STRAIGHTERLINE A&P II FINAL EXAM 2026/2027 | 100%
Correct Answers with Complete Solutions | Human Anatomy
& Physiology II | Clinical Correlations | Homeostasis | Pass
Guaranteed - A+ Graded
Domain 1: Endocrine System (15 Questions)
Q1: A 45-year-old patient presents with fatigue, weight gain, cold intolerance, dry skin,
and bradycardia. Laboratory tests show elevated TSH and decreased free T4. Which
endocrine disorder is most consistent with these findings?
A. Graves' disease (autoimmune hyperthyroidism with elevated T3/T4 and decreased
TSH)
B. Cushing's syndrome (cortisol excess causing weight gain but typically with
hypertension and hyperglycemia, not cold intolerance)
C. Primary hypothyroidism (correct: elevated TSH indicates pituitary attempting to
stimulate underactive thyroid, low T4 confirms thyroid failure, symptoms match
decreased metabolic rate) [CORRECT]
D. Addison's disease (adrenal insufficiency causing fatigue and weight loss,
hyperpigmentation, hypotension)
Correct Answer: C
Rationale: The presentation is classic for primary hypothyroidism. The pituitary gland
secretes TSH (thyroid-stimulating hormone) to stimulate the thyroid; when the thyroid
fails, TSH rises in compensation while T4 (thyroxine) falls. Symptoms reflect decreased
metabolic rate: cold intolerance (impaired thermogenesis), weight gain (reduced
,metabolism), dry skin (reduced sweat/sebaceous secretion), bradycardia (reduced
cardiac sensitivity to catecholamines), and fatigue. Option A (Graves') presents with
opposite symptoms (heat intolerance, weight loss, tachycardia) and suppressed TSH;
Option B (Cushing's) features central obesity, moon face, buffalo hump, and striae but
not cold intolerance; Option D (Addison's) involves cortisol deficiency with hypotension,
hyperpigmentation, and salt craving.
Q2: A patient with a pituitary adenoma exhibits polyuria, polydipsia, and dilute urine with
low specific gravity. Which hormone deficiency explains these findings?
A. Growth hormone (causes growth failure and metabolic changes, not water balance)
B. Antidiuretic hormone (ADH/vasopressin) (correct: posterior pituitary deficiency
causes diabetes insipidus, inability to concentrate urine, massive water loss) [CORRECT]
C. Thyroid-stimulating hormone (affects metabolic rate, not water reabsorption)
D. Adrenocorticotropic hormone (ACTH deficiency causes adrenal insufficiency, not
water diuresis)
Correct Answer: B
Rationale: The posterior pituitary stores and releases ADH (vasopressin), which acts on
V2 receptors in collecting ducts to insert aquaporin-2 channels, enabling water
reabsorption. ADH deficiency causes central diabetes insipidus: inability to concentrate
urine despite intact kidneys, leading to massive polyuria (5-20 L/day) and compensatory
polydipsia. Urine specific gravity falls below 1.005 (dilute). Option A (GH deficiency)
causes short stature and metabolic syndrome; Option C (TSH deficiency) causes
,secondary hypothyroidism; Option D (ACTH deficiency) causes secondary adrenal
insufficiency with cortisol deficiency.
Q3: Which hormone is classified as a steroid hormone and acts primarily through
intracellular receptors to regulate gene transcription?
A. Insulin (peptide hormone acting via membrane receptor tyrosine kinases)
B. Epinephrine (amine hormone acting via G-protein coupled receptors)
C. Cortisol (correct: steroid hormone derived from cholesterol, diffuses through
membrane, binds intracellular receptors, acts as transcription factor) [CORRECT]
D. Glucagon (peptide hormone acting via Gs-coupled receptors and cAMP)
Correct Answer: C
Rationale: Steroid hormones (cortisol, aldosterone, testosterone, estrogen,
progesterone) are lipid-soluble, derived from cholesterol, and diffuse through plasma
membranes. They bind intracellular receptors (cytoplasmic or nuclear), forming
hormone-receptor complexes that act as transcription factors, altering gene expression
over hours. Cortisol is the primary glucocorticoid regulating metabolism and stress
response. Option A (insulin) and D (glucagon) are peptide hormones binding membrane
receptors with rapid second-messenger cascades; Option B (epinephrine) is a
catecholamine (amine class) acting via GPCRs.
