4.

Hormones that are useful in the

MCQ: diagnosis of endocrine insufficiency
include
1. Which one of the following a. Corticotropin-releasing hormone
compounds is not a hormone? b. Cosyntropin
a. Bromocriptine c. Gonadotropin–releasing hormone
b. Somatomedin d. Thyrotropin–releasing hormone
c. Somatotropin e. All of the above
d. Thyroxine
e. Vasopressin 5. All of the following substances
are endogenous topic hormones
2. Which one of the following secreted by the pituitary gland
hormones not synthesized in the except
hypothalamus? a. Somatotropin
a. Corticotropin–releasing hormone b. Human chorionic gonadotropin (HCG)
b. Luteinizing hormone
c. Follicle-stimulating hormone (FSH)
c. Oxytocin
d. Thyroid-stimulating hormone (TSH)
d. Thyrotropin–releasing hormone
e. Vasopressin e. Adrenocorticotropic hormone
(ACTH)
3. A 27-year-old woman with
amenorrhea, infertility, and 6. Actions of thyroxine do not
galactorrhea was treated with a drug include
that successful restored ovulation a. Acceleration of cardiac rate
and menstruation. Before being given b. Decreased glomerular filtration rate
the drug, the woman was carefully c. Fine tremor of skeletal muscles
questioned about previous mental d. Increased appetite
health problems, which she did not e. Stimulation of oxygen consumption
have. She was advised to take the
drug orally. The drug used to treat 7. Effects of iodide salts given in
this patient was probably. large doses do not include
a. Bromocriptine a. Decreased size of the thyroid gland
b. Desmopressin b. Decreased vascularity of the
c. Human gonadotropin hormone thyroid gland
d. Leuprolide c. Decreased hormone release
e. Octreotide d. Decreased iodination of tyrosine
e. Increased I uptake
8. Synptoms of hypothyroidism 11. Which of the following
(myxedema) do not include glucocorticoids produces the least
a. Dry, puffy skin sodium retention?
b. Increased appetite a. Corticosone
c. Lethargy, sleepiness b. Hydrocorticosone
d. Slow heart rate c. Prednisolone
d. Dexamethasone
9. For patients who have been on e. Fludrocortisone
long-term therapy with a
glucocorticoid and who now wish to 12. Which of the following
discontinue the drug, gradual preparations is used to attain
tapering of the glucocorticoid is remission of thyrotoxicosis?
needed to allow recovery of a. Propranolol
a. Depressed release of insulin from b. Liotrix
pancreatic B cells c. Levothyroxine
b. Hematopoiesis in the bone marrow d. Propylthiouracil
c. Normal osteoblast function e. Desiccated thyroid
d. The control by vasopressin of water
excretion 13. The thyroid gland normally
e. The hypothalamic-pituitary-adrenal secretes which of the following
system substances into the serum?
a. Thyrotropin-releasing hormone
10. In the treatment of (TRH)
hypothyroidism, thyroxine is b. Thyrotropin (thyroid-stimulating
preferred over liothyronine because hormone)
thyroxine c. Diiodothyronine (DIT)
a. Can be made more easily by d. Thyroglobulin
recombinant DNA technology e. Thyroxine (T4)
b. Has a longer half-life
c. Has higher affinity for thyroid 14. All of the following conditions are
hormone receptors causes of hypothyroidism except
d. Is faster acting a. Endemic goiter
e. Is more likely to improve a patient’s b. Surgical excision
mood c. Hashimoto’s thyroiditis
d. Goitrin-induced iodine deficiency
e. Graves’s disease
15. Propylthiouracil is useful in the 20. Adrenocorticotropic hormone is
treatment of primarily used for
a. Derangement toxicosis a. Treatment of Addison’s disease
b. Hypothyroidism b. Treatment of congenital adrenal
c. Hypoparathyroidism hyperplasia
d. Hyperthyroidism c. Treatment of autoimmune disease
e. Thyroidits d. Diagnosis of pituitary-adrenal axis
disorders
16. Angiotensin II causes rise in blood
pressure by 21. Actions of thyroxine include the
a. Direct vasoconstriction following except
b. Releasing adrenaline from adrenal a. Rise in blood sugar level
medulla b. Reduction in plasma cholesterol level
c. Increasing central sympathetic tone c. Fall in plasma free fatty acid level
d. All of the above d. Induction of negative nitrogen
balance
17. Somatostatin inhibits the release
of 22. Triiodothyronine is preferred over
a. Growth hormone thyroxine in the treatment of
b. Insulin a. Endemic goiter
c. Thyrotropin b. Cretinism
d. All of the above c. Papillary carcinoma of thyroid
d. Myxoedema coma
18. For therapeutic use, growth
hormone is obtained from 23. Carbimazole acts by inhibiting
a. Recombinant DNA technique a. Iodide trapping
b. Human cadaver pituitaries b. Oxidation of iodide
c. Porcine pituitaries c. Proteolysis of thyroglobulin
d. Chemical synthesis d. Synthesis of thyroglobulin protein

19. Serum TSH levels are high in most 24. Glucose entry into the cells of the
cases of following organ/ tissue is highly
a. Myxoedema dependent on the presence of insulin.
b. Grave’s disease a. Brain
c. Carcinoma thyroid b. Liver
d. Toxic nodular goiter c. Adipose tissue
d. Kidney tubules
25. Which hormone is secreted by d. Progestins
pancreatic β cells to facilitate e. Androgens
glucose and amino acid transport for
normal cellular metabolic processes? 29. Oxytocin is preferred over
a. Testosterone ergometrine for augmenting labour
b. Insulin because
c. Corticotropin a. It has brief and titratable action
d. Estradiol b. It is less likely to cause foetal
e. Vasopressin anoxia
c. It is less likely to impede foetal
26. Which hormone promotes the descent
resorption of water at the renal d. All of the above
distal convoluted tubule
a. Testosterone 30. The drug of choice for controlling
b. Insulin postpartum haemorrhage is
c. Corticotropin a. Oxytocin
d. Estradiol b. Methylergometrine
e. Vasopressin c. Dihydroergotamine
d. Prostaglandin E

27. Which of the following tissues is

31. Ergometrine stops post partum
most sensitive to oxytocin
haemorrhage by
a. Myometrium
a. Causing vasoconstriction of uterine
b. Myoepithelium of mammary alveoli
arteries
c. Vascular smooth muscle
b. Increasing tone of uterine muscle
d. Renal collecting ducts
c. Promoting coagulation
d. Inducing platelet aggregation
28. Which class of drug closely relates
to: “Peptic ulceration and 32. Bone resorption is accelerated by
gastrointestinal hemorrhage; a. Estrogens
hyperglycemia, hypertension, and b. Parathormone
edema; “buffalo hump” and “moon c. Bisphosphonates
face”; psychological disturbances; d. Calcitonin
and increased susceptibility to
infection?
a. Antithyroid agents
b. Sulfonylurea oral hypoglyccemics
c. Adrenocorticosteroids
33. The primary action of 37. Which of the following is
parathormone is physiological role of vasopressin ?
a. To increase intestinal calcium a. Smooth muscle vasoconstriction
absorption b. Neurotransmission/neuromodulation
b. To increase calcium reabsorption in c. Increased factor VIII
kidney tubules concentration
c. To promote calcium deposition in d. All of the above
extraosseus tissues
d. To increase resorption of calcium 38. Hormones are:
from bone a. Products of endocrine gland
secretion
34. The drug of choice for b. Mediators of inflammatory
hypoparathyroidism is process
a. Parathormone c. By-products of tissue metabolism
b. Calcium lactate d. Product of exocrine gland
c. Vitamin D secretion
d. Pamidronate
39. Select an endocrine drug which
35. The most suitable Vitamin D is an amino acid derivative:
preparation for vitamin D dependent a. Insulin
rickets is b. Hydrocortisone
a. Calciferol c. Calcitonin
b. Cholecalciferol d. Thyroxine
c. Calcifediol
d. Calcitriol 40. Select an endocrine drug
which is a peptide derivative:
36. The vitamin that is regarded to be a. Oxitocin
a hormone is b. Prednisolone
a. Vitamin D c. Nandrolone
b. Vitamin C d. Progesterone
c. Vitamin B
d. Vitamin A 41. Select an endocrine drug
which is a steroidal derivative:
a. Gonadorelin
b. Insulin
c. Levothyroxine
d. Hydrocortisone
42. Hormone analogues are: 45. The posterior pitutary does
a. Naturally occurring substances NOT secret:
but slightly different from a. Vasopressin
hormones b. Oxytocin
b. Naturally occurring substances c. Growth hormone
but less efficacious than d. All of the above
hormones
c. Naturally occurring substances 46. Which of the following
having the same structure but organs is a target for
different pharmacological prolactin?
properties than hormones a. Liver
d. Synthetic compounds, which b. Adrenal cortex
resemble the naturally occurring c. Thyroid
hormones d. Mammary gland

43. Which of the following 47. Which of the following organ

hormones is produced by the hormones is a target for
hypothalamic gland? growth hormone (somatotropine,
a. Growth hormone-releasing GH)?
hormone (GHRH) a. Glucocorticoids
b. Follicle-stimulating hormone b. Insulin-like growth factors (IGF,
(FSH) somatomedins)
c. Aldosterone c. Triiodthyronine
d. Estradiol d. Testosterone

44. Which of the following 48. All of the following

hormones is produced by the statements about growth
anterior lobe of the pituitary? hormone are true, EXCEPT:
a. Thyrotropin-releasing hormone a. It may stimulate the synthesis or
(TRH) release of somatomedins
b. Corticotropin-releasing hormone b. Low levels of insulin-like growth
(CRH) factor (IGF)-1 are associated
c. Growth hormone (somatotropin, with dwarfism
GH) c. Hypersecretion can result in
d. Growth hormone-releasing acromegaly
hormone (GHRH) d. It is contraindicated in subjects
with closed epiphyses
49. Correct statements about 53. Indications of vasopressin
adrenocorticotropic hormone are following:
(ACTH) include all of the a. Diabetes mellitus
following, EXCEPT: b. Hypertension
a. Endogenous ACTH is also called c. Pituitary diabetes insipidus
corticotropin d. Incompleted abortion
b. ACTH stimulates the synthesis
of corticosteroids 54. Vasopressin possesses the
c. ACTH is most useful clinically as following:
a diagnostic tool in adrenal a. Antidiuretic property
insufficiency b. Vasodilatation property
d. The oral route is the preferred c. Release of a thyroid hormone
rout of administration into the plasma
d. Diuretic property
50. The hypothalamic control
exists for the thyroid gland. 55. Oxytocin produces the
This consideration is: following effects:
a. True a. It causes contraction of the
b. False. uterus
b. It assists the progress of
51. Indications of bromocriptine spermatozoa into the uterine
are following, EXCEPT: cavity
a. Prolactin-secreting adenomas c. It brings about milk ejection
b. Amenorrhea-Galactorrhea from the lactating mammary
c. Prolactin deficiency gland
d. Acromegaly d. All of the above

52. Indications of oxitocin are 56. Vasopressin causes a pressor

following: effect by:
a. Labor and augment dysfunctional a. Releasing noradrenaline from the
labor for conditions requiring nerve terminals
early vaginal delivery b. Releasing and activating renin-
b. Incompleted abortion angiotensin system
c. For control of pospartum uterine c. A direct action on smooth
hemorrhage muscles of the blood vessels
d. All of the above d. All of the above mechanisms
57. Which of the following 61. Thyroid hormones produce
statements is true various pharmacological effects.
a. Hypothyroidism is a syndrome Indicate the wrong
resulting from deficiency of statement(s).
thyroid hormones and is a. Decline of the basal metabolic
manifested largely by a rate in the body
reversible slowing down of all b. Increase in the rate and force of
body functions contraction of the heart
b. Hypothyroidism is the clinical c. Increase in the blood cholestrol
syndrome that results when level
tissues are exposed to high levels d. Increase in the heat production
of thyroid hormone
62. Synthesis and release of
58. Which of the following thyroid hormones are controlled
hormones is produced by the by:
thyroid gland? a. Anterior pituitary alone
a. Thyroxine b. Hypothalamus alone
b. Thyroid-stimulating hormone c. Blood levels of thyroid hormones
c. Thyrotropin-releasing hormone alone
d. Thyroglobulin. d. All of the above

59. Which of the following 63. Thyrotrophin stimulates the

hormones is produced by the following processes:
thyroid gland? a. Concentration of iodine by
a. Thyroid-stimulating hormone thyroid follicles
b. Thyrotropin-releasing hormone b. Iodination of thyroxine.
c. Triiodothyronine c. Release of thyroxine and
d. Thyroglobulin. triidothyronine
d. De-iodination of thyroid
60. Thyroid stimulating hormone hormones.
regulates the following:
a. Iodine uptake
b. Biosynthesis of iodothyroglobulin
c. Release of thyroid hormone into
the plasma
d. All of the above.
64. The rate of secretion of 68. Daily administration of large
thyrotropin is controlled by: doses (several milligrammes) of
a. The amount of iodine in the iodides to a thyrotoxic patient
thyroid gland causes:
b. The amount of thyroid hormones a. Involution of the thyroid which
in the thyroid gland reaches a maximum in two weeks
c. The concentration of thyroid b. Increased vascularity of the
hormones in blood thyroid gland
d. The concentration of c. Decreased storage of the colloid
catecholamines in blood in the thyroid gland
d. Thyroid gland growing firm and
65. Indications of thyroid less vascular
hormones are following, 69. Radioiodines (I131 and
EXCEPT: I132) is suitable for:
a. Cretinism a. Elderly patients (over 45 years)
b. Myxoedema b. Pregnant women
c. Hashimoto's disease c. Nursing mothers
d. For treatment of simple obesity d. Younger patients

