Physiology - Module 12 2026 Ratio

B. A tumor in the sella turcica

A 23/F patient consulted you for galactorrhea. On further work-up, the patient was found to have elevated Prolactin levels. Which of the following is the most possible explanation of her problem?

A. A tumor in the brainstem

B. A tumor in the sella turcica

C. The patient is probably pregnant

D. A milk-producing tumor in the breast

C. Failure to lactate (D. Severe water retention)

Which of the following situations suggest a production problem from the neurohypophysis?

A. Increased serum thyroxine levels

B. Increased serum glucose levels

C. Failure to lactate

D. Severe water retention

C. Tissue binding has an influence in the half-life

Which of the following is true regarding clearance of hormones?

A. Only the liver and kidneys clear the hormones out

B. The higher the half-life, the higher the excretion rate

C. Tissue binding has an influence in the half-life

D. Clearance depends primarily on production of the hormones

B. Production rate of hormones and receptors will regulate the final physiologic effect

Which of the following is true of regulation of hormone activity via the hormone-receptor complex?

A. Activating the receptor site of the hormone will halt the activity of the complex

B. Production rate of hormones and receptors will regulate the final physiologic effect

C. Sequestration of the hormone would not affect the hormone-receptor activity

D. Destruction of the complex would trigger increased physiologic hormone effect

D. Inside cytoplasm

Where is the location of the receptor of aldosterone?

A. In plasma

B. On the cell membrane

C. Inside nucleus

D. Inside cytoplasm

B. GH has direct effects on target organs

Growth Hormone (GH) is different from Adrenocorticotrophic Hormone (ACTH) in terms of their activity because:

A. GH operates by negative feedback

B. GH has direct effects on target organs

C. GH responds to its own serum levels

D. GH is regulated by the hypothalamus

B. It increases osteogenic cell amino acid uptake

Which of the following is true regarding the physiologic effects of Growth Hormone?

A. It increases muscle glucose uptake

B. It increases osteogenic cell amino acid uptake

C. It increased adipose tissue amino acid uptake

D. It increased adipose tissue glucose uptake

C. Stage II REM sleep can trigger GH secretion

Which of the following is true regarding Growth Hormone (GH) activity?

A. Two sets of 4 hour sleep has the same effect to GH as 1 set of 8-hour sleep

B. Its secretion is decreased at night time

C. Stage II REM sleep can trigger GH secretion

D. Light exercises have a profound effect on GH secretion

C. Fasting state

Which of the following triggers Growth Hormone (GH) secretion?

A. Obesity

B. Somatostatin release

C. Fasting state

D. Increased blood glucose

D. Somatomedins

Which of the following inhibits Growth Hormone (GH) secretion?

A. Stress exposure

B. Testosterone

C. Growth hormone-releasing hormone

D. Somatomedins

A. Amino Acids

Which of the following have the same effect on Growth Hormone (GH) secretion as that of insulin?

A. Amino Acids

B. Glucose

C. Free Fatty Acids

B. Decreasing

Somatostatin affects Growth Hormone (GH) by _____ its release

A. Increasing

B. Decreasing

C. No effect

D. 50%

After age 20, a normal individual would have the concentration of Growth Hormone secretion to be ____

A. 33%

B. 25%

C. 66%

D. 50%

A. Large stature

Which of the following findings of a person with Growth Hormone (GH) excess would point towards an early onset (during childhood)?

A. Large stature

B. Large facial features

C. Large extremities

D. Large tongue

C. Thyroxine

Which of the following is composed of tyrosine?

A. Cortisol

B. Norepinephrine

C. Thyroxine

D. Insulin

C. Peroxidase catalyses iodination AND coupling of iodotyrosine molecules to thyroglobulin

Which of the following is true regarding thyroid hormone synthesis?

A. Pinocytosis will release formed T3 and T4 to the bloodstream

B. Deiodination converts iodide to nascent iodine or I3-

C. Peroxidase catalyses iodination AND coupling of iodotyrosine molecules to thyroglobulin

D. Iodide ions get exchanged for sodium ions in order to trap them intracellularly by thyroid cells

A. Iodotyrosine molecules couple with thyroglobulin

Which of the following describes organification in thyroid hormone production?

