Chapter 1
EASY QUESTIONS
Question 1
Case Scenario:
A first-year pharmacy student is revising the basic mechanisms of hormonal signaling. The
student reads that certain hormones cannot pass through the plasma membrane due to
their polarity and instead act on surface receptors.
Lead In:
Which of the following best describes the nature of peptide hormones in terms of their
mechanism of action?
A. They freely diffuse into the cell and bind to nuclear receptors
B. They require transport proteins to enter the nucleus
C. They bind to cell surface receptors like GPCR or RTK
D. They are stored in lipid droplets before release
E. They always act via transcriptional repressors
Correct Answer: C
Peptide hormones are hydrophilic and bind to extracellular receptors such as GPCRs and
RTKs to mediate their effects.
Question 2
Case Scenario:
A patient is diagnosed with hyperglycemia. The endocrinologist explains that a certain
pancreatic hormone is primarily responsible for reducing blood glucose levels by enhancing
cellular uptake.
Lead In:
Which hormone is primarily responsible for regulating plasma glucose concentration?
A. Cortisol
B. Vasopressin
C. Insulin
D. Thyroid hormone
E. Parathyroid hormone
Correct Answer: C
Insulin, secreted from β-cells in the pancreas, reduces blood glucose levels and maintains
homeostasis.
MEDIUM QUESTIONS
Question 3
Case Scenario:
A pharmacology researcher is studying different hormone secretion pathways. They
discover that some hormones are not stored but synthesized and secreted as needed in
response to enzymatic signals.
Lead In:
Which of the following is a TRUE statement regarding steroid hormone secretion?
A. They are released in vesicles upon stimulation by peptide-releasing factors
B. They are stored in granules and released via exocytosis
C. Their secretion is regulated by neurotransmitter-mediated depolarization
D. They are synthesized and released on demand via diffusion
E. Their β-subunit determines receptor specificity
Correct Answer: D
Steroid hormones are lipophilic and synthesized on demand, then released via diffusion.
Question 4
Case Scenario:
A medical student is asked to classify hormones by their mechanism of action. The student
identifies a hormone that acts by directly binding to nuclear receptors and altering gene
transcription.
Lead In:
Which of the following hormones utilizes hydrophobic mechanisms to exert its effect?
A. Follicle Stimulating Hormone (FSH)
B. Thyroid Hormone
C. Adrenaline
D. Glucagon
E. Oxytocin
Correct Answer: B
Thyroid hormone is hydrophobic and enters cells to bind to nuclear receptors, altering gene
transcription.
Question 5
Case Scenario:
A pharmaceutical scientist is developing a new formulation of a steroid hormone. They
emphasize the need for including a carrier protein to stabilize the hormone in the
bloodstream.
Lead In:
Why are plasma protein carriers essential for the function of steroid hormones?
A. They enhance the transcription of peptide hormone genes
B. They facilitate exocytosis at the glandular site
C. They reduce hormonal degradation and regulate free hormone levels
D. They restrict hormone entry into the brain
E. They transport hydrophilic hormones across the blood-brain barrier
Correct Answer: C
Plasma proteins like SHBG regulate bioavailability and protect hydrophobic hormones from
degradation and rapid excretion.
HARD QUESTIONS
Question 6
Case Scenario:
An endocrinologist is treating a patient with growth hormone deficiency using a continuous
infusion pump. However, the patient does not respond as expected. A review of recent
literature suggests physiological hormone release is not constant.
Lead In:
Which of the following best explains why continuous hormone infusion therapy may be less
effective than pulsatile secretion?
A. Continuous exposure enhances receptor sensitivity
B. Pulsatile secretion reduces renal clearance
C. Continuous exposure can desensitize receptors or disrupt physiological rhythm
D. Pulsatile secretion inhibits enzyme degradation
E. Continuous therapy ensures optimal carrier protein binding
Correct Answer: C
Hormones like GnRH and GH follow pulsatile patterns. Continuous exposure can lead to
receptor desensitization and reduced therapeutic efficacy.
Question 7
Case Scenario:
A 45-year-old woman presents with fatigue, cold intolerance, and weight gain. Her labs
show high TSH and low free T4 levels. The endocrinologist suspects an issue in the gland
responsible for thyroid hormone synthesis.
Lead In:
What would be the most likely diagnosis if a patient with hypothyroid symptoms presents
with elevated TSH and low thyroid hormone levels?
A. Hypothalamic dysfunction
B. Pituitary tumor
C. Primary hypothyroidism
D. Secondary hypothyroidism
E. Normal physiological feedback
Correct Answer: C
In primary hypothyroidism, the thyroid gland is dysfunctional, resulting in low T4 and
compensatory high TSH levels.
Question 8
Case Scenario:
A graduate student studying endocrinology is investigating the first step of steroidogenesis.
She finds that a mitochondrial protein is crucial in transporting cholesterol for the
production of pregnenolone.
Lead In:
Which of the following best illustrates the role of StAR protein in steroidogenesis?
A. Degrades peptide hormones after secretion
B. Transports glucose into steroidogenic cells
C. Facilitates the conversion of mRNA into protein
D. Regulates cholesterol transport within mitochondria for steroid synthesis
E. Inhibits the release of thyroid hormones from follicles
Correct Answer: D
The Steroidogenic Acute Regulatory (StAR) protein is essential for moving cholesterol into
mitochondria, initiating steroid hormone biosynthesis.