66. The common side effect of 70. Radioiodines in the body

thyroid hormones is all of the emit:
following except: a. Mainly β radiations
a. Increases in basal metabolic rate b. Mainly γ radiations
b. Angina pectoris c. β and γ radiations equally.
c. Tremors d. Do not emit any radiation,
d. Exopthalmos therefore, are safe

67. In an area where goitre is

71. Glucocorticoids are hormonal
endemic, which of the following
steroids:
drugs is used?
a. Having an important effect on
a. Iodide 1 part in 100000
intermediary metabolism,
b. Propylthiouracil 200 mg daily
cardiovascular function, growth,
c. Methimazole 40 mg daily
and immunity
d. Any of the above can be used.
b. Having principally salt-retaining
activity
c. Having androgenic or estrogenic
activity
d. All of the above
72. Correct statements about 74. Anti-inflammatory effect of
glucocorticoids include all of glucocorticoids is caused by
the following, EXCEPT: a. Reducing the prostaglandin and
a. Effects of glucocorticoids are leukotriene which results from
mediated by widely distributed inhibition of phospholipase A
glucocorticoid receptors that are b. Reducing macrophages migration
members of the superfamily of into the site of inflammation
nuclear receptors. c. Decreasing capillary permeability
b. Glucocorticoids have dose- d. All of the above
related metabolic effects on
carbohydrate, protein, and fat 75. Indication of glucocorticoids
metabolism. is:
c. Glucocorticoids have pro- a. Chronic (Addison’s disease) and
inflammatory effects. acute adrenocortical
d. Glucocorticoids have catabolic insufficiency
effects in lymphoid and b. Organ transplants (prevention
connective tissue, muscle, fat, and treatment of rejection –
and skin. immunosuppression)
c. Inflammatory conditions of
73. Physiologic doses of bones and joints (arthritis,
glucocorticoid can result in: bursitis, tenosynovitis).
a. Increased liver glycogen stores, d. All of the above
gluconeogenesis and lipolysis
b. Maintenance of cardiovascular 76. Indications of glucocorticoids
function (by potentiation of are following, EXCEPT:
norepinephrine) and skeletal a. Gastrointestinal diseases
muscle function (inflammatory bowel disease)
c. Increased hemoglobin synthesis, b. Postmenopausal hormonal therapy
resulting in elevated of red blood c. Inflammatory conditions of
cell count bones and joints (arthritis,
d. All of the above bursitis, tenosynovitis)
d. Skin diseases (atopic dermatitis,
dermatoses, localized
neurodermatitis)
77. Serious side effects of d. All of the above
glucocorticoids include the
following, EXCEPT: 80. The parathyroid hormone
a. Acute peptic ulcers increases serum calcium and
b. Iatrogenic Cushing’s syndrome decreases serum phosphate.
(rounding, puffiness, fat This consideration is:
deposition and plethora alter the a. True
appearance of the face – moon b. False.
faces)
c. Salicylism (vomiting, tinnitus, 81. The following statements
decreased hearing, and vertigo) about the parathyroid hormone
d. Hypomania or acute psychosis are true, EXCEPT:
a. The parathyroid hormone
78. Serious side effects of (PTH) is a single-chain peptide
glucocorticoids include the hormone composed of 84 amino
following: acids
a. Adrenal suppression b. The parathyroid hormone
b. Insomnia, behavioral changes increases calcium and phosphate
(primarily hypomania) absorption in intestine (by
c. Rounding, puffiness, fat increased 1,25-dihydroxyvitamin D
deposition and plethora alter the production)
appearance of the face – moon c. The parathyroid hormone
faces increases serum calcium and
d. All of the above decreases serum phosphate
d. The parathyroid hormone
79. Action of the parathyroid increases calcium excretion and
hormone is: decreases phosphate excretion in
a. Increased calcium and kidneys
phosphate absorption in intestine
(by increased 1,25- 82. Which of the following
dihydroxyvitamin D production) statements about calcitonin is
b. Decreased calcium excretion true:
and increased phosphate excretion a. Calcitonin secreted by
in kidneys parafollicular cells of the
c. In bone, calcium and mammalian thyroid is a single-chain
phosphate resorption increased by peptide hormone with 32 amino
high doses. Low doses may increase acids
bone formation.
b. Effects of calcitonin are to 86. Estrogens can prevent
lower serum calcium and phosphate accelerated bone loss during
by acting on bones and kidneys. the immediate postmenopausal
c. Calcitonin inhibits osteoclastic period and at least transiently
bone resorption. increase bone in the
d. All of the above postmenopausal subject. This
consideration is:
83. Indications for calcitonin a. True
administration are the b. False
following, EXCEPT:
a. Hypercalcemia 87. Action of vitamin D3 is:
b. Paget's disease a. Increased calcium and
c. Hypophosphatemia phosphate absorption by 1,25-
d. Osteoporosis dihydroxyvitamin D
b. Calcium and phosphate
84. Side effect of calcitonin is: excretion may be decreased by 25-
a. Hypercalcemia hydroxyvitamin D and 1,25-
b. Metastatic calcifications dihydroxyvitamin D
c. Tetany c. Increased calcium and
d. GI toxicity phosphate resorption by 1,25-
dihydroxyvitamin D bone formation
85. Glucocorticoid hormones may be increased by
alter bone mineral homeostasis: 25,24dihydroxyvitamin D
a. By antagonizing vitamin D- d. All of the above
stimulated intestinal calcium
transport 88. Vitamin D3 increases serum
b. By stimulating renal calcium calcium and phosphate. This
excretion consideration is:
c. By increasing parathyroid a. True
hormone stimulated bone b. False
resorption
d. By all of the above 89. Route of administration of
vitamin D3 is:
a. Subcutaneous
b. Oral
c. Intravenous
d. Intranasal
90. Indication of vitamin D3 is: 94. Route of administration of
a. Hypercalcemia alendronate is:
b. Paget's disease a. Intravenous
c. Hypophosphatemia b. Subcutaneous
d. Osteomalacia c. Oral
d. Intranasal
91. 25-hydroxyvitamin D3
(calcifediol) is less effective 95. Correct statements about
than 1,25-dihydroxyvitamin D3 alendronate include all of the
(calcitriol) in stimulating following, EXCEPT:
intestinal calcium transport, so a. Can be irritable to the
that hypercalcemia is less of a esophagus if not washed promptly
problem with calcifediol. This to the stomach
consideration is: b. 1st generation biphosphonate
a. True c. Reduces osteoclast activity
b. False without significantly affecting
osteoblasts; useful in the
92. Indications for 1,25- treatment of Paget's disease
dihydroxyvitamin D3 (calcitriol)
administration are the 96. Indications of alendronate
following, EXCEPT: are the following, EXCEPT:
a. Hypocalcemia in chronic renal a. Hypoparathyroidism
failure b. Glucocorticoid-induced
b. Vitamin D-dependent rickets osteoporosis
c. Malabsorption of vitamin D c. Paget's disease
from intestine d. Syndromes of ectopic
d. Elevated skeletal turnover calcification

93. The long-term effects of 97. Indication for etidronate

hypophosphatemia include administration is:
proximal muscle weakness and a. Malabsorption of vitamin D
abnormal bone mineralization from intestine
(osteomalacia). This b. Paget's disease
consideration is: c. Vitamin D deficiency in a diet
a. True d. Hypercalciuria
b. False
98. Indications for etidronate 102. Which of the following
administration are the synthetic steroids shows
following, EXEPT: predominantly mineralocorticoid
a. Paget's disease action?
b. Osteoporosis a. Hydrocortisone
c. Hypophosphatemia b. Spironolactone
d. Hypercalcemia c. Dexamethasone
d. Fludrocortisone
99. The major causes of
hypocalcemia in the adult are: 103. The major mineralocorticoids
a. Hypoparathyroidism are the following, EXCEPT:
b. Vitamin D deficiency a. Aldosterone
c. Renal failure and b. Deoxycorticosterone
malabsorption c. Fludrocortisone
d. All of the above d. Hydrocortisone
104. Pretibial myxedema is
100. The major causes of associated with
hypercalcemia in the adult are a. Graves’ disease
the following, EXCEPT : b. Jod-Basedow phenomenon
a. Hyperparathyroidism c. Choriocarcinoma
b. Cancer with or without bone d. Struma ovarii
metastases e. Toxic multinodular goiter
c. Renal failure and
malabsorption 105. Infiltration of orbital soft
d. Hypervitaminosis D tissue and extraocular muscles
with lymphocytes,
101. Indication for calcium mucopolysaccharides, and fluid
administration is: is seen with
a. Failure of formation of a. Graves’ disease
vitamin D in skin b. Jod-Basedow phenomenon
b. Malabsorption of vitamin D c. Choriocarcinoma
from intestine d. Struma ovarii
c. Hypercalcemia of malignancy e. Toxic multinodular goiter
d. Vitamin D deficiency
106. The most common cause of 110. The most common variety of
goiter in developing nations is thyroid cancer is
a. Iodine deficiency a. Thyroid lymphoma
b. Lithium b. Medullary thyroid
c. Hashimoto’s thyroiditis carcinoma
d. Propylthiouracil c. Papillary thyroid carcinoma
e. Toxic multinodular goiter d. Anaplastic thyroid
carcinoma
107. Endemic goiter results from e. Follicular thyroid
a. Iodine deficiency carcinoma
b. Lithium
c. Hashimoto’s thyroiditis 111. A patient with chronic
d. Propylthiouracil autoimmune (Hashimoto’s)
e. Toxic multinodular goiter thyroiditis develops a rapidly
enlarging thyroid mass. Most
108. The conversion of T3 to T4 likely this is
is inhibited by: a. Thyroid lymphoma
a. Iodine deficiency b. Medullary thyroid
b. Lithium carcinoma
c. Hashimoto’s thyroiditis c. Papillary thyroid carcinoma
d. Propylthiouracil d. Anaplastic thyroid
e. Toxic multinodular goiter carcinoma
e. Follicular thyroid
109. A low TSH, high T4, and carcinoma
high T3 suggests
a. Hyperthyroidism 112. Psammoma bodies are a
b. Nonthyroidal illness (sick histologic feature of
euthyroidism) a. Thyroid lymphoma
c. Estrogen therapy b. Medullary thyroid
d. Subclinical hypothyroidism carcinoma
e. Familial (euthyroid) c. Papillary thyroid carcinoma
dysalbuminenic d. Anaplastic thyroid
hyperthyroxinemia carcinoma
e. Follicular thyroid
carcinoma
113. Elevated plasma calcitonin is 116. A 30-year-old woman
seen with presents with a 6-month
a. Thyroid lymphoma history of amenorrhea. Your
b. Medullary thyroid initial evaluation should include
carcinoma measurement of
c. Papillary thyroid carcinoma a. Prolactin
d. Anaplastic thyroid b. Estradiol
carcinoma c. Progesterone
e. Follicular thyroid d. Testosterone
carcinoma e. DHEA-S

114. A 40-year-old patient with

a recent viral infection 117. A pheochromocytoma is a
presents with a significantly common tumor of the adrenal
tender gland, low radioiodine medulla. In the presence of
uptake, and signs and symptoms this tumor, which of the
of thyrotoxicosis. This following symptoms would most
presentation is most likely likely be observed?
a. Graves’ disease a. Hypotension
b. Subacute thyroiditis b. Hypoglycemia
c. Toxic multinodular goiter c. Hirsutism
d. Hashimoto’s thyroiditis d. Decreased metabolic rate
e. Toxic adenoma e. Paroxysms

115. A 30-year-old woman with 118. Which of the following cells

thyrotoxicosis has a diffusely or parts of the pituitary are
enlarged gland on palpation of derived embryologically from
the neck. Her thyroid scan and neuroectoderm?
24-h uptake show uniformity of a. Gonadotrophs
uptake and an increased b. Pars intermedia
percentage uptake. This patient c. Pars tuberalis
has d. Herring bodies
a. Graves’ disease e. Lactotrophs
b. Subacute thyroiditis
c. Toxic multinodular goiter
d. Hashimoto’s thyroiditis
e. Toxic adenoma
119. A 45-year-old woman, who 120. Hormone that binds to
works as a corporate executive, intracellular receptor is
presents with the primary a. Adrenocorticotropic hormone
complaint of “always being b. Thyroxine
tired.” She comments that she c. Follicle stimulating hormone
has been tired for 4 months d. Glucagon
even though she is sleeping
more. She complains of being 121. A hormone secreted from
unable to finish household anterior pituitary is
chores and “dragging at work.” a. Growth hormone
She indicates that she is often b. Vasopressin
constipated and is intolerant to c. Oxytocin
cold. She is continuously turning d. Epinephrine
the thermostats in the house
and work to higher 122. A hormone secreted from
temperatures, to the dismay of posterior pituitary is
family members and coworkers, a. Vasopressin
respectively. She also complains b. Thyrotropic hormone
that her skin is very dry; use c. Prolactin
of lotions and creams have not d. Adrenocorticotropic hormone
helped the dryness. A biopsy of
the organ indicates dense 123. Growth hormone causes
lymphocytic infiltration with hyperglycemia. It is a result of
germinal centers throughout the a. Decreased peripheral
parenchyma. A battery of tests utilization of glucose
is carried out. You would b. Decreased hepatic production
expect which of the following? via gluconeo- genesis
a. Elevated TSH levels in the c. Increased glycolysis in muscle
serum d. Decrersed lipolysis
b. Elevated T3 and T4 levels in
the serum 124. Acromegaly results due to
c. Autoantibodies to the thyroid excessive release of
hormone receptor a. Thyroxine
d. Elevated calcitonin levels b. Growth hormone
e. Elevated glucocorticoid levels c. Insulin
d. Glucagon
125. Growth hormone is released 129. Hyperglycemic effect of
by glucocorticoids is due to
a. Somatostatin a. Inactivation of protein
b. Growth hormone releasing phosphatase
hormone b. Inactivation of fructose 1,6-
c. Prolactin release inhibiting biphosphatase
hormone c. Stimulation of synthesis of
d. Luteinizing releasing hormone pyruvate carboxylase
d. Stimulation of synthesis of
126. ACTH stimulates the eltroxykinase
secretion of
a. Glucocorticoids 130. The predominant
b. Epinephrine glucocorticoid is
c. Thyroxine a. Cortisol
d. Luteinizing hormone b. Aldosterone
c. Dehydroephiandrosterone
127. Excessive secretion of ACTH d. Androstenedione
causes
a. Cushing’s syndrome 131. Cortisol is synthesized in
b. Addison’s disease a. Zona fasiculata
c. Myxoedema b. Zona glomerulosa
d. Thyrotoxicosis c. Zona reticularis
d. Chromaffin cells
128. In Cushing’s syndrome-a
tumour associated disease of 132. All mammalian steroid
adrenal cortex, there is hormones are formed from
a. Decreased epinephrine a. Purine
production b. Pyrimidine
b. Excessive cortisol production c. Cholesterol
c. Excessive epinephrine d. Pyrrole
production
d. Decreased cortsoil production 133. Aldosterone synthesis occurs
in
a. Zona reticularis
b. Zona fasciculata
c. Zona glomerulosa
d. Chromaffian cells
134. The most important effect 138. Catecholamine hormones are
of aldosterone is to synthesized in the
a. Increase the rate of tubular a. Chromaffin cells of adrenal
reabsorption of sodium medulla
b. Decrease the rate of tubular b. Zona glomerulosa of adrenal
reabsorption of potassium cortex
c. Decrease the reabsorption of c. Zona fasciculate of adrenal
chloride cortex
d. Decrease the renal d. Zona reticularis of adrenal
reabsorption of sodium cortex