, Q4: In the regulation of blood calcium, which hormone increases osteoclast activity,
decreases calcium excretion by kidneys, and increases calcium absorption from the
intestine?
A. Calcitonin (decreases blood calcium by inhibiting osteoclasts, opposite effect)
B. Parathyroid hormone (PTH) (correct: raises blood calcium via all three
mechanisms—bone resorption, renal reabsorption, and activation of vitamin D for
intestinal absorption) [CORRECT]
C. Aldosterone (regulates sodium/potassium, not calcium)
D. Growth hormone (anabolic effects on bone but not primary calcium regulator)
Correct Answer: B
Rationale: PTH is the primary regulator of blood calcium homeostasis. When calcium
falls, parathyroid glands release PTH, which: 1) stimulates osteoclasts to resorb bone
and release calcium/phosphate, 2) increases distal tubule calcium reabsorption (and
phosphate excretion), and 3) stimulates renal 1α-hydroxylase to convert vitamin D to
calcitriol, enhancing intestinal calcium absorption. Calcitonin (Option A) opposes PTH,
lowering calcium by inhibiting osteoclasts. Aldosterone (Option C) regulates
electrolytes and volume; GH (Option D) has indirect effects via IGF-1.
Q5: A patient with type 1 diabetes mellitus presents with polyuria, polydipsia,
polyphagia, and fruity breath odor. Which metabolic derangement causes the fruity
breath?
A. Hyperglycemia alone (does not produce odor)
B. Ketoacidosis (correct: insulin deficiency causes uncontrolled lipolysis and hepatic
ketogenesis, producing acetone with characteristic fruity odor) [CORRECT]
Correct Answers with Complete Solutions | Human Anatomy
& Physiology II | Clinical Correlations | Homeostasis | Pass
Guaranteed - A+ Graded
Domain 1: Endocrine System (15 Questions)
Q1: A 45-year-old patient presents with fatigue, weight gain, cold intolerance, dry skin,
and bradycardia. Laboratory tests show elevated TSH and decreased free T4. Which
endocrine disorder is most consistent with these findings?
A. Graves' disease (autoimmune hyperthyroidism with elevated T3/T4 and decreased
TSH)
B. Cushing's syndrome (cortisol excess causing weight gain but typically with
hypertension and hyperglycemia, not cold intolerance)
C. Primary hypothyroidism (correct: elevated TSH indicates pituitary attempting to
stimulate underactive thyroid, low T4 confirms thyroid failure, symptoms match
decreased metabolic rate) [CORRECT]
D. Addison's disease (adrenal insufficiency causing fatigue and weight loss,
hyperpigmentation, hypotension)
Correct Answer: C
Rationale: The presentation is classic for primary hypothyroidism. The pituitary gland
secretes TSH (thyroid-stimulating hormone) to stimulate the thyroid; when the thyroid
fails, TSH rises in compensation while T4 (thyroxine) falls. Symptoms reflect decreased
metabolic rate: cold intolerance (impaired thermogenesis), weight gain (reduced
,metabolism), dry skin (reduced sweat/sebaceous secretion), bradycardia (reduced
cardiac sensitivity to catecholamines), and fatigue. Option A (Graves') presents with
opposite symptoms (heat intolerance, weight loss, tachycardia) and suppressed TSH;
Option B (Cushing's) features central obesity, moon face, buffalo hump, and striae but
not cold intolerance; Option D (Addison's) involves cortisol deficiency with hypotension,
hyperpigmentation, and salt craving.
Q2: A patient with a pituitary adenoma exhibits polyuria, polydipsia, and dilute urine with
low specific gravity. Which hormone deficiency explains these findings?
