1
ANP 1106 Human Anatomy and
Physiology II Midterm 1 Midterm 2 Final
Bundled Exam Actual Exam 2026/2027
with Detailed Rationales | Complete
Exam-Style Questions | Pass Guaranteed
– A+ Graded
TABLE OF CONTENTS
Section 1 | The Endocrine System | Q1 – Q10
Section 2 | Cardiovascular System — Blood & Heart | Q11 – Q20
Section 3 | Cardiovascular System — Blood Vessels & Circulation | Q21
– Q27
Section 4 | Respiratory, Digestive, and Renal Systems | Q28 – Q37
Section 5 | Reproductive Systems & Integrated Case Analysis | Q38 –
Q50
Instructions: Choose the single best answer unless otherwise indicated.
Pass: 40/50 in 90 minutes.
══════════════════════════════════════
SECTION 1: THE ENDOCRINE SYSTEM Q1 – Q10
══════════════════════════════════════
,2
Question 1 of 50
A 34-year-old woman presents to her primary care provider with fatigue,
weight gain despite decreased appetite, cold intolerance, dry skin, and
constipation. Laboratory testing reveals elevated TSH levels and low
free T4. Her symptoms began gradually over several months following a
viral illness.
A. Primary hypothyroidism caused by autoimmune destruction of
thyroid tissue, resulting in decreased negative feedback on the anterior
pituitary and compensatory TSH elevation
B. Secondary hypothyroidism due to hypothalamic dysfunction causing
inadequate TRH stimulation of the anterior pituitary gland
C. Tertiary hypothyroidism resulting from pituitary adenoma
compression leading to isolated TSH deficiency
D. Euthyroid sick syndrome where peripheral conversion of T4 to T3 is
impaired during chronic illness without true thyroid dysfunction ✓
CORRECT
Correct Answer: A
Rationale: In primary hypothyroidism, the thyroid gland itself is
dysfunctional (often due to Hashimoto's thyroiditis), producing
insufficient T4 and T3. The resulting loss of negative feedback causes
the anterior pituitary to secrete excess TSH in a futile attempt to
stimulate thyroid hormone production. Choice D describes a different
clinical picture where TSH would typically be normal or low, not
elevated as seen here.
,3
Question 2 of 50
During a physiology laboratory session, students are analyzing a patient
with an ACTH-secreting pituitary adenoma. The patient demonstrates
central obesity, moon facies, buffalo hump, thin skin with easy bruising,
hypertension, and hyperglycemia. Serum cortisol remains elevated even
after administration of high-dose dexamethasone.
A. Cushing disease caused by an anterior pituitary tumor secreting
excess ACTH, which stimulates adrenal cortical hyperplasia and cortisol
overproduction ✓ CORRECT
B. Cushing syndrome due to an adrenal cortical adenoma autonomously
secreting cortisol independent of ACTH regulation
C. Ectopic ACTH syndrome from a small cell lung carcinoma producing
paraneoplastic ACTH secretion
D. Pseudo-Cushing state secondary to chronic alcoholism or major
depressive disorder causing HPA axis hyperactivity
Correct Answer: A
Rationale: The key diagnostic feature is that high-dose dexamethasone
fails to suppress cortisol production, indicating the source is pituitary
(which is partially resistant to suppression) rather than adrenal or ectopic
sources (which would show no suppression at any dose). Choice B
would show suppressed ACTH levels since the adrenal tumor provides
negative feedback independent of pituitary control.
, 4
Question 3 of 50
A 28-year-old male athlete presents after collapsing during a marathon
on a hot day. He is disoriented, has weak rapid pulse, and laboratory
findings reveal serum sodium of 128 mEq/L, serum osmolarity of 265
mOsm/kg, and urine osmolarity of 150 mOsm/kg (inappropriately
dilute). He reports drinking large amounts of plain water throughout the
race.
A. Diabetes insipidus characterized by inability to concentrate urine due
to ADH deficiency or renal resistance, causing polyuria and polydipsia
B. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
causing water retention, dilutional hyponatremia, and inappropriately
concentrated urine
C. Primary aldosteronism (Conn's syndrome) causing sodium retention,
potassium wasting, and hypertension through excessive
mineralocorticoid activity
D. Exercise-associated hyponatremia from excessive hypotonic fluid
intake suppressing ADH release and overwhelming renal excretory
capacity ✓ CORRECT
Correct Answer: D
Rationale: This athlete developed hyponatremia from consuming free
water far exceeding renal and insensible losses, diluting serum sodium.
