2026/2027 | Complete Exam-Style Questions with
Detailed Rationales | Pass Guaranteed – A+ Graded
SECTION 1: ENDOCRINE SYSTEM (10 Questions)
Q1: A patient with a pituitary adenoma exhibits gigantism. Which hormone is most likely
being hypersecreted by the anterior pituitary?
A. Thyroid-stimulating hormone (TSH)
B. Adrenocorticotropic hormone (ACTH)
C. Growth hormone (GH) [CORRECT]
D. Follicle-stimulating hormone (FSH)
Correct Answer: C
Rationale: Correct because excess growth hormone (GH) before epiphyseal plate
closure causes gigantism; after closure, it causes acromegaly. GH stimulates bone and
tissue growth via IGF-1.
Q2: A 45-year-old female presents with fatigue, weight gain, cold intolerance, and
bradycardia. Laboratory studies reveal elevated TSH and decreased free T4. Which
endocrine disorder best matches this clinical picture?
A. Graves' disease
B. Hashimoto's thyroiditis causing primary hypothyroidism [CORRECT]
C. Thyroid storm
D. Toxic multinodular goiter
Correct Answer: B
Rationale: Correct because elevated TSH with low T4 indicates primary hypothyroidism;
the thyroid gland fails to produce T4, removing negative feedback on the pituitary.
Hashimoto's is the most common cause.
Q3: A patient with Addison's disease presents with hypotension, hyperkalemia, and
hyponatremia. Which hormone deficiency is primarily responsible for the electrolyte
abnormalities?
A. Cortisol deficiency
B. Aldosterone deficiency [CORRECT]
,C. Epinephrine deficiency
D. Androgen deficiency
Correct Answer: B
Rationale: Correct because aldosterone normally promotes Na+ reabsorption and K+
excretion in the distal convoluted tubule; its deficiency causes hyponatremia,
hyperkalemia, and volume depletion.
Q4: A diabetic patient injects rapid-acting insulin before breakfast but skips the meal.
Thirty minutes later, she becomes diaphoretic, tachycardic, and confused. Which
mechanism explains her symptoms?
A. Hyperglycemia causing osmotic diuresis
B. Insulin-induced hypoglycemia triggering sympathetic activation [CORRECT]
C. Ketoacidosis from insufficient insulin
D. Glucagon excess stimulating glycogenolysis
Correct Answer: B
Rationale: Correct because insulin promotes glucose uptake without dietary intake,
causing hypoglycemia; the sympathetic nervous system responds with epinephrine
release, producing sweating, tachycardia, and confusion.
Q5: A patient with a head injury develops diabetes insipidus. Which hormone is
deficient, and what is the primary urinary finding?
A. Aldosterone; hypernatremia with concentrated urine
B. Antidiuretic hormone (ADH); dilute polyuria [CORRECT]
C. Atrial natriuretic peptide (ANP); sodium retention
D. Oxytocin; decreased urine output
Correct Answer: B
Rationale: Correct because ADH (vasopressin) from the posterior pituitary promotes
water reabsorption in collecting ducts; deficiency prevents water reabsorption,
producing large volumes of dilute urine and polydipsia.
Q6: A 32-year-old male presents with hypertension, weight gain, moon facies, and purple
striae. Laboratory studies show elevated cortisol and suppressed ACTH. Which
diagnosis is most likely?
A. Cushing's disease (pituitary ACTH-secreting adenoma)
B. Cushing's syndrome from adrenal cortical adenoma [CORRECT]
C. Addison's disease
, D. Pheochromocytoma
Correct Answer: B
Rationale: Correct because elevated cortisol with suppressed ACTH indicates an
adrenal source (autonomous cortisol secretion) rather than pituitary-driven Cushing's
disease; the negative feedback loop suppresses hypothalamic CRH and pituitary ACTH.
Q7: A patient with hyperparathyroidism develops kidney stones and bone pain. Which
mechanism explains the bone pathology?
A. Increased osteoblast activity depositing excess calcium
B. Osteoclast activation by PTH releasing calcium from bone [CORRECT]
C. Calcitonin excess stimulating bone resorption
D. Vitamin D deficiency impairing calcium absorption
Correct Answer: B
Rationale: Correct because PTH stimulates osteoclasts to resorb bone, releasing
calcium and phosphate into blood; chronic elevation causes osteoporosis, bone pain,
and pathologic fractures.
Q8: Which second messenger system is utilized by insulin when binding to its target cell
receptor?
A. cAMP activation of protein kinase A
B. IP3/DAG release of intracellular calcium
C. Tyrosine kinase receptor autophosphorylation [CORRECT]
D. cGMP activation of protein kinase G
Correct Answer: C
Rationale: Correct because insulin binds to tyrosine kinase receptors on cell
membranes; autophosphorylation initiates a cascade that recruits GLUT4 transporters
to the membrane for glucose uptake.
Q9: A patient with a pheochromocytoma experiences episodic hypertension, sweating,
and anxiety. Which hormones are responsible for these symptoms?
A. Cortisol and aldosterone
B. Epinephrine and norepinephrine [CORRECT]
C. Insulin and glucagon
D. T3 and T4
Correct Answer: B