2021 Is GERD Lecture Endo Physio. Practice Question Wong

IS-GERD ENDOCRINE MODULE
Endocrine Physiology Practice Exam Questions-Spring 2021

Instructor: T. Wong
IS GERD Endocrine System Spring 2021

Endocrine Physiology Practice Exam Questions-SET A
1. Which of the following endocrine hormones is correctly matched with its structural
classification?
A. Vitamin D: Steroid
B. Insulin: Amino Acid Derivative
C. Thyroxine: Protein/Peptide
D. ACTH: Steroid
E. Prolactin: Amino Acid Derivative
2. Which of the following properties is most typical of peptide & protein endocrine
hormones?
A. secreted from endocrine cells by simple diffusion

B. biosynthesized as inactive preprohormones
C. half-life in plasma measured in hours
D. stimulate target cells via intracellular receptors
E. circulate in plasma almost entirely bound to plasma proteins
3. Which of the following most likely correct regarding steroid endocrine hormones?
A. epinephrine and thyroid hormones are steroids

B. synthesized by neurons of hypothalamus, but stored in posterior pituitary
C. total concentration in plasma typically lower compared to protein hormones
D. stimulate target cells via G-protein membrane receptors
E. stimulate target cell gene transcription
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IS-GERD ENDOCRINE MODULE-1
Instructor: T. Wong
4. Which of the following is most likely correct regarding the groups of hormones (Set A-E)
listed above in Figure 1?
A. Set A lists hormones that are all proteins or peptides

B. Set B lists three hormones secreted from the anterior pituitary
C. Set C lists a hormone secreted from the adrenal cortex
D. Set D lists a hormone whose primary function is to increase gastric acid secretion
E. Set E lists a hormone also known as dopamine
5. Which statement regarding endocrine hormones is most likely correct?
A. all known peptide/protein hormones act on target cells via G-protein receptors
B. thyroxine is classified structurally as a protein hormone
C. epinephrine is classified structurally an amino acid derived hormone
D. half-life of peptide/protein hormones in plasma is typically measured in days
E. oxytocin acts on target cells via a tyrosine kinase receptor
6. Dopamine secreted as an endocrine hormone from hypothalamic neurons most directly

regulates the secretion of which pituitary hormone?
A. Growth Hormone
B. Vasopressin
C. Oxytocin
D. Prolactin
E. Somatostatin
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Instructor: T. Wong
7. Five endocrine disorders related to hormones regulated by the hypothalamic-pituitary
axis are described below. Which would most likely develop into a condition classified as
a secondary HYPERfunction?
A. autoimmune destruction of thyroid follicle cells

B. anterior pituitary adenoma causing excessive secretion of ACTH
C. blockage of hypothalamic-pituitary portal circulation causing deficient TSH secretion
D. congenital 21-hydroxylase deficiency of the adrenal cortex
E. autoimmune antibody excessively stimulating TSH receptors on thyroid follicle cells
8. Which group of hormones (Set A-E) in Figure 2 lists hormones that are ALL secreted by
the Anterior Pituitary lobe?
A. Set A
B. Set B
C. Set C
D. Set D
E. Set E
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Instructor: T. Wong
9. Which statement regarding ADH is most likely correct?
A. causes vasodilation of systemic vasculature

B. acts on target cells via a membrane tyrosine kinase receptor
C. alternative name is oxytocin.
D. deficient ADH secretion results in abnormally dilute urine
E. biosynthesized by posterior pituitary cells
10. Which statement related to growth hormone is most likely correct?
A. acts on target cells via a G-protein membrane receptor

B. actions include stimulation of adipose tissue lipogenesis
C. secreted from liver in response to IGF-1 stimulation
D. secretion inhibited by somatostatin from hypothalamic neurons
E. deficiency causes hyperglycemia and potentially diabetes.
11. Which hormone is regulated physiologically by positive feedback and open loop
mechanisms?
A. Growth Hormone
B. Thyroid Hormones
C. Oxytocin
D. ADH
E. Cortisol
12. Prolactin
A. stimulates milk ejection from mammary alveoli during lactation

B. secretion would increase if the hypothalamic-pituitary portal circulation were blocked
C. acts on target cells via a type of membrane G-protein receptor
D. secretion is inhibited by the REM stage of sleep
E. is not secreted in males
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Instructor: T. Wong
13. Which statement related to thyroid hormone biosynthesis & secretion is most likely
correct?
A. biosynthesized from of iodinated alanine dimers

B. predominantly secreted in the form of T3
C. iodide “trapping” mechanism co-transports Na+ & I- from plasma into follicle cells
D. secreted from follicles into plasma by exocytosis
E. colloid stores of T4 are sufficient to last at least 10 years
14. Receptor mechanism of action of thyroid hormones on target cells is most similar to
which hormone?
A. Cortisol
B. Insulin
C. Epinephrine
D. TSH
E. Growth Hormone
15. Which pathophysiological feature would be most expected to develop as a consequence

of a chronic Primary HYPERthyroid condition?
A. decreased basal metabolic rate

B. skeletal muscle hypertrophy
C. increased heart rate and contractility
D. high plasma TSH level
E. myxedema
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Instructor: T. Wong
16. You are asked to evaluate a 43 year-old female patient. The only clinical information that
is given is that she has developed a significant goiter. Based on other observed clinical
manifestations, you suspect some type of thyroid hormone related disorder and request
a plasma thyroid hormone & TSH analysis. Results were as follows:
• Total T4 = 1.5 µg/dL (Normal Range = 5.5-11.0 µg/dL)

• Total T3 = 27 ng/dL (Normal Range =70-204 ng/dL)
• TSH = 12.4 µU/mL (Normal Range = 0.4-4.2 µU/ml)
Which condition is most consistent with these findings?
A. Graves’ disease
B. blockage of hypothalamic-pituitary portal circulation
C. adenoma that is hypersecreting TSH
D. adenoma that is hypersecreting TRH
E. chronic iodine deficiency
17. Which pair of terms and/or characteristic below is correctly matched?
A. Cretinism: Neonatal Hyperthyroidism

B. Elevated T4 & TSH: Primary Hyperthyroidism
C. Myxedema: Goiter
D. Graves’ Disease: Secondary Hypothyroidism
E. Addison’s Disease: Decreased T4 & TSH
18. Which statements below related to glucocorticoids is most likely correct?
A. regulated by CRH & ACTH

B. secreted from glomerulosa layer of adrenal cortex.
C. major secreted glucocorticoid in humans is corticosterone
D. acts on target cells via membrane G-protein receptors.
E. plasma half-life measured in seconds-minutes
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Instructor: T. Wong
19. Based on your knowledge of the normal Steroid Hormone Biosynthesis capabilities of
each of the three distinguished layers of the Adrenal Cortex, which statement is most
likely correct? Use Figure 3 above.
A. Loss of 11-Hydroxylase (11-OH) activity results in excess Cortisol &

Aldosterone synthesis from adrenal cortex.
B. Loss of 17-Hydroxylase (17-OH) activity results in excess Corticosterone
production and deficient Cortisol secretion from the Fasciculata.
C. Loss of 21-Hydroxylase (21-OH) activity results in excess 11-Deoxycortisol
production and deficient Androstenedione secretion from the Fasciculata.
D. Loss of 18-Hydroxylase (18-OH) activity results in excess Corticosterone
secretion from the Fasciculata & Reticularis.
E. Loss of 17-Hydroxylase (17-OH) activity results in excess Aldosterone secretion
from the Fasciculata.
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Instructor: T. Wong
20. Which pathophysiological feature is most consistent with a disorder causing excessive
glucocorticoid action on target tissues?
A. decreased adipose tissue lipolysis

B. increased skeletal muscle protein catabolism
C. hypoglycemia
D. decreased hepatic gluconeogenesis
E. increased skeletal muscle glucose uptake
21. Which set of laboratory and clinical data (Set A-E) shown above in Figure 4 is most
consistent with an adrenal cortex adenoma causing fasciculata cell HYPERsecretion and
the development of classic symptoms related to Cushing’s Syndrome.
A. Set A
B. Set B
C. Set C
D. Set D
E. Set E
22. Which statement related to aldosterone is most likely correct?
A. actions on renal tubules include stimulation of Na+ excretion

B. site of secretion is reticularis layer of adrenal cortex
C. mechanism of actions on target cells is via G-protein membrane receptor
D. major hormonal regulators of secretion are renin & angiotensin II
E. clinical consequences of hypersecretion include hyperkalemia and metabolic acidosis
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Instructor: T. Wong
23. Parathyroid hormone
A. is classified as a steroid hormone.

