front 1 Insulin is a major ____ hormone. | back 1 B. Anabolic |
front 2 After a mixed meal, which hormone promotes glycogen storage in liver
and muscle? | back 2 D. Insulin |
front 3 In adipocytes after eating, which hormone promotes nutrient storage
as triacylglycerols? | back 3 A. Insulin |
front 4 A resistance-trained patient uses post-workout nutrients for
myofibrils. Insulin promotes synthesis of: | back 4 C. Proteins |
front 5 Relative to fasting hormones, insulin antagonizes which
process? | back 5 A. Fuel mobilization |
front 6 A “counterregulatory” hormone to insulin is also called: | back 6 D. Contrainsular |
front 7 The major action of glucagon is fuel mobilization by
stimulating: | back 7 C. Glycogenolysis and gluconeogenesis |
front 8 Which is NOT a contrainsular hormone? | back 8 B. Insulin |
front 9 Thyroid hormone is insulin-counterregulatory because it: | back 9 B. Increases fuel use, lowers sensitivity |
front 10 A hormone changes metabolism within minutes–hours mainly by: | back 10 A. Catalytic activity changes |
front 11 A hormone changes metabolism over hours–days mainly by: | back 11 D. Transcription and translation changes |
front 12 Insulin’s growth effects are hard to separate from: | back 12 B. Somatomedin |
front 13 Within islets, β-cell insulin suppresses α-cell glucagon via: | back 13 A. Paracrine signaling |
front 14 A 37–amino acid peptide co-secreted with insulin when glucose rises
is: | back 14 C. Amylin |
front 15 Amylin most directly: | back 15 D. Suppresses postprandial glucagon |
front 16 A patient on an amylin-mimetic has improved postprandial glucose
partly by slowing: | back 16 B. Gastric emptying |
front 17 The shared physiologic goal of amylin’s actions is: | back 17 A. Reduces blood glucose |
front 18 In type 1 diabetes, β-cell destruction removes secretion of: | back 18 C. Insulin and amylin |
front 19 A patient with T1D wants an adjunct replacing a missing β-cell
peptide. Best drug: | back 19 D. Pramlintide |
front 20 The adverse effect most limiting pramlintide use is: | back 20 B. Nausea or vomiting |
front 21 Glucagon is synthesized as part of the precursor: | back 21 A. Proglucagon |
front 22 Proglucagon is produced primarily in: | back 22 C. α-cells and intestinal L-cells |
front 23 Pancreatic cleavage yields glucagon that is about what fraction of
immunoreactive blood glucagon? | back 23 C. 60–80% |
front 24 Glucagon’s key second messenger in many target cells is: | back 24 B. cAMP |
front 25 Portal vein glucagon can reach approximately: | back 25 C. 500 pg/mL |
front 26 Adenylate cyclase activation by glucagon directly increases: | back 26 A. cAMP |
front 27 In the pancreas, glucagon is cleaved from proglucagon mainly
in: | back 27 D. α-cells |
front 28 Thyroid hormone strengthens counterregulation partly by increasing
sensitivity to: | back 28 B. Counterregulatory hormones |
front 29 A genetics question asks where the peptide precursor for somatostatin
is encoded. Which locus fits the provided description? | back 29 B. Chromosome 3q |
front 30 A cyclic peptide was named for inhibiting GH release from the
anterior pituitary. Which peptide is this? | back 30 A. Somatostatin SS-14 |
front 31 During a mixed-meal study, Somatostatin is released from two main
sites. Which pairing is correct? | back 31 C. Hypothalamus and D cells |
front 32 Compared with SS-14, prosomatostatin (SS-28) is structurally defined
by: | back 32 A. Fourteen extra amino acids |
front 33 A pharmacology stem compares biologic potency of SS-28 vs SS-14 on GH
and insulin release. Which magnitude is correct? | back 33 C. 7–10 times more potent |
front 34 A patient starts tolbutamide and has increased insulin secretion.
Which additional pancreatic hormone secretion also rises? | back 34 B. Somatostatin secretion rises |
front 35 An octreotide analog binds somatostatin receptors on target cells.