135. One of the potent 139. The hormone required for

stimulators of aldosterone uterine muscle contraction for
secretion is child birth is
a. Increased sodium a. Progesterone
concentration b. Estrogen
b. Decreased potassium c. Oxytocin
concentration d. Vasopressin
c. Increased potassium
concentration 140. ADH
d. Increased ECF volume a. Reabsorbs water from renal
tubules
136. In the rennin-angiotensin b. Excretes water from renal
system the primary hormone is tubules
a. Angiotensinogen c. Excretes hypotonic urine
b. Angiotensin I d. Causes low specific gravity of
c. Angiotensin II urine
d. Angiotensin III
141. Increased reabsorption of
137. Aldosterone release is water from the kidney is the
stimulated by major consequence of the
a. α-Globulin secretion of the hormone?
b. Renin a. Cortisol
c. Angiotensin II b. Insulin
d. Growth hormone c. Vasopressin
d. Aldosterone
142. An increase in the osmolality 146. Excess secretion of thyroid
of extracellular compartment hormones causes
will a. Hyperthyroidism
a. Inhibit ADH secretion b. Myxoedema
b. Stimulate ADH secretion c. Cretinism
c. Cause no change in ADH d. Cushing syndrome
secretion
d. Stimulate the volume and 147. Insufficient free T3 and T4
osmoreceptor and inhibit ADH results in
secretion a. Grave’s disease
b. Mysoedema
143. Pheochromocytomas are c. Cushing syndrome
tumours of d. Gigantism
a. Adrenal cortex 148. TSH stimulates the
b. Adrenal medulla synthesis delete
c. Pancreas a. Thyroxine
d. Bone b. Adrenocorticoids
c. Epinephrine
144. A characteristic of d. Insulin
pheochromocytoma is elevated
urinary excretion of 149. Thyroid hormones are
a. Dopamine synthesized by the iodination of
b. Tyrosine the amino acid:
c. Vinylmandelic acid a. Glycine
d. Phenylalanine b. Phenylalanine
c. Alanine
145. Epinephrine stimulates d. Tyrosine
glycogenolysis in
a. Liver 150. PTH
b. Muscle a. Reduces the renal clearance
c. Liver and muscle or excretion of calcium
d. Kidney b. Increases renal phosphate
clearance
c. Increases the renal clearance
of calcium
d. Decreases the renal
phosphate clearance
e. A and B
151. Calcitonin causes 156. Insulin is a dimmer. The
a. Calcinuria and phosphaturia number of amino acids in the A
b. Decrease in urinary calcium and B chain respectively is
c. Decrease in urinary a. 19 and 28
phosphorous b. 21 and 30
d. Increase in blood calcium level c. 25 and 35
d. 29 and 38
152. The characteristic of
hyperparathyroidism is 157. In the insulin molecule, the
a. Low serum calcium number of interchain disulphide
b. High serum phosphorous brides is
c. Low serum calcium and high a. 1
serum phosphorous b. 2
d. High serum calcium and low c. 3
serum Phosphate d. 4

153. Parathyroid hormone 158. In the insulin molecule, the

a. Is released when serum Ca is number of intrachain disulphide
too high bridges is
b. Inactivates vitamin D a. 1
c. Is secreted when Ca++ is too b. 2
low c. 3
d. Depends on vitamin K for d. 4
adequate activity
159. The half life of insulin is
154. δ-Cells of islet of a. < 3–5 minutes
langerhans of pancreas produce b. < 8–10 minutes
a. Pancreatic polypeptide c. < 15 minutes
b. Pancreatic lipase d. < 15 minutes
c. Somatostatin
d. Steapsin 160. Insulin stimulates
a. Hepatic glycogenolysis
155. β-cells of islet of langerhans b. Hepatic glycogenesis
of the pancreas secrete c. Lipolysis
a. Insulin d. Gluconeogenesis
b. Glucagon
c. Somatostatin
d. Pancreatic polypeptide
161. Action of insulin on lipid 165. Following is a normal
metabolism is overnight fast and a cup of
a. It increases lipolysis and black coffee, a diabetic woman
increases triglyceride feels slightly nausious and
synthesis decides to skip breakfast.
b. It decreases lipolysis and However she does take her shot
increases triglyceride of insulin. This may result in
synthesis a. Heightened glycogenolysis
c. It decreases lipolysis and b. Hypoglycemia
decreases triglyceride c. Increased lipolysis
synthesis d. Glycosuria
d. It increases synthesis of
triglyceride and increased 166. Deficiency of insulin results
ketogenesis in
a. Rapid uptake of sugar
162. Insulin increases the activity b. Low blood glucose level
of c. Decrease urine output
a. Pyruvate kinase d. Presence of glucose in urine
b. Phosphorylase
c. Triacylglycerol kinase 167. The primary stimulus for
d. Fructose 2, 6-bisphosphatase insulin secretion is increased.
a. Blood level of epinephrine
163. Insulin decreases the b. Blood level of glucagon
activity of c. Blood level of glucose
a. cAMP dependent protein d. Water intake
kinase
b. HMG CoA-reductas 168. The α-cells of pancreas
c. Phosphodiesterase islets produce
d. Acetyl CoA-carboxylase a. Insulin
b. Glucagon
164. The human insulin gene c. Somatostatin
located on the short arm of d. Pancreatic polypeptide
chromosome:
a. 11
b. 17
c. 18
d. 20
169. The number of amino acids 173. Down regulation is
in single chain polypeptide a. Increased destruction of a
glucagons is hormone
a. 21 b. Feedback inhibition of
b. 29 hormone secretion
c. 31 c. Decreased concentration of a
d. 39 hormone in blood
d. Decrease in number of
170. Glucagon enhances receptors for a hormone
a. Hepatic glycogenolysis
b. Muscle glycogenolysis 174. All the following statements
c. Hepatic glycogenesis about hormones are true except
d. Lipogenesis a. All of them require specific
carriers in plasma
171. Glucagon b. All of them require specific
a. Increases protein synthesis receptors in target cells
b. Inhibits lipolysis in adipocytes c. Some of them are subject to
c. Increases gluconeogenesis in feedback regulation
liver d. Some of them increase the
d. Stimulates muscle transcription of certain genes
glycogenolysis
175. All the following statements
172. Hormone receptors possess about steroid hormones are
all the following properties true except
except a. They are hydrophobic
a. All of them are proteins b. They require carriers to
b. They possess a recognition transport them in circulation
domain c. Their receptors are
c. They bind hormones with a intracellular
high degree of specificity d. They require cyclic AMP as
d. Number of receptors in a second messenger
target cell is constant
176. Cyclic GMP acts as the 181. The nucleotide binding site
second messenger for of G-proteins is present on
a. Nerve growth factor their
b. Atrial natriuretic factor a. α-Subunit
c. Epinephrine b. β-Subunit α- and β-
d. Norepinephrine c. γ-Subunit
d. δ-Subunit
177. G-proteins act as
a. Hormone carriers 182. Adenylate cyclase is
b. Hormone receptors activated by
c. Second messengers a. GDP-bearing α-Subunit of G-
d. Signal transducers protein
b. GTP-bearing α-Subunit of G-
178. Signal transducer for protein
glucagons is a c. GDP-bearing γ-Subunit of G-
a. Cyclic nucleotide protein
b. Phosphoinositide d. GTP-bearing γ-Subunit of G-
c. Stimulatory G-protein protein
d. Inhibitory G-protein
183. Tyrosine kinase activity is
179. G-proteins are present in
a. Monomers a. α-Adrenergic receptors
b. Dimers b. β-Adrenergic receptors
c. Trimers c. Cholinergic receptors
d. Tetramers d. Insulin receptors

180. G-proteins have a nucleotide 184. Insulin receptor is a

binding site for a. Monomer
a. ADP/ATP b. Dimer
b. GDP/GTP c. Trimer
c. CDP/CTP d. Tetramer
d. UDP/UTP
185. Protein kinase C is activated
by
a. Cyclic AMP
b. Cyclic GMP
c. Diacyl glycerol
d. Inositol triphosphate
 190. Posterior pituitary gland
186. Melatonin is synthesised in secretes
a. Hypothalamus a. Catecholamines
b. Posterior pituitary gland b. Oxytocin
c. Pineal gland c. Follicle stimulating hormone
d. Melanocytes d. Serotonin

191. Diabetes insipidus is caused

187. Melanocyte stimulating by deficient secretion of
hormone is secreted by a. Insulin
a. Pineal gland b. Glucagon
b. Anterior lobe of pituitary c. Vasopressin
gland d. Oxytocin
c. Posterior lobe of pituitary
gland 192. Peripheral vasoconstriction is
d. Intermediate lobe of pituitary caused by high concentrations
gland of
a. Antidiuretic hormone
188. MSH causes b. Melatonin
a. Dispersal of melanin granules c. Glucagon
in melanocytes d. Oxytocin
b. Increase in melanin
concentration in melanocytes 193. Somatotropin is secreted by
c. Decerease in melanin a. Hypothalamus
concentration in melanocytes b. Anterior pituitary
d. Increase in number of c. Posterior pituitary
melanocytes d. Thyroid gland