B. secretion is stimulated in response to hypercalcemia.
C. actions on bone result in decreased bone resorption.
D. actions on renal tubules results in decreased PO4 reabsorption into plasma.
E. secretion is stimulated by vitamin D via a negative feedback mechanism
24. The physiologically active form of vitamin D
A. is also known as calcitonin.

B. is directly secreted into plasma from skin cells after activation by PTH
C. acts on the GI tract to increase Ca++ & PO4 absorption into blood.
D. acts on target cells via membrane G-Protein receptors
E. causes the bone disease Rickets when secreted in excess
25. Which condition below related to plasma Ca++ homeostasis would be classified as
Secondary HYPOparathyroidism?
A. chronic hypercalcemia caused by massive bone resorption resulting from

osteoporosis
B. hypersecreting adenoma of parathyroid gland that is unregulatable by plasma
[Ca++]
C. chronic hypocalcemia due to a renal disease that destroys 50% of renal tubules
D. autoimmune disease that destroys 75% of the parathyroid gland
E. vitamin D deficiency caused by congenital absence of 1α-hydroxylase enzyme
26. The most rapid (within minutes) hormonal action that occurs to maintain ECF Ca++
homeostasis in response to the development of HYPOcalcemia is
A. increased Ca++ absorption from GI tract by vitamin D

B. increased renal Ca++ reabsorption by PTH
C. increased osteoclast bone resorption by PTH
D. decreased bone resorption by calcitonin
E. increased vitamin D activation by PTH
____________________________________________________________________________
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Instructor: T. Wong
ANSWERS: SET A
1. A
2. B
3. E
4. E
5. C
6. D
7. B
8. B
9. D
10. D
11. C
12. B
13. C
14. A
15. C
16. E
17. C
18. A
19. B
20. B
21. B
22. D
23. D
24. C
25. A
26. B
______________________________________________________________________
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Instructor: T. Wong
Endocrine Physiology Practice Exam Questions-SET B
1. Which hormone (left) is correctly matched with its physiological site of secretion (right)
into blood?
A. ADH: Posterior Pituitary Gland

B. Calcitonin: Parathyroid Gland
C. Prolactin: Mammary Gland
D. Epinephrine: Adrenal Cortex
E. ACTH: Hypothalamus
2. Which hormone is classified as a protein hormone based in its biochemical structure?
A. Thyroxine
B. Cortisol
C. Epinephrine
D. Growth Hormone
E. 1,25 Dihydroxycholecalciferol
3. Which hormone (left) is correctly matched with its physiological class of target cell
receptor (right)?
A. Insulin: G-Protein Membrane Receptor

B. Cortisol: Intracellular Receptor
C. Thyroxine: Tyrosine Kinase Membrane Receptor
D. Oxytocin: Intracellular Receptor
E. Gastrin: Tyrosine Kinase Membrane Receptor
4. Which basic hormone property is most typical of protein/peptide hormones?
A. act on target cells via intracellular receptors

B. half-life in plasma measured in days to weeks
C. circulate in blood predominantly bound to plasma proteins
D. secreted from endocrine cells by passive diffusion mechanism
E. stimulation of target cell receptors initiates phosphorylation cascade
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Instructor: T. Wong
5. Which statement regarding the endocrine hormones below is most likely correct?
A. insulin, glucagon & cholecystokinin are all secreted by pancreatic islet cells
B. thyroxine, cortisol & aldosterone are all classified as steroid hormones
C. epinephrine & calcitonin act on target cells via G-protein membrane receptors
D. LH & FSH are secreted by hypothalamic neuroendocrine cells
E. cortisol & insulin are normally secreted at a very constant level throughout the day
6. Which hormone pair is both biosynthesized by neuroendocrine cells of the

hypothalamus?
A. Calcitonin & Parathyroid Hormone

B. Growth Hormone & Prolactin
C. Luteinizing Hormone & Follicle Stimulating Hormone
D. Dopamine & Somatostatin
E. Corticotropin Releasing Hormone & Adrenocorticotropin
7. Which set of hormones are ALL classified structurally as amino acid derivatives?
A. PRL, GH, IGF-I, insulin

B. gastrin, secretin & cholecystokinin
C. cortisol, aldosterone, dehydroepiandrosterone
D. GHRH & somatostatin
E. thyroxine, epinephrine, PRIH
8. Which pair of hormones is secreted into the blood from the posterior pituitary gland?
A. aldosterone & cortisol

B. vasopressin & oxytocin
C. corticotrophin releasing hormone & thyrotropin releasing hormone
D. growth Hormone & prolactin
E. epinephrine & norepinephrine
9. Which statement regarding growth hormone is most likely correct?
A. actions stimulate muscle protein synthesis and adipose tissue lipolysis

B. hypoglycemia is a symptom of excessive secretion
C. acts on target cells via a type of G-protein receptor
D. acromegaly results from deficient secretion
E. indirect actions on target cells mediated by somatostatin secreted from liver
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Instructor: T. Wong
10. Which statement regarding prolactin is most likely correct?
A. secreted into blood from epithelial cells of mammary gland

B. stimulates milk production from mammary epithelial cells
C. stimulates contraction of myoepithelial cells of mammary alveoli
D. acts on target cells via a G-protein receptor
E. secretion rate decreases if hypothalamic-ant. pituitary portal circulation is blocked
11. Which hormone plays a regulatory role in both lactation and parturition?
A. vasopressin
B. calcitonin
C. thyroglobulin
D. oxytocin
E. prolactin
12. Which hormone (left) is correctly matched with a target tissue (s) (right) central to its
physiological action(s)?
A. LH & FSH: ovaries & testes

B. TRH: thyroid gland
C. Glucagon: skeletal & cardiac muscle
D. Aldosterone: proximal renal tubules
E. ACTH: adrenal medulla
13. The disorder nephrogenic diabetes insipidus results from a genetic mutation of the ADH
receptor that causes complete ADH insensitivity of target tissues. Which statement most
likely correct regarding this condition?
A. plasma osmolality is typically abnormally low

B. classified as a primary hypersecretion disorder
C. plasma [ADH] is typically normal or high
D. urine osmolality typically increase after exogenous ADH treatment
E. urine output is typically abnormally low
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Instructor: T. Wong
14. Which pair of molecules comprises the basic components of the biochemical structure of
thyroxine?
A. iodine & tryptophan

B. thyroglobulin & thyroperoxidase
C. iron & tyrosine
D. iodine & tyrosine
E. zinc & cholesterol
15. Which statement regarding thyroid hormones is most likely correct?
A. most highly secreted hormone from thyroid gland is T3

B. circulates in blood mostly as unbound active hormone
C. half-life in plasma is measured in seconds-minutes
D. symptoms of hypothyroidism may not manifest for months if biosynthesis is stopped
E. most physiologically potent form on a mole to mole basis is thyroxine
16. Which clinical manifestation would be most consistent with a chronic primary hypothyroid
condition?
A. low TSH level in plasma

B. hypersecreting thyrotrope adenoma in anterior pituitary
C. exophthalmos
D. sweating & heat intolerance at rest
E. tissue myxedema
17. Which of these relationships is correctly matched?
A. Low T4: Graves’ Disease

B. Iodine Deficiency: Thyroid Storm
C. High TSH & HighT4: Secondary Hyperthyroidism
D. Low TSH & High T4: Cretinism
E. Hypertension & Tachycardia: Hypothyroidism
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Instructor: T. Wong
18. Which hormone property is common to both thyroid hormones and glucocorticoids?
A. classification as steroid hormones

B. hypersecretion causes goiter development
C. act on target cells via intracellular receptor mechanism
D. half-life in blood measure in seconds-minutes
E. anti-inflammatory actions
19. Which clinical manifestation would most likely result from a hyperthyroid disorder that
exaggerates metabolic actions on skeletal muscle, lipid and carbohydrate energy
stores?
A. bradycardia & hypotension

B. weight loss & muscle atrophy
C. weight gain & increased lipogenesis
D. hypoglycemia & decreased glucose oxidation
E. myxedema & deepened voice
20. Due to the physiological absence of an essential P450 enzyme, which hormone is not
normally biosynthesized by any layer of the adrenal cortex?
A. testosterone
B. aldosterone
C. dehydroepiandrosterone
D. progesterone
E. corticosterone
21. Which statement regarding endocrine hormones secreted from the adrenal cortex is
most likely correct?
A. all are classified biochemically as protein hormones