What is the canonical effect on adenylate cyclase? | back 35 D. Inactivation |
front 36 A signaling question asks which pathway is directly regulated by
somatostatin receptors besides adenylate cyclase. | back 36 A. Phosphotyrosine phosphatases |
front 37 Somatostatin receptor signaling is also linked to modulation
of: | back 37 C. MAP kinases |
front 38 Somatostatin receptors can alter intracellular ion concentrations,
especially: | back 38 B. Ca and K |
front 39 Somatostatin reduces: | back 39 A. Nutrient absorption |
front 40 A patient on octreotide develops fat malabsorption. Which mechanism
best matches the provided notes? | back 40 C. Diminished pancreatic exocrine secretion |
front 41 A patient with episodic flushing and diarrhea has elevated serotonin.
Somatostatin analogs can suppress GH increases seen in: | back 41 D. Carcinoid tumor syndrome |
front 42 Somatostatin suppresses basal secretion of several hormones. Which is
included? | back 42 B. TRH |
front 43 Many growth-hormone effects in tissues are mediated by: | back 43 A. IGFs |
front 44 A patient with acromegaly needs a drug that blocks GH signaling at
its receptor. Best choice? | back 44 D. Pegvisomant |
front 45 A patient with acromegaly cannot undergo surgery. Which listed
dopamine agonist inhibits GH secretion? | back 45 C. Cabergoline |
front 46 A stem asks where the growth hormone gene is located. Which
chromosome is correct? | back 46 B. Chromosome 17 |
front 47 Growth hormone is secreted by which anterior pituitary cell
type? | back 47 D. Somatotroph |
front 48 A patient suspected of acromegaly drinks 100 g glucose. Which
abnormal result supports the diagnosis? | back 48 A. GH remains high |
front 49 GH increases expression of which gene in liver and extrahepatic
tissues? | back 49 B. IGF-1 |
front 50 IGF-1 from hepatocytes limits GH secretion by negative feedback
on: | back 50 C. Somatotrophs |
front 51 A physiologic question: rising blood glucose normally does what to GH
release? | back 51 A. Suppresses GH release |
front 52 During an insulin overdose, which change in GH secretion is expected
in normal physiology? | back 52 D. Increased secretion |
front 53 In a provocative endocrine test, which substrate can stimulate GH
release when levels rise? | back 53 B. Arginine |
front 54 A subject receives arginine to stimulate GH. Rising free fatty acids
would most likely: | back 54 C. Blunt the GH rise |
front 55 GH shifts adipocyte metabolism by changing responsiveness to other
hormones. GH increases adipocyte: | back 55 A. Sensitivity to catecholamine lipolysis |
front 56 Shortly after a GH pulse, which circulating substrates rise due to
adipose effects? | back 56 D. FFA and glycerol |
front 57 GH can reduce glucose uptake in fat and muscle by postreceptor
inhibition of: | back 57 C. Insulin action |
front 58 A somatostatin receptor agonist decreases adenylate cyclase activity.
