Endocrine system

Practice questions
 Test your
understanding

Insulin
a)activates glucagon
b)increases gluconeogenesis
c) secretion is inhibited by an increase in
plasma amino acid concentration
d)stimulates glycogenesis
e)stimulates glycogenolysis
 Test your
understanding

Insulin
a)activates glucagon
b)increases gluconeogenesis
c) secretion is inhibited by an increase in
plasma amino acid concentration
d)stimulates glycogenesis
e)stimulates glycogenolysis
 Test your
understanding

The table below shows results for blood samples collected from two persons
(A and B) each with a different metabolic condition.
Blood Result A B
Plasma glucose
 
concentration

Plasma insulin
 
concentration
Plasma glucagon
 
concentration

Providing a physiological explanation for all data in the table, decide which person
(A or B) is most likely to have: insulin resistance.
 Test your
understanding
The table below shows results for blood samples collected from two persons
(A and B) each with a different metabolic condition.
Blood Result A B
Plasma glucose
 
concentration

Plasma insulin
 
concentration
Plasma glucagon
 
concentration

Providing a physiological explanation for all data in the table, decide which person
(A or B) is most likely to have: insulin resistance.
B: a person with an insulin resistance would have: increased insulin
concentration because they have insulin resistance and therefore
produce more insulin than a normal person to compensate for the
resistance (1). increased blood glucose, because in spite of the
increased insulin, they cannot produce enough to overcome the
insulin resistance. Thus glucose uptake is insufficient (1). Insulin
inhibits glucagon, therefore decreased glucagon (1).
 Test your
understanding

The table below shows results for blood samples collected from two persons
(A and B) each with a different metabolic condition.
Blood Result A B
Plasma glucose
 
concentration

Plasma insulin
 
concentration
Plasma glucagon
 
concentration

Providing a physiological explanation for all data in the table, decide which person
(A or B) is most likely to have: untreated type-I diabetes mellitus.
 Test your
understanding
The table below shows results for blood samples collected from two persons
(A and B) each with a different metabolic condition.
Blood Result A B
Plasma glucose
 
concentration

Plasma insulin
 
concentration
Plasma glucagon
 
concentration

Providing a physiological explanation for all data in the table, decide which person
(A or B) is most likely to have: untreated type-I diabetes mellitus.
A: a patient with untreated type-I diabetes mellitus would have
low plasma insulin because insulin-producing beta cells of the
pancreas have been destroyed or due to antibodies against beta
cells (1). high blood glucose because they do not make enough
insulin to stimulate cell uptake of glucose from the blood (1). high
glucagon level because insulin inhibits glucagon secretion, thus a
deficiency/lack of insulin which shoes this inhibition (1).
 Test your
understanding

Which of the following statements concerning vitamin

D is INCORRECT? Vitamin D
a) enhances the effect of calcitonin on bone
b) can be synthesised by the skin on exposure to
sunlight
c) must be modified by biochemical alterations within
the liver and kidneys before it is biologically active
d) increases Ca2+ absorption in the intestine
e) deficiency in children results in rickets
 Test your
understanding

Which of the following statements concerning vitamin

D is INCORRECT? Vitamin D
a)enhances the effect of calcitonin on bone
b) can be synthesised by the skin on exposure to
sunlight
c) must be modified by biochemical alterations within
the liver and kidneys before it is biologically active
d) increases Ca2+ absorption in the intestine
e) deficiency in children results in rickets
 Test your
understanding

Which one of the following statements is

INCORRECT concerning peptide hormones
a) They circulate freely in plasma
b) They are released by exocytosis upon
appropriate stimulation
c) They are stored in secretory vesicles
d) They exert their effect largely by means of
second-messenger systems
e) They bind to intracellular receptors
 Test your
understanding

Which one of the following statements is

INCORRECT concerning peptide hormones
a) They circulate freely in plasma
b) They are released by exocytosis upon
appropriate stimulation
c) They are stored in secretory vesicles
d) They exert their effect largely by means of
second-messenger systems
e) They bind to intracellular receptors
 Test your
understanding

Which one of the following statements refers to the

permissive effects of hormones
a) Hormones permit cellular processes to occur
b) Hormones permit their target organs to function at
the optimal rate
c) One hormone must be present in adequate
amounts for the full effect of another hormone's
effect
d) One hormone causes a loss of another
hormone’s receptors
e) Tropic hormones permit other endocrine glands
to secrete their hormones
 Test your
understanding