189. A hormone synthesised in 194. Secretion of Insulin-like

the hypothalamus is Growth Factor-I is promoted by
a. Melatonin a. Insulin
b. Melanocyte stimulating b. Glucagon
hormone c. Growth hormone
c. Vasopressin d. Somatomedin C
d. Prolactin
195. Growth hormone increases 200. Overproduction of growth
a. Protein synthesis hormone during childhood
b. Lipogenesis causes
c. Glycogenolysis a. Acromegaly
d. All of these b. Gigantism
c. Cushing’s disease
196. Secretion of growth hormone d. Simmond’s disease
is inhibited by
a. Somatomedin C 201. Decreased secretion of
b. Somatostatin growth hormone during
c. Feedback inhibition childhood causes
d. All of these a. Simmond’s disease
b. Cushing’s disease
197. Secretion of somatotrophin c. Dwarfism
is promoted by d. Cretinism
a. Somatomedin C
b. Somatostatin 202. Stature is increased in
c. Growth hormone releasing a. Gigantism
hormone b. Acromegaly
d. Hypoglycaemia c. Simmond’s disease
d. Cushing’s disease
198. Secretion of luteinising
hormone is increased by 203. An amino acid used for the
a. GnRH synthesis of thyroid hormone is
b. FSH a. Tyrosine
c. Testosterone b. Tryptophan
d. None of these c. Histidine
d. Proline
199. Acromegaly results in all the
following except 204. Receptors for thyroid
a. Overgrowth of the bones of hormones are present
face, hands and feet a. On the cell membrane
b. Increased stature b. Across the cell membrane
c. Enlargements of viscera c. Inside the cells
d. Impaired glucose tolerance d. In association with G-proteins
205. Binding of thyroxine to its 209. All the following may occur
receptors in myxoedema except
a. Activates Adenylate cyclase a. Cold intolerance
b. Activates guanylate cyclase b. Low BMR
c. Activates a stimulatory G- c. Tachycardia
protein d. Dry and coarse skin
d. Increases transcription
210. Mental retardation can occur
206. Secretion of thyroid in
hormones is regulated by a. Cretinism
a. Hypothalamus b. Juvenile myxoedema
b. Anterior pituitary c. Myxoedema
c. Feedback regulation d. Juvenile thyrotoxicosis
d. All of these
211. Parathyroid hormone (PTH)
207. Clinical features of is synthesised in
hyperthyroidism include a. Chief cells of parathyroid
a. Goitre, heat intolerance, glands
weight loss and tachycardia b. Oxyphil cells of parathyroid
b. Goitre, tremors, tachycardia glands
and cold intolerance c. Para follicular cells of thyroid
c. Exophthalmos, goiter, glands
tachycardia and loss of d. Follicular cells of thyroid
appetite gland
d. Exophthalmos, goiter, tremors
and obesity 212. A high concentration of PTH
in blood causes
208. All the following may occur a. Increase in plasma calcium
in hyperthy- roidism except and inorganic phosphorous
a. Goitre b. Decrease in plasma calcium
b. Increased appetite and inorganic phosphorous
c. Loss of weight c. Increase in plasma calcium
d. Low BMR and decrease in plasma
inorganic phosphorous
d. Decrease in plasma calcium
and increase in plasma
inorganic phosphorous
213. Tetany can occur 218. β-Subunits of insulin
a. In primary receptor are present
hyperparathyroidism a. Outside the cell membrane
b. In secondary b. In the cell membrane
hyperparathyroidism c. Across the cell membrane
c. In idiopathic d. In the cytosol
hypoparathyroidism
d. After accidental removal of 219. In the insulin receptor,
parathyroid glands tyrosine kinase domain is
present in
214. Crystallisation of insulin e. α-Subunits
occurs in the presence of f. β-Subunits
a. Chromium g. γ-Subunits
b. Copper h. δ-Subunits
c. Zinc
d. Calcium 220. Binding of insulin to its
receptor activates
215. Insulin receptors are a. Adenylate cyclase
decreased in number in b. Guanylate cyclase
a. Obesity c. Phospholipase C
b. Starvation d. Tyrosine kinase
c. Hyperinsulinism
d. Kwashiorkor 221. Insulin receptor is made up
of
216. Insulin binding sites are a. One α-and one β-subunit
present on the b. Two α-and two β-subunit
a. α-subunits of insulin receptor c. Two, α two β-and two γ-
b. β-subunits of insulin receptor subunit
c. γ-subunits of insulin receptor d. One α, one β-one γ-and one δ-
d. α-and β−subunits of insulin subunit
receptor
222. Insulin decreases
217. α-Subunits of insulin a. Glycogenesis
receptor are present b. Glyolysis
a. Outside the cell membrane c. Gluconeogenesis
b. In the cell membrane d. Tubular reabsorption of
c. Across the cell membrane glucose
d. In the cytosol
223. Insulin increases 228. Second messenger for
a. Glycogenesis glucagons is
b. Gluconeogenesis a. Cyclic AMP
c. Lipolysis b. (B) Diacylglycerol
d. Blood glucose c. Cyclic GMP
d. (D) Inositol triphosphate
224. Insulin increases
a. Protein synthesis 229. Number of amino acid
b. Fatty acid synthesis residues in glucagons is
c. Glycogen synthesis a. 29
d. All of these b. 34
c. 51
225. Insulin decreases the d. 84
synthesis of
a. Hexokinase 230. Glucagon secretion increases
b. Glucokinase a. After a carbohydrate-rich
c. PEP carboxykinase meal
d. Glycogen synthetase b. After a fat-rich meal
c. When blood glucose is high
226. Diabetes mellitus can occur d. When blood glucose is low
due to all of the following
except 231. The maineffecting of
a. Deficient insulin secretion glucagons is to increase
b. Tumour of β−cells a. Glycolysis in muscles
c. Decrease in number of insulin b. Glycogenolysis in muscles
receptors c. Glycogenolysis in liver
d. Formation of insulin d. Glycogenesis in liver
antibodies
232. Epinephrine is synthesised in
227. Hypoglycaemic coma can a. Chromaffin cells of adrenal
occur medulla
a. In untreated diabetes b. Sympathetic ganglia
mellitus c. Brain
b. In starvation d. All of these
c. After overdose of oral
hypoglycaemic drugs
d. After overdose of insulin
233. Binding of catecholamines to 238. Zona glomerulosa of adrenal
α2−adrenergicreceptors cortex synthesises
a. Increases the intracellular a. Glucocorticoids
concentration ofcAMP b. Mineralocorticoids
b. Increases the intracellular c. Androgens
concentration of cGMP d. Estrogen and progesterone
c. Decreases the intracellular
concentration of cAMP 239. Cortisol is a
d. Decreases the intracellular a. Glucocorticoid
concentration of cGMP b. Mineralocorticoid
c. Androgen
234. Phosphoinositide cascade is d. Estrogen
activated on binding of
catecholamines to 240. The major mineralcorticoid
a. Α2-Adrenergic receptors is
b. α1-Adrenergic receptors a. Hydrocortisone
c. β2-Adrenergic receptors b. Aldosterone
d. β1-Adrenergic receptors c. Aldactone A
d. Androstenedione
235. Epinephrine decreases
a. Glycogenesis 241. Steroid hormones are
b. Glycogenolysis synthesised in all of the
c. Gluconeogenesis following except
d. Lipolysis a. Testes
b. Ovaries
236. Epinephrine increases all of c. Adrenal medulla
the following except d. Adrenal cortex
a. Glycogenolysis in muscles
b. Lipolysis in adipose tissue 242. Steroid hormones are
c. Gluconeogenesis in muscles synthesised from
d. Glucagon secretion a. Cholesterol
b. 7-Dehydrocholesterol
237. Secretion of catecholamines c. Calcitriol
is increased in d. 7-Hydroxycholesterol
a. Cushing’s syndrome
b. Addison’s disease
c. Phaeochromocytoma
d. Simmond’s disease
243. The second messenger for 247. Mineralcorticoids regulate
glucocorticoids is the metabolism of all of the
a. Cyclic AMP following except
b. Cyclic GMP a. Sodium
c. Inositol triphosphate b. Potassium
d. No second messenger is c. Calcium
required d. Chloride

244. Glucocorticoids increase the 248. Mineralocorticoids increase

synthesis of all of the following the tubular reabsorption of
except a. Sodium and calcium
a. Glucokinase b. Sodium and potassium
b. Glucose-6-phosphatase c. Sodium and chloride
c. Fructose-1, 6-biphosphatase d. Potassium and chloride
d. Pyruvate carboxylase
249. Mineralocorticoids increase
245. Secretion of glucocorticoida the tubular secretion of
is regulated by all the following a. Sodium
except b. Potassium
a. Hypothalamus c. Chloride
b. Anterior pituitary d. Bicarbonate
c. Feedback control by blood
glucose 250. Secretion of
d. Feedback control by mineralcorticoids is increased
glucocorticoids by
a. ACTH
246. Excessive secretion of b. Angiotensin
glucocorticoids raises blood c. Hypokalaemia
glucose by d. Hypernatraemia
a. Decreasing glycogenesis
b. Increasing glycogenolysis 251. In Addison’s disease, there
c. Increasing gluconeogenesis is excessive retention of
d. Inhibiting HMP shunt a. Potassium
b. Sodium
c. Chloride
d. Water
252. Secretion of androgens is 257. Activated phospholipase C
increased by acts on
a. LH a. Phosphatidyl inositol-4, 5-
b. FSH biphosphate
c. ACTH b. Inositol-1, 4, 5-triphosphate
d. Growth hormone c. Protein kinase C
d. Pl-3 kinase
253. Vasoconstrictor effect of
ADH is mediated by 258. Radioactive iodine uptake by
a. cAMP thyroid gland is increased in
b. cGMP a. Endemic goitre
c. Protein kinase C b. Hyperthyroidism
d. Angiotensin II c. Myxoedema
d. Creatinism
254. Urinary excretion of vanillyl
madelic acid is increased in 259. Administration of TSH
a. Phaeochromocytoma increases serum and T4 in
b. Cushing’s syndrome a. Hyperthyroidism of pituitary
c. Carcinoid syndrome origin
d. Aldosteronism b. Hyperthyroidism of thyroid
origin
255. Activation of IRS-1, PI-3 c. Hypothyroidism of pituitary
kinase and GRB2 is brought origin
about by d. Hypothyroidism of thyroid
a. Glucagon origin
b. Insulin
c. Prolactin 260. High level of T3 and T4 and
d. IGF-2 low TSH in serum indicates
a. Hyperthyroidism of pituitary
256. The protein IRS-1 is origin
phosphorylated by b. Hypothyroidism of pituitary
a. Protein kinase A origin
b. Protein kinase C c. Hyperthyroidism of thyroid
c. Tyrosine kinase activity of origin
insulin receptor d. Hypothyroidism of thyroid
d. Tyrosine kinase activity of origin
IGF-1 receptor
261. BMR is increased in 266. In hyperparathyroidism
a. Endemic goitre there is
b. Thyrotoxicosis a. Hypocalcemia
c. Myxoedema b. Hypophophatemia
d. Cretinism c. Hypokalemia
d. Hyperkalemia
262. The second messenger for
many hormones is 267. This pancreatic hormone
a. ATP increases the blood-sugar level:
b. cyclic AMP a. Insulin
c. cGMP b. Glucagon
d. UTP c. Pancreozymin
d. Pancreatic polypeptide
263. The most potent hormone
concerned with the retention of 268. T3 is
sodium in the body is a. Thyroxine
a. Cortisone b. Triodo thyronine
b. Aldosterone c. Triodo tyrosine
c. Corticosterone d. Reverse tri iodo thyronine
d. Cortisol
269. Whcih of the following
264. Retention of sodium in the hormone does not activate
body leads to a retention of adenylate cyclase?
a. Potassium a. Epinephrine
b. Water b. Glucagon
c. Potassium and water c. Parathyroid hormone
d. Neither potassium nor water d. Insulin

265. There is polyuria without 270. Pheochromacytoma is a

glycosuria in this disorder tumor of
a. Diabetes insipidus a. adrenal medulla
b. Diabetes millitus b. bone
c. Bronze diabetes c. head of Pancreas
d. Juvenile diabetes d. pituitary
271. Which one of the following 275. Which of the following is
statements is incorrect? used for inducin labour?
a. Insulin increases glucose a. Prostaglandins
phosphorylation b. Prostacyclins
b. Insulin increases glycolysis c. Vasopressin
c. Insulin augments HMP shunt d. Thromboxanes
d. Insulin promotes
gluconeogenesis 276. Which is incorrect?
Epinephrin promotes the
272. The blood sugar raising glycogenolysis in
action of the hormone of a. Muscle
suprarenal cortex is due to b. Liver
a. Gluconeogenesis c. Heart
b. Glycogenolysis d. None of these
c. Glucagon like activity
d. due to inhibition of glomerular 277. Which of one of the
filtration of glucose following is released by
hypothalamus?
273. Hyper insulinism can cause a. Somatostatin
coma since b. Somatotropic hormone
a. The chief nutrient for the c. Somato medin C
brain is glucose d. Luteinising hormone
b. The chief nutrient for the
heart is glucose 278. Which of the following
c. The glucostatic role of the hormone is not under the
liver is damaged control of ACTH?
d. The kidneys are damaged a. Aldosterone
b. Cortisol
274. Vasopressin is also known as c. Corticosterone
a. Antidiabetogenic hormone d. Deoxycorticosterone
b. Antidiuretic hormone
c. Somatotropic hormone 279. Prolactin release inhibiting
d. Pitoxin hormone is believed to be
a. Serotonin
b. Norepinephrine
c. Dopamine
d. Acetyl choline
280. Which one of the following 284. Which of the following
is not a symptom of cushing’s statements is correct?
disease? a. Thyroxine inhibits utilization
a. Hyperglycemia of glucose
b. Hypernatremia b. Insulin increases utilization of
c. Hirsutism glucose
d. Hyperkalemia c. Glucagon promotes muscle
glycogenolysis
281. Insulin increases the d. Insulin inhibits lipogenesis
permeability of glucose across from carbohydrates
the plasma membrane of muscle
cells by 285. Which of the following is
a. Acting on adenylate cycle noted in cushing’s syndrome, a
b. By loosening the integrity of tumor associated disease of the
the membrane adrenal cortex?
c. Through Ca 2+ions a. Decreased production of
d. By membrane cruting the epinephrine
hexose carries of intracellular b. Excessive production of
organelles and making them epinephrine
fuse with the plasma c. Excessive production of
membrane vasopressin
d. Excessive production of
282. Somatostatin is produced by cortisol
a. Hypothalamus
b. Pancreas 286. Increased reabsorption of
c. Hypothalamus and pancreas water from the kidney is the
d. Hypothalamus and Adrenals major consequence of which of
the following hormones?
283. It is unique that the a. Cortisol
following single antidiabetogenic b. Insulin
hormone effectively counter c. Vasopressin
acts the several diabetogenic d. Aldosterone
hormones:
a. Glucagon
b. Glucocorticoids
c. Insulin
d. Growth hormone
287. Insulin regulates fatty acid 291. Insulin is a polypeptide
synthesis by hence:
a. Dephosphorylating of acetyl a. It is resistant to destruction
CoA carboxylase by gastric juice
b. Activating phosphorylase b. It is destroyed by gastric
c. Inhibiting malonyl CoA juice
formation c. It is not a polypeptide
d. Controlling carnitine-Acyl CoA d. It is metabolized immediately
transferase activity by cellular enzymes

288. TSH hormone biochemically 292. Bovine insulin is less

is a antigenic than porcine. This
a. Protein consideration is:
b. Fat a. True
c. Glycoprotein b. False
d. Carbohydrate
293. Insulin causes reduction in
blood sugar level by the
289. Secretory products of following mechanisms, EXCEPT:
pancreatic β-cells are: a. Increased glucose uptake in
a. Glucagon, proglucagon the peripheral tissue
b. Insulin, C-peptide, proinsulin, b. Reduction of breakdown of
islet amyloid polypeptide (IAPP) glycogen
c. Somatostatin c. Diminished gluconeogenesis
d. Pancreatic polypeptide (PP) d. Decreased glucose absorption
from the gut
290. Insulin is:
a. A glycoprotein with a 294. Which of the following is
molecular weight of 6000 true for glucagon?
b. A small protein with a a. Stimulates gluconeogenesis in
molecular weight of 5808 having the liver
disulphide linkage b. Stimulates the secretion of
c. A fructoolygosaccharide insulin by beta cells
d. A catecholamine c. Inhibits glucose utilization by
skeletal muscle
d. Inhibits uptake of aminoacids
by cells.
295. Insulin can not be 299. Sulphonylureas act by:
administered by: a. Reducing the absorption of
a. Oral route carbohydrate from the gut
b. Intravenous route b. Increasing the uptake of
c. Subcutaneous route glucose in peripheral tissues
d. Intramuscular route. c. Reducing the hepatic
gluconeogenesis
296. The primary reason for a d. Stimulating the beta islet
physician to prescribe human cells of pancreas to produce insulin
insulin is that:
a. It has a faster onset of 300. Sulphonylureas are effective
action than other insulins in totally insulin deficient
b. It has a shorter duration of patients. This consideration is:
action than other insulins a. True
c. It can be given to patients b. False
who have an allergy to animal
insulins 301. Currently used second-
d. It is more effective in generation sulfonylureas include
preventing the complications of the following,
diabetes than animal insulins a. Glyburide (Glibenclamide)
b. Glipizide (Glydiazinamide)
297. Correct statements about c. Glimepiride (Amaril)
crystalline zinc (regular) insulin d. Tolbutamide (Orinase)
include all of the following,
EXCEPT: 302. Currently used oral
a. It can serve as replacement hypoglycemic thiazolidinediones
therapy for juvenile-onset diabetes include the following,
b. It can be administered a. Pioglitazone (Actos)
intravenously b. Rosiglitazone (Avandia)
c. It is a short-acting insulin c. Troglitazone (Rezulin)
d. It can be administered orally d. All of the above

