3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD

1. This is a signaling molecule that regulates physiology or behavior in a multicellular organism

 hormone
 humoral release
 antagonism
 thyroid gland

2. All the following are primary functions of the endocrine system except:
 maintain homeostasis
 facilitate growth and development
 deliver oxygen throughout the body
 coordination of the reproductive system

3. The steroid hormones are made from

 protein
 enzyme
 cholesterol
 receptors

4. Which endocrine hormone is produced in the kidney to stimulate red blood cell production?
 thyroid hormone
 parathyroid hormone
 estrogen
 erythropoietin

5. A mother breastfeeding her baby resulting in an increase in milk production through the in-
creased production of prolactin is an example of:
 positive feedback mechanism
 negative feedback mechanism
 endocrine axis
 hormone antagonism

6. Hormones work by binding to

 smooth endoplasmic reticulum
 cortisol
 other hormones
 receptors
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
7. Insulin lowers serum blood glucose levels. Glucagon, cortisol, epinephrine, and growth hor-
mone increase blood glucose levels. This is an example of:
 ectopic hormonal release
 endocrine disorder
 hormone antagonism
 positive feedback

8. This kind of hormone binds to receptors on the cell membrane.

 steroid hormone
 peptide hormone
 amino acid derivative hormone
 nucleus

9. The hypothalamic-pituitary axis

 Stimulates red blood cell production
 Controls the release and inhibition of many hormones
 Removes toxins from the blood
 Is the vision center of the body

10. Oxytocin is stored in the:

 hypothalamus
 anterior pituitary
 thyroid
 posterior pituitary

11. Which structure protects the pituitary gland?

 sella turcica
 optic chiasm
 infundibulum
 mammary body

12. The primary problem in diabetes insipidus is

 Excess prolactin
 Excess growth hormone
 Oxytocin insufficiency
 ADH insufficiency
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
13. This structure connects the hypothalamus and the pituitary gland
 Sella turcica
 Optic chiasm
 Infundibulum
 Pars Nervosa

14. This disease may cause men to start producing milk in their breasts
 SIADH
 COVID-19
 diabetes insipidus
 prolactinoma

15. Oxytocin may be used as a medicine to

 Augment labor
 Treat urinary tract infection
 Decrease the size of prolactinomas
 Stimulate weight loss

16. Hormones created by the hypothalamus get to their target receptors in the anterior pituitary
via
 Hypothalamohypophysial nerve tract
 Hypophysial portal system
 Paracrine Activity
 Autocrine Activity

17. Growth hormone exerts its effect on

 Most tissues in the body
 The anterior pituitary gland
 The intestines
 The skin

18. Growth hormone stimulates the liver to produce

 Somatostatin
 IGF-1
 Erythropoietin
 Thyroid hormone
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
19. Growth hormone does all of the following except:
 Increases protein deposition
 Enhances fat utilization for energy
 Decreases carbohydrate utilization
 Causes lymphocyte differentiation in the bone marrow

20. Growth hormone release

 is decreased by vigorous activity
 increases in old age
 is increased in the first few hours of deep sleep
 is not affected by blood sugar levels

21. What is the most common cause of acromegaly?

 A pituitary tumor
 trauma
 meningitis
 myocardial infarction

22. A pituitary tumor may cause gigantism if :

 The patient is elderly
 The growth plates are not yet closed
 The patient has a mutated growth hormone receptor
 The patient also has diabetes

23. Achondroplasia is this kind of disorder

 Growth hormone deficiency
 Bone dysplasia
 Growth hormone insensitivity syndrome
 Inborn error of metabolism

24. A child with growth hormone deficiency

 Will have a delayed bone age
 Will have a normal bone age
 Will have an advanced bone age
 Should not have a bone age performed

25. The most important function of the thyroid gland is to:

 Regulate calcium levels in the blood
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
 Promote growth and development
 Regulate metabolism
 Sodium regulation

26. The main substance contained within follicles of the thyroid is called
 calcitonin
 colloid
 c cells
 TSH

27. What mineral is key to the production of thyroid hormone?

 sulfer
 copper
 magnesium
 iodine

28. What is the most common cause of diffuse non-toxic goiter?

 Iodine deficiency
 TSH receptor stimulating antibodies
 Critical illness
 A diet with excess cabbage intake

29. What is the name of the molecule in the colloid that stores thyroid hormone?
 TRH
 Calcitonin
 TSH
 thyroglobulin

30. What is the predominant hormone released by the thyroid?

 T3
 T4
 Reverse T3
 thyroglobulin

31. Which of these is not a function of thyroid hormone?

 Increase fat metabolism
 Increase protein synthesis
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
 Promote growth and development
 Decrease basal metabolic rate