EASY QUESTIONS (CONTINUED)
Question 3
Case Scenario:
During a physiology lecture, a student is asked why steroid and thyroid hormones can enter
cells while others cannot. The student recalls that these hormones are chemically non-polar.
Lead In:
What allows steroid and thyroid hormones to cross the plasma membrane?
A. Their small size
B. Their hydrophilic nature
C. The action of carrier enzymes
D. Their hydrophobic nature
E. Their affinity for glycoproteins
Correct Answer: D
Steroid and thyroid hormones are hydrophobic, allowing them to diffuse through lipid
bilayers into target cells.
Question 4
Case Scenario:
A nursing student is reviewing hormone families and comes across LH, FSH, and TSH. She
notes that these hormones share common subunits and act via similar mechanisms.
Lead In:
Which of the following statements best describes peptide hormones like LH, FSH, and TSH?
A. They are composed of identical α- and β-subunits
B. Their β-subunit confers biological specificity
C. They bind intracellular nuclear receptors
D. They are hydrophobic and circulate freely
E. They have identical functions
Correct Answer: B
Peptide hormones like LH, FSH, and TSH share an α-subunit, while the β-subunit confers
specificity.
MEDIUM QUESTIONS (CONTINUED)
Question 6
Case Scenario:
A pharmaceutical developer is studying hormone degradation and uptake. She identifies
that plasma protein binding plays a role in hormone longevity and regulation.
Lead In:
What is one of the key functions of plasma protein carriers in hormone transport?
A. Enhance hormone degradation by the liver
B. Increase renal clearance of hormones
C. Prevent hormones from crossing into the brain
D. Maintain a reservoir of inactive hormones
E. Stimulate receptor upregulation
Correct Answer: D
Plasma protein carriers serve as hormone reservoirs, increasing half-life and regulating
bioavailability.
Question 7
Case Scenario:
In an endocrine lab, a researcher observes that insulin mRNA translation increases in
response to glucose. The phenomenon appears regulated at a specific level of gene
expression.
Lead In:
What level of gene expression regulation is involved in glucose-modulated insulin
synthesis?
A. DNA methylation
B. Post-translational modification
C. Alternative splicing
D. Translational level
E. Protein glycosylation
Correct Answer: D
Insulin synthesis is regulated translationally in response to glucose via RNA-binding
proteins.
Question 8
Case Scenario:
A student is confused about the endocrine system's structural organization. His textbook
explains that unlike other systems, the endocrine system lacks defined anatomical
boundaries.
Lead In:
Which of the following best describes the structure of the endocrine system?
A. It is confined to the central nervous system
B. It consists solely of endocrine glands in the brain
C. It operates as a distributed network throughout the body
D. It is a closed-loop structure involving ducts
E. It shares boundaries with the cardiovascular system
Correct Answer: C
The endocrine system is a distributed network involving glands and hormones acting
throughout the body.
HARD QUESTIONS (CONTINUED)
Question 9
Case Scenario:
A patient is prescribed a new drug that binds strongly to plasma proteins, reducing the
amount of free cortisol. Over time, symptoms of adrenal insufficiency appear despite
normal total cortisol levels.
Lead In:
How might a drug that displaces cortisol from binding proteins affect hormone action?
A. It increases hormone synthesis
B. It decreases plasma volume
C. It decreases the active (free) hormone level
D. It causes increased receptor expression
E. It enhances hormone degradation
Correct Answer: C
Displacement or altered binding can reduce free hormone concentration, affecting
biological activity.
Question 10
Case Scenario:
A neonatologist explains that certain hormonal systems are regulated by positive feedback
loops. The team discusses oxytocin and its role during labor.
Lead In:
Which of the following is an example of positive feedback in the endocrine system?
A. Insulin lowering blood glucose
B. Cortisol suppressing ACTH
C. Oxytocin stimulating uterine contractions
D. TSH decreasing thyroid hormone
E. ADH regulating water retention
Correct Answer: C
Oxytocin promotes uterine contractions, which in turn stimulate more oxytocin release—an
example of a positive feedback loop.
Question 11
Case Scenario:
A researcher studying nuclear receptors finds two classes: one activates gene expression
directly, and the other removes inhibitors to allow transcription.
Lead In:
Which mechanism is associated with one class of nuclear hormone receptors?
A. Binding to cell surface G-proteins
B. Inhibition of RNA polymerase
C. Removal of co-activators
D. Displacement of co-repressors upon hormone binding
E. Direct cleavage of mRNA
Correct Answer: D
One class of nuclear receptors removes transcriptional co-repressors and recruits co-
activators upon hormone binding.
Question 12
Case Scenario:
In an advanced endocrinology class, a student presents a case on hormone metabolism and
mentions that hormone degradation may occur during passage through certain organs.
Lead In:
Which anatomical sites are major locations of hormone inactivation and clearance?
A. Brain and bone marrow
B. Kidney and adrenal gland
C. Liver and lungs
D. Pancreas and skin
E. Heart and spleen
Correct Answer: C
The liver and lungs play key roles in hormone degradation and in limiting the duration of
hormonal effects.