298. Diabetic coma is treated by

the administration of:
a. Lente insulin
b. Glucose
c. Crystalline insulin
d. Oral anti-diabetic drugs.
 303. Thiazolidinediones act by: 306. The action of insulin is
a. Diminishing insulin resistance potentiated by:
by increasing glucose uptake and a. Sulphonylureas
metabolism in muscle and adipose b. Glucagon
tissues c. Biguanides
b. Reducing the absorption of d. None of the above
carbohydrate from the gut
c. Stimulating the beta islet 307. Biguanides are used in the
cells of pancreas to produce insulin following conditions, EXCEPT:
d. All of the above a. As a supplement to sulphonylurea,
where it is insufficient to give good
304. Alpha-glucosidase inhibitors results
act by: b. In over weight diabetics
a. Diminishing insulin resistance by c. To reduce insulin requirements
increasing glucose uptake and d. In case of hyperglycemic shock
metabolism in muscle and adipose
tissues 308. Which of the following
b. Competitive inhibiting of intestinal agents is/are important
alpha-ghucosidases and modulating hormonal antagonists of insulin
the postprandial digestion and in the body?
absorption of starch and a. Glucagon
disaccharides b. Adrenal steroids
c. Reducing the absorption of c. Adrenaline
carbohydrate from the gut d. All of the above
d. Stimulating the beta islet cells of
pancreas to produce insulin 309. Glucagon is:
1. A glycoprotein with a molecular
305. Currently used oral weight of 6000
hypoglycemic biguanides include 2. A peptide – identical in all
the following: mammals – consisting of a single
a. Repaglinide (Prandin) chain of 29 amino acids
b. Metformin 3. A a fructoolygosaccharide
c. Phenformine 4. A small protein with a molecular
d. Glipizide weight of 5808 having disulphide
linkage
 310. Which of the following 314. A hormone secreted from
statements is FALSE? anterior pituitary is
a. Glucagon is synthesized in the A cells
of the pancreatic islets of a. Growth hormone
Langerhans. b. Vasopressin
b. Glucagon is a peptide – identical in all c. Oxytocin
mammals – consisting of a single chain d. Epinephrine
of 29 amino acids
c. Glucagon is extensively degraded in
the liver and kidney as well as in 315. A hormone secreted from
plasma, and at its tissue receptor posterior pituitary is
sites.
a. Vasopressin
d. Half-life of glucagon is between 6 and
b. Thyrotropic hormone
8 hours, which is similar to that of
c. Prolactin
insulin
d. Adrenocorticotropic
hormone
311. Glucagon can be used in the
following situations, EXCEPT:
a. Severe hypoglycemia 316. Growth hormone causes
b. Severe hyperglycemia hyperglycemia. It is a result of
c. Endocrine diagnosis
d. Beta-blocker poisoning a. Decreased peripheral
utilization of glucose
312. Main complications of insulin b. Decreased hepatic
therapy include the following: production via gluconeo-
a. Hypoglycemia genesis
b. Insulin allergy c. Increased glycolysis in
c. Lipodystrophy at an injection site muscle
d. All of the above d. Decrersed lipolysis

313. Hormone that binds to 317. Acromegaly results due to

intracellular receptor is excessive release of
a. Adrenocorticotropic hormone a. Thyroxine
a. Thyroxine b. Growth hormone
b. Follicle stimulating hormone c. Insulin
c. Glucagon d. Glucagon
318. Growth hormone is released 322. Hyperglycemic effect of
by glucocorticoids is due to
a. Somatostatin a. Inactivation of protein
b. Growth hormone releasing phosphatase
hormone b. Inactivation of fructose 1,6-
c. Prolactin release inhibiting biphosphatase
hormone c. Stimulation of synthesis of
d. Luteinizing releasing hormone pyruvate carboxylase
d. Stimulation of synthesis of
eltroxykinase
319. ACTH stimulates the
secretion of 323. The predominant
a. Glucocorticoids glucocorticoid is :
b. Epinephrine a. Cortisol
c. Thyroxine b. Aldosterone
d. Luteinizing hormone c. Dehydroephiandrosterone
d. Androstenedione

320. Excessive secretion of ACTH 324. Cortisol is synthesized in

causes a. Zona fasiculata
a. Cushing’s syndrome b. Zona glomerulosa
b. Addison’s disease c. Zona reticularis
c. Myxoedema d. Chromaffin cells
d. Thyrotoxicosis
325. All mammalian steroid
hormones are formed from
321. In Cushing’s syndrome-a
a. Purine
tumour associated disease of
b. Pyrimidine
adrenal cortex, there is
c. Cholesterol
a. Decreased epinephrine
d. Pyrrole
production
b. Excessive cortisol production
326. Aldosterone synthesis occurs
c. Excessive epinephrine production
in
d. Decreased cortsoil production
a. Zona reticularis
b. Zona fasciculata
c. Zona glomerulosa
d. Chromaffian cells
327. The most important effect 331. Catecholamine hormones are
of aldosterone is to synthesized in the
a. Increase the rate of tubular a. Chromaffin cells of adrenal
reabsorption of sodium medulla
b. Decrease the rate of tubular b. Zona glomerulosa of adrenal
reabsorption of potassium cortex
c. Decrease the reabsorption of c. Zona fasciculate of adrenal
chloride cortex
d. Decrease the renal reabsorption d. Zona reticularis of adrenal
of sodium cortex

328. One of the potent 332. The hormone required for

stimulators of aldosterone uterine muscle contraction for
secretion is child birth is
a. Increased sodium concentration a. Progesterone
b. Decreased potassium b. Estrogen
concentration c. Oxytocin
c. Increased potassium d. Vasopressin
concentration
d. Increased ECF volume 333. ADH
a. Reabsorbs water from renal
329. [Link] the rennin-angiotensin tubules
system the primary hormone is b. Excretes water from renal
a. Angiotensinogen tubules
b. Angiotensin I c. Excretes hypotonic urine
c. Angiotensin II d. Causes low specific gravity of
d. Angiotensin III urine

330. Aldosterone release is 334. Increased reabsorption of

stimulated by water from the kidney is the
a. α-Globulin major consequence of the
b. Renin secretion of the hormone?
c. Angiotensin II a. Cortisol
d. Growth hormone b. Insulin
c. Vasopressin
d. Aldosterone
335. An increase in the osmolality 339. Excess secretion of thyroid
of extracellular compartment hormones causes
will a. Hyperthyroidism
a. Inhibit ADH secretion b. Myxoedema
b. Stimulate ADH secretion c. Cretinism
c. Cause no change in ADH d. Cushing syndrome
secretion
d. Stimulate the volume and 340. Insufficient free T3 and T4
osmoreceptor and inhibit ADH results in
secretion a. Grave’s disease
b. Mysoedema
336. Pheochromocytomas are c. Cushing syndrome
tumours of d. Gigantism
a. Adrenal cortex
b. Adrenal medulla 341. TSH stimulates the
c. Pancreas synthesis delete
d. Bone a. Thyroxine
b. Adrenocorticoids
337. A characteristic of c. Epinephrine
pheochromocytoma is elevated d. Insulin
urinary excretion of 342. Thyroid hormones are
a. Dopamine synthesized by the iodination of
b. Tyrosine the amino acid:
c. Vinylmandelic acid a. Glycine
d. Phenylalanine b. Phenylalanine
c. Alanine
338. Epinephrine stimulates d. Tyrosine
glycogenolysis in
a. Liver 343. PTH
b. Muscle a. Reduces the renal clearance or
c. Liver and muscle excretion of calcium
d. Kidney b. Increases renal phosphate
clearance
c. Increases the renal clearance of
calcium
d. Decreases the renal phosphate
clearance
e. A ana B
344. Calcitonin causes 348. β-cells of islet of langerhans
a. Calcinuria and of the pancreas secrete
phosphaturia a. Insulin
b. Decrease in urinary b. Glucagon
calcium c. Somatostatin
c. Decrease in urinary d. Pancreatic polypeptide
phosphorous
d. Increase in blood calcium 349. Insulin is a dimmer. The
level number of amino acids in the A
and B chain respectively is
345. The characteristic of a. 19 and 28
hyperparathyroidism is b. 21 and 30
a. Low serum calcium c. 25 and 35
b. High serum phosphorous d. 29 and 38
c. Low serum calcium and
high serum phosphorous 350. In the insulin molecule, the
d. High serum calcium and number of interchain disulphide
low serum Phosphate brides is
a. 1
346. Parathyroid hormone b. 2
a. Is released when serum c. 3
Ca is too high d. 4
b. Inactivates vitamin D
c. Is secreted when Ca++ is 351. In the insulin molecule, the
too low number of intrachain disulphide
d. Depends on vitamin K for bridges is
adequate activity a. 1
b. 2
347. δ-Cells of islet of c. 3
langerhans of pancreas produce d. 4
a. Pancreatic polypeptide
b. Pancreatic lipase 352. The half life of insulin is
c. Somatostatin a. < 3–5 minutes
d. Steapsin b. < 8–10 minutes
c. < 15 minutes
d. < 15 minutes
353. Insulin stimulates 357. The human insulin gene
a. Hepatic glycogenolysis located on the short arm of
b. Hepatic glycogenesis chromosome:
c. Lipolysis a. 11
d. Gluconeogenesis b. 17
c. 18
354. Action of insulin on lipid d. 20
metabolism is
a. It increases lipolysis and 358. Following is a normal
increases triglyceride synthesis overnight fast and a cup of
b. It decreases lipolysis and black coffee, a diabetic woman
increases triglyceride synthesis feels slightly nausious and
c. It decreases lipolysis and decides to skip breakfast.
decreases triglyceride synthesis However she does take her
d. It increases synthesis of shot of insulin. This may result
triglyceride and increased in
ketogenesis a. Heightened glycogenolysis
b. Hypoglycemia
355. Insulin increases the activity c. Increased lipolysis
of d. Glycosuria
a. Pyruvate kinase
b. Phosphorylase 359. Deficiency of insulin results
c. Triacylglycerol kinase in
d. Fructose 2, 6-bisphosphatase a. Rapid uptake of sugar
b. Low blood glucose level
356. Insulin decreases the c. Decrease urine output
activity of d. Presence of glucose in urine
a. cAMP dependent protein kinase
b. HMG CoA-reductas 360. The primary stimulus for
c. Phosphodiesterase insulin secretion is increased.
d. Acetyl CoA-carboxylase a. Blood level of epinephrine
b. Blood level of glucagon
c. Blood level of glucose
d. Water intake
361. The α-cells of pancreas
islets produce 366. Down regulation is
a. Insulin a. Increased destruction of a
b. Glucagon hormone
c. Somatostatin b. Feedback inhibition of hormone
d. Pancreatic polypeptide secretion
c. Decreased concentration of a
362. The number of amino acids hormone in blood
in single chain polypeptide d. Decrease in number of receptors
glucagons is for a hormone
a. 21
b. 29 367. All the following statements
c. 31 about hormones are true except
d. 39 a. All of them require specific
carriers in plasma
363. Glucagon enhances b. All of them require specific
a. Hepatic glycogenolysis receptors in target cells
b. Muscle glycogenolysis c. Some of them are subject to
c. Hepatic glycogenesis feedback regulation
d. Lipogenesis d. Some of them increase the
transcription of certain genes
364. Glucagon
a. Increases protein synthesis 368. All the following statements
b. Inhibits lipolysis in adipocytes about steroid hormones are
c. Increases gluconeogenesis in true except
liver a. They are hydrophobic
d. Stimulates muscle glycogenolysis b. They require carriers to
transport them in circulation
365. Hormone receptors possess c. Their receptors are intracellular
all the following properties d. They require cyclic AMP as
except second messenger
a. All of them are proteins
b. They possess a recognition 369. Cyclic GMP acts as the
domain second messenger for
c. They bind hormones with a high a. Nerve growth factor
degree of specificity b. Atrial natriuretic factor
d. Number of receptors in a target c. Epinephrine
cell is constant d. Norepinephrine
 375. Adenylate cyclase is
370. G-proteins act as activated by
a. Hormone carriers a. GDP-bearing α-Subunit of
b. Hormone receptors G-protein
c. Second messengers b. GTP-bearing α-Subunit of
d. Signal transducers G-protein
c. GDP-bearing γ-Subunit of
371. Signal transducer for G-protein
glucagons is a d. GTP-bearing γ-Subunit of
a. Cyclic nucleotide G-protein
b. Phosphoinositide
c. Stimulatory G-protein 376. Tyrosine kinase activity is
d. Inhibitory G-protein present in
a. α-Adrenergic receptors
372. G-proteins are b. β-Adrenergic receptors
a. Monomers c. Cholinergic receptors
b. Dimers d. Insulin receptors
c. Trimers
d. Tetramers 377. Insulin receptor is a
a. Monomer
373. G-proteins have a nucleotide b. Dimer
binding site for c. Trimer
a. ADP/ATP d. Tetramer
b. GDP/GTP
c. CDP/CTP 378. Protein kinase C is activated
d. UDP/UTP by
a. Cyclic AMP
374. The nucleotide binding site b. Cyclic GMP
of G-proteins is present on c. Diacyl glycerol
their d. Inositol triphosphate
a. α-Subunit
b. β-Subunit α- and β- 379. Melatonin is synthesised in
c. γ-Subunit a. Hypothalamus
d. δ-Subunit b. Posterior pituitary gland
c. Pineal gland
d. Melanocytes
380. Melanocyte stimulating
hormone is secreted by 385. Peripheral vasoconstriction is
a. Pineal gland caused by high concentrations
b. Anterior lobe of pituitary gland of
c. Posterior lobe of pituitary gland a. Antidiuretic hormone
d. Intermediate lobe of pituitary b. Melatonin
gland c. Glucagon
d. Oxytocin
381. MSH causes
a. Dispersal of melanin granules in 386. Somatotropin is secreted by
melanocytes a. Hypothalamus
b. Increase in melanin concentration b. Anterior pituitary
in melanocytes c. Posterior pituitary
c. Decerease in melanin d. Thyroid gland
concentration in melanocytes
d. Increase in number of 387. Secretion of Insulin-like
melanocytes Growth Factor-I is promoted by
a. Insulin
382. A hormone synthesised in b. Glucagon
the hypothalamus is c. Growth hormone
a. Melatonin d. Somatomedin C
b. Melanocyte stimulating hormone
c. Vasopressin 388. Growth hormone increases
d. Prolactin a. Protein synthesis
b. Lipogenesis
383. Posterior pituitary gland c. Glycogenolysis
secretes d. All of these
a. Catecholamines
b. Oxytocin 389. Secretion of growth hormone
c. Follicle stimulating hormone is inhibited by
d. Serotonin a. Somatomedin C
b. Somatostatin
384. Diabetes insipidus is caused b. Feedback inhibition
by deficient secretion of c. All of these
a. Insulin
b. Glucagon
c. Vasopressin
d. Oxytocin
390. Secretion of somatotrophin d. Cretinism
is promoted by
a. Somatomedin C 395. Stature is increased in
b. Somatostatin a. Gigantism
c. Growth hormone releasing b. Acromegaly
hormone c. Simmond’s disease
d. Hypoglycaemia d. Cushing’s disease

