PGY 412 EXAM 1 QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026
endocrine system - Answers body's main system for communicating, controlling, and coordinating
homeostasis
hormones: diurnal, pulsitile, cyclic, dependent on circulating substrates - Answers -24 hr cycle
(meletonin)
-pulses throughout day
-menstural cycle
-Ca, Na, hormones
negative feedback - Answers hormones can feedback and shut off the gland that produces the
hormone
-hypo (TRH) -> ant. pit. (TSH) -> thyroid (T3 + T4) -> ant. pit. (TSH) -> hypo (TRH)
long vs short vs ultra short feedback - Answers -end point (terminal gland) -> beginning (hypo)
-jumps up 1 step (thyroid -> ant. pit.)
-hormone (t3 + t4) -> gland (thyroid)
up regulation - Answers increase in number of receptors
-MORE sensitive
down regulation - Answers decrease in number of receptors
-LESS sensitive
water soluble hormones - Answers circulate in free, unbound forms
-SHORT acting response
-bind to surface receptors -> 2nd messenger -> pro. kinase A/C -> cellular response
-catecholamines, peptide hormones (insulin)
lipid soluble hormones - Answers primarily circulate bound to receptor
-rapid, LONG lasting response
-diffuse freely across plasma + nuclear mem + bind to CYSTOLIC or NUCLEAR receptors
-steroid, Vit. D, retanoic acid
factors that affect endocrine function - Answers aging, illness, endocrine pathologies, stress, external
factors, cycles of hormone release
endocrine disorders - Answers -hormone amt. too much/little
-not enough receptors/binding sites
-problem regulating/ clearing hormones in blood stream
Hypothalamus - Answers regulates body temperature, hunger, thirst, and sex drive
-in center of brain so it's protected
Pituitary - Answers connected to hypo. by stalk like structure (below)
-ANT: derived from ectoderm of buccal cavity
-POST: from neural ectoderm
hypothalamic control of ANT occurs via... - Answers secretion into hypo-pit portal system
-hypo. neurosecratory cells (secrete hormone) -> sup. hypophysial ARTERY -> target cells in ant. pit. ->
ant. hypophysial VEIN
hypothalamic control of PIT occurs via... - Answers direct neural connection
-paraventricular + supraoptic nuclei neurons in hypo. synthesize hormones that are transported down
AXONS to terminals in post. pit. where they are STORED until stimulus release
anterior pituitary - Answers prolactin, GH, ACTH, TSH, LH, FSH
posterior pituitary - Answers ADH and oxytocin
ADH - Answers regulates abs of water from collecting ducts in kidneys
-nerve cells in hypo. determine when blood is too concentrated (ADH released + kidneys reabsorb)
-as blood dilutes, ADH is not released (neg. feedback)
Syndrom of Inappropriate ADH (SIADH) - Answers incresed levels of ADH w/o normal stimuli
-inc ADH = dec OSMOLARITY
SIASH cause - Answers -tumor cells secrete ADH
-small cell carcinoma of lungs (most common)
-carcinoma (doudenum, pancresa, leukemia, lymphoma, Hodgkin's)
-other (TBI, stroke, hemorrhage)
diabetes insipidus - Answers disorder of ADH
-symptoms: thirst, polydispia, polyuria
neurogenic diabetes insipidus - Answers inability of hypo. neurons to synthesize or secrete ADH
, nephrogenic diabetes insipidus - Answers inability of nephron to respond to ADH
Hypopituitarism - Answers cause: pituitary tumors
-vascular thrombosis (clot) leading to necrosis (cells die) of the gland (stops blood flow)
-idiopathic or autoimmune disease
panhypopituitarism - Answers all hormones absent
-child: inhibition of growth, pit. dwarfism, lack of secondary sex, mental impairment
-adult: hypogonadism, hypothyroidism, adrenal insufficiency
pituitary tumors - Answers -secratory: produce too much hormone
-non secratory: problems bc of size
hyperpituitarism - Answers primary adenoma
-prolactinoma, acromealy + gigantism, cushing's disease, TSH secreting tumors
prolactinoma - Answers secrete excessive amounts of prolactin (most common pit. secreting tumor)
-inappropriate milk production, menstural changes, visual disturbance, dec sex drive, osteoporosis,
infertility
Acromegaly - Answers caused by noncancerous tumor in pit
-inc. GH