Which second messenger falls in hepatocytes? | back 58 B. cAMP |
front 59 IGF-2 is also called somatomedin: | back 59 B. Somatomedin A |
front 60 IGFs exert effects through which mechanisms? | back 60 D. Endocrine or paracrine or autocrine |
front 61 Most cells express IGF mRNA, but the highest message concentration is
in the: | back 61 A. Liver |
front 62 After liver, the next-highest IGF mRNA concentration is in
the: | back 62 C. Kidney |
front 63 Catecholamines are best classified as: | back 63 A. Bioamines |
front 64 A patient with an adrenal mass has excess epinephrine. Epinephrine is
synthesized in the: | back 64 C. Adrenal medulla |
front 65 A catecholamine that is stored in the adrenal medulla is also stored
in: | back 65 D. Adrenergic nerve endings |
front 66 The major precursor for catecholamine synthesis is: | back 66 C. Tyrosine |
front 67 Episodic headaches, palpitations, diaphoresis, and elevated urine
catecholamines most strongly suggest: | back 67 A. Pheochromocytoma |
front 68 Catecholamines act mainly via which receptor classes? | back 68 D. Alpha and beta receptors |
front 69 Epinephrine blood half-life is: | back 69 B. Short half-life |
front 70 Catecholamines often require high local concentrations because they
have: | back 70 A. Low receptor affinity |
front 71 Hypothalamic CRH synthesis/release is driven in part by: | back 71 C. Acetylcholine and serotonin |
front 72 CRH reaches anterior pituitary targets primarily through: | back 72 D. Portal vessels |
front 73 ACTH’s major trophic influence on cortisol synthesis is at the
step: | back 73 B. Cholesterol to pregnenolone |
front 74 Cortisol is secreted from the ____ in response to ACTH. | back 74 C. Adrenal cortex |
front 75 High circulating cortisol suppresses secretion of: | back 75 A. CRH and ACTH |
front 76 Excess cortisol due to excess ACTH secretion is termed: | back 76 D. Cushing disease |
front 77 Primary cortisol excess from an adrenocortical tumor (for example) is
termed: | back 77 B. Cushing syndrome |
front 78 A key genomic effect of glucocorticoids is inhibition of: | back 78 C. DNA and RNA protein synthesis |
front 79 In addition to synthesis inhibition, glucocorticoids
stimulate: | back 79 A. DNA and RNA protein degradation |
front 80 Thyroid acinar (follicular) cells secrete primarily: | back 80 B. T4 and T3 |
front 81 The first listed step in thyroid T3/T4 synthesis is: | back 81 D. Iodide trapping into cell |
front 82 After iodide trapping, iodide is oxidized to form an: | back 82 A. Iodinating species |
front 83 Formation of T3/T4 within thyroglobulin requires coupling of: | back 83 B. MIT and DIT |
front 84 The step that releases free thyroid hormone into blood is: | back 84 D. Proteolysis of thyroglobulin |
front 85 After liver and kidney, the next-highest IGF mRNA concentration is in
the: | back 85 C. Heart |
front 86 Norepinephrine is synthesized/stored in adrenal medulla and also
in: | back 86 A. CNS regions |
front 87 Catecholamines are secretory products of the: | back 87 D. Sympathoadrenal system |
front 88 Catecholamine receptors (alpha/beta) are located on the: | back 88 B. Plasma membrane |
front 89 Acidic chyme entering the proximal small bowel triggers a hormone
from which enteroendocrine cell? | back 89 B. S cells |
front 90 Type 2 diabetes improves after gastric bypass before weight loss
mainly due to sustained increases in: | back 90 A. Amylin and GLP-1 |
front 91 A patient has rapid gastric emptying and large post-meal nutrient
spikes. Which β-cell peptide dysfunction best fits? | back 91 C. Amylin |
front 92 A hormone that inhibits GH, TSH, insulin, glucagon, gastrin, and TRH
is: | back 92 D. Somatostatin |
front 93 Which metabolite trio increases somatostatin release? | back 93 C. Glucose arginine leucine |
front 94 Which hormone trio increases somatostatin release? | back 94 B. Glucagon VIP CCK |
front 95 After GH administration, hepatocytes increase expression of: | back 95 D. Ornithine decarboxylase |
front 96 A hypothalamic hormone encoded on chromosome 20 and released from the
arcuate nucleus to stimulate somatotrophs is: | back 96 A. GHRH |
front 97 Rising levels of which growth factor provide negative feedback that
inhibits GHRH? | back 97 B. IGF-1 |
front 98 During low plasma insulin (fasting), which hormone enhances fatty
acid oxidation supporting hepatic gluconeogenesis? | back 98 D. Growth hormone |
front 99 Which oxidation pattern best matches GH “sparing” effects? | back 99 C. ↑FA oxidation, ↓glucose oxidation |