391. Secretion of luteinising 396. An amino acid used for the

hormone is increased by synthesis of thyroid hormone is
a. GnRH a. Tyrosine
b. FSH b. Tryptophan
c. Testosterone c. Histidine
d. None of these d. Proline

392. Acromegaly results in all the 397. Receptors for thyroid

following except hormones are present
a. Overgrowth of the bones a. On the cell membrane
of face, hands and feet b. Across the cell membrane
b. Increased stature c. Inside the cells
c. Enlargements of viscera d. In association with G-proteins
d. Impaired glucose
tolerance 398. Binding of thyroxine to its
receptors
393. Overproduction of growth a. Activates Adenylate cyclase
hormone during childhood b. Activates guanylate cyclase
causes c. Activates a stimulatory G-protein
a. Acromegaly d. Increases transcription
b. Gigantism
c. Cushing’s disease 399. Secretion of thyroid
d. Simmond’s disease hormones is regulated by
a. Hypothalamus
394. Decreased secretion of b. Anterior pituitary
growth hormone during c. Feedback regulation
childhood causes d. All of these
a. Simmond’s disease
b. Cushing’s disease
c. Dwarfism
400. Clinical features of 404. Parathyroid hormone (PTH)
hyperthyroidism include is synthesised in
a. Goitre, heat intolerance, weight a. Chief cells of parathyroid glands
loss and tachycardia b. Oxyphil cells of parathyroid
b. Goitre, tremors, tachycardia and glands
cold intolerance c. Para follicular cells of thyroid
c. Exophthalmos, goiter, glands
tachycardia and loss of appetite d. Follicular cells of thyroid gland
d. Exophthalmos, goiter, tremors
and obesity 405. A high concentration of PTH
in blood causes
401. All the following may occur a. Increase in plasma calcium and
in hyperthy- roidism except inorganic phosphorous
a. Goitre b. Decrease in plasma calcium and
b. Increased appetite inorganic phosphorous
c. Loss of weight c. Increase in plasma calcium and
d. Low BMR decrease in plasma inorganic
phosphorous
402. All the following may occur d. Decrease in plasma calcium and
in myxoedema except increase in plasma inorganic
a. Cold intolerance phosphorous
b. Low BMR
c. Tachycardia 406. Tetany can occur
d. Dry and coarse skin a. In primary hyperparathyroidism
b. In secondary
403. Mental retardation can occur hyperparathyroidism
in c. In idiopathic hypoparathyroidism
a. Cretinism d. After accidental removal of
b. Juvenile myxoedema parathyroid glands
c. Myxoedema
d. Juvenile thyrotoxicosis 407. Crystallisation of insulin
occurs in the presence of
a. Chromium
b. Copper
c. Zinc
d. Calcium
408. Insulin receptors are 413. Binding of insulin to its
decreased in number in receptor activates
a. Obesity a. Adenylate cyclase
b. Starvation b. Guanylate cyclase
c. Hyperinsulinism c. Phospholipase C
d. Kwashiorkor d. Tyrosine kinase

409. Insulin binding sites are

present on the 414. Insulin receptor is made up
a. α-subunits of insulin receptor of
b. β-subunits of insulin receptor a. One α-and one β-subunit
c. γ-subunits of insulin receptor b. Two α-and two β-subunit
d. α-and β−subunits of insulin c. Two, α two β-and two γ-subunit
receptor d. One α, one β-one γ-and one δ-
subunit
410. α-Subunits of insulin
receptor are present
a. Outside the cell membrane 415. Insulin decreases
b. In the cell membrane a. Glycogenesis
c. Across the cell membrane b. Glyolysis
d. In the cytosol c. Gluconeogenesis
d. Tubular reabsorption of glucose
411. β-Subunits of insulin
receptor are present
416. Insulin increases
a. Outside the cell membrane
a. Glycogenesis
b. In the cell membrane
b. Gluconeogenesis
c. Across the cell membrane
c. Lipolysis
d. In the cytosol
d. Blood glucose

412. In the insulin receptor,

417. Insulin increases
tyrosine kinase domain is
a. Protein synthesis
present in
b. Fatty acid synthesis
a. α-Subunits
c. Glycogen synthesis
b. β-Subunits
d. All of these
c. γ-Subunits
d. δ-Subunits
418. Insulin decreases the 422. Number of amino acid
synthesis of residues in glucagone is
a. Hexokinase a. 29
b. Glucokinase b. 34
c. PEP carboxykinase c. 51
d. Glycogen synthetase d. 84

419. Diabetes mellitus can occur 423. Glucagon secretion increases

due to all of the following a. After a carbohydrate-rich meal
except b. After a fat-rich meal
a. Deficient insulin secretion c. When blood glucose is high
b. Tumour of β−cells d. When blood glucose is low
c. Decrease in number of insulin
receptors
d. Formation of insulin antibodies 424. The main effect of glucagon
is to increase
a. Glycolysis in muscles
420. Hypoglycaemic coma can b. Glycogenolysis in muscles
occur c. Glycogenolysis in liver
a. In untreated diabetes mellitus d. Glycogenesis in liver
b. In starvation
c. After overdose of oral
hypoglycaemic drugs 425. Epinephrine is synthesised in
d. After overdose of insulin a. Chromaffin cells of adrenal
medulla
b. Sympathetic ganglia
421. Second messenger for c. Brain
glucagone is d. All of these
a. Cyclic AMP
b. Diacylglycerol
c. Cyclic GMP
d. Inositol triphosphate
426. Binding of catecholamines 430. Secretion of catecholamines
to α2−adrenergicreceptors is increased in
a. Increases the intracellular
concentration ofcAMP a. Cushing’s syndrome
b. Increases the intracellular b. Addison’s disease
concentration of cGMP c. Phaeochromocytoma
c. Decreases the intracellular d. Simmond’s disease
concentration of cAMP
d. Decreases the intracellular
concentration of cGMP 431. Zona glomerulosa of adrenal
cortex synthesizes
a. Glucocorticoids
427. Phosphoinositide cascade is b. Mineralocorticoids
activated on binding of c. Androgens
catecholamines to d. Estrogen and progesterone
a. Α2-Adrenergic receptors
b. α1-Adrenergic receptors
c. β2-Adrenergic receptors 432. Cortisol is a
d. β1-Adrenergic receptors a. Glucocorticoid
b. Mineralocorticoid
c. Androgen
428. Epinephrine decreases d. Estrogen
a. Glycogenesis
b. Glycogenolysis
c. Gluconeogenesis 433. The major mineralcorticoid
d. Lipolysis is
a. Hydrocortisone
b. Aldosterone
429. Epinephrine increases all of c. Aldactone A
the following except d. Androstenedione
a. Glycogenolysis in muscles
b. Lipolysis in adipose tissue
c. Gluconeogenesis in muscles 434. Steroid hormones are
d. Glucagon secretion synthesised in all of the
following except
a. Testes
b. Ovaries
c. Adrenal medulla
d. Adrenal cortex
435. Steroid hormones are 439. Excessive secretion of
synthesised from glucocorticoids raises blood
a. Cholesterol glucose by
b. 7-Dehydrocholesterol a. Decreasing glycogenesis
c. Calcitriol b. Increasing glycogenolysis
d. 7-Hydroxycholesterol c. Increasing gluconeogenesis
d. Inhibiting HMP shunt

436. The second messenger for

glucocorticoids is 440. Mineralcorticoids regulate
a. Cyclic AMP the metabolism of all of the
b. Cyclic GMP following except
c. Inositol triphosphate a. Sodium
d. No second messenger is required b. Potassium
c. Calcium
d. Chloride
437. Glucocorticoids increase the
synthesis of all of the following
except 441. Mineralocorticoids increase
a. Glucokinase the tubular reabsorption of
b. Glucose-6-phosphatase a. Sodium and calcium
c. Fructose-1, 6-biphosphatase b. Sodium and potassium
d. Pyruvate carboxylase c. Sodium and chloride
d. Potassium and chloride

438. Secretion of glucocorticoida

is regulated by all the following 442. Mineralocorticoids increase
except the tubular secretion of
a. Hypothalamus a. Sodium
b. Anterior pituitary b. Potassium
c. Feedback control by blood c. Chloride
glucose d. Bicarbonate
d. Feedback control by
glucocorticoids
443. Secretion of 448. Activation of IRS-1, PI-3
mineralcorticoids is increased kinase and GRB2 is brought
by about by
a. ACTH a. Glucagon
b. Angiotensin b. Insulin
c. Hypokalaemia c. Prolactin
d. Hypernatraemia d. IGF-2

444. In Addison’s disease, there 449. The protein IRS-1 is

is excessive retention of phosphorylated by
a. Potassium a. Protein kinase A
b. Sodium b. Protein kinase C
c. Chloride c. Tyrosine kinase activity
d. Water of insulin receptor
d. Tyrosine kinase activity
of IGF-1 receptor
445. Secretion of androgens is
increased by
a. LH 450. Activated phospholipase C
b. FSH acts on
c. ACTH a. Phosphatidyl inositol-4,
d. Growth hormone 5-biphosphate
b. Inositol-1, 4, 5-
triphosphate
446. Vasoconstrictor effect of c. Protein kinase C
ADH is mediated by d. Pl-3 kinase
a. cAMP
b. cGMP
c. Protein kinase C 451. Radioactive iodine uptake by
d. Angiotensin II thyroid gland is increased in
a. Endemic goitre
b. Hyperthyroidism
447. Urinary excretion of vanillyl c. Myxoedema
madelic acid is increased in d. Cretinism
a. Phaeochromocytoma
b. Cushing’s syndrome
c. Carcinoid syndrome
d. Aldosteronism
452. Administration of TSH 456. The most potent hormone
increases serum and T4 in concerned with the retention of
a. Hyperthyroidism of pituitary sodium in the body is
origin a. Cortisone
b. Hyperthyroidism of thyroid b. Aldosterone
origin c. Corticosterone
c. Hypothyroidism of pituitary d. Cortisol
origin
d. Hypothyroidism of thyroid origin
457. Retention of sodium in the
body leads to a retention of
453. High level of T3 and T4 and a. Potassium
low TSH in serum indicates b. Water
a. Hyperthyroidism of pituitary c. Potassium and water
origin d. Neither potassium nor water
b. Hypothyroidism of pituitary
origin
c. Hyperthyroidism of thyroid 458. There is polyuria without
origin glycosuria in this disorder
d. Hypothyroidism of thyroid origin a. Diabetes insipidus
b. Diabetes millitus
c. Bronze diabetes
454. BMR is increased in d. Juvenile diabetes
a. Endemic goitre
b. Thyrotoxicosis
c. Myxoedema 459. In hyperparathyroidism
d. Cretinism there is
a. Hypocalcemia
b. Hypophophatemia
455. The second messenger for c. Hypokalemia
many hormones is d. Hyperkalemia
a. ATP
b. cyclic AMP
c. cGMP 460. This pancreatic hormone
d. UTP increases the blood-sugar level:
a. Insulin
b. Glucagon
c. Pancreozymin
d. Pancreatic polypeptide
461. T3 is 465. The blood sugar raising
a. Thyroxine action of the hormone of
b. Triodo thyronine suprarenal cortex is due to
c. Triodo tyrosine a. Gluconeogenesis
d. Reverse tri-iodo thyronine b. Glycogenolysis
c. Glucagon like activity
d. due to inhibition of glomerular
462. Which of the following filtration of glucose
hormone does not activate
adenylate cyclase?
a. Epinephrine 466. Hyper insulinism can cause
b. Glucagon coma since
c. Parathyroid hormone a. The chief nutrient for the brain
d. Insulin is glucose
b. The chief nutrient for the heart
is glucose
463. Pheochromacytoma is a c. The glucostatic role of the liver
tumor of is damaged
a. adrenal medulla d. The kidneys are damaged
b. bone
c. head of Pancreas
d. pituitary 467. Vasopressin is also known as
a. Antidiabetogenic hormone
b. Antidiuretic hormone
464. Which one of the following c. Somatotropic hormone
statements is incorrect? d. Pitoxin
a. Insulin increases glucose
phosphorylation
b. Insulin increases glycolysis 468. Which of the following is
c. Insulin augments HMP shunt used for inducin labour?
d. Insulin promotes gluconeogenesis a. Prostaglandins
b. Prostacyclins
c. Vasopressin
d. Thromboxanes
469. Which is incorrect? 473. Which one of the following
Epinephrin promotes the is not a symptom of cushing’s
glycogenolysis in disease?
a. Muscle a. Hyperglycemia
b. Liver b. Hypernatremia
c. Heart c. Hirsutism
d. None of these d. Hyperkalemia