-soft tissue changes, hypertension, diabetes mellitus
Gigantism - Answers acromegaly in children
nonsecratory tumors - Answers non-functioning adenoma, craniopharyngiomas
non-functioning adenoma - Answers symptoms: visual field disturbance, loss of peripheral vision,
headaches
treatment: surgery, hormone replacement
Craniopharyngioma - Answers symptoms: delayed growth in children, dec sex drive, constipation,
thirst + freq urination
treatment: surgery or radiation
thyroid gland importance to metabolic homeostasis - Answers energy metabolism, oxygen
consumption, cardiac contractility
thyroid hormones - Answers follicular: T4, T3, rT3 (inactive)
parafollicular: (c-cells) calcetonin (dec Ca)
parathyroid hormone - Answers increases calcium
iodine deficiency - Answers iodine is crucial to thyroid hormone structure
-dec iodine causes GOITER (enlargment)
-ant. pit. releases TSH to stimulate production of T4
-USRDA for iodine is 150 mg
thyroid mechanism of action - Answers hormone enters cell into nucleus -> interacts w/ receptor to
produce gene activity response -> transcription/ translation of DNA/RNA
hyperthyroidism (thyroxicosis) - Answers Grave's disease: thyroid gland enlarged
HEAT intolerance
-nodular thyroid disease: autonomous function of follicular cells
-eyes protrude due to edema
-inc T3 + T4 dec TSH + TRH
hypothyroidism - Answers hashiomoto's: autoimmune (primary form in USA)
COLD intolerance
creatinism: individuals w/ dec thyroid function since birth (short + stocky, treatment MUST begin
before 2 months)
myxedema: hypo in adults (thyroid hormones restore normal function)- long term = edema around
eyes
-dec T3 + T4 inc TRH + TSH
Assessment of thyroid - Answers -TSH levels
-TSH supression test (give them hormone)
-T4 levels (bound + free)
thyroid storm - Answers rare; worsening of thyrotoxic state by stress/ infection in Grave's
nontoxic goiters - Answers 20-60 ys old (more in females)
-no symptoms other than enlarged gland
-cause: iodine deficiency- impaired secretion of T4
thyroid neoplasms - Answers papilary carcinoma: 80%
follicular carcinoma: 20%
endocrine system - Answers body's main system for communicating, controlling, and coordinating
homeostasis
hormones: diurnal, pulsitile, cyclic, dependent on circulating substrates - Answers -24 hr cycle
(meletonin)
-pulses throughout day
-menstural cycle
-Ca, Na, hormones
negative feedback - Answers hormones can feedback and shut off the gland that produces the
hormone
-hypo (TRH) -> ant. pit. (TSH) -> thyroid (T3 + T4) -> ant. pit. (TSH) -> hypo (TRH)
long vs short vs ultra short feedback - Answers -end point (terminal gland) -> beginning (hypo)
-jumps up 1 step (thyroid -> ant. pit.)
-hormone (t3 + t4) -> gland (thyroid)
up regulation - Answers increase in number of receptors
-MORE sensitive
down regulation - Answers decrease in number of receptors
-LESS sensitive
water soluble hormones - Answers circulate in free, unbound forms
-SHORT acting response
-bind to surface receptors -> 2nd messenger -> pro. kinase A/C -> cellular response
-catecholamines, peptide hormones (insulin)
lipid soluble hormones - Answers primarily circulate bound to receptor
-rapid, LONG lasting response
-diffuse freely across plasma + nuclear mem + bind to CYSTOLIC or NUCLEAR receptors
-steroid, Vit. D, retanoic acid
factors that affect endocrine function - Answers aging, illness, endocrine pathologies, stress, external
factors, cycles of hormone release
endocrine disorders - Answers -hormone amt. too much/little
-not enough receptors/binding sites
-problem regulating/ clearing hormones in blood stream
Hypothalamus - Answers regulates body temperature, hunger, thirst, and sex drive
-in center of brain so it's protected
Pituitary - Answers connected to hypo. by stalk like structure (below)
-ANT: derived from ectoderm of buccal cavity
-POST: from neural ectoderm
hypothalamic control of ANT occurs via... - Answers secretion into hypo-pit portal system
-hypo. neurosecratory cells (secrete hormone) -> sup. hypophysial ARTERY -> target cells in ant. pit. ->
ant. hypophysial VEIN
