BIO202 FINAL EXAM STUDY GUIDE 2026/2027 |
StraighterLine A&P II Complete Solution | Human Anatomy &
Physiology II | Comprehensive Review | Clinical Correlations
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Domain 1: Endocrine System (15 Questions)
Q1: A 45-year-old patient presents with weight gain, moon face, buffalo hump, purple
striae on the abdomen, and hyperglycemia. Laboratory tests show elevated cortisol
levels and suppressed ACTH. Which endocrine disorder is most likely?
A. Addison's disease
B. Cushing's syndrome
C. Graves' disease
D. Diabetes insipidus
Correct Answer: B
Rationale: Cushing's syndrome is characterized by hypercortisolism leading to the
classic presentation: central obesity (moon face, buffalo hump), thin skin with purple
striae, hyperglycemia (cortisol is a glucocorticoid that raises blood glucose), and
suppressed ACTH (negative feedback from high cortisol). The ACTH suppression
suggests an adrenal tumor or exogenous steroid use rather than a pituitary source.
Option A (Addison's) would show hypotension, hyperpigmentation, and low cortisol with
high ACTH. Option C (Graves') involves hyperthyroidism with weight loss, heat
,intolerance, and exophthalmos. Option D (diabetes insipidus) presents with polyuria and
polydipsia due to ADH deficiency, not metabolic changes.
Q2: A patient with a pituitary adenoma exhibits bitemporal hemianopsia (loss of
peripheral vision in both temporal fields), galactorrhea, and amenorrhea. Which
hormone is most likely elevated?
A. Growth hormone (GH)
B. Thyroid-stimulating hormone (TSH)
C. Prolactin
D. Adrenocorticotropic hormone (ACTH)
Correct Answer: C
Rationale: Prolactinoma (prolactin-secreting pituitary adenoma) is the most common
functional pituitary tumor. Prolactin causes galactorrhea (milk production), amenorrhea
(inhibition of GnRH pulsatility, suppressing LH/FSH), and infertility. The bitemporal
hemianopsia results from the tumor compressing the optic chiasm (superior to the sella
turcica), affecting the crossing fibers from the nasal retina (temporal visual fields).
Option A (GH excess) causes acromegaly in adults or gigantism in children. Option B
(TSH excess) causes hyperthyroidism. Option D (ACTH excess) causes Cushing's
disease.
Q3: The hypothalamic-pituitary-thyroid axis involves which sequence of hormonal
regulation?
A. TRH → TSH → T3/T4 → negative feedback on hypothalamus and pituitary
,B. CRH → ACTH → cortisol → negative feedback
C. GnRH → LH/FSH → estrogen/testosterone → positive feedback only
D. GHRH → GH → IGF-1 → positive feedback on hypothalamus
Correct Answer: A
Rationale: The HPT axis follows the classic tropic hormone cascade: Hypothalamic TRH
(thyrotropin-releasing hormone) stimulates pituitary TSH (thyroid-stimulating hormone)
release, which stimulates the thyroid to produce T3/T4 (thyroid hormones). T3/T4 exert
negative feedback on both hypothalamus (reducing TRH) and pituitary (reducing TSH).
Option B describes the HPA axis. Option C is incorrect because sex steroids exert both
positive (mid-cycle LH surge) and negative feedback. Option D is incorrect because
IGF-1 exerts negative feedback on GH and GHRH.
Q4: A patient with Hashimoto's thyroiditis develops hypothyroidism. Which laboratory
findings would be expected?
A. Low TSH, low T3/T4
B. High TSH, low T3/T4
C. Low TSH, high T3/T4
D. Normal TSH, normal T3/T4
Correct Answer: B
Rationale: Primary hypothyroidism (thyroid gland failure) results in low T3/T4 with
compensatory high TSH (loss of negative feedback). Hashimoto's is an autoimmune
destruction of the thyroid. Option A describes secondary hypothyroidism (pituitary
, failure). Option C describes primary hyperthyroidism (e.g., Graves'). Option D is
euthyroid. The elevated TSH is the earliest marker of subclinical hypothyroidism.
Q5: Insulin and glucagon are classified as which type of hormone based on their
chemical structure and mechanism of action?
A. Steroid hormones that diffuse through plasma membranes
B. Peptide hormones that bind cell surface receptors and use second messengers
C. Amine hormones derived from tyrosine
D. Eicosanoids derived from arachidonic acid
Correct Answer: B
Rationale: Insulin (51 amino acids, two chains) and glucagon (29 amino acids) are
peptide hormones synthesized as preprohormones. They cannot cross plasma
membranes and bind cell surface receptors (insulin: tyrosine kinase receptor; glucagon:
G-protein coupled receptor), activating second messenger systems (tyrosine kinase
cascade or cAMP/PKA pathway). Option A describes cortisol, aldosterone, sex steroids.
Option C describes thyroid hormones and catecholamines. Option D describes
prostaglandins, leukotrienes.
Q6: A Type 1 diabetic patient presents with polyuria, polydipsia, polyphagia, and fruity
breath odor. Which metabolic derangement explains these symptoms?