32. Which of these increases the secretion of thyroid hormone?

 Thyroid hormone
 Cold weather
 Serious illness
 Starvation

33. Over the last three years, a 50-year-old woman has had the following symptoms: weight gain,
puffy face, decreased energy, weakness, constipation, hair loss, and edema. What is the most
likely cause?
 Solitary toxic nodule
 adrenal insufficiency
 hyperthyroidism
 hypothyroidism

34. A 50 year-old-woman has the following symptoms: weight loss, tremor, palpitations, bulging
eyes, red thickened skin on her shins, anxiety, and an enlarged thyroid gland. What is the
likely diagnosis?
 Diffuse nontoxic goiter
 Hashimoto thyroiditis
 Graves disease
 Adrenal insufficiency

35. What is the most common cause of hypothyroidism in developed countries?

 Graves disease
 Hashimoto thyroiditis
 Adrenal insufficiency
 Solitary toxic adenoma

36. What is the most common cause of preventable intellectual disability in the world?
 endemic iodine deficiency
 hyperthyroidism
 growth hormone deficiency
 Hashimoto thyroiditis

37. Which of the following is a disease marked by decreased functionality of thyroid hormone?
 hyperthyroidism
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
 hypothyroidism
 Cushing syndrome
 Adrenal insufficiency

38. What is the most common cause of congenital hypothyroidism?

 radiation exposure
 thyroid agenesis
 excessive cabbage in diet
 endemic iodine deficiency

39. This condition is marked by extremely high thyroid hormone levels and symptoms including
hyperthermia, arrhythmia, heart failure, tachycardia, delirium, and possible death:
 myxedema
 subacute thyroiditis
 thyrotoxicosis
 painless thyroiditis

40. What is the best screening test for thyroid disease?

 TSH
 TRH
 Free T4
 Radioactive iodine uptake

41. The parathyroid glands

 regulate sodium homeostasis
 promote growth and development
 regulate calcium homeostasis
 promote lymphocyte differentiation

42. The parathyroid glands are located

 Along the posterior surface of the thyroid gland
 At the superior portion of the kidneys
 Inside the sella turcica at the base of the brain
 Inferior to the cerebellum

43. What cell type secretes parathyroid hormone?

 C Cells
 Parietal cells
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
 Chief cells
 Oxyphil cells

44. Which of the following stimulates release of parathyroid hormone?

 Low serum calcium
 High serum vitamin D
 Low serum phosphate
 High serum calcium

45. Which of the following is not true of parathyroid hormone?

 PTH mobilizes calcium and phosphate from the bone
 PTH inactivates vitamin D
 PTH stimulates calcium reabsorption in the kidney
 PTH stimulates phosphate excretion in the kidney

46. Which of the following is not true of Vitamin D?

 It is synthesized in skin
 It is modified in the liver and kidneys
 It increases intestinal absorption of calcium and phosphate
 It is activated by T4

47. The most common cause of hyperparathyroidism is

 genetic defects
 autoimmune parathyroid destruction
 parathyroid adenoma
 renal disease

48. The symptoms of hypoparathyroidism are mostly related to:

 Vitamin D toxicity
 hypocalcemia
 hyponatremia
 hypothyroidism

49. What part of the ovary contains follicles?

 seminiferous tubules
 the hilum
 the medulla
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
 the cortex

50. Theca cells

 produce androgens
 convert androgens to estrogen
 support spermatogenesis
 produce parathyroid hormone

51. Which enzyme stimulates the conversion of androgens into estrogens?

 follicle stimulating hormone
 aromatase
 5 alpha reductase
 peroxidase

52. Which is the following is not true of estrogen?

 facilitates closure of growth plates of long bones
 maintains bone density
 regulates calcium homeostasis
 produced by granulosa cells of the ovary

53. What hormone is sometimes referred to as “the hormone of pregnancy.”

 progesterone
 estrogen
 testosterone
 inhibin

54. Which of the following occurs 1 year prior to puberty starting and stimulates puberty?
 nocturnal pulses of LH and FSH
 decreased secretion of GnRH
 unregulated release of estrogen from granulosa cells
 increased production of adrenal androgens

55. What is the first physical sign of puberty in males?

 pubic hair
 growth spurt
 penile growth
 testicular growth
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
56. A 25-year-old obese woman comes to clinic because she is no longer having periods. She has
acne and some hair on her chin. An ultrasound would likely demonstrate.
 absent uterus
 absent ovaries
 cystic ovaries
 an ovarian tumor