hypothalamic control of PIT occurs via... - Answers direct neural connection
-paraventricular + supraoptic nuclei neurons in hypo. synthesize hormones that are transported down
AXONS to terminals in post. pit. where they are STORED until stimulus release
anterior pituitary - Answers prolactin, GH, ACTH, TSH, LH, FSH
posterior pituitary - Answers ADH and oxytocin
ADH - Answers regulates abs of water from collecting ducts in kidneys
-nerve cells in hypo. determine when blood is too concentrated (ADH released + kidneys reabsorb)
-as blood dilutes, ADH is not released (neg. feedback)
Syndrom of Inappropriate ADH (SIADH) - Answers incresed levels of ADH w/o normal stimuli
-inc ADH = dec OSMOLARITY
SIASH cause - Answers -tumor cells secrete ADH
-small cell carcinoma of lungs (most common)
-carcinoma (doudenum, pancresa, leukemia, lymphoma, Hodgkin's)
-other (TBI, stroke, hemorrhage)
diabetes insipidus - Answers disorder of ADH
-symptoms: thirst, polydispia, polyuria
neurogenic diabetes insipidus - Answers inability of hypo. neurons to synthesize or secrete ADH
, nephrogenic diabetes insipidus - Answers inability of nephron to respond to ADH
Hypopituitarism - Answers cause: pituitary tumors
-vascular thrombosis (clot) leading to necrosis (cells die) of the gland (stops blood flow)
-idiopathic or autoimmune disease
panhypopituitarism - Answers all hormones absent
-child: inhibition of growth, pit. dwarfism, lack of secondary sex, mental impairment
-adult: hypogonadism, hypothyroidism, adrenal insufficiency
pituitary tumors - Answers -secratory: produce too much hormone
-non secratory: problems bc of size
hyperpituitarism - Answers primary adenoma
-prolactinoma, acromealy + gigantism, cushing's disease, TSH secreting tumors
prolactinoma - Answers secrete excessive amounts of prolactin (most common pit. secreting tumor)
-inappropriate milk production, menstural changes, visual disturbance, dec sex drive, osteoporosis,
infertility
Acromegaly - Answers caused by noncancerous tumor in pit
-inc. GH
-soft tissue changes, hypertension, diabetes mellitus
Gigantism - Answers acromegaly in children
nonsecratory tumors - Answers non-functioning adenoma, craniopharyngiomas
non-functioning adenoma - Answers symptoms: visual field disturbance, loss of peripheral vision,
headaches
treatment: surgery, hormone replacement
Craniopharyngioma - Answers symptoms: delayed growth in children, dec sex drive, constipation,
thirst + freq urination
treatment: surgery or radiation
thyroid gland importance to metabolic homeostasis - Answers energy metabolism, oxygen
consumption, cardiac contractility
thyroid hormones - Answers follicular: T4, T3, rT3 (inactive)
parafollicular: (c-cells) calcetonin (dec Ca)
parathyroid hormone - Answers increases calcium
iodine deficiency - Answers iodine is crucial to thyroid hormone structure
-dec iodine causes GOITER (enlargment)
-ant. pit. releases TSH to stimulate production of T4
-USRDA for iodine is 150 mg
thyroid mechanism of action - Answers hormone enters cell into nucleus -> interacts w/ receptor to
produce gene activity response -> transcription/ translation of DNA/RNA
hyperthyroidism (thyroxicosis) - Answers Grave's disease: thyroid gland enlarged
HEAT intolerance
-nodular thyroid disease: autonomous function of follicular cells
-eyes protrude due to edema
-inc T3 + T4 dec TSH + TRH
hypothyroidism - Answers hashiomoto's: autoimmune (primary form in USA)
COLD intolerance
creatinism: individuals w/ dec thyroid function since birth (short + stocky, treatment MUST begin
before 2 months)
myxedema: hypo in adults (thyroid hormones restore normal function)- long term = edema around
eyes
-dec T3 + T4 inc TRH + TSH
Assessment of thyroid - Answers -TSH levels
-TSH supression test (give them hormone)
-T4 levels (bound + free)
thyroid storm - Answers rare; worsening of thyrotoxic state by stress/ infection in Grave's
nontoxic goiters - Answers 20-60 ys old (more in females)
-no symptoms other than enlarged gland
-cause: iodine deficiency- impaired secretion of T4
thyroid neoplasms - Answers papilary carcinoma: 80%
follicular carcinoma: 20%
