
c.    Both of the above are true.

9.    Among women with PCOS:

a.    Insulin resistance is related to the three- to fivefold increase in early pregnancy loss.   
b.    Metformin was associated with a lower rate of fetal loss.
c.    Metformin was associated with a higher pregnancy rate.
d.    All of the above are true statements.

10.    Lipodystrophy syndromes are conditions of reduced adipose tissue.     These conditions are associated with:

a.    increased insulin sensitivity
b.    decreased insulin sensitivity
c.    no effect on insulin sensitivity