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Problem Set: The Endocrine System

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1.
Joe is a 22 year old male who has been training for his college swim team. To gain muscle mass, he
has taken a diet supplement for the last three months. In this time period his hands, feet and hat size
have also increased. When asked, he states that the diet supplement includes human growth
hormone (GH). Which of the following factors is most likely increased in his blood?

A. GHRH

B. IGF-1

C. Both GHRH and IGF-1

D. Neither GHRH nor IGF-1

2.
Thyroid hormones trigger their target cells response by activating:

A. cAMP second messenger pathways

B. heat shock proteins

C. DNA transcription factors

D. Ca++ channels on the cell surface

3. C?
Why is the pulsatile secretion of hypothalamus peptides critical for a normal response by the
pituitary?

A. prevents accumulation of intracellular calcium in pituitary target cells

B. increases target cell receptor number in pituitary

C. prevents down-regulation of target cell surface receptors in pituitary

D. increases synthesis of carriers for peptide hormones by the liver

4.
If a persons diet is low in iodine, predict what happens to the production of thyroid hormone (TH)
and thyroid stimulating hormone (TSH).

A. TH production increases; TSH secretion increases

B. TH production increases; TSH secretion decreases

C. TH production decreases; TSH secretion increases

D. TH production decreases; TSH secretion decreases

5.
The hormone, somatostatin, regulates which of the following?

A. insulin like growth factor 1 (IGF-1)

B. growth hormone (GH)

C. thyroid hormone

D. anti-diuretic hormone (ADH)

6.
Mary is a 22 year old graduate student. She complains of profuse sweating, increased heart rate,
and nervousness. Her basal metabolic rate is significantly elevated. Because she has decreased
levels of TSH in her blood, you suspect a primary endocrine disorder. Which of the following thyroid
hormone patterns would you expect after laboratory tests?

A. Normal T3 and T4.

B. Decreased T3 and T4.

C. Increased T3 and T4.

D. Decreased T3 and increased T4.

7.
Grave's disease is a primary endocrine pathology in which there is hypersecretion of thyroid
hormone. What is the underlying cause of this condition?

A. increased activity of the thyroid gland Na-I transporter

B. pituitary tumor that is secreting excess TRH

C. increased activity of the TSH receptor by antibodies that mimic TSH

D. pituitary tumor that is secreting thyroglobulin

8.
A 30 year old female complains of increasing fatigue and weakness. Her blood pressure is 70/45.
She appears deeply tanned even in areas not exposed to the sun. Your examination reveals low
serum Na+, low cortisol, and high ACTH levels. The most likely diagnosis of her disease is:

A. Secondary hypothyroidism

B. Primary hypothyroidism

C. Secondary ACTH insufficiency.

D. Primary adenocortical insufficiency (Addisons disease).

9.
The hypotension seen in the patient described in question 8 with low serum Na+, low cortisol, and
high ACTH levels most likely results from low circulating levels of:

A. Antidiuretic hormone

B. Growth hormone.

C. Cortisol

D. Aldosterone.

10.
Explain why the serum ACTH is elevated in the 30 year old female described in question 8?

A. absence of negative feedback to the pituitary by cortisol

B. impaired negative feedback to the hypothalamus by ACTH

C. low sodium levels in the blood stimulates ACTH secretion by the posterior pituitary

D. low blood pressure directly stimulates ACTH secretion by the heart

11.
Your examination reveals a blood pressure of 75/45, low serum Na+, low cortisol, and high ACTH
levels. Which statement most accurately describes the physiologic basis for the hypotension in this
patient?

A. Elevated plasma K+ levels because of increased ACTH secretion.

B. Low plasma Na+ levels because of increased ACTH secretion.

C. Decreased ECF because of decreased plasma aldosterone levels.

D. Increased ECF because of increased plasma aldosterone levels.

E. Elevated blood glucose because of decreased cortisol secretion.

12.
Jim had 100 mLs of blood drawn 2 hours before his 15 kilometer race on Monday. A second blood
sample was taken immediately at the end of his race. Which of the following hormones were
increased in the second blood sample?

A. epinephrine and cortisol

B. cortisol and growth hormone

C. epinephrine and growth hormone

D. epinephrine, cortisol, and growth hormone

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