B. most potent secreted mineralcorticoid is cortisol
C. cortisol secretion is primarily regulated by anterior pituitary ACTH
D. androstenedione is the major secreted androgen
E. aldosterone is secreted exclusively from zona reticularis layer
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Instructor: T. Wong
Figure 2 is a standard flow chart of steroid biosynthesis. Use the diagram and your
knowledge of the major hormones secreted from each layer of the Adrenal Cortex to
answer the following two questions.
22. (Use Figure 2) A genetic mutation causes complete loss of 17-Hydroxylase (17-OH)
enzyme activity in your patient? Which statement is most likely correct regarding this
condition?
A. excess aldosterone secretion would occur from the zona fasciculata

B. cortisol biosynthesis from the zona glomerulosa would be initiated to compensate
C. androstenedione would become predominant hormone secreted from zona reticularis
D. biosynthesis of cortisol & all androgens from adrenal cortex would be lost
E. biosynthesis of aldosterone would be lost
23. (Use Figure 2) As a result of the disorder described above, which hormone would
MOST likely accumulate and be secreted in excess from the zona fasciculata?
A. aldosterone
B. 18-OH Corticosterone
C. 17-Hydroxyprogesterone
D. 11-Deoxycortisol
E. corticosterone
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Instructor: T. Wong
24. Which statement regarding cortisol is most likely correct?
A. secretion is typically suppressed by physical and mental stress conditions

B. target cell response to receptor stimulation is rapid (within seconds)
C. liver is not a physiological target tissue
D. actions on energy metabolism stimulate muscle protein synthesis
E. actions on energy metabolism promote hyperglycemia
25. Which of relationship is correctly matched?
A. Cushing’s Disease: Cortisol Deficiency

B. Cushing’s Disease: ACTH levels low
C. Cushing’s Disease: Muscle Atrophy, Hyperglycemia & Hypertension
D. Addison’s Disease: Secondary Hyperglucocorticoidism
E. Addison’s Disease: Moon Face; Thin Skin & Slow Wound Healing
26. Which statement regarding mineralcorticoids is most likely correct?
A. cortisone is the most potent mineralcorticoid

B. excess secretion results in hypokalemia & mild alkalemia
C. deficient secretion results in hypertension & hypernatremia
D. physiological actions include stimulation of Na+ secretion from GI tract
E. physiological regulation if primarily via CRH-ACTH hormone axis
27. Which statement regarding hormone secretions from the adrenal medulla is most likely
correct?
A. excess secretion results in tachycardia & hypertension

B. deficient secretion promotes hyperglycemia
C. actions affecting glucose metabolism are redundant with insulin’s actions
D. norepinephrine is predominant secreted hormone product
E. derived structurally from tryptophan residues
28. Which statement regarding calcium & phosphorus homeostasis is most likely correct?
A. largest single pool of Ca++ in body is within intracellular microsomes

B. Ca++ regulating hormones are secreted in response to changes in ECF [Ca++]
C. hydroxyapatite is a an example of a secondary hyperparathyroid disorder
D. all major hormones regulating Ca++ homeostasis are classified as protein hormones
E. liver is a major target tissue of calcium regulating hormone actions
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Instructor: T. Wong
29. Which statement regarding the major hormones that regulate calcium & phosphorus
homeostasis is most likely correct?
A. 1,25 (OH)2-cholecalciferol mimics PTH action on renal phosphate reabsorption

B. calcitonin stimulates bone resorption
C. PTH increases osteocyte Ca++ permeability to mobilize bone Ca++ into plasma
D. calcitonin actions include stimulation of Ca++ absorption from intestines
E. 1,25 (OH)2-cholecalciferol synthesis is inhibited by PTH
30. Parathyroid hormone
A. is also known as calcitriol

B. actions increase phosphate reabsorption from the proximal renal tubules
C. secretion increases when plasma Ca++ concentration increases
D. is classified as a steroid hormone
E. actions increase resorption of bone hydroxyapatite
31. Muscle tetany is typically associated clinically with
A. hypercalcemia
B. hypocalcemia
32. The physiologically active form of vitamin D is enzymatically produced and secreted from
the ___________________.
A. skin
B. bone
C. kidneys
D. liver
E. GI tract
33. A patient is diagnosed with a disorder classified as secondary hyperparathyroidism.

Which of the following is most likely correct?
A. potential etiology is a vitamin D deficiency

B. target tissue insensitivity to PTH can be ruled out as a potential etiology
C. potential etiology is a PTH hypersecreting adenoma
D. potential etiology is autoimmune destruction of parathyroid glands
E. renal dysfunction can be ruled out as a potential etiology
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Instructor: T. Wong
34. In response to chronic hypocalcemia due to deficient dietary calcium intake, which
physiological compensatory mechanism is typically stimulated first?
A. stimulation of bone resorption by PTH

B. inhibition of bone resorption by calcitonin
C. increased vitamin D biosynthesis
D. increased dietary Ca++ absorption from GI tract
E. increased Ca++ reabsorption from renal tubules by PTH
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Instructor: T. Wong
ANSWERS: SET B
1. A
2. D
3. B
4. E
5. C
6. D
7. E
8. B
9. A
10. B
11. D
12. A
13. C
14. D
15. D
16. E
17. C
18. C
19. B
20. A
21. C
22. D
23. E
24. E
25. C
26. B
27. A
28. B
29. C
30. E
31. B
32. C
33. A
34. E
______________________________________________________________________
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Instructor: T. Wong
Endocrine Physiology Practice Exam Questions-SET C
1. Which hormone (left) is correctly matched with the endocrine gland (right) from which its
active mature form is secreted into blood?
A. Epinephrine : Adrenal Cortex

B. Insulin: Alpha (α) Islet Cells of Pancreas
C. Oxytocin: Liver Hepatocytes
D. Prolactin: Posterior Pituitary Gland
E. Vitamin D: Kidneys
2. Hormone X is synthesized as the inactive precursor Prepro-Hormone-X. Physiologically,

Hormone X is secreted in response to eating and acts on target cells via a tyrosine
kinase receptor. Target tissues include skeletal muscle, adipose tissue and the liver. A
chronic excess of a different hormone termed Hormone YZ from the anterior pituitary
results in secondary hypersecretion of Hormone X. Hormone X is most likely to be?
A. Cortisol
B. Prolactin
C. GH
D. Insulin
E. Secretin
3. Based on your knowledge of endocrine hormones and their basic properties, which
statement is most likely correct?
A. both cortisol & T4 act on target cells via intracellular receptors

B. vast majority of endocrine hormones are structurally classified as steroids
C. glucagon’s half-life in blood is longer than that of aldosterone
D. renin & angiotensin II are both secreted by liver heptatocytes
E. cholecystokinin & insulin are both secreted from the pancreas
4. Which statement is generally true regarding hormones circulate in the blood

predominantly bound to plasma proteins?
A. typically hydrophilic
B. predominantly protein/peptide hormones
C. blood concentration typically lower than hormones that are predominantly unbound
D. metabolized more slowly than hormones that are predominantly unbound
E. catecholamines & posterior pituitary hormones are examples of this group
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Instructor: T. Wong
5. Which characteristic is most likely shared by all of these hormones: TRH; ADH; PRIH;
PTH; FSH?
A. all biosynthesized by the hypothalamus

B. all classified as protein/peptide hormones
C. all act on target cells via a type of membrane G-protein receptor
D. all are secreted from the anterior pituitary
E. all possess longer half-lives in plasma than glucocorticoids.
6. Select the statement that is most likely correct.
A. all hormones secreted by ovaries & testes are classified as peptides

B. all GI tract endocrine hormones are secreted from APUD cells by a diffusion process
C. angiotensin II is also known as vasopressin
D. calcitonin is secreted from cells of the thyroid gland
E. T4, and epinephrine are both derived from the amino acid tryptophan
7. Select the group below that lists hormones that are all biosynthesized by the
neuroendocrine cells of the hypothalamus.
A. TRH; ACTH; OT; GH; LH

B. FSH; PRIH; PRL; CIH; PRF
C. CRH; ADH; GnRH; GHRH; Somatostatin
D. TRH; ADH; PRIH; PTH; FSH
E. IGF-I; CRH; Somatostatin; LH; PTH
8. Which statement is most likely correct regarding anterior pituitary hormones?
A. all regulated by both a releasing & inhibitory hormone secreted by hypothalamus

B. two hormones are regulated by the same releasing hormone from hypothalamus
C. one hormone is classified as an amino acid-derived hormone
D. two hormones are biosynthesized by hypothalamus, but secreted by anterior pituitary
E. one hormone’s principal target tissue is parathyroid gland
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Instructor: T. Wong
9. GH is a (Choose one: Protein?; Steroid?; Amino Acid?) hormone that stimulates target
tissues by binding to a type of (Choose one: G-Protein?; Tyrosine Kinase?;
Intracellular?) receptor. Physiological actions related to increased GH secretion include
(Choose one: Increasing?; Decreasing?) skeletal muscle Protein Synthesis and (Choose
one: Increasing?; Decreasing?) tissue Glucose Uptake from plasma.
A. Protein; Tyrosine Kinase; Increasing; Decreasing

B. Protein; Tyrosine Kinase; Increasing; Increasing
C. Protein; G-Protein; Increasing; Decreasing
D. Amino Acid; Tyrosine Kinase; Decreasing; Increasing
E. Steroid; Intracellular; Increasing; Decreasing
10. Which basic endocrine hormone characteristic is common to both PRL and OT
A. act on target cells via type of G-protein membrane receptor.