470. Which of one of the 474. Insulin increases the

following is released by permeability of glucose across
hypothalamus? the plasma membrane of muscle
a. Somatostatin cells by
b. Somatotropic hormone a. Acting on adenylate cycle
c. Somato medin C b. By loosening the integrity of the
d. Luteinising hormone membrane
c. Through Ca 2+ions
d. By membrane cruting the hexose
471. Which of the following carries of intracellular organelles
hormone is not under the and making them fuse with the
control of ACTH? plasma membrane
a. Aldosterone
b. Cortisol
c. Corticosterone 475. Somatostatin is produced by
d. Deoxycorticosterone a. Hypothalamus
b. Pancreas
c. Hypothalamus and pancreas
472. Prolactin release inhibiting d. Hypothalamus and Adrenals
hormone is believed to be
a. Serotonin
b. Norepinephrine 476. It is unique that the
c. Dopamine following single antidiabetogenic
d. Acetyl choline hormone effectively counter
acts the several
diabetogenic hormones:
a. Glucagon
b. Glucocorticoids
b. Insulin
c. Growth hormone
477. Which of the following 480. Insulin regulates fatty acid
statements is correct? synthesis by
a. Thyroxine inhibits utilization of
glucose a. Dephosphorylating of acetyl CoA
b. Insulin increases utilization of carboxylase
glucose b. Activating phosphorylase
c. Glucagon promotes muscle c. Inhibiting malonyl CoA formation
glycogenolysis d. Controlling carnitine-Acyl CoA
d. Insulin inhibits lipogenesis from transferase activity
carbohydrates

481. TSH hormone biochemically

478. Which of the following is is a
noted in cushing’s syndrome, a
tumor associated disease of the a. Protein
adrenal cortex? b. Fat
a. Decreased production of c. Glycoprotein
epinephrine d. Carbohydrate
b. Excessive production of
epinephrine
c. Excessive production of
vasopressin
d. Excessive production of cortisol

479. Increased reabsorption of

water from the kidney is the
major consequence of which of
the following hormones?

a. Cortisol
b. Insulin
c. Vasopressin
d. Aldosterone
Answers: 33. D 66. D
34. C 67. A
1. A
35. D 68. D
2. B
36. A 69. A
3. A
37. D 70. A
4. E
38. A 71. A
5. B
39. D 72. C
6. B
40. A 73. D
7. E
41. D 74. D
8. B
42. D 75. D
9. C
43. A 76. B
10. B
44. C 77. C
11. D
45. C 78. D
12. D
46. D 79. D
13. E
47. B 80. A
14. C
48. A 81. D
15. D
49. D 82. D
16. D
50. A 83. C
17. D
51. C 84. C
18. A
52. D 85. D
19. A
53. C 86. A
20. D
54. A 87. D
21. D
55. D 88. A
22. D
56. C 89. B
23. B
57. A 90. C
24. C
58. A 91. A
25. B
59. C 92. D
26. C
60. D 93. A
27. B
61. A 94. C
28. C
62. D 95. B
29. D
63. C 96. A
30. B
64. C 97. B
31. B
65. D 98. C
32. B
99. D 136. b 174. b
100. C 137. c 175. d
101. D 138. a 176. b
139. c 177. d
102. D
140. a 178. c
103. D
141. c 179. c
104. A 142. b 180. b
105. A 143. b 181. a
106. A 144. c 182. b
107. A 145. c 183. d
108. D 146. a 184. d
109. A 147. b 185. c
110. C 148. a 186. c
111. A 149. d 187. d
112. C 150. e 188. b
113. B 151. a 189. c
114. B 152. d 190. b
115. A 153. c 191. c
116. A 154. c 192. a
117. E 155. a 193. a
118. D 156. b 194. c
119. A 157. b 195. a
120. b 158. a 196. d
121. a 159. a 197. c
122. a 160. b 198. d
123. a 161. b 199. d
124. b 162. a 200. b
125. b 163. a 201. c
126. a 164. a 202. a
127. a 165. b 203. a
128. b 166. d 204. c
129. c 167. c 205. d
130. a 168. b 206. d
131. a 169. b 207. a
132. c 170. a 208. d
133. c 171. c 209. c
134. a 172. d 210. a
135. c 173. d 211. a
212. c 250. b 288. a
213. d 251. a 289. b
214. c 252. c 290. b
215. a 253. d 291. b
216. a 254. a 292. b
217. a 255. b 293. d
218. c 256. c 294. a
219. b 257. a 295. a
220. d 258. b 296. c
221. b 259. a 297. d
222. a 260. c 298. c
223. a 261. b 299. d
224. d 262. b 300. b
225. c 263. b 301. a
226. b 264. b 302. a
227. d 265. a 303. d
228. a 266. c 304. b
229. a 267. b 305. b
230. d 268. b 306. c
231. c 269. d 307. d
232. a 270. a 308. d
233. a 271. d 309. b
234. b 272. a 310. d
235. a 273. a 311. b
236. c 274. b 312. d
237. c 275. a
238. b 276. b
239. a 277. a 313. b
240. b 278. a 314. a
241. c 279. c 315. a
242. b 280. d 316. a
243. d 281. d 317. b
244. a 282. a 318. b
245. c 283. c 319. a
246. c 284. b 320. a
247. c 285. d 321. b
248. c 286. c 322. c
249. b 287. a 323. a
324. a 362. b 399. D
325. c 363. a 400. A
326. c 364. c 401. D
327. a 365. d
402. C
328. c 366. d
403. A
329. b 367. b
330. c 368. d 404. A
331. a 369. b 405. C
332. c 370. d 406. D
333. a 371. c 407. C
334. c 372. c 408. A
335. b 373. b
409. A
336. b 374. a
337. c 375. b 410. A
338. c 376. d 411. C
339. a 377. d 412. B
340. b 378. c 413. D
341. a 379. c 414. B
342. d 380. d
415. A
343. e 381. b
416. A
344. a 382. c
345. d 383. b 417. D
346. c 384. c 418. C
347. c 385. a 419. B
348. a 386. a 420. D
349. b 387. c 421. A
350. b 388. a
422. A
351. a 389. d
423. D
352. a 390. c
353. b 391. d 424. C
354. b 392. d 425. A
355. a 393. B 426. A
356. a 394. C 427. B
357. a 395. A 428. A
358. b
396. A 429. C
359. d
397. C 430. C
360. c
361. b 398. D 431. B
432. A 465. A
433. B 466. A
434. C 467. B
435. B 468. A
436. D 469. B
437. A 470. A
438. C 471. A
439. C 472. C
440. C 473. D
441. C 474. D
442. B 475. A
443. B 476. C
444. A 477. B
445. C 478. D
446. D 479. C
447. A 480. A
448. B 481. A
449. C
450. A
451. B
452. A
453. C
454. B
455. B
456. B
457. B
458. A
459. C
460. B
461. B
462. D
463. A
464. D
 Cases:

1. A 41-year-old woman with a history of rheumatoid arthritis presents with

increasing weakness and cold intolerance. Physical examination finds a goiter,
and laboratory evaluation finds her thyroid function tests to be consistent with
primary hypothyroidism. Which of the following histologic findings is most
consistent with a diagnosis of Hashimoto thyroiditis in this individual?
A. Amyloid deposition
B. Granulomatous inflammation
C. Lymphoid infiltrate with Hürthle cells
D. Parafollicular hyperplasia
E. Scalloping of colloid

2. A 35-year-old woman presents with increasing fatigue, slight weight gain, and a
low-grade fever. Approximately 3 weeks before developing these symptoms she
had a 4-day upper respiratory viral infection. At present a physical examination
finds a tender enlarged thyroid gland. If a biopsy specimen reveals
granulomatous inflammation with giant cells, which of the following is the
correct diagnosis?
A. De Quervain thyroiditis
B. Graves disease
C. Hashimoto thyroiditis
D. Plummer disease
E. Schmidt syndrome

3. The clinical combination of hyperthyroidism, exophthalmos, and pretibial

myxedema is most likely t be seen in an individual with which of the following
types of autoantibodies?
A. Antimitochondrial antibodies
B. Antineutrophil cytoplasmic antibodies
C. Antismooth muscle antibodies
D. TSH-receptor-blocking antibodies
E. TSH-receptor-stimulating antibodies
4. A 34-year-old woman presents with recurrent episodes of severe headaches,
palpitations, tachycardia, and sweating. Her blood pressure is found to be
elevated during one of those episodes. Which of the following is the most
common primary site for the origin of a tumor that could produce this
constellation of clinical signs and symptoms?
A. Anterior portion of the pituitary gland
B. Interstitium of the thyroid gland
C. Medulla of the adrenal gland
D. Superior portion of the hypothalamus
E. White pulp of the spleen

5. An individual with a pheochromocytoma who has recurrent symptoms most likely

would have elevated 24-hour urinary levels of which of the following
substances?
A. Aminolevulinic acid
B. Homogentisic acid
C. Methylmalonic acid
D. Orotic acid
E. Vanillylmandelic acid

6. A 13-month-old female infant who presented with an enlarging abdominal mass

is found to have elevated urinary levels of metanephrine. The mass is resected
surgically, and histologic sections reveal that mass is composed of numerous
proliferating small “blue” cells. Occasional Homer-Wright rosettes are
identified. Which of the following is the most likely diagnosis?
A. Hepatoblastoma
B. Medulloblastoma
C. Nephroblastoma
D. Neuroblastoma
E. Pheoblastoma

7. Which of the following statements best describes the pathomechanism involved

in producing secondary hyperparathyroidism in an individual with chronic renal
failure?
A. Decreased PTH levels increase serum calcium.
B. Elevated serum phosphorus levels increase PTH levels.
C. Increased PTH levels decrease serum calcium.
D. Loss of calcium increases PTH levels.
 E. Retention of calcium increases PTH levels.
8. Which of the following enzymes is necessary for the final biochemical reaction
involved in the activation of vitamin D?
A. 1-α-Hydroxylase in the kidney
B. 7-α-Hydroxylase in the liver
C. 17-Hydroxylase in the adrenal cortex
D. 11-Hydroxylase in the adrenal cortex
E. 25-Hydroxylase in the skin

9. A 67-year-old man visits his primary care physician because of headaches,

weakness, and an increase in hat and glove size. Blood pressure is determined to
be elevated. The workup reveals a tumor originating within the pituitary gland.
This tumor is most likely secreting which of the following substances?
A. Adrenocorticotropic hormone (ACTH)
B. Antidiuretic hormone (ADH)
C. Growth hormone (GH)
D. Prolactin
E. Thyroid-stimulating hormone (TSH)

10. The inability to lactate after delivery and prolonged amenorrhea due to
gonadotrophin deficiency are classic signs of which of the following
abnormalities?
A. Acromegaly
B. Diabetes insipidus
C. Hyperprolactinemia
D. Kallmann syndrome
E. Sheehan syndrome

11. A 22-year-old woman is discovered to have a nontender thyroid nodule that is

found to be a cold nodule on a radioisotope scan. The pathology report from a
fine needle aspiration of the nodule describes a follicular neoplasm, the
differential of which includes a benign follicular adenoma and a malignant
follicular carcinoma. Which is the single best histologic criterion to
differentiate between these two neoplasms?
A. Hyperplasia of follicles
B. Inspissation of colloid
C. Invasion into vessels
 D. Number of mitoses
E. Presence of atypia

12. A 23-year-old man is being evaluated for the new development of a nodule in his
neck. Physical examination finds a 3.5-cm thyroid [Link] lesion is removed
surgically, and histologic sections reveal groups of poorly differentiated tumors
cells within a stroma with large areas of amyloid. So its probably ...
A. Papillary carcinoma.
B. Medullary carcinoma.
C. Follicular carcinoma.
D. Adenoma.

13. A 41-year-old woman presents to her primary care physician with weight and
hair loss, diarrhea, nervousness, and eye pressure. She has no medical problems,
but some of her family members have similar symptoms and require medication.
On examination, she is noted to have exophthalmos, an enlarged nontender
goiter, hyperreflexia, and a tremor when her arms are outstretched. The
patient has a decreased thyroid-stimulating hormone (TSH) level and an
increased free thyroxine (T) level is diagnosed with Graves disease
(hyperthyroidism).
A. What will be the effect of high levels of I?
B. How does propylthiouracil (PTU) inhibit thyroid synthesis?

14. A 33-year-old chemist takes L-thyroxine (Synthroid) 1 μg orally each day. He

asks how the thyroxine works on a cellular level. Which of the following is the
best explanation?
A. It binds onto membrane surface receptor and activates protein
synthesis.
B. It binds onto membrane surface receptor and activates a secondary
messenger.
C. It binds onto a nuclear receptor to affect transcription.
D. It has a direct effect on the hypothalamic nuclei affecting metabolism.