A. Iodotyrosine molecules couple with thyroglobulin

B. Iodotyrosine molecules bind together to form T2, T3, or T4

C. Converts iodide to nascent iodine or I3-

D. Iodide gets trapped inside thyroid follicular cells

B. The activity of T4 is about 25% of T3

Which of the following is true regarding T3 and T4?

A. T3 usually peaks a few minutes after release from the thyroid gland

B. The activity of T4 is about 25% of T3

C. They have albumin as their main carrier

D. Majority of them are free in the plasma

C. Iodinase

Which of the following enzymes catalyse the conversion of T4 into its active form?

A. Thyroid hormone receptor

B. Peroxidase

C. Iodinase

D. Deiodinase

C. It increases hepatic glucose output

Which of the following is true of thyroid hormone effects on carbohydrate metabolism?

A. It decreases glycogenolysis

B. It antagonizes insulin effects

C. It increases hepatic glucose output

D. It stimulates glucose exit from cells

B. There is enhancement of ATP production

Which of the following reflects the effect of thyroid hormone on cellular metabolism?

A. There is endocytosis of excess Na-K ATPase pumps from the cell membrane

B. There is enhancement of ATP production

C. There are increased number of lysosomes

D. There is decreased glucose utilization intracellularly

B. Cardiac contractility is increased initially

Which of the following is true regarding thyroid hormone effects on the cardiovascular system?

A. The cardiac muscles undergoes physiologic hypertrophy

B. Cardiac contractility is increased initially

C. The left ventricle relaxes and decreases work

D. There is an increased systemic vascular resistance

C. It may not be due to thyroid hormone effects

A 25/F patient consulted you for diarrhea. On further evaluation, you noted that the patient experiences frequent bowel movements, lethargy, cold intolerance, and forgetfulness. She has no anterior neck mass. Which of the following could be causing her diarrhea?

A. Hyperthyroidism

B. Thyroid storm

C. It may not be due to thyroid hormone effects

D. Hypothyroidism

B. Alertness could be enhanced by thyroid hormone

Which of the following is true regarding the neurologic effects of thyroid hormone?

A. Difficulty in waking up could be an effect of excess thyroid hormone

B. Alertness could be enhanced by thyroid hormone

C. Insomnia is directly linked to decreased thyroid hormone activity

D. Tremors are a result of increased fatigue from insomnia

B. Thyroid hormone has a role in influencing sexual urges

Which of the following is true regarding the reproductive effects of thyroid hormone?

A. Infertility is a feature of hyperthyroidism, more than hypothyroidism

B. Thyroid hormone has a role in influencing sexual urges

C. The presence of amenorrhea differentiates the thyroid hormone abnormality of the patient

D. Abnormal menstrual bleeding usually signifies a problem other than thyroid hormone abnormalities.

A. TRH determination is insufficient in determining the location of the pathology

Which of the following is true regarding a patient with low T3 and T4 levels?

A. TRH determination is insufficient in determining the location of the pathology

B. The TSH and TRH levels will both be elevated in this case

C. TSH should be the only one in high serum concentration in all cases

D. If the TSH is low, the problem is in the thyroid gland

C. Hypocalcemia

What is the primary stimulus of Parathyroid Hormone (PTH) release?

A. Hypercalcemia

B. Hyperphosphatemia

C. Hypocalcemia

D. Hypophosphatemia

B. Bone remodeling is enhanced by PTH

Which of the following is true regarding the effects of Parathyroid Hormone (PTH)?

A. PTH activates osteoclasts only for its effect

B. Bone remodeling is enhanced by PTH

C. PTH also increases phosphorus via its effect on the intestines

D. The effect of PTH on the kidneys is coursed through Vitamin D activity

D. It is not affected by sunlight

Which type of UV light directly promotes conversion of cholecalciferol to 25-hydroxycholecalciferol via 25-hydroxylase?

A. UV-C

B. UV-A

C. UV-B

D. It is not affected by sunlight

B. Kidney

Where does the production of 24,25-dihydroxycholecalciferol occur?

A. Skin

B. Kidney

C. Intestine

D. Liver

A. Insulin

Which of the following is degraded by insulinase

A. Insulin

B. Proinsulin

C. Preproinsulin

D. C Peptide

A. No other mechanisms are available

Aside from Insulin, which of the following can considerably decrease serum glucose when the glucose levels in the blood becomes excessive?