B. secretion increases if hypothalamic-anterior portal circulation is blocked
C. secretion regulated by open loop feedback mechanism
D. stimulate milk production from mammary epithelial cells during lactation
E. regulate uterine contraction during parturition
11. Which hormone (left) is correctly matched with the associated physiological property
(right)?
A. CRH: principal target tissue is adrenal cortex

B. PRL: secretion suppressed during sleep
C. IGF-I: mediates most actions of insulin on target tissues
D. PRL: decreases male & female fertility at chronic high levels
E. OT: stimulates vasodilation at high physiological levels
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Instructor: T. Wong
12. Patient Q comes to see you complaining of lethargy and lack of energy along with
persistent polyuria. Physical examination reveals mild bradycardia (57 beats/min).
Patient Q is not taking any prescribed medications. A diagnostic laboratory analysis is
performed and the following results are obtained:
Patient Q:
Fasting [Glucose] = 90 mg/dL Normal = 70-100 mg/dL
Plasma Osmolality = 335 mOsm Normal = 290 mOsm
Urine Osmolality = 375 mOsm Normal = 500-800 mOsm
Plasma [ADH] = 128 pg/dL Normal = 250-300 pg/dL
Plasma [TSH] = 0.2 µU/ml Normal = 0.4-4.2 µU/ml
Total T4 = 3.6 µg/dL Normal = 5.5-11 µg/dL
Which condition is most consistent with the data from Patient Q?
A. decreased sensitivity of target cell to hormone stimulation

B. decreased hormone secretion by hypothalamic neurons
C. target tissue insensitivity to peripheral hormone stimulation
D. autoimmune hyperstimulation of peripheral endocrine gland
E. chronic renal failure
13. Which statement is most likely correct?
A. chronic high level of GH may result in development of diabetes

B. ADH secretion is stimulated by low plasma osmolality
C. PRF is also known as somatostatin.
D. primary target tissue of ACTH is anterior pituitary corticotrophs
E. OT typically causes smooth muscle relaxation in target tissues
14. Which basic hormone property related to thyroid hormones is most likely correct?
A. structural classification is same as TSH & TRH

B. act on target cells via tyrosine kinase receptor
C. greater than 99% of circulating hormone is bound to plasma proteins in blood
D. mature hormone is biosynthesized from cholesterol substrate
E. secretion from follicle into blood occurs through exocytosis mechanism
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Instructor: T. Wong
15. The most abundant secreted and circulating form of thyroid hormone is (Choose one:
T3?; T4?; rT3?). Physiologically, the most potent thyroid hormone acting on target cells
is (Choose one: T3?; T4?; rT3?). By contrast, the secreted thyroid hormone (Choose
one: T3?; T4?; rT3?) is physiologically inactive. Pharmacologically, (Choose one: T3?;
T4?; rT3?) is typically prescribed as hormone replacement for hypothyroid conditions
because of its (Choose one: Longer?; Shorter?) half-life in plasma.
A. T3; T4; rT3; T3; Shorter

B. T4; rT3; T3; T4; Longer
C. T3; T3; T4; T4; Shorter
D. T4; T3; rT3; T4; Longer
E. T4; T3; rT3; T3; Longer
16. Which relationship is correctly matched?
A. thyroglobulin: binds thyroid hormone in plasma

B. DIT + MIT: thyroxine
C. TSH: stimulates TRH secretion from anterior pituitary
D. iodide transporter: exchanges iodide into follicle cells for intracellular K+
E. thyroid peroxidase: actions include oxidation of iodide (I-) to iodine (I)
17. Which set of patient laboratory values is most consistent with untreated Graves
Disease? Normal Ranges are given below:
Total T4: Normal Range = 5.5-11.0 g/dL

Total T3: Normal Range = 70-204 ng/dL
TSH: Normal Range = 0.4-4.2 U/ml
A. Total T4 = 2.2 mg/dL; Total T3 = 55 ng/dL; TSH = 8.2 mU/ml

B. Total T4 = 8.3 mg/dL; Total T3 = 125 ng/dL; TSH = 3.2 mU/ml
C. Total T4 = 28.0 mg/dL; Total T3 = 325 ng/dL; TSH = 0.2 mU/ml
D. Total T4 = 33.0 mg/dL; Total T3 = 554 ng/dL; TSH = 12.7 mU/ml
E. Total T4 = 21.0 mg/dL; Total T3 = 38 ng/dL; TSH = 8.7 mU/ml
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Instructor: T. Wong
18. Which pair of concepts related to the pathophysiology of thyroid hormone disorders is
correctly matched?
A. chronic iodine deficiency: decreased metabolic rate & low [TSH]

B. 2° hyper- & 1° hypo-thyroidism: goiter & high [TSH]
C. Graves disease: short stature, obesity & low [T4]
D. myxedema: hypertension & truncal obesity
E. 2° hypothyroidism: exophthalmos & tachycardia
19. Which effects on energy metabolism is correctly matched with the corresponding chronic
hyperthyroidism or hypothyroidism condition?
A. hyperthyroidism: protein synthesis greater than protein degradation

B. hypothyroidism: lowers plasma cholesterol & risk of cardiovascular disease
C. hyperthyroidism: increases plasma free fatty acids & risk of cardiovascular disease
D. hypothyroidism: stimulates gluconeogenesis causing mild hyperglycemia
E. hyperthyroidism: decreases cellular glucose uptake and oxidation
20. Principal glucocorticoid secreted from the adrenal gland is _____(1)_____.

Principal mineralcorticoid secreted from the adrenal gland is _____(2)_____.
Principal androgen secreted from the adrenal gland is _____(3)_____.
Principal steroid secreted from the adrenal fasciculata is _____(4)_____.
A. (1) Cortisol; (2) Aldosterone; (3) Dehydroepiandrosterone; (4) Cortisol

B. (1) Corticosterone; (2) Aldosterone; (3) Androstenedione; (4) Aldosterone
C. (1) Cortisone; (2) Aldosterone; (3) Dehydroepiandrosterone; (4) Cortisol
D. (1) Cortisol; (2) Corticosterone; (3) Testosterone; (4) Dehydroepiandrosterone
E. (1) Cortisol; (2) Aldosterone; (3); Testosterone (4) Cortisol
21. Which statement related to hormones secreted by the adrenal gland is most likely
correct?
A. taking exogenous glucocorticoids would increase ACTH secretion

B. pheochromocytomas hypersecrete mineralcorticoids
C. osteoporosis, diabetes & muscle atrophy are diagnostic of Addison’s disease
D. hypertension is a common to Cushing’s & Conn’s Disease and pheochromocytoma
E. CRH and ACTH are the primary regulators of aldosterone secretion
22. Which set of clinical symptoms is most consistent with a hypersecreting adenoma
causing Conn’s Syndrome?
A. Hypernatremia; Hyperkalemia; Hypertension; Alkalemia

B. Hyponatremia; Hypokalemia; Hypotension; Acidemia
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Instructor: T. Wong
C. Hypernatremia; Hypokalemia; Hypertension; Alkalemia
D. Hypernatremia; Hypokalemia; Hypertension; Acidemia
E. Hyponatremia; Hyperkalemia; Hypotension; Alkalemia
Use the diagram of general Steroid Biosynthesis in Figure 2 and your knowledge of the
major physiological hormones secreted from each Adrenal Cortex layer to answer the
following three questions.
23. (Use Fig 2) A female patient (early 20’s) is diagnosed with hypertension. However,
common underlying causes such as atherosclerosis are not apparent. A differential
laboratory diagnosis is performed, including tests for possible adrenal cortex disorders.
Results included data below, which are expressed relative to normal plasma values:
ACTH High
Aldosterone Low
Deoxycortisol High
All Adrenal Androgens Normal to Slightly High
Cortisol Low
Deoxycorticosterone High
Analysis of the results suggest impaired function of a crucial P450 enzyme involved in
adrenal steroid hormone biosynthesis. Which enzyme deficiency is most likely?
A. 11-Hydroxylase (11-OH) Deficiency

B. 17-Hydroxylase (17-OH) Deficiency
C. 18-Hydroxylase (18-OH) Deficiency
D. 18-Hydroxysteroid Dehydrogenase (18-HSD) Deficiency
E. 21-Hydroxylase (21-OH) Deficiency
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Instructor: T. Wong
24. (Use Fig 2) Your conclusion is that the enzyme impairment and laboratory results are
consistent with the manifestation of hypertension in the patient. What is the most likely
pathophysiological cause of hypertension development in this case?
A. excess deoxycortisol was diverted into mineralcorticoid pathway to form excess

aldosterone
B. hypersecretion of the weak mineralcorticoid corticosterone caused unregulated
stimulation of aldosterone receptor
C. enzyme impairment also caused excess production of adrenal catecholamines
D. ability of cortisol to bind aldosterone receptor caused unregulated stimulation of Na+
and H2O reabsorption
E. hypersecretion of the weak mineralcorticoid deoxycorticosterone caused unregulated
stimulation of aldosterone receptor
25. (Use Fig 2) In contrast to the patient above, certain P450 enzyme disorders result in
impaired secretion of adrenal androgens. Which P450 enzyme deficiency below would
impair androgen secretion, but would NOT directly affect glucocorticoid or minercorticoid
secretion from the adrenal cortex?