15. A 36-year-old woman presents to her gynecologist with complaints of

amenorrhea and hirsutism. She has also noticed an increase in her weight
(especially in the trunk region) and easy fatigability. She denies any medical
 problems. Her periods were always normal until 6 months ago, and her hirsutism
has been gradual in onset. On examination, she has a very rounded hirsute face
with centripetal obesity. Her blood pressure is elevated, as is her weight
compared with previous visits. On abdominal examination, she is noted to have
striae and a male-like distribution of hair on the lower abdomen The patient
then undergoes studies that demonstrate increased cortisol production and
failure to suppress cortisol secretion normally when dexamethasone is
administered. She is diagnosed with Cushing syndrome.
A. Where in the adrenal cortex is cortisol produced?
B. How do glucocorticoids inhibit prostaglandin production?
C. Why is hyperpigmentation not found in patients with secondary
adrenocortical insufficiency?

16. Mineralocorticoids play a critical role in fluid and electrolyte balance in the
body. A normal response to aldosterone is to increase acid secretion in the
kidney. The hyperaldosteronism that occurs with some adrenal tumors has
interesting and profound effects on acid–base balance as a result of increased
renal H+ secretion. Which of the following would be the most likely result o
hyperaldosteronism?
A. Excretion of excess bicarbonate
B. Generation of metabolic alkalosis
C. Hyperkalemia caused by renal K+ resorption
D. Increased H+ resorption by renal tubular cells
E. Movement of K+ out of cells in exchange for H +

17. A 70-year-old woman is brought to the emergency department with right flank
pain, nausea vomiting, and blood in her urine. She has no fever or urinary tract
symptoms. She has recurrent kidney stones, vague abdominal pain, muscle
weakness, and atrophy. On examination, she is in moderate distress secondary
to her flank pain. She appears thin and fragile. Other than right back pain, her
physical examination is normal. Urinalysis reveals large amounts of blood but no
signs of infection. An intravenous pyelogram (IVP) is performed and reveals
numerous kidney stones. A metabolic pane shows an extremely elevated calcium
level. Further workup demonstrates that the patient has hyperparathyroidism
from a parathyroid adenoma.
A. How does parathyroid hormone (PTH) increase intestinal calcium
absorption?
 B. What effect do elevated levels of PTH have on renal phosphate
reabsorption?
C. What are three factors that increase the activity of 1 a-hydroxylase in
the kidney?

18. Parathyroid hormone plays a critical role in regulating plasma calcium levels, as
is evident in individuals with hyperparathyroidism, in which persistent
hypercalcemia is evident. Under normal conditions, low plasma calcium
stimulates PTH secretion, which in turn activates and/or inhibits calcium-
handling processes at a number of different sites. High PTH levels stimulate
and/or inhibit which of the following processes to return plasma calcium levels
toward normal?
A. Inhibit calcium secretion by the gastrointestinal tract
B. Reduce the expression of plasma calcium-binding proteins
C. Stimulate bone resorption, leading to the release of calcium into the
plasma
D. Stimulate calcium reabsorption by the renal proximal tubule
E. Stimulate the release of calcium from muscle cells

19. A 50-year-old individual is admitted to the emergency room with a fractured

tibia. The fracture occurred while this person was lifting light boxes. Bone
scans of the spine and hip reveal low bone density. Laboratory tests show low
plasma calcium, elevated PTH levels, and low vitamin D levels. The patient
indicates that she is on a balanced diet with sufficient fruits and vegetables.
However, the patient’s plasma creatinine and blood urea nitrogen (BUN) levels
are elevated markedly. Which of the following is the most likely reason for the
hypocalcemia and reduced bone mass?
A. Excessive urinary excretion of calcium
B. Impaired secretion of calcitonin
C. Low dietary calcium
D. A parathyroid gland tumor generating excessive amounts of PTH
E. Reduced renal activity of 1 α-hydroxylase activity (which con- verts the
inactive form of vitamin D to the active form)

20. A 35-year-old woman undergoes a thyroidectomy for papillary serous thyroid

cancer. The surgeon suspects that the parathyroid glands have been removed.
Which of the following findings is most likely to be seen in the patient 1 week
postoperatively?
 A. Coma
B. Constipation
C. Esophagitis
D. Muscle spasms and tetany

21. A 13-year-old boy is brought to the pediatrician by his mother because of

concerns about his growth. The patient is considerably taller than all his
classmates, has coarse facial features, and has prominent jaw. Both parents are
short in stature, and his growth is very abnormal for other family members. On
examination, the patient is noted to be extremely tall for his age with frontal
bossing, increased hand and foot size, and coarse facial features with a
prominent jaw and an enlarged tongue. His skin is noted to be oily with numerous
skin tags. After further workup is performed, the patient is diagnosed with
gigantism.
A. With what other pituitary hormone is growth hormone homologous?
B. How does somatostatin inhibit growth hormone?
C. The actions of GH are mediated in part by which of the following?
i. Insulin
ii. Somatomedins
iii. Thyroid hormone
iv. Estrogen

22. A 45-year-old woman has a cerebrovascular accident that causes necrosis of

the posterior pituitary. Which of the following effects is most likely to be
seen?
A. Inability to lactate
B. Hypothyroidism
C. Hypoglycemia
D. Hypernatremia

23. GH acts on which of the following cells to cause long bone growth?
A. Chrondrocytes
B. Osteocytes
C. Intracellular matrix
D. Lymphocytes
24. An 18-year-old female presents with increasing hair growth on her face and
chest, deepening of her voice, and acne over the past year. She has no history
of other medical problems. On examination, she has acne, abnormal male pattern
balding, and enlargement of her clitoris. The pelvic examination is normal
including the ovaries. Blood tests show that the serum testosterone levels are
normal, but that the level of dihydroepiandrostenedione sulfate, an adrenal
androgen, is markedly elevated. What is the most likely diagnosis?

25. As a surgeon about to remove the right adrenal gland, you examine the blood
supply of the right adrenal gland and observe which of the following?
A. It receives its arterial blood supply from the aorta only
B. Its central vein drains into the IVC
C. Its central vein drains into the left renal vein
D. It is in contact with the head of the pancreas
E. It lies external to the renal fascia

26. Helen Ames is a 51-year-old homemaker who experienced what she thought
were severe menopausal symptoms. These awful "attacks" were becoming more
frequent. Her heart raced and pounded; she had a throbbing headache and
visual disturbances; she felt hot, but her hands and feet were cold; and she was
nauseated sometimes to the point of vomiting. Mrs. Ames called her physician,
who agreed that the symptoms were probably menopausal and prescribed
hormone replacement therapy over the phone. Mrs. Ames took the hormones (a
combination of estrogen and progesterone), but they did not relieve her
symptoms. The attacks were occurring almost daily. She made an appointment
with her [Link] the physician's office, Mrs. Ames' blood pressure was
severely elevated at 200/110, and her heart rate was increased at 110
beats/min. To rule out a pheochromocytoma (a rare tumor of the adrenal
medulla), the physician ordered a 24-hour urine measurement of 3-methoxy-4-
hydroxymandelic acid (VMA). To his surprise, the results of the 24-hour urinary
VMA test were positive, a finding that provided nearly conclusive evidence of a
pheochromocytoma. A computerized tomographic scan confirmed that Mrs.
Ames had a 3-cm mass on her right adrenal gland. While awaiting surgery to
remove the tumor, she was given phenoxybenzamine, an (XI-adrenergic
antagonist. After an appropriate dosage of phenoxybenzamine was established,
she was also given a low dose of propranolol, a f3-adrenergic antagonist. She
was cleared for surgery when the medications had decreased her blood
pressure to 140/90.
 A. What is the relationship of the adrenal medulla to the autonomic nervous
system?
B. What hormones are secreted by a pheochromocytoma?
C. Why does an elevated urinary level of VMA (a metabolite of epinephrine
and norepinephrine) suggest the presence of a pheochromocytoma?
D. In view ofthe pathophysiology of pheochromocytoma, explain Mrs. Ames'
symptoms, specifically, her increased heart rate, pounding heart and
cold hands
E. Why are two values reported for arterial pressure, and what is the
significance of each value? Why were both the systolic and the diastolic
blood pressures elevated?
F. Is there a plausible explanation for the fact that Mrs. Ames felt hot,
even though her hands and feet were cold?

27. A 46-year-old man presents to his primary care physician with complaints of
confusion, headache, disorientation, and visual difficulties in the morning upon
awakening. He also has episodes of heart palpitations, sweating, and tremor in
the morning. All the symptoms usually resolve after he eats breakfast and do
not recur unless he skips a meal. His physical examination is completely normal.
A complete blood count is normal, and a basic metabolic panel reveals a fasting
blood sugar < 50 mg/dL. The patient denies any alcohol or drug use. The patient
subsequently is diagnosed with an insulinoma that is causing hypoglycemia. The
physician explains to the patient that the insulin secreting tumor causes a low
blood sugar, and the body increases the hormones epinephrine and cortisol to
try t elevate the blood sugar.
A. What effect does epinephrine have on pancreatic islet cells?
B. What effect does prolonged fasting have on cortisol secretion?

28. A 36-year-old female biochemist reflects on the action of insulin as she is

eating toast at breakfast. Insulin action on target cells results in which of the
following?
A. Activation of a tyrosine kinase
B. Activation of adenyl cyclase
C. Increased glucagon secretion
D. Increased gluconeogenesis

29. Glucagon action on the liver is mediated by which of the following?

A. A cell surface receptor tyrosine kinase receptor
 B. A specific G protein–coupled receptor and activation of adenyl cyclase
C. Binding to an intracellular receptor
D. Ligand binding to specific enzymes

30. An 8-year-old child is diagnosed with type I diabetes. Insulin deficiency results
in which of th following?
A. Decreased glycogenolysis
B. Decreased lipolysis
C. Increased protein synthesis
D. Ketogenesis

31. A 12-year-old boy presents to the emergency department with complaints of

weight loss, fatigue, polydipsia (excess thirst), polyphagia (excess hunger), and
polyuria (excess urination). The patient has no medical problems but there are
many family members with diabetes and hypertension. On examination, the
patient is a thin ill-appearing male in no acute distress with normal vital signs.
His examination is unremarkable. A urinalysis reveals glucosuria and a markedly
elevated serum fasting blood sugar. The patient is diagnosed with type I
diabetes mellitus (insulin-dependent), and is advised by the physician to start
insulin therapy. The patient’s parents ask whether oral agents such as
sulfonylurea tablets can be used instead of insulin.
A. What is the major factor that regulates insulin secretion?
B. What hormones do the delta cells of the pancreas produce?
C. How do sulfonylurea drugs increase insulin secretion?
D. Insulin secretion is inhibited by which of the following?
i. Glucagon
ii. Epinephrine
iii. Amino acids
iv. Glucose

32. An experimental animal is instrumented to monitor plasma glucose and insulin

levels. After a control fasting period to establish a steady state, a test
substance is administered to the animal. Shortly after the administration of
the substance, there is an increase in the plasma insulin concentration and a fall
in the plasma glucose concentration. The substance is most likely which of the
following?
A. Glucagon
B. Epinephrine
 C. A sulfonylurea compound
D. Somatostatin
E. Glucose

33. In a normal individual, the liver is the main regulator of the plasma glucose
concentration. When there is an increase in the plasma glucose concentration,
the liver extracts glucose from the blood and converts it into glycogen and, to a
lesser extent, triglycerides. When the plasma glucose concentration falls, the
liver will begin to produce glucose and release it into the blood to maintain its
concentration. In an untreated type I diabetic patient, the liver fails to extract
glucose and continues to produce glucose regardless of its plasma concentration.
Which of the following most likely contributes to this failure?
A. Increased glucokinase activity
B. Decreased phosphorylase activity
C. Increased gluconeogenesis
D. Diminished muscle protein catabolism
E. Insulin-dependent glucose transport in the liver

34. A 39-year-old female presents to the clinic for a routine health maintenance
exam. The patient reports she is feeling nervous and anxious all the time with
frequent palpitations. On further questioning she reports having diarrhea and
has been losing weight. She has also noticed a change in hair and fingernail
growth and frequently feels warm while others are cold or comfortable. She
denies any history of depression or anxiety disorder and is not taking any
medications. On examination, her heart rate is 110 beats per minute. She has a
slight tremor and has increased reflexes in al extremities. A nontender thyroid
enlargement is appreciated in the thyroid region. Her TSH level is low at 0.1
mIU/mL. The patient is told that she has an autoimmune antibody process.
A. What is the most likely diagnosis?
B. What is the biochemical mechanism for this disorder?
C. The thyroid hormones T3 and T4 bind to the thyroid hormone receptor
(THR) in the target cells. Which of the following mechanisms best
describes the role of the THR?
i. It activates adenylyl cyclase to produce cAMP.
ii. It activates the phosphoinositide cascade.
iii. It is a soluble guanylyl cyclase.
iv. It is a tyrosine kinase.
 v. It is a transcription factor.

35. A 26-year-old male presents complaining of heat intolerance, heavy sweating,

tremulousness, an feeling “jittery inside.” Physical examination reveals reddened
conjunctiva and warm and moist palms, buthethyroid gland was not visibly
enlarged. Which of the following tests would be most helpful to obtain an
accurate diagnosis?
A. Electrocardiogram
B. Free thyroxine level
C. Serum cortisol levels
D. Serum electrolytes
E. Serum glucose level

36. A 50-year-old Hispanic female presents to your clinic with complaints of

excessive thirst, fluid intake and urination. She denies any urinary tract
infection symptoms. She reports no medical problems, but has not seen a doctor
in many years. On examination she is an obese female in no acute distress. Her
physical exam is otherwise normal. The urinalysis revealed large glucose, and a
serum random blood sugar level was 320 mg/dL.
A. What is the most likely diagnosis?
B. What other organ systems can be involved with the disease?
C. What is the biochemical basis of this disease?