A. No other mechanisms are available

B. Decreased gastrointestinal glucose absorption

C. Renal excretions

D. Vomiting

B. Glycogen is the source of energy on initial phases of muscle activity.

Which of the following is true regarding carbohydrate utilization in muscles?

A. Fatty acid utilization is important during intense exercise

B. Glycogen is the source of energy on initial phases of muscle activity.

C. Insulin allows glucose to be available for utilization when the muscles are at rest

D. Insulin allows entry of glucose into muscles via GLUT-3 channels

A. Glycogen phosphorylase

Which of the following is inactivated by insulin to promote gluconeogenesis?

A. Glycogen phosphorylase

B. Glycogen synthase

C. Hexokinase

D. Glucokinase

B. 30 mg/dL

Which of the following blood sugar levels would place a patient at greatest risk for neuroglycopenia?

A. 50 mg/dL

B. 30 mg/dL

C. 90 mg/dL

D. 70 mg/dL

C. The response of the brain to glucose is similar to that of the retina

Which of the following is true regarding insulin action and the brain?

A. The brain is protected from hypoglycemia up to a certain extent due to insulin effects

B. Neuroglycopenia is imminent when glucose levels reach 70 mg/dL

C. The response of the brain to glucose is similar to that of the retina

D. Insulin promotes entry of glucose via GLUT-3 channels

B. Hepatic glucose gets converted to acetyl CoA once hepatic glycogen stores reach about 5% threshold

Which of the following is true regarding insulin effects on fat metabolism?

A. Insulin activates lipoprotein lipase to break down fats when energy is needed

B. Hepatic glucose gets converted to acetyl CoA once hepatic glycogen stores reach about 5% threshold

C. Triglycerides have little role on fat metabolism

D. Lipogenesis is decreased to mobilize substrates to the liver

B. Increased Beta-oxidation

What happens when there is too little insulin circulating in the body?

A. Increased Acetyl CoA utilization

B. Increased Beta-oxidation

C. Reversal of atherosclerosis

D. Increased Lipogenesis

B. Protein structures are protected from catabolism

Which of the following is true regarding insulin effects on protein metabolism?

A. mRNA translation is decreased to conserve intracellular amino acids

B. Protein structures are protected from catabolism

C. Insulin counterbalances Growth Hormone effects on amino acid utilization

D. The uptake of cellular amino acids is decreased to make them available for protein synthesis in the liver.

B. Keeping ATP-sensitive Potassium Channels closed

Sulfonylureas promote insulin secretion by beta cells of the pancreas by:

A. Keeping Voltage-gated Calcium Channels closed

B. Keeping ATP-sensitive Potassium Channels closed

C. Keeping Voltage-gated Calcium Channels open

D. Keeping ATP-sensitive Potassium Channels open

B. GLUT2

Which of the following glucose transport channels allow beta cells to auto-regulate insulin secretion?

A. GLUT3

B. GLUT2

C. GLUT1

D. GLUT4

C. Obesity (D. Increased parasympathetic activity)

Which of the following increases insulin secretion?

A. Decreased beta-adrenergic stimulation

B. Decreased glucagon levels

C. Obesity

D. Increased parasympathetic activity

A. Alpha-adrenergic activity

Somatostatin has the same effect on insulin secretion as:

A. Alpha-adrenergic activity

B. Beta-adrenergic activity

C. Glucagon

D. Incretins

A. Glycogenolysis

What is glucagon’s most dramatic effect on glucose metabolism?

A. Glycogenolysis

B. Gluconeogenesis

C. Lipolysis

D. Glycolysis

D. Normal

A 30-year-old pregnant woman on her 27th week age of gestation underwent a 75g oral glucose tolerance test. The results are: Fasting – 90 mg/dL, 1st hour – 155 mg/dL, 2nd hour 150 mg/dL. What is her diagnosis?

A. Gestational diabetes mellitus

B. Prediabetes

C. Type 2 diabetes mellitus

D. Normal

A. Zona fasciculata

Which of the following layers of the adrenal cortex predominantly produces corticosterone?

A. Zona fasciculata

B. Adrenal medulla

C. Zona reticularis

D. Zona glomerulosa

C. 21-alpha-hydroxylase

Which of the four enzymes facilitate both aldosterone and cortisol production in the adrenal gland?