57. A 28-year-old female professional marathon runner comes to clinic because she stopped hav-
ing her periods 2 years go. What is the likely diagnosis?
 polycystic ovary syndrome
 functional hypothalamic amenorrhea
 Kallman syndrome
 Klinefelter syndrome

58. A 16-year-old female with a history of coarctation of the aorta presents to clinic because she
has never had her period. She is short. On exam, you notice she has wide spaced nipples and
a webbed neck. What is the likely diagnosis?
 polycystic ovary syndrome
 Kallman syndrome
 Turner syndrome
 Klinefelter syndrome

59. Which of the following stimulates ovulation?

 Increase in testosterone
 Decrease in GnRH
 pulsatile release of activin
 A surge in FSH and LH

60. Which of the following reflects the role of FSH in the menstrual cycle?
 stimulates progesterone production during the luteal/secretory phase
 stimulates estradiol production during the follicular/proliferative stage
 inhibits ovulation
 maintains the corpus luteum

61. What is the most important male sex hormone?

 estrogen
 activin
 progesterone
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
 testosterone

62. What hormone stimulates the Leydig cells to produce testosterone?

 follicle stimulating hormone
 luteinizing hormone
 estrogen
 testosterone

63. Which of the following is not a function of testosterone?

 stimulates sebaceous glands
 stimulates growth of cartilage on the larynx causing vocal changes
 promotes breast development
 facilitates bone and muscle growth

64. A mildly intellectual tall 30-year-old man presents to an infertility clinic with his wife. On
exam, he is noted to have gynecomastia, no facial hair, a high-pitched voice, sparse chest hair,
wide hips, and small hard testicles. What is the most likely cause of infertility?
 Graves disease
 Kallman syndrome
 Klinefelter syndrome
 Acromegaly

65. What is the primary function of the endocrine pancreas?

 regulation of carbohydrate metabolism
 regulation of fat metabolism
 regulation of protein metabolism
 regulation of carbohydrate, fat, and protein metabolism.

66. β-cells are located within which of the following structures?

 pancreatic acinar
 the Islets of Langerhans
 thyroid follicles
 ovarian follicles

67. What type of cell secretes glucagon?

 α-cells
 β- cells
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
 δ- cells
 chief cells

68. Which peptide is a byproduct of insulin synthesis and is secreted with insulin?
 proinsulin
 preproinsulin
 peptide
 glucagon

69. Eating which food would stimulate insulin secretion the most?
 pork fat
 fish
 bread
 egg

70. Which hormone shifts potassium into cells and is sometimes used to treat patients with hyper-
kalemia?
 glucagon
 insulin
 somatostatin
 ADH

71. 60% of glucose in a meal is stored in this organ after eating and later returned to the blood.
 the liver
 the pancreas
 the muscle
 the brain

72. What hormone works synergistically with growth hormone to promote growth?
 FSH
 Somatostatin
 Glucagon
 Insulin

73. Insulin promotes the use of which macromolecule for energy

 carbohydrates
 nucleic acids
 protein
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
 lipids

74. Hypoglycemia may cause seizures, coma, and death. Why?

 neuronal dehydration causing cell death
 the production of ketones results in metabolic acidosis and cellular dysfunction
 the brain requires glucose for metabolism
 neuronal swelling causing cell death

75. A fifteen-year-old male with known type 1 Diabetes Mellitus developed abdominal pain and
vomiting two hours ago. He is now breathing fast and appears dehydrated. His breathe
smells fruity. What is the likely diagnosis?
 Type 2 diabetes
 Diabetic ketoacidosis
 Celiac disease
 Asthma

76. What is the cause of the cause of type 2 Diabetes Mellitus?

 autoimmune destruction of β-cells
 insulin resistance
 defective insulin secretion
 insulin resistance and defective insulin secretion

77. Which of the following is a not a common complication of poorly controlled diabetes?
 kidney disease
 Eye disease
 thyroid disease
 coronary heart disease

78. Which of the following is not a risk factor for the development of type 2 diabetes mellitus?
 Obesity
 Sedentary lifestyle
 diet high in dairy
 diet high in white rice

79. Which structure serves as “the master clock” of our circadian rhythm?
 suprachiasmatic nuclei
 the anterior pituitary gland
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
 the cerebellum
 the pineal gland

80. Which hormone helps maintain our circadian rhythm?

 ACTH
 Melanin
 Melatonin
 Epinephrine

81. Which part of the adrenal secretes mineralocorticoids?

 zona glomerulosa
 zona fasciculata
 zona reticularis
 medulla

82. For a person with a normal sleep schedule, at around what time of day are cortisol levels
highest?
 2 am
 8 am
 2 pm
 11 pm