Which one of the following statements refers to the

permissive effects of hormones
a) Hormones permit cellular processes to occur
b) Hormones permit their target organs to function at
the optimal rate
c) One hormone must be present in adequate
amounts for the full effect of another
hormone's effect
d) One hormone causes a loss of another
hormone’s receptors
e) Tropic hormones permit other endocrine glands
to secrete their hormones
 Test your
understanding

The posterior pituitary

a) secretes hormones into the hypothalamo-
hypophyseal portal system
b) stores anterior pituitary hormones, which are
released into the blood upon hypothalamic
stimulation
c) stores vasopressin and oxytocin
d) synthesizes releasing and inhibiting hormones
e) synthesizes ACTH and TSH
 Test your
understanding

The posterior pituitary

a) secretes hormones into the hypothalamo-
hypophyseal portal system
b) stores anterior pituitary hormones, which are
released into the blood upon hypothalamic
stimulation
c) stores vasopressin and oxytocin
d) synthesizes releasing and inhibiting hormones
e) synthesizes ACTH and TSH
 Test your
understanding

The hypothalamo-hypophyseal portal system

a) carries vasopressin and oxytocin from the
hypothalamus to the posterior pituitary for storage.
b) carries hypophysiotropic hormones from the
hypothalamus to the posterior pituitary to control the
release of posterior pituitary hormones.
c) carries hypophysiotropic hormones from the
hypothalamus to the anterior pituitary to control the
release of anterior pituitary hormones.
d) carries vasopressin and oxytocin from the
hypothalamus to the anterior pituitary to control the
release of anterior pituitary hormones.
e) Both (b) and (c) above.
 Test your
understanding

The hypothalamo-hypophyseal portal system

a) carries vasopressin and oxytocin from the
hypothalamus to the posterior pituitary for storage.
b) carries hypophysiotropic hormones from the
hypothalamus to the posterior pituitary to control the
release of posterior pituitary hormones.
c) carries hypophysiotropic hormones from the
hypothalamus to the anterior pituitary to control
the release of anterior pituitary hormones.
d) carries vasopressin and oxytocin from the
hypothalamus to the anterior pituitary to control the
release of anterior pituitary hormones.
e) Both (b) and (c) above.
 Test your
understanding

_______ is the hypothalamic hormone which causes the

anterior pituitary to release _______, thus, resulting in
thyroid hormone release
a) thyroid-releasing hormone; thyroid-stimulating hormone
b) thyroid stimulating hormone; thyrotropin-releasing
hormone
c) thyrotropin-releasing hormone; thyroid-stimulating
hormone
d) thyroid hormone; Thyrotropin-releasing hormone
e) thyrotropin-releasing hormone; Thyroid hormone
 Test your
understanding

_______ is the hypothalamic hormone which causes the

anterior pituitary to release _______, thus, resulting in
thyroid hormone release
a) thyroid-releasing hormone; thyroid-stimulating hormone
b) thyroid stimulating hormone; thyrotropin-releasing
hormone
c) thyrotropin-releasing hormone; thyroid-stimulating
hormone
d) thyroid hormone; Thyrotropin-releasing hormone
e) thyrotropin-releasing hormone; Thyroid hormone
 Test your
understanding

Which one of the following is NOT an effect of

growth hormone (GH)?
a) increased fat breakdown
b) increased bone growth
c) decreased glucose uptake into muscle cells
d) decreased protein synthesis
e) increased rate of cell division
 Test your
understanding

Which one of the following is NOT an effect of

growth hormone (GH)?
a) increased fat breakdown
b) increased bone growth
c) decreased glucose uptake into muscle cells
d) decreased protein synthesis
e) increased rate of cell division
 Test your
understanding

Excessive growth hormone secretion in an adult

leads to
a) gigantism
b) disproportionate growth resulting in thickened
bones and coarse features
c) no symptoms because growth is already
complete
d) acromegaly
e) Both options b) and d) are correct
 Test your
understanding

Excessive growth hormone secretion in an adult

leads to
a) gigantism
b) disproportionate growth resulting in thickened
bones and coarse features
c) no symptoms because growth is already
complete
d) acromegaly
e) Both options b) and d) are correct
 Test your
understanding