A. 17,20 lyase

B. 17-alpha-hydroxylase

C. 21-alpha-hydroxylase

D. 17-beta-hydroxysteroid dehydrogenase

C. Both aldosterone and cortisol

A newborn with a congenital deficiency of 11-beta-hydroxylase would need supplementation of:

A. Cortisol only

B. Aldosterone only

C. Both aldosterone and cortisol

D. Neither aldosterone and cortisol

D. It will result in ambiguous genitalia in males

Which of the following is true of 17,20 lyase activity deficiency in steroidogenesis?

A. It will result in increased ACTH secretion

B. It will result in glucocorticoid deficiency

C. It will result in mineralocorticoid deficiency

D. It will result in ambiguous genitalia in males

A. Pregnenolone

For steroidogenesis to go smoothly, which of the following molecule should be present on all zones of the adrenal cortex?

A. Pregnenolone

B. Cyclopentanoperhydropenanthrene

C. Cholesterol

D. Progesterone

A. Fludrocortisone

Which of the following is a synthetic mineralocorticoid?

A. Fludrocortisone

B. Cortisol

C. Deoxycorticosterone

D. Corticosterone

E. Cortisone

D. It causes significant vasoconstriction

Which of the following is true of the adrenergic hormone NOREPINEPHRINE?

A. It has the same activity as epinephrine

B. It stimulates bronchodilation

C. It induces significant palpitations

D. It causes significant vasoconstriction

B. It causes a decline in cell membrane GLUT 4

Which of the following is true of glucocorticoid activity?

A. Its effect on glucose utilization is well understood and its mechanisms mapped out

B. It causes a decline in cell membrane GLUT 4

C. It decreases glucose utilization by increases signaling cascade

D. It decreases conversion of amino acid to glucose to make it available in plasma.

D. Cellular proteins

Glucocorticoids reduce which of the following proteins?

A. Liver proteins

B. Plasma proteins

C. It does not decrease proteins

D. Cellular proteins

B. The cellular lysosomes are more stable with the treatment

A 24/F was given glucocorticoids as treatment for her Rheumatoid Arthritis. Which of the following are true in her case?

A. Phagocytosis by white blood cells increases to reduce joint swelling

B. The cellular lysosomes are more stable with the treatment

C. It prevents immunosuppression to fight the illness

D. Her treatment increases capillary permeability

A. Morning

It is recommended that you mimic the physiologic fluctuations in serum glucocorticoid levels when you give oral glucocorticoid treatment. This would mean that it should be given in the

A. Morning

B. Evening

C. Midnight

D. Afternoon

D. All of the choices are correct

If cortisol is in abnormally high concentrations in the body, which of the following physiologic effects could be seen in the patient?

A. Increased blood pressure

B. Increased blood glucose

C. Immunosuppression

D. All of the choices are correct

D. Pituitary gland tumor

A 27/M patient consulted your clinic for high blood pressure. On further history and physical examination, you found that his blood pressure is 180/110 despite having 3 medications for hypertension. You noticed that he also has truncal obesity, buffalo hump, and hyperpigmentation of certain parts of his body. Which of the following could best explain his signs and symptoms?

A. Adrenal gland tumor

B. Increased oral steroid use

C. Diabetes

D. Pituitary gland tumor

A. Inhaled steroids are better since they help avoid dangerous physiologic effects from excessive glucocorticoid exposure

A 32/F consulted your clinic for bronchial asthma management. She said she is unable to use her inhaled glucocorticoids because it’s too technical for her. She asked if she could take oral systemic steroids instead. Which of the following advice for her is correct?

A. Inhaled steroids are better since they help avoid dangerous physiologic effects from excessive glucocorticoid exposure

B. The effect of oral steroids is similar to inhaled steroids, so it is acceptable to take the former instead

C. Inhaled steroids provide greater anti-inflammatory effects than oral steroids so she should stick to the inhaler

D. Oral steroids are more effective in suppressing bronchial inflammation, so they are actually better to use than inhaled forms

C. Osteoporosis

Which of the following is a result of excessive glucocorticoid exposure RATHER THAN mineralocorticoid excess?

A. High blood pressure

B. Palpitations

C. Osteoporosis

D. Hypernatremia