B. 17, 20 Desmolase (17, 20 Des) Deficiency
C. 3 Hydroxysteroid Dehydrogenase (3 HSD) Deficiency
D. 20, 21 Desmolase (20, 21 Des) Deficiency
E. 21-Hydroxylase (21-OH) Deficiency
26. Patient X is an adult female in her 20’s diagnosed with Cushing’s syndrome caused by
an adrenal gland tumor. Patient Y is an adult female in her 40’s diagnosed with
acromegaly caused by an anterior pituitary gland tumor. Both conditions are chronic and
have been left untreated. Which clinical manifestation would be expected to be common
to both patients?
A. bone loss due to osteoporosis

B. skeletal muscle atrophy & weakness
C. obesity
D. hypotension & tachycardia
E. hyperglycemia and reduced insulin sensitivity
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Instructor: T. Wong
27. Which statement related to PTH is most likely correct?
A. increased PTH secretion acts to increase plasma phosphate level

B. PTH secretion is stimulated in response to increased plasma Ca++ level
C. PTH inhibits the enzyme that activates vitamin D in the GI tract
D. PTH directly stimulates reabsorption of Ca++ from the proximal renal tubules
E. vitamin D deficiency can result in a form of secondary hyperparathyroidism
28. A patient is diagnosed with a rare genetic mutation that causes target tissue receptor
insensitivity to PTH stimulation. Which of the following would be most consistent with
this condition?
A. hypercalcemia
B. primary hypoparathyroidism
C. secondary hypoparathyroidism
D. increased Ca++ absorption from GI Tract
E. vitamin D deficiency
29. Which property related to hormones involved in the regulation of calcium & phosphate is
A. calcitonin & PTH both act to increase the plasma Ca++

B. 24,25 (OH)2-cholecalciferol is the active form of vitamin D secreted from the liver
C. plasma half-life of vitamin D is much shorter than either PTH or Calcitonin
D. calcitonin secretion is stimulated in response to hypercalcemia
E. PTH inhibits osteoclast activity and stimulates osteoblast activity
30. Which statement regarding vitamin D is most likely correct?
A. primary physiological role of vitamin D is to inhibit bone resorption

B. vitamin D & PTH act on their respective target tissues via the same basic type of
hormone receptor
C. active form of vitamin D is secreted from skin
D. rickets is caused by excessive vitamin D actions in adolescents
E. severe renal disease can result in vitamin D deficiency and hyperparathyroidism
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Instructor: T. Wong
31. Which of the relationships regarding the pathophysiology of calcium & phosphate
regulatory hormones is correctly matched?
A. primary vitamin D deficiency: secondary hyperparathyroidism

B. hypercalcemia: muscle tetany
C. hyperparathyroidism: ↑ plasma [PO4]
D. hypocalcemia: kidney stones
E. primary hyperparathyroidism: Rickets
ANSWERS:
1. E
2. D
3. A
4. D
5. C
6. D
7. C
8. B
9. A
10. C
11. D
12. B
13. A
14. C
15. D
16. E
17. C
18. B
19. C
20. A
21. D
22. C
23. A
24. E
25. B
26. E
27. E
28. E
29. D
30. E
31. A
______________________________________________________________________
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Instructor: T. Wong
Endocrine Physiology Practice Exam Questions-SET D
1. Which hormone property typical of most protein/peptide hormones?
A. secreted into blood by simple diffusion mechanism

B. initially biosynthesized as inactive preprohormones
C. long half-life in plasma (hours to days)
D. steady-state plasma concentrations greater than steroid hormones
E. target cells stimulated through intracellular receptors
2. Fill in the blanks. Mature steroid hormones are biosynthesized from the precursor
_______1________ and are secreted by _______2________ across the endocrine cell
membrane. Actions at target cells occur through _______3________ receptors and
typically stimulate _______4________.
A. 1. tryptophan; 2. diffusion; 3. membrane; 4. gene transcription

B. 1. cholesterol; 2. diffusion; 3. intracellular; 4. gene transcription
C. 1. cholesterol; 2. exocytosis; 3. membrane; 4. gene transcription
D. 1. tyrosine; 2. exocytosis; 3. membrane; 4. a phosphorylation cascade
E. 1. cholesterol; 2. diffusion; 3. intracellular; 4. a phosphorylation cascade
3. Which group of hormone all act on target cells through a type of tyrosine kinase
membrane receptor?
A. renin, angiotensin II, aldosterone

B. cortisol, aldosterone, dehydroepiandrosterone
C. parathyroid hormone, vitamin D, calcitonin
D. thyroxine, epinephrine, PRIH
E. prolactin, growth hormone, insulin
4. The hormone sensitivity of a target tissue for Hormone X becomes decreased over time
due to excessive and chronic secretion of Hormone X. Which statement is most likely
correct regarding this condition?
A. lower concentration of Hormone X is required to elicit same physiological response

from target tissue than before decrease in sensitivity
B. higher concentration of Hormone X is required to elicit same physiological response
from target tissue than before decrease in sensitivity
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Instructor: T. Wong
5. Destruction of the entire pituitary gland (complete loss of secretory function would not
significantly reduce the concentration of which hormone?
A. ACTH
B. thyroxine
C. cortisol
D. aldosterone
E. TSH
6. Which statement is most likely correct?
A. physiological target tissue of TRH is thyroid gland.

B. GHRIH is only hypothalamic hormone that is not a protein/peptide
C. ACTH and TSH are regulated by a hypothalamic inhibitory hormone
D. ACTH is a cleavage product of precursor protein proopiomelanocortin (POMC)
E. PRIH is also known as somatostatin.
7. Which choice lists endocrine hormones that are all biosynthesized by the
neuroendocrine cells of the hypothalamus?
A. ACTH; TRH; GnRH, POMC

B. GH; LH; TSH; PRL
C. PRL; GHRIH; FH; LSH
D. somatostatin, TSH; PRF’s; oxytocin
E. ADH; dopamine; GHRH; CRH
Next two questions are linked:
8. A condition resulting from a congenital disorder causing receptor insensitivity of target

cells to GH is Laron dwarfism. This impairment is typically characterized by
_______1________ plasma GH levels and _______2_________ plasma IGF-1 levels.
A. 1. high; 2. low
b. 1. low; 2. low
C. 1. normal; 2. high
D. 1. high; 2. normal
E. 1. high; 2. high
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Instructor: T. Wong
9. Based on the etiology of Laron Dwarfism, this condition would be most appropriately
classified clinically as a
A. primary HYPER-GH disorder

B. primary HYPO-GH disorder
C. secondary HYPER-GH disorder
D. secondary HYPO-GH disorder
E. tertiary HYPO-GH disorder
10. Which of the following statements related to growth hormone (GH) is most likely correct?
A. GH acts on target cells via a G-protein receptor.