A. Hyperglycemia causing osmotic diuresis and ketone body production
B. Hypoglycemia causing glucagon suppression
C. Hyperinsulinemia causing cellular glucose overload
StraighterLine A&P II Complete Solution | Human Anatomy &
Physiology II | Comprehensive Review | Clinical Correlations
| Pass Guaranteed - A+ Graded
Domain 1: Endocrine System (15 Questions)
Q1: A 45-year-old patient presents with weight gain, moon face, buffalo hump, purple
striae on the abdomen, and hyperglycemia. Laboratory tests show elevated cortisol
levels and suppressed ACTH. Which endocrine disorder is most likely?
A. Addison's disease
B. Cushing's syndrome
C. Graves' disease
D. Diabetes insipidus
Correct Answer: B
Rationale: Cushing's syndrome is characterized by hypercortisolism leading to the
classic presentation: central obesity (moon face, buffalo hump), thin skin with purple
striae, hyperglycemia (cortisol is a glucocorticoid that raises blood glucose), and
suppressed ACTH (negative feedback from high cortisol). The ACTH suppression
suggests an adrenal tumor or exogenous steroid use rather than a pituitary source.
Option A (Addison's) would show hypotension, hyperpigmentation, and low cortisol with
high ACTH. Option C (Graves') involves hyperthyroidism with weight loss, heat
,intolerance, and exophthalmos. Option D (diabetes insipidus) presents with polyuria and
polydipsia due to ADH deficiency, not metabolic changes.
Q2: A patient with a pituitary adenoma exhibits bitemporal hemianopsia (loss of
peripheral vision in both temporal fields), galactorrhea, and amenorrhea. Which
hormone is most likely elevated?
A. Growth hormone (GH)
B. Thyroid-stimulating hormone (TSH)
C. Prolactin
D. Adrenocorticotropic hormone (ACTH)
Correct Answer: C
Rationale: Prolactinoma (prolactin-secreting pituitary adenoma) is the most common
functional pituitary tumor. Prolactin causes galactorrhea (milk production), amenorrhea
(inhibition of GnRH pulsatility, suppressing LH/FSH), and infertility. The bitemporal
hemianopsia results from the tumor compressing the optic chiasm (superior to the sella
turcica), affecting the crossing fibers from the nasal retina (temporal visual fields).
Option A (GH excess) causes acromegaly in adults or gigantism in children. Option B
(TSH excess) causes hyperthyroidism. Option D (ACTH excess) causes Cushing's
disease.
Q3: The hypothalamic-pituitary-thyroid axis involves which sequence of hormonal
regulation?
A. TRH → TSH → T3/T4 → negative feedback on hypothalamus and pituitary
,B. CRH → ACTH → cortisol → negative feedback
C. GnRH → LH/FSH → estrogen/testosterone → positive feedback only
D. GHRH → GH → IGF-1 → positive feedback on hypothalamus
Correct Answer: A
Rationale: The HPT axis follows the classic tropic hormone cascade: Hypothalamic TRH
(thyrotropin-releasing hormone) stimulates pituitary TSH (thyroid-stimulating hormone)
release, which stimulates the thyroid to produce T3/T4 (thyroid hormones). T3/T4 exert
negative feedback on both hypothalamus (reducing TRH) and pituitary (reducing TSH).
Option B describes the HPA axis. Option C is incorrect because sex steroids exert both
positive (mid-cycle LH surge) and negative feedback. Option D is incorrect because
IGF-1 exerts negative feedback on GH and GHRH.
Q4: A patient with Hashimoto's thyroiditis develops hypothyroidism. Which laboratory
findings would be expected?
A. Low TSH, low T3/T4
B. High TSH, low T3/T4
C. Low TSH, high T3/T4
D. Normal TSH, normal T3/T4
Correct Answer: B
Rationale: Primary hypothyroidism (thyroid gland failure) results in low T3/T4 with
compensatory high TSH (loss of negative feedback). Hashimoto's is an autoimmune
destruction of the thyroid. Option A describes secondary hypothyroidism (pituitary
, failure). Option C describes primary hyperthyroidism (e.g., Graves'). Option D is
euthyroid. The elevated TSH is the earliest marker of subclinical hypothyroidism.
Q5: Insulin and glucagon are classified as which type of hormone based on their
chemical structure and mechanism of action?
A. Steroid hormones that diffuse through plasma membranes
B. Peptide hormones that bind cell surface receptors and use second messengers
C. Amine hormones derived from tyrosine
D. Eicosanoids derived from arachidonic acid
Correct Answer: B
Rationale: Insulin (51 amino acids, two chains) and glucagon (29 amino acids) are
peptide hormones synthesized as preprohormones. They cannot cross plasma
membranes and bind cell surface receptors (insulin: tyrosine kinase receptor; glucagon:
G-protein coupled receptor), activating second messenger systems (tyrosine kinase
cascade or cAMP/PKA pathway). Option A describes cortisol, aldosterone, sex steroids.
Option C describes thyroid hormones and catecholamines. Option D describes
prostaglandins, leukotrienes.
Q6: A Type 1 diabetic patient presents with polyuria, polydipsia, polyphagia, and fruity
breath odor. Which metabolic derangement explains these symptoms?
A. Hyperglycemia causing osmotic diuresis and ketone body production
B. Hypoglycemia causing glucagon suppression
C. Hyperinsulinemia causing cellular glucose overload