Which of the following factors does NOT

increase growth hormone secretion
a)Sleep
b)Exercise
c)Low blood amino acid level
d)Healthy stress
e)Low blood glucose level
 Test your
understanding

Which of the following factors does NOT

increase growth hormone secretion
a)Sleep
b)Exercise
c)Low blood amino acid level
d)Healthy stress
e)Low blood glucose level
 Test your
understanding
Complete the following table
Cause Plasma Goitre?
concentrations
Hyperthyroidism Grave’s disease (↑ TSI)

Primary hyperthyroidism ↑ T3 & T4, ↓ TSH No

Hypothalamic or pituitary
tumours (↑ TRH or TSH)
Hypothyroidism Thyroid tumours
(↓ thyroid function)
Hypothalamic or pituitary
(↓ TRH or TSH)

Iodine deficiency ↓ T3 & T4, ↑ TSH

 Test your
understanding
Complete the following table
Cause Plasma Goitre?
concentrations
Hyperthyroidism Grave’s disease (↑ TSI) ↑ T3 & T4, ↓TSH Yes (TSI)

Primary hyperthyroidism ↑ T3 & T4, ↓ TSH No

Hypothalamic or pituitary ↑TRH, ↑TSH, Yes
tumours (↑ TRH or TSH) ↑ T3 & T4
Hypothyroidism Thyroid tumours ↓ T3 & T4, ↑ Yes
(↓ thyroid function) TSH
Hypothalamic or pituitary ↓ TRH, ↓TSH, No
(↓ TRH or TSH) ↓ T3 & T4

Iodine deficiency ↓ T3 & T4, ↑ TSH Yes

 Test your
understanding

The table below shows the relative plasma concentrations of thyroid

stimulating hormone (TSH) and thyroid hormones (T3 and T4) in three
patients with abnormal thyroid function.
Patient 1 Patient 2 Patient 3

Thyroid stimulating hormone (TSH) Increased Decreased Decreased

Thyroid hormones (T3 and T4) Increased Increased Decreased

1. Explaining the physiological mechanism involved, decide whether

patient 1 or 3 has a goitre
2. Explaining the physiological mechanism involved, decide whether
patient 2 or 3 has Grave’s disease
3. Explaining the physiological mechanism involved, decide whether
patient 2 or 3 has an increased body temperature.
 Test your
understanding

The table below shows the relative plasma concentrations of thyroid

stimulating hormone (TSH) and thyroid hormones (T3 and T4) in three
patients with abnormal thyroid function.
Patient 1 Patient 2 Patient 3

Thyroid stimulating hormone (TSH) Increased Decreased Decreased

Thyroid hormones (T3 and T4) Increased Increased Decreased

1. Explaining the physiological mechanism involved, decide whether

patient 1 or 3 has a goitre
Patient 1 has increased TSH levels causing the growth of the
thyroid gland and hence the development of the goitre.
 Test your
understanding

The table below shows the relative plasma concentrations of thyroid

stimulating hormone (TSH) and thyroid hormones (T3 and T4) in three
patients with abnormal thyroid function.
Patient 1 Patient 2 Patient 3

Thyroid stimulating hormone (TSH) Increased Decreased Decreased

Thyroid hormones (T3 and T4) Increased Increased Decreased

2. Explaining the physiological mechanism involved, decide whether

patient 2 or 3 has Grave’s disease
Patient 2 has Grave’s disease because the plasma levels of T3
and T4 are increased even though the TSH levels are low
 Test your
understanding

The table below shows the relative plasma concentrations of thyroid

stimulating hormone (TSH) and thyroid hormones (T3 and T4) in three
patients with abnormal thyroid function.
Patient 1 Patient 2 Patient 3

Thyroid stimulating hormone (TSH) Increased Decreased Decreased

Thyroid hormones (T3 and T4) Increased Increased Decreased

3. Explaining the physiological mechanism involved, decide whether

patient 2 or 3 has an increased body temperature.
Patient 2 has an increased body temperature because of the
increased T3 and T4 levels which increases the basal metabolic
rate (increases heat production).
 Test your
understanding

Melatonin’s actions may include:

a)regulation of circadian rhythms
b)antioxidant activity
c)induction of calcium reabsorption
d)Both options a) and b) are correct
e)Both options a) and c) are correct
 Test your
understanding

Melatonin’s actions may include:

a)regulation of circadian rhythms
b)antioxidant activity
c)induction of calcium reabsorption
d)Both options a) and b) are
correct
e)Both options a) and c) are correct
 Test your
understanding