B. GH plasma level gradually increases between the ages of 30-70 years
C. GH stimulates adipose tissue lipolysis and inhibits skeletal muscle glucose uptake.
D. GH secretion is stimulated by somatostatin
E. chronic GH deficiencies typically result in hyperglycemia
11. Prolactin
A. primarily functions to stimulate breast milk ejection during lactation

B. is classified as an amino acid derived hormone.
C. secretion decreases if hypothalamic-anterior pituitary portal circulation were blocked
D. is not normally biosynthesized and secreted by males
E. hypersecretion disorders can result in decreased fertility
12. Which statement related to the posterior pituitary hormones is most likely correct?
A. ADH and oxytocin are biosynthesized by posterior pituitary gland

B. ocytocin is also known as vasopressin
C. decreased plasma osmolality stimulates ADH secretion
D. increased ADH secretion results in a more dilute urine
E. uterine contractions during childbirth stimulate oxytocin secretion
13. A 45 year-old female develops an anterior pituitary adenoma that results in

hypersecretion of TSH and is refractile to feedback regulation by plasma T4 and T3
levels. Which statement is most likely correct in relation to this condition?
A. classified as primary hyperthyroidism

B. characterized by high TSH and low T4 levels
C. characterized by decreased TRH secretion
D. condition also known as Graves’ disease
E. related clinical manifestations include bradycardia and myxedema
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Instructor: T. Wong
14. Which statement related to the biosynthesis and secretion of thyroid hormones is most
likely correct?
A. all biosynthesis steps occur within cytoplasm of follicle cells

B. iodide transporter exchanges intracellular K+ for plasma iodide
C. synthesized from lysine residues of a large glycoprotein called thyroxine
D. less than 1% of total T3 & T4 circulates in blood bound to plasma proteins
E. predominant secreted and circulating form of thyroid hormone is T4
15. The net effects of chronic hyperthyroidism on energy substrate metabolism would most
likely result in which clinical manifestation?
A. skeletal muscle atrophy

B. body weight gain
C. myxedema
D. mild hypoglycemia
E. high plasma cholesterol
16. Which choice below is most consistent with Graves disease?
A. secondary hyperthyroidism
B. primary hypothyroidism
C. high T4; high TSH
D. heat intolerance, tachycardia, hyperactivity
E. iodine deficiency
17. Which disorder related to thyroid hormones (left) is correctly matched with a potential
clinical manifestation consistent with the condition (right)?
A. Graves’ disease: myxedema

B. hypothyroidism: thyroid “storm”
C. cretinism: hypertension & tachycardia
D. hypothyroidism: goiter
E. chronic iodine deficiency: exophthalmos
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Instructor: T. Wong
18. Which statement related to the basic physiological properties of thyroid hormones is
A. potency of T4 significantly greater than T3

B. thyroperoxidase (TPO) catalyzes deiodination of T4 to T3
C. act on target cells via tyrosine kinase membrane receptor
D. hypothyroid symptoms delayed by months due to colloid stores
E. half-life much shorter than typical protein and peptide hormones
19. In humans, the principal mineralcortcoid ________1________ is biosynthesized by the

_______2_______ layer of the adrenal cortex and the principal glucocorticoid
_______3_______ is biosynthesized by the _______4______ layer of the adrenal
cortex.
A. 1. aldosterone; 2. glomerulosa; 3. cortisol; 4. fasciculata.

B. 1. aldosterone; 2. reticularis; 3. 11-deoxycortisol; 4. fasciculata.
C. 1. corticosterone; 2. glomerulosa; 3. cortisol; 4. reticularis.
D. 1. progesterone; 2. fasciculata; 3. cortisol; 4. glomerulosa.
E. 1. aldosterone; 2. glomerulosa; 3. corticosterone; 4. fasciculata.
20. In adult humans, the principal androgen hormone synthesized by the adrenal gland is
A. dihydrotestosterone (DHT)
B. dehydroepiandrosterone (DHEA)
C. testosterone
D. progesterone
E. estrogen
21. Which effect on energy substrate metabolism listed below is most consistent with the
physiological actions of glucocorticoids?
A. increased muscle protein synthesis

B. increased glucose uptake into muscle
C. decreased adipose tissue lipolysis
D. decreased liver gluconeogenesis
E. decreased muscle & fat insulin sensitivity
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Instructor: T. Wong
Use the diagram of general Steroid Biosynthesis in Figure 1 and your knowledge of the major
physiological hormones secreted from each Adrenal Cortex layer to answer the following TWO
questions.
22. A female patient displays abnormally high plasma levels of Corticosterone, but relatively
normal plasma levels of Aldosterone. Based on this information alone, which enzyme
disorder is the MOST likely cause?

B. 18-Hydroxylase (18-OH) Deficiency
C. 11-Hydroxylase (11-OH) Deficiency
D. 21-Hydroxylase (21-OH) Deficiency
E. 18-Hydroxylase (18-OH) Excess
23. If a genetic mutation causes complete loss of function in the entire body of the defective
enzyme above, which clinical manifestation(s) below would be most expected?
A. high plasma dehydroepiandrosterone level

B. infertility & low libido
C. hypotension & female hirsutism
D. low plasma ACTH level
E. normal plasma estradiol, but high androgen levels.
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Instructor: T. Wong
24. A patient displays clinical symptoms consistent with Cushing’s syndrome. Laboratory
data indicate abnormally high glucocorticoid and low ACTH plasma levels. Based on
this information alone, which statement related to this condition is a possibility?
A. patient may have an adrenal cortex adenoma hypersecreting glucocorticoids

B. patient may be taking excessive exogenous glucocorticoids
C. neither A or B is possible.
D. both A and B are possible
25. Which clinical manifestation (left) related to Cushing’s syndrome is correctly matched
with a different endocrine hormone disorder (right) that typically displays the same
clinical symptom?
A. increased appetite: hypothyroidism

B. hypergycemia: acromegaly
C. hypertension: aldosterone deficiency
D. osteoporosis: type 2 diabetes
E. truncal obesity: Graves’ disease
26. Aldosterone
A. is primarily regulated by CRH and ACTH

B. is biosynthesized only by zona reticularis layer of adrenal cortex
C. hypersecretion typically results in hypertension and hypokalemia.
D. hypersecretion is a typical manifestation of Addison’s disease.
E. is also known as the hormone angiotensin II
27. After a complete bilateral adrenalectomy, the plasma concentration of the

hormone_________________ would be expected to remain within relatively normal
range limits. Assume there is no pharmacological compensatory therapy.
A. cortisol
B. epinephrine
C. aldosterone
D. norepinephrine
E. dehydroepiandrosterone (DHEA)`
28. The physiological actions of PTH on target tissues include:
A. increasing Ca++ reabsorption from the proximal renal tubules.

B. increasing PO4 reabsorption from the distal renal tubules.
C. inhibiting dietary PO4 absorption from the GI tract.
D. stimulating hydroxyappatite resorption in bone.
E. inhibiting vitamin D activation in the skin.
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Instructor: T. Wong
29. A patient develops a parathyroid gland adenoma that causes hypersecretion of PTH.
Which of the following is most consistent with this condition?
A. vitamin D deficiency
B. low plasma [calcitonin]
C. muscle tetany
D. hypophosphatemia
E. hypocalcemia
30. The major physiological target tissue for vitamin D’s calcium regulating actions is
__________________.
A. skin
B. bone osteoclasts
C. distal renal tubules
D. liver
E. intestinal tract
31. Which statement related to the hormonal regulation of calcium is most likely correct?
A. PTH and calcitonin both increase plasma [Ca++]

B. PTH is biosynthesized as inactive prepro-PTH, which requires activation by sunlight
C. calcitonin is the biologically active form of vitamin D
D. rickets is a disorder caused by hyperparathyroidism disorders
E. osteomalacia is a disorder caused by vitamin D deficiency
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Instructor: T. Wong
ANSWERS: SET D
1. B
2. B
3. E
4. B
5. D
6. D
7. E
8. A
9. C
10. C
11. E
12. E
13. C
14. E
15. A
16. D
17. D
18. D
19. A
20. B
21. E
22. A
23. B
24. D
25. B
26. C
27. D
28. D
29. D
30. E
31. E
______________________________________________________________________
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Instructor: T. Wong
40
Instructor: T. Wong
Endocrine Physiology Practice Exam Questions-SET E
1. Which hormone (left) is correctly matched with its alternative hormone name (right)?
A. CRH = corticotropin
B. GHRH = somatostatin
C. Calcitonin = calcitriol
D. PRIH = dopamine
E. ADH = oxytocin
2. Which endocrine property is shared by all of the following hormones: cortisol, growth
hormone, thyroxine, insulin, epinephrine, & glucagon?
A. all are structurally protein/peptide hormones

B. all act on target cells via a type of membrane g-protein receptor
C. all share liver & adipose tissue as target tissues for their actions
D. all stimulate skeletal muscle protein synthesis mechanisms
E. all are secreted from their glands by an exocytosis mechanism
3. Hormone X is physiologically stimulated in response to eating and during sleep. Under

certain circumstances, Hormone X is stimulated in parallel with a posterior pituitary
hormone through a mechanoreceptor mechanism. Hormone X’s secretion rate is
predominantly regulated by an inhibitory hormone that is amino acid-derived. Excessive
secretion of Hormone X can potentially result in Decreased Fertility. Hormone X is most
likely __________________.
A. growth hormone
B. cortisol
C. thyroxine
D. prolactin
E. luteinizing hormone
4. Which statement regarding endocrine hormone properties is most likely correct?
A. protein hormones typically possess longer plasma half-lives than steroids