front 100 In acute stress, increased NE/E causes which pancreatic secretion
pattern? | back 100 A. ↓Insulin, ↑glucagon |
front 101 Elevated urinary metanephrines (VMA) most strongly implicate a tumor
arising from: | back 101 D. Adrenal medulla chromaffin cells |
front 102 A patient with consistently high catecholamines in blood/urine should
be evaluated for: | back 102 B. Pheochromocytoma |
front 103 During severe stress, cortisol negative feedback on CRH/ACTH is
typically: | back 103 A. Overridden |
front 104 The GH receptor is classically linked to which signaling
pathway? | back 104 C. JAK/STAT |
front 105 The hormone in this set that signals via Gi-protein receptors
is: | back 105 D. Somatostatin |
front 106 Which hormone is classified as contra-insular in these notes? | back 106 A. Cortisol |
front 107 A hepatic protein induced by GH (besides IGF-1) in these notes
is: | back 107 B. Alpha-2 macroglobulin |
front 108 Which GH tissue-effect pairing best matches these notes? | back 108 A. Adipose lipolysis, muscle protein synthesis |
front 109 In hepatocytes, GH most directly increases expression of: | back 109 D. IGF-1 |
front 110 Stressors like pain, hemorrhage, exercise, and hypoglycemia increase
hypothalamic drive partly via: | back 110 C. Acetylcholine and serotonin |
front 111 A patient has a GI hormone that stimulates gastric and pancreatic
enzyme secretion to aid nutrient digestion. It is secreted by proximal
small-bowel M cells. Which hormone? | back 111 B. Motilin |
front 112 A hormone that regulates pancreatic enzyme secretion and inhibits
gastrin/acid is released from which proximal small-bowel cell
type? | back 112 D. S cells |
front 113 A post-op patient has reduced gastric emptying and slower
upper-intestinal motility from a peptide secreted by pancreatic
islets. Which hormone? | back 113 A. Pancreatic polypeptide |
front 114 A peptide from pancreatic islet alpha cells inhibits gastric
secretion. Which hormone? | back 114 B. Peptide YY |
front 115 A patient’s proximal small-bowel enteroendocrine dysfunction reduces
a cyclic hormone that stimulates GI/pancreatic enzyme secretion. Which
hormone is missing? | back 115 A. Motilin |
front 116 A patient with refractory gastric acid hypersecretion improves with a
proximal small-bowel hormone that inhibits gastrin and gastric acid
and regulates pancreatic enzyme secretion. Which hormone? | back 116 D. Secretin |
front 117 A patient receives an incretin-based therapy that reduces
postprandial glucagon and slows gastric emptying. Which hormone
mediates this? | back 117 C. GLP-1 |
front 118 A peptide hormone improves glucose homeostasis by inhibiting
alpha-cell glucagon release and slowing gastric emptying. Which
hormone? | back 118 A. GLP-1 |
front 119 A patient’s adipocytes increase energy storage after meals via a
peptide hormone acting on adipocyte receptors. Which hormone? | back 119 B. GIP |
front 120 A surface protease rapidly limits incretin signaling by inactivating
both GLP-1 and GIP. Which protease? | back 120 C. DPP-4 |
front 121 That protease cleaves GLP-1 into which amino acid (per provided
note)? | back 121 A. Alanine |
front 122 A patient with hyperphagia has elevated ghrelin signaling. Ghrelin
increases appetite by activating which hypothalamic kinase? | back 122 C. AMPK |
front 123 Ghrelin-driven AMPK activation increases appetite by promoting
release of: | back 123 D. Neuropeptide Y |
front 124 A sulfonylurea increases insulin secretion and also increases
somatostatin secretion. Which drug is most consistent? | back 124 B. Tolbutamide |
front 125 A long-acting analog used clinically for somatostatin has ~110-minute
half-life. Which drug? | back 125 C. Octreotide |
front 126 A patient with episodic headaches, palpitations, and elevated
catecholamine metabolites is diagnosed with pheochromocytoma. Major
cause? | back 126 B. Adrenal medulla neoplasm |
front 127 A patient has increased insulin degradation/clearance and variable
glucose intolerance (“metathyroid diabetes mellitus”). Underlying
disorder? | back 127 A. Hyperthyroidism |
front 128 In hyperthyroidism, glucose intolerance is partly explained by
increased: | back 128 B. Insulin clearance |
front 129 An obese patient with T2D has near-immediate glycemic improvement
after gastric bypass, before weight loss. The key rapidly increased
hormone is: | back 129 A. GLP-1 |
front 130 Shortly after gastric bypass, improved glycemia is linked to
increased release of: | back 130 D. Insulin and amylin |