83. Which if the following is not true regarding the function of cortisol in the body?
 Cortisol stimulates gluconeogenesis
 Cortisol stabilizes lysosomes
 Cortisol mobilizes protein and fats
 Cortisol promotes inflammation

84. Which of the following is true?

 cortisol has more mineralocorticoid activity than aldosterone
 aldosterone has no glucocorticoid activity
 aldosterone has more glucocorticoid activity than cortisol
 cortisol and aldosterone both have glucocorticoid and mineralocorticoid activity

85. Epinephrine
 is a steroid hormone
 is synthesized from phenylalanine
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
 is produced in the adrenal cortex
 stimulates the parasympathetic nervous system

86. Which statement reflects the effect glucocorticoids have on the immune system?
 glucocorticoids are immunosuppressive
 glucocorticoids cause lymph node hyperplasia
 glucocorticoids increase the number of eosinophils in the blood
 glucocorticoids have no effect on the immune system

87. What hormone causes water and sodium reabsorption in the kidney while increasing po-
tassium excretion?
 epinephrine
 norepinephrine
 androgens
 aldosterone

88. Which of the following is most important in regulating aldosterone secretion?

 Angiotensin II
 Stress signals sent from the limbic system
 Chloride concentration
 ADH

89. What is the name of the hormone produced in the heart that decreases aldosterone secretion?
 Angiotensin I
 Angiotensin II
 Atrial natriuretic peptide
 thymosin

90. This disease may cause hypertension, hypokalemia, and periodic muscle paralysis
 pheochromocytoma
 adrenal insufficiency
 primary aldosteronism
 DiGeorge Syndrome

91. How do conditions associated with an increased amount of ACTH cause skin color changes?
 ACTH has melanocyte stimulating hormone activity which causes melanin deposition in the
epidermis
 ACTH has melatonin activity which inhibits melanin deposition in the skin
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
 ACTH causes epidermal hyperplasia
 ACTH has β-lipotropin activity which causes melanin deposition in the epidermis

92. Excessive amounts of this hormone causes atypical fat deposition resulting in patients having
a a buffalo hump, moon face, and red stretch marks
 aldosterone
 cortisol
 androgens
 thymosin

93. What is the primary function of the thymus?

 to regulate calcium
 to regulate magnesium
 to regulate potassium
 T cell maturation

94. Which condition is associated with hypocalcemia, congenital heart disease, and thymic
aplasia?
 Turner Syndrome
 DiGeorge Syndrome
 Klinefelter Syndrome
 Cushing Syndrome

95. A 50-year-old man has developed severe hypertension over the last two month refractory to
treatment. He also describes episodes in which he becomes sweaty with a rapid heart rate,
tremor, and headache. He says he feels afraid during these episodes and sometimes vomits.
What is the most likely explanation?
 diabetic ketoacidosis
 adrenal insufficiency
 pheochromocytoma
 primary aldosteronism

96. Which of the following stimulates cortisol release?

 Aldosterone
 Stress
 Cortisol
 Angiotensin II
 3rd Year 2nd Semester 2020-2021 IPBN TSMC UHS, Human Pathology 4-1 : Endocrine by Ethan Helm, MD
97. A patient presents with a cough and is found to have lung cancer. Subsequent lab evaluation
demonstrates that he has hypercalcemia. What is the most likely cause of his hypercalcemia?
 ectopic production of PTHrP
 a parathyroid tumor
 hypervitaminosis d
 hypoparathyroidism

98. This word describes an early stage in sexual development marked by the development of pub-
lic hair, body odor, skin oiliness, and acne.
 puberty
 menarche
 menopause
 adrenarche

99. A 50-year-old man presents to the emergency department unconscious and in shock with a
low blood pressure of 70/50. His wife notes, “over the past 2 months, his skin seemed a lot
darker than usual” and you note he has black spots on his lip and his hands are dark. Prior
to arrival, he reportedly complained of nausea, vomiting, abdominal pain, weakness, and leth-
argy. This patient is deficient of which of the following:
 insulin
 thyroid hormone
 growth hormone
 cortisol

100. A thirty-year-old female presents to clinic with difficulty sleeping, weight loss, fatigue, and
diarrhea. She says for the last month she has felt more nervous and irritable than usual. Her
husband says that she just can’t seem to keep still. She says her heart seems to always be
beating fast and she feels shaky. On exam, she is tachycardic to 120. Her hands are warm to
touch. Her eyes seem to be bulging, and she has a red colored swelling and hardness of her
skin over bilateral distal tibias. Her condition is most likely caused by:
 autoantibodies that stimulate the thyroid gland
 thyroid follicle destroying autoantibodies
 iodine deficiency
 a bacterial thyroid infection