B. plasma concentrations of steroid hormones are typically within 10-3-10-6 gm/L
C. kidney & liver cells do not secrete any known endocrine hormones
D. secretin & cholecystokinin are secreted by pancreatic acinar cells
E. tyrosine kinase receptors are located intracellularly within the nucleus
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Instructor: T. Wong
5. A 39 year-old male patient is diagnosed with hyposomatotropinism resulting from
autoimmune destruction of growth hormone (GH) secreting cells. Which statement is
A. neuroendocrine cells of the hypothalamus were destroyed

B. patient’s plasma GH concentration is abnormally low
C. patient’s plasma IGF-1 concentration is abnormally high
D. expected clinical manifestations include hyperglycemia
E. condition is classified as a type of secondary hyposomatotropinism
6. Which statement related to the thyroid hormones is most likely correct?
A. goiter coupled with a high TSH level are consistent with Graves’ disease
B. chronic hyperthyroidism or hypothyroidism increases cardiovascular disease risk
C. act on target cells via a tyrosine kinase receptor mechanism
D. thyroid cells concentrate iodide via a facilitated diffusion Na+/iodide exchanger
E. major secreted form of thyroid hormone is thyroglobulin
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Instructor: T. Wong
Use Figure 1 above to answer the next TWO questions.
7. (Use Fig. 1) Which Set (A-D-C-D-E) of hormones all share skeletal muscle as a
physiological target tissue?
A. Set A
B. Set B
C. Set C
D. Set D
E. Set E
8. (Use Fig. 1) Which of the following is most likely correct?
A. primary target tissue of all hormones in Set C is the anterior pituitary.

B. all sets list at least one steroid, protein/peptide & amino-acid derived hormone.
C. all hormones in Set E cause net bone loss when secreted in excess.
D. only one hormone listed in Set B acts on target cells via intracellular receptors
E. hormones in Set A indicate alternative names of each hormone in Set D
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Instructor: T. Wong
Next THREE questions related to steroid hormone biosynthesis scheme in Figure 2 above.
9. (Use Fig. 2) The steroid hormone indicated by “B” is _______1_______ and is almost
exclusively biosynthesized by cells of the ___________2_____________ layer of the
Adrenal Cortex.
A. 1. aldosterone; 2. fascilulata
B. 1. DHEA; 2. reticularis
C. 1. cortisol; 2. glomerulosa
D. 1. cortisol; 2. fasciculata
E. 1. aldosterone; 2. reticularis
10. (Use Fig. 2) A male patient is diagnosed with a 3β-hydroxy-steroid dehydrogenase (3β-
HSD) deficiency. Which manifestation is most consistent with this disorder?
A. DHEA secretion from glomerulosa layer will increase.

B. DHEA secretion from fasciculata layer will increase
C. DHEA secretion from reticularis layer will decrease
D. progesterone secretion from all adrenal cortex layers will Increase
E. testosterone secretion from testes will remain normal
11. (Use Fig. 2) A 19 year-old male patient diagnosed with a P450 enzyme deficiency
possesses normal testosterone, but high DHEA levels coupled with high ACTH & low
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Instructor: T. Wong
cortisol levels. Based on this information alone, select the most likely conclusion.
A. could only be an 18-OH deficiency

B. could be either a 17-OH or 21-OH deficiency
C. could be either a 21-OH or 11-OH deficiency
D. could be a 17-OH, 21-OH, or 11-OH deficiency
E. could be either a 3β-HSD, 21-OH, or 11-OH deficiency
12. Which set of clinical Information (left) is consistent with the clinical disorder (right)?
A. primary hypoparathyroidism: chronic renal failure

B. hyperglycemia & hypertension: Addison’s disease
C. low GH & high IGF-1: Laron dwarfism (tissue insensitivity to GH)
D. Low TSH & High T4/T3: Graves Disease
E. hypercalcemia & hypophosphatemia hypoparathyroidism
13. Which statement related to the hormones of the adrenal gland is most likely?
A. loss of adrenal catecholamines is more life-threatening than loss of glucocorticoids

B. pheochromocytoma affects hormone secretion from glomerulosa layer
C. hyperkalemia & mild acidemia are consistent with 1° hyperaldosteronism
D. during acute stress, catecholamine response is faster than glucocorticoids
E. muscle catabolism is a feature common to both excess aldosterone and cortisol
14. Which pair of hormones (left) is correctly matched with a physiological metabolic action
(right) common to both hormones?
A. insulin & GH: ↑ muscle protein synthesis

B. cortisol & glucagon: ↑ muscle glycogenolysis
C. epinephrine & GH: ↑ hepatic glycogenolysis
D. glucagon & insulin: ↑ hepatic gluconeogenesis
E. thyroxine & GH: ↑ adipose tissue lipogenesis
15. Which endocrine property is typical of most steroid hormones?
A. enter target cells by endocytosis mechanism

B. target cell actions transduced via phosphorylation cascade
C. hormone bound to proteins in blood is considered dissolved in plasma
D. normal half-life in blood is typically within seconds-to-minutes
E. target cells response to stimulation typically delayed by hours-days
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Instructor: T. Wong
16. A patient displays hyperprolactinemia. Based on this information alone, which etiology
below is most consistent with this condition?
A. excessive secretion of dopamine by hypothalamic neuroendocrine cells.

B. unregulated posterior pituitary adenoma
C. blocked blood flow through hypothalamic-anterior pituitary portal circulation
D. low TRH secretion due to chronic primary hyperthyroid condition
E. autoimmune destruction of anterior pituitary lactotrophs
17. Which endocrine property related to the posterior pituitary hormones is most likely
correct?
A. ADH causes blood vessel vasodilation and uterine smooth muscle relaxation
B. vasopressin target cells include proximal renal tubules and mammary cells
C. clinical manifestations ADH deficiency include hyperosmolality & hypotension
D. vasopressin regulation includes positive feedback response to hyperosmolarity
E. vasopressin and ADH are the only hormones secreted from the gland
18. Which statement related to vitamin D derivatives and actions is most likely correct?
A. primary target cells of physiologically active form are bone osteoblasts

B. cholesterol precursor is stored in kidneys and circulated to skin cells where it is
cleaved by infrared light to form physiologically active calcitonin
C. physiologically active form is also termed 24,25 (OH)2 cholecalciferol
D. osteomalacia is a chronic hypercalcemia disorder in children caused by excessive
intake of dietary vitamin D
E. increased bone resorption and 2° hyperparathyroidism are expected compensatory
responses to a 1° vitamin D deficiency
19. Triiodthyronine (T3)
A. is a physiologically inactive form of thyroid hormone

B. is the most abundant circulating form of thyroid hormone in blood
C. is a more potent form of thyroid hormone than tetraiodothyronine
D. is also known as thyroperoxidase
E. is more commonly prescribed clinically than T4 because of its longer plasma half-life
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Instructor: T. Wong
20. Which set of clinical manifestations is consistent with an endocrine disorder resulting in
excessive production of the prohormone proopiomelanocortin (POMC)?
A. hypotension
B. hypoglycemia
C. infertility &/or delayed puberty
D. hyperpigmentation of skin
E. low plasma cortisol level
21. Cretinism is a disorder related to a deficiency of which hormone?
A. thyroxine
B. growth hormone
C. cortisol
D. prolactin
E. PTH
22. Hormone A secretion is stimulated soon after falling asleep and stays elevated during
the sleep period. Hormone B secretion is influenced by the circadian sleep-wake cycle
and is stimulated just prior to the normal waking time. Hormone C secretion is
stimulated during the early sleep period, but is suppressed by the REM (Rapid-Eye-
Movement) stage of sleep. Which choice correctly identifies each hormone?
A. Hormone A = Cortisol; Hormone B = PRL; Hormone C = GH

B. Hormone A = GH; Hormone B = Cortisol; Hormone C = PRL
C. Hormone A = Cortisol; Hormone B = GH; Hormone C = PRL
D. Hormone A = PRL; Hormone B = Cortisol; Hormone C = GH
E. Hormone A = PRL; Hormone B = GH; Hormone C = Cortisol
23. Which clinical manifestation (left) is correctly matched with the related clinical disorder
(right)?
A. Myxedema: Addisons’ Disease

B. Trousseau’s Sign: Primary Hyperparathyroidism
C. Infertility: Hyperprolactinemia
D. Exophthalmos: Iodine Deficiency
E. Mental Retardation: Ricket’s
47
Instructor: T. Wong
24. A patient presents with polyuria and is suspected of having nephrogenic diabetes
insipidus, which is a disorder that causes his kidneys to become completely insensitive
to ADH stimulation. The diagnosis is supported by laboratory results after exogenous
ADH is administered to the patient. Based on the etiology of this condition, which set of
data is most consistent with this disorder?
A. urine osmolality is low before and remains low after exogenous ADH treatment
B. plasma osmolality is low before and remains low after exogenous ADH treatment
C. urine osmolality increases after exogenous ADH treatment
D. plasma osmolality decreases after exogenous ADH treatment
E. patient’s endogenous plasma [ADH] is low
25. Hormone Q’s physiological actions include (1) stimulation of adipose tissue lipolysis &
lipogenesis, (2) stimulation of muscle protein anabolism & catabolism, and (3)
stimulation of liver glycogenolysis, glycogenesis & gluconeogenesis. Hormone Q is
most likely ___________________.
A. Cortisol
B. Glucagon
C. Insulin
D. Thyroxine
E. Epinephrine
26. Somatostatin
A. is a peptide hormone secreted from (alpha) α-islet cells of endocrine pancreas.