The inappropriately dilute urine (150 mOsm/kg) indicates ADH was
appropriately suppressed by hypo-osmolality, but water intake simply
overwhelmed excretion capacity. Choice B (SIADH) would present with
ANP 1106 Human Anatomy and
Physiology II Midterm 1 Midterm 2 Final
Bundled Exam Actual Exam 2026/2027
with Detailed Rationales | Complete
Exam-Style Questions | Pass Guaranteed
– A+ Graded
TABLE OF CONTENTS
Section 1 | The Endocrine System | Q1 – Q10
Section 2 | Cardiovascular System — Blood & Heart | Q11 – Q20
Section 3 | Cardiovascular System — Blood Vessels & Circulation | Q21
– Q27
Section 4 | Respiratory, Digestive, and Renal Systems | Q28 – Q37
Section 5 | Reproductive Systems & Integrated Case Analysis | Q38 –
Q50
Instructions: Choose the single best answer unless otherwise indicated.
Pass: 40/50 in 90 minutes.
══════════════════════════════════════
SECTION 1: THE ENDOCRINE SYSTEM Q1 – Q10
══════════════════════════════════════
,2
Question 1 of 50
A 34-year-old woman presents to her primary care provider with fatigue,
weight gain despite decreased appetite, cold intolerance, dry skin, and
constipation. Laboratory testing reveals elevated TSH levels and low
free T4. Her symptoms began gradually over several months following a
viral illness.
A. Primary hypothyroidism caused by autoimmune destruction of
thyroid tissue, resulting in decreased negative feedback on the anterior
pituitary and compensatory TSH elevation
B. Secondary hypothyroidism due to hypothalamic dysfunction causing
inadequate TRH stimulation of the anterior pituitary gland
C. Tertiary hypothyroidism resulting from pituitary adenoma
compression leading to isolated TSH deficiency
D. Euthyroid sick syndrome where peripheral conversion of T4 to T3 is
impaired during chronic illness without true thyroid dysfunction ✓
CORRECT
Correct Answer: A
Rationale: In primary hypothyroidism, the thyroid gland itself is
dysfunctional (often due to Hashimoto's thyroiditis), producing
insufficient T4 and T3. The resulting loss of negative feedback causes
the anterior pituitary to secrete excess TSH in a futile attempt to
stimulate thyroid hormone production. Choice D describes a different
clinical picture where TSH would typically be normal or low, not
elevated as seen here.
,3
Question 2 of 50
During a physiology laboratory session, students are analyzing a patient
with an ACTH-secreting pituitary adenoma. The patient demonstrates
central obesity, moon facies, buffalo hump, thin skin with easy bruising,
hypertension, and hyperglycemia. Serum cortisol remains elevated even
after administration of high-dose dexamethasone.
A. Cushing disease caused by an anterior pituitary tumor secreting
excess ACTH, which stimulates adrenal cortical hyperplasia and cortisol
overproduction ✓ CORRECT
B. Cushing syndrome due to an adrenal cortical adenoma autonomously
secreting cortisol independent of ACTH regulation
C. Ectopic ACTH syndrome from a small cell lung carcinoma producing
paraneoplastic ACTH secretion
D. Pseudo-Cushing state secondary to chronic alcoholism or major
depressive disorder causing HPA axis hyperactivity
Correct Answer: A
Rationale: The key diagnostic feature is that high-dose dexamethasone
fails to suppress cortisol production, indicating the source is pituitary
(which is partially resistant to suppression) rather than adrenal or ectopic
sources (which would show no suppression at any dose). Choice B
would show suppressed ACTH levels since the adrenal tumor provides
negative feedback independent of pituitary control.
, 4
Question 3 of 50
A 28-year-old male athlete presents after collapsing during a marathon
on a hot day. He is disoriented, has weak rapid pulse, and laboratory
findings reveal serum sodium of 128 mEq/L, serum osmolarity of 265
mOsm/kg, and urine osmolarity of 150 mOsm/kg (inappropriately
dilute). He reports drinking large amounts of plain water throughout the
race.
A. Diabetes insipidus characterized by inability to concentrate urine due
to ADH deficiency or renal resistance, causing polyuria and polydipsia
B. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
causing water retention, dilutional hyponatremia, and inappropriately
concentrated urine
C. Primary aldosteronism (Conn's syndrome) causing sodium retention,
potassium wasting, and hypertension through excessive
mineralocorticoid activity
D. Exercise-associated hyponatremia from excessive hypotonic fluid
intake suppressing ADH release and overwhelming renal excretory
capacity ✓ CORRECT
Correct Answer: D
Rationale: This athlete developed hyponatremia from consuming free
water far exceeding renal and insensible losses, diluting serum sodium.
The inappropriately dilute urine (150 mOsm/kg) indicates ADH was
appropriately suppressed by hypo-osmolality, but water intake simply
overwhelmed excretion capacity. Choice B (SIADH) would present with