A. Growth hormone (causes growth failure and metabolic changes, not water balance)
B. Antidiuretic hormone (ADH/vasopressin) (correct: posterior pituitary deficiency
causes diabetes insipidus, inability to concentrate urine, massive water loss) [CORRECT]
C. Thyroid-stimulating hormone (affects metabolic rate, not water reabsorption)
D. Adrenocorticotropic hormone (ACTH deficiency causes adrenal insufficiency, not
water diuresis)
Correct Answer: B
Rationale: The posterior pituitary stores and releases ADH (vasopressin), which acts on
V2 receptors in collecting ducts to insert aquaporin-2 channels, enabling water
reabsorption. ADH deficiency causes central diabetes insipidus: inability to concentrate
urine despite intact kidneys, leading to massive polyuria (5-20 L/day) and compensatory
polydipsia. Urine specific gravity falls below 1.005 (dilute). Option A (GH deficiency)
causes short stature and metabolic syndrome; Option C (TSH deficiency) causes
,secondary hypothyroidism; Option D (ACTH deficiency) causes secondary adrenal
insufficiency with cortisol deficiency.
Q3: Which hormone is classified as a steroid hormone and acts primarily through
intracellular receptors to regulate gene transcription?
A. Insulin (peptide hormone acting via membrane receptor tyrosine kinases)
B. Epinephrine (amine hormone acting via G-protein coupled receptors)
C. Cortisol (correct: steroid hormone derived from cholesterol, diffuses through
membrane, binds intracellular receptors, acts as transcription factor) [CORRECT]
D. Glucagon (peptide hormone acting via Gs-coupled receptors and cAMP)
Correct Answer: C
Rationale: Steroid hormones (cortisol, aldosterone, testosterone, estrogen,
progesterone) are lipid-soluble, derived from cholesterol, and diffuse through plasma
membranes. They bind intracellular receptors (cytoplasmic or nuclear), forming
hormone-receptor complexes that act as transcription factors, altering gene expression
over hours. Cortisol is the primary glucocorticoid regulating metabolism and stress
response. Option A (insulin) and D (glucagon) are peptide hormones binding membrane
receptors with rapid second-messenger cascades; Option B (epinephrine) is a
catecholamine (amine class) acting via GPCRs.
, Q4: In the regulation of blood calcium, which hormone increases osteoclast activity,
decreases calcium excretion by kidneys, and increases calcium absorption from the
intestine?
A. Calcitonin (decreases blood calcium by inhibiting osteoclasts, opposite effect)
B. Parathyroid hormone (PTH) (correct: raises blood calcium via all three
mechanisms—bone resorption, renal reabsorption, and activation of vitamin D for
intestinal absorption) [CORRECT]
C. Aldosterone (regulates sodium/potassium, not calcium)
D. Growth hormone (anabolic effects on bone but not primary calcium regulator)
Correct Answer: B
Rationale: PTH is the primary regulator of blood calcium homeostasis. When calcium
falls, parathyroid glands release PTH, which: 1) stimulates osteoclasts to resorb bone
and release calcium/phosphate, 2) increases distal tubule calcium reabsorption (and
phosphate excretion), and 3) stimulates renal 1α-hydroxylase to convert vitamin D to
calcitriol, enhancing intestinal calcium absorption. Calcitonin (Option A) opposes PTH,
lowering calcium by inhibiting osteoclasts. Aldosterone (Option C) regulates
electrolytes and volume; GH (Option D) has indirect effects via IGF-1.
Q5: A patient with type 1 diabetes mellitus presents with polyuria, polydipsia,
polyphagia, and fruity breath odor. Which metabolic derangement causes the fruity
breath?
A. Hyperglycemia alone (does not produce odor)
B. Ketoacidosis (correct: insulin deficiency causes uncontrolled lipolysis and hepatic
ketogenesis, producing acetone with characteristic fruity odor) [CORRECT]