B. physiologically inhibits the secretion of gastrin, GH, insulin & glucagon
C. is secreted by somatotrophs of the anterior pituitary gland.
D. physiologically regulates growth hormone secretion via a paracrine mechanism.
E. is also known as the hormone somatomedin-C
27. Which statement related to the clinical significance of the C-Peptide of insulin is ?
A. plasma C-peptide reflects amount of active insulin secreted from pancreas

B. plasma C-peptide/insulin (ratio) commonly increases in type 2 diabetics
C. plasma C-peptide/proinsulin (ratio) commonly increases in type 2 diabetics
D. plasma C-peptide is typically higher than normal in type 1 diabetic patients
E. plasma C-peptide is absent in normal healthy individuals
48
Instructor: T. Wong
28. Which plasma [Ca++] homeostasis mechanism would be most rapidly responsive to a
decrease from normal plasma [Ca++]?
A. stimulation of hydroxyapatite resorption

B. stimulation of Ca++ absorption from GI tract
C. stimulation of calcitonin secretion
D. stimulation of renal Ca++ reabsorption from distal tubules
E. stimulation of vitamin D activation and secretion
29. Which set of relative laboratory values is consistent with a secondary HYPO-secretion
endocrine disorder? Assume classification refers to the status of the peripheral gland
hormone.
A. Low [Ca++] + Low [PTH]

B. Low [ACTH] + High [Cortisol]
C. High Plasma [Osmolality] + Low [ADH]
D. High [PRIH] + Low [PRL]
E. High [TSH] + Low [T4]
30. Which set of hormones all act on target cells via a tyrosine kinase receptor mechanism?
A. Insulin, PRL, GH
B. Thyroxine, Epinephrine, PRIH
C. Cortisol, GH, Glucagon
D. T3, TSH, ACTH
E. Insulin, IGF-1, FSH, LH
31. Which statement related to glucagon is most likely correct?
A. secretion increases in response to hyperglycemia

B. metabolic actions include stimulation of skeletal muscle glycogenolysis
C. metabolic actions include stimulation of adipose tissue lipolysis
D. secretion would be expected to be higher after eating than during fasting
E. excess would be expected to cause severe hypoglycemia
32. Which concept related to endocrine hormones is most likely correct?
A. glucose uptake into brain & liver cells does not require insulin
B. norepinephrine is the predominant hormone secreted by adrenal medulla
C. oxytocin is biosynthesized by endocrine cells of the posterior pituitary
C. glucocorticoid actions stimulate the inflammatory response to trauma
E. calcitonin is biosynthesized by endocrine cells of the parathyroid gland
49
Instructor: T. Wong
33. A clinical feature consistent with Cushing’s disease, acromegaly, types 1 & 2 diabetes,
pheochromocytoma, and Graves’ disease is
A. skeletal muscle atrophy

B. obesity
C. polyuria
D. hypotension
E. hyperglycemia
34. Muscle tetany is a more common clinical manifestation of HYPOcalcemia than

HYPERcalcemia (1. TRUE or FALSE) whereas kidney stones are more commonly
associated with HYPERcalcemia than HYPOcalcemia (2. TRUE or FALSE).
A. 1. TRUE; 2. TRUE
B. 1. FALSE; 2. FALSE
C. 1. TRUE; 2. FALSE
D. 1. FALSE; 2. TRUE
35. A patient’s laboratory data indicates normal plasma [Ca++], but a relatively high plasma
PTH level and very low plasma [PO4]. Which condition is consistent with these data?
A. primary hyperparathyroidism
B. chronic renal failure
C. insufficient dietary vitamin D
D. chronic excessive calcium diet
50
Instructor: T. Wong
ANSWERS: SET E
1. D
2. C
3. D
4. B
5. B
6. B
7. B
8. E
9. D
10. B
11. C
12. D
13. D
14. A
15. E
16. C
17. C
18. E
19. C
20. D
21. A
22. D
23. C
24. A
25. D
26. B
27. A
28. D
29. D
30. A
31. C
32. A
33. E
34. A
35. C
______________________________________________________________________
51

2021 Is GERD Lecture Endo Physio. Practice Question Wong

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IS-GERD ENDOCRINE MODULE

Endocrine Physiology Practice Exam Questions-Spring 2021

IS GERD Endocrine System Spring 2021

A. secreted from endocrine cells by simple diffusion

A. epinephrine and thyroid hormones are steroids

A. Set A lists hormones that are all proteins or peptides

5. Which statement regarding endocrine hormones is most likely correct?

6. Dopamine secreted as an endocrine hormone from hypothalamic neurons most directly

A. autoimmune destruction of thyroid follicle cells

A. causes vasodilation of systemic vasculature

10. Which statement related to growth hormone is most likely correct?

A. acts on target cells via a G-protein membrane receptor

A. stimulates milk ejection from mammary alveoli during lactation

A. biosynthesized from of iodinated alanine dimers

15. Which pathophysiological feature would be most expected to develop as a consequence

A. decreased basal metabolic rate

• Total T4 = 1.5 µg/dL (Normal Range = 5.5-11.0 µg/dL)

Which condition is most consistent with these findings?

17. Which pair of terms and/or characteristic below is correctly matched?

A. Cretinism: Neonatal Hyperthyroidism

18. Which statements below related to glucocorticoids is most likely correct?

A. regulated by CRH & ACTH

A. Loss of 11-Hydroxylase (11-OH) activity results in excess Cortisol &

A. decreased adipose tissue lipolysis

22. Which statement related to aldosterone is most likely correct?

A. actions on renal tubules include stimulation of Na+ excretion

23. Parathyroid hormone

A. is classified as a steroid hormone.

24. The physiologically active form of vitamin D

A. is also known as calcitonin.

A. chronic hypercalcemia caused by massive bone resorption resulting from

A. increased Ca++ absorption from GI tract by vitamin D

A. ADH: Posterior Pituitary Gland

2. Which hormone is classified as a protein hormone based in its biochemical structure?

A. Insulin: G-Protein Membrane Receptor

4. Which basic hormone property is most typical of protein/peptide hormones?

A. act on target cells via intracellular receptors

6. Which hormone pair is both biosynthesized by neuroendocrine cells of the

A. Calcitonin & Parathyroid Hormone

A. PRL, GH, IGF-I, insulin

A. aldosterone & cortisol

9. Which statement regarding growth hormone is most likely correct?

A. actions stimulate muscle protein synthesis and adipose tissue lipolysis

A. secreted into blood from epithelial cells of mammary gland

A. LH & FSH: ovaries & testes

A. plasma osmolality is typically abnormally low

A. iodine & tryptophan

15. Which statement regarding thyroid hormones is most likely correct?

A. most highly secreted hormone from thyroid gland is T3

A. low TSH level in plasma

17. Which of these relationships is correctly matched?

A. Low T4: Graves’ Disease

A. classification as steroid hormones

A. bradycardia & hypotension

A. all are classified biochemically as protein hormones

A. excess aldosterone secretion would occur from the zona fasciculata

24. Which statement regarding cortisol is most likely correct?

A. secretion is typically suppressed by physical and mental stress conditions

25. Which of relationship is correctly matched?

A. Cushing’s Disease: Cortisol Deficiency

26. Which statement regarding mineralcorticoids is most likely correct?

A. cortisone is the most potent mineralcorticoid

20. Principal glucocorticoid secreted from the adrenal gland is _(1)_.

19. In humans, the principal mineralcortcoid 1 is biosynthesized by the