Which of the following is NOT a function of cortisol

a)Stimulates antibody productions
b)Stimulates gluconeogenesis in the liver
c) Increases protein degradation in muscle
d)Promotes lipolysis
e)Exerts permissive actions on catecholamines
 Test your
understanding

Which of the following is NOT a function of cortisol

a)Stimulates antibody productions
b)Stimulates gluconeogenesis in the liver
c) Increases protein degradation in muscle
d)Promotes lipolysis
e)Exerts permissive actions on catecholamines
 Test your
understanding

Which one of the following is a consequence of

cortisol deficiency
a)Reduced plasma calcium ion (Ca2+) concentration
b)Increased skin pigmentation
c) Increased blood pressure
d)Hyperglycaemia
e)Skeletal muscle wasting
 Test your
understanding

Which one of the following is a consequence of

cortisol deficiency
a)Reduced plasma calcium ion (Ca2+) concentration
b)Increased skin pigmentation
c) Increased blood pressure
d)Hyperglycaemia
e)Skeletal muscle wasting
 Test your
understanding

Which of the following is NOT seen in Addison's

disease
a)Increased sodium loss in the urine
b)Lowered blood glucose levels
c) Increased potassium retention
d)Increased protein degradation
e)Lowered blood pressure levels
 Test your
understanding

Which of the following is NOT seen in Addison's

disease
a)Increased sodium loss in the urine
b)Lowered blood glucose levels
c) Increased potassium retention
d)Increased protein degradation
e)Lowered blood pressure levels
 Test your
understanding

The table below shows changes in hormone concentrations of four

patients (1, 2, 3 and 4). Patients

1 2 3 4
Corticotrophin releasing hormone ↑ ↓ N ↓
(CRH)
Adrenocorticotrophic hormone ↓ ↑ N ↓
(ACTH)
Cortisol ↓ ↑ N ↑
Aldosterone N N ↑ ↑

The patient(s) most likely to present with hyperpigmentation is/are

a) patient 1.
b) patient 2.
c) patients 1 and 3.
d) patients 2 and 4.
 Test your
understanding

The table below shows changes in hormone concentrations of four

patients (1, 2, 3 and 4). Patients

1 2 3 4
Corticotrophin releasing hormone ↑ ↓ N ↓
(CRH)
Adrenocorticotrophic hormone ↓ ↑ N ↓
(ACTH)
Cortisol ↓ ↑ N ↑
Aldosterone N N ↑ ↑

The patient(s) most likely to present with hyperpigmentation is/are

a) patient 1.
b) patient 2.
c) patients 1 and 3.
d) patients 2 and 4.
 Test your
understanding

The table below shows changes in hormone concentrations of four

patients (1, 2, 3 and 4). Patients

1 2 3 4
Corticotrophin releasing hormone ↑ ↓ N ↓
(CRH)
Adrenocorticotrophic hormone ↓ ↑ N ↓
(ACTH)
Cortisol ↓ ↑ N ↑
Aldosterone N N ↑ ↑

The cortisol concentration in patient 4 is most likely a result of

a) adrenal gland insufficiency.
b) an adrenal gland secreting tumour.
c) increased anterior pituitary secretion.
d) decreased hypothalamic secretion.
 Test your
understanding

The table below shows changes in hormone concentrations of four

patients (1, 2, 3 and 4). Patients

1 2 3 4
Corticotrophin releasing hormone ↑ ↓ N ↓
(CRH)
Adrenocorticotrophic hormone ↓ ↑ N ↓
(ACTH)
Cortisol ↓ ↑ N ↑
Aldosterone N N ↑ ↑

The cortisol concentration in patient 4 is most likely a result of

a) adrenal gland insufficiency.
b) an adrenal gland secreting tumour.
c) increased anterior pituitary secretion.
d) decreased hypothalamic secretion.
 Test your
understanding

The table below shows changes in hormone concentrations of four

patients (1, 2, 3 and 4). Patients

1 2 3 4
Corticotrophin releasing hormone ↑ ↓ N ↓
(CRH)
Adrenocorticotrophic hormone ↓ ↑ N ↓
(ACTH)
Cortisol ↓ ↑ N ↑
Aldosterone N N ↑ ↑

Patient 3 is most likely to have decreased plasma

a) angiotensin II concentration.
b) glucose concentration.
c) sodium ion (Na+) concentration.
d) potassium ion (K+) concentration.
 Test your
understanding

The table below shows changes in hormone concentrations of four

patients (1, 2, 3 and 4). Patients

1 2 3 4
Corticotrophin releasing hormone ↑ ↓ N ↓
(CRH)
Adrenocorticotrophic hormone ↓ ↑ N ↓
(ACTH)
Cortisol ↓ ↑ N ↑
Aldosterone N N ↑ ↑

Patient 3 is most likely to have decreased plasma

a) angiotensin II concentration.
b) glucose concentration.
c) sodium ion (Na+) concentration.
d) potassium ion (K+) concentration.
 Test your
understanding

The table below shows changes in hormone concentrations of four

patients (1, 2, 3 and 4). Patients

1 2 3 4
Corticotrophin releasing hormone ↑ ↓ N ↓
(CRH)
Adrenocorticotrophic hormone ↓ ↑ N ↓
(ACTH)
Cortisol ↓ ↑ N ↑
Aldosterone N N ↑ ↑

Giving a physiological explanation for your answer, decide whether patient 1 is

likely to have a decreased plasma glucose concentration.
 Test your
understanding

The table below shows changes in hormone concentrations of four

patients (1, 2, 3 and 4). Patients

1 2 3 4
Corticotrophin releasing hormone ↑ ↓ N ↓
(CRH)
Adrenocorticotrophic hormone ↓ ↑ N ↓
(ACTH)
Cortisol ↓ ↑ N ↑
Aldosterone N N ↑ ↑

Giving a physiological explanation for your answer, decide whether patient 1 is

likely to have a decreased plasma glucose concentration.
Correct. Patient 1 has a low concentration of cortisol. Cortisol
stimulates gluconeogenesis and reduces glucose uptake in the cells
(1). Therefore with low cortisol levels, less glucose will be formed and
the glucose in the blood will be utilized (1).
 Test your
understanding

The table below shows changes in hormone concentrations of four

patients (1, 2, 3 and 4). Patients

1 2 3 4
Corticotrophin releasing hormone ↑ ↓ N ↓
(CRH)
Adrenocorticotrophic hormone ↓ ↑ N ↓
(ACTH)
Cortisol ↓ ↑ N ↑
Aldosterone N N ↑ ↑

Giving a physiological explanation for your answer, decide whether patient 3 is

likely to have decreased blood pressure.
 Test your
understanding

The table below shows changes in hormone concentrations of four

patients (1, 2, 3 and 4). Patients

1 2 3 4
Corticotrophin releasing hormone ↑ ↓ N ↓
(CRH)
Adrenocorticotrophic hormone ↓ ↑ N ↓
(ACTH)
Cortisol ↓ ↑ N ↑
Aldosterone N N ↑ ↑

Giving a physiological explanation for your answer, decide whether patient 3 is

likely to have decreased blood pressure.
Incorrect. Patient 3 has an increased plasma aldosterone concentration,
which results in increased reabsorption of Na+ which induces osmotic
retention of water (1). This will result in increased ECF volume leading
to an increase in blood pressure (1).
 Test your
understanding

The table below shows changes in hormone concentrations of four

patients (1, 2, 3 and 4). Patients

1 2 3 4
Corticotrophin releasing hormone ↑ ↓ N ↓
(CRH)
Adrenocorticotrophic hormone ↓ ↑ N ↓
(ACTH)
Cortisol ↓ ↑ N ↑
Aldosterone N N ↑ ↑

Giving a physiological explanation for your answer, decide whether patient 4 is

likely to present with abdominal striae (stretch marks).
 Test your
understanding

The table below shows changes in hormone concentrations of four

patients (1, 2, 3 and 4). Patients

1 2 3 4
Corticotrophin releasing hormone ↑ ↓ N ↓
(CRH)
Adrenocorticotrophic hormone ↓ ↑ N ↓
(ACTH)
Cortisol ↓ ↑ N ↑
Aldosterone N N ↑ ↑

Giving a physiological explanation for your answer, decide whether patient 4 is

likely to present with abdominal striae (stretch marks).
Correct. Patient 4 has a high plasma cortisol concentration which results
in protein degradation and decreases collagen formation in many
tissues, including connective tissue. This weakens the connective tissue
resulting in the appearance of stretch marks.