Endocrinology — MCQs

Endocrinology Indian Medical PG Practice Questions and MCQs

Question 811: Thyroid hormone binds to which receptor ?

A. Membrane
B. Cytoplasmic
C. Nuclear (Correct Answer)
D. None of the options

Explanation: ***Nuclear*** - Thyroid hormones, being **lipid-soluble**, readily diffuse across the **cell membrane** to bind to receptors located in the nucleus. - This binding directly influences **gene expression** and protein synthesis, mediating the hormone's effects. *Membrane* - Membrane receptors typically bind **water-soluble hormones** (e.g., peptide hormones, catecholamines) that cannot freely cross the cell membrane. - These interactions usually trigger a **second messenger cascade** within the cell. *Cytoplasmic* - While some **steroid hormones** bind to cytoplasmic receptors which then translocate to the nucleus, thyroid hormones bind directly to nuclear receptors. - Cytoplasmic receptors are located in the **cytosol** before their ligand-induced translocation. *None of the options* - This option is incorrect, as thyroid hormones have a specific and well-defined receptor location. - The direct action on **gene regulation** necessitates a nuclear receptor.

Question 812: Which of the following does not stimulate growth hormone (GH) release?

A. Exercise
B. Free fatty acids (Correct Answer)
C. Fasting
D. Stress

Explanation: ***Free fatty acids*** - High levels of **free fatty acids** in the bloodstream inhibit growth hormone (GH) secretion. - This occurs through a **negative feedback loop** at the level of the hypothalamus and pituitary gland. *Fasting* - **Fasting** (especially prolonged) is a potent stimulus for GH release, helping to mobilize fat stores and maintain **glucose homeostasis**. - During fasting, ghrelin levels increase, which further promotes GH secretion. *Exercise* - **Physical exercise** is a well-known physiological stimulus for GH release, contributing to muscle growth and repair. - The intensity and duration of exercise can influence the magnitude of GH secretion. *Stress* - Various forms of **stress**, including physical (e.g., trauma, surgery) and psychological stress, stimulate GH release. - This response is mediated in part by the **sympathetic nervous system** and increased cortisol levels.

Question 813: Which of the following hormones is not stored in cells?

A. Thyroxin
B. Renin
C. Insulin
D. Cortisol (Correct Answer)

Explanation: ***Cortisol*** - Cortisol is a **steroid hormone** that is synthesized from **cholesterol** on demand and is **not stored** in secretory vesicles or elsewhere within cells. - Being **lipophilic**, it diffuses freely across cell membranes immediately after synthesis. - Its release is regulated by the **hypothalamic-pituitary-adrenal (HPA) axis**, with synthesis and immediate secretion occurring upon stimulation. *Insulin* - Insulin is a **peptide hormone** synthesized as **proinsulin** and then cleaved into active insulin. - It is **stored in secretory granules** within pancreatic beta cells, allowing for rapid release in response to elevated blood glucose. *Thyroxine* - Thyroxine (T4) is a **thyroid hormone** that is synthesized from tyrosine and iodine. - It is **stored extracellularly** within the thyroid gland's follicles as part of a large protein called **thyroglobulin**. - Unlike cortisol (which is never stored), thyroxine has a **substantial storage pool** that can last weeks, though the storage is extracellular rather than intracellular. *Renin* - Renin is an **enzyme** produced by the **juxtaglomerular cells** of the kidney. - It is **stored in secretory granules** within these cells and released in response to decreased renal perfusion pressure or sympathetic stimulation.

Question 814: Which of the following statements about thyroid hormone receptors is correct?

A. They directly bind to thyrotropin-releasing hormone (TRH)
B. They directly bind to thyroid-stimulating hormone (TSH)
C. They cause nuclear transcription after binding with T4
D. They are intracellular receptors that mediate gene transcription after binding with T3 or T4, but their primary action is through T3. (Correct Answer)

Explanation: ***They are intracellular receptors that mediate gene transcription after binding with T3 or T4, but their primary action is through T3.*** - **Thyroid hormone receptors** are indeed **intracellular** and act as **ligand-activated transcription factors**, regulating gene expression. - While both **T3** and **T4** can bind, **T3 (triiodothyronine)** is the more potent and active form, binding with much higher affinity to the receptors to exert its primary metabolic effects. *They directly bind to thyrotropin-releasing hormone (TRH)* - **TRH (thyrotropin-releasing hormone)** is produced by the hypothalamus and acts on the **pituitary gland** to stimulate TSH release, not directly on thyroid hormone receptors. - Thyroid hormone receptors bind to thyroid hormones (**T3 and T4**), not to the hypothalamic releasing hormones like TRH. *They directly bind to thyroid-stimulating hormone (TSH)* - **TSH (thyroid-stimulating hormone)** is produced by the pituitary gland and primarily acts on receptors located on the **thyroid gland cells** to stimulate thyroid hormone synthesis and release. - Thyroid hormone receptors are distinct from TSH receptors and bind to the hormones themselves (**T3/T4**), not the stimulating hormone TSH. *Causes nuclear transcription after binding with T4* - While **T4 (thyroxine)** can bind to thyroid hormone receptors, it is primarily a **prohormone**. - T4 is largely converted to the more active **T3** within target cells, and **T3** is the main mediator of nuclear transcription through these receptors.

Question 815: During starvation, which hormone level increases?

A. Leptin
B. MSH
C. Insulin
D. Ghrelin (Correct Answer)

Explanation: ***Ghrelin*** - **Ghrelin** is often referred to as the "hunger hormone" because its levels typically rise during fasting or periods of starvation. - It stimulates **appetite** and signals the brain to increase food intake, playing a crucial role in energy balance. *Leptin* - **Leptin** is a hormone produced by **adipose tissue** that signals satiety and helps regulate long-term energy balance. - During starvation, **leptin levels typically decrease** as fat stores are depleted, which further increases appetite and reduces energy expenditure. *MSH* - **Melanocyte-stimulating hormone (MSH)** is involved in skin pigmentation and appetite regulation, but its levels do not primarily increase in response to starvation. - While MSH can influence appetite, it is often seen to decrease appetite when present in higher concentrations, which is counterintuitive during starvation. *Insulin* - **Insulin** is a hormone produced by the **pancreas** that helps regulate blood glucose levels by promoting glucose uptake into cells. - During starvation, blood glucose levels decrease, leading to a **reduction in insulin secretion** to preserve glucose for vital organs like the brain.

Question 816: Which of the following hormones does not mediate its action through cAMP?

A. Glucagon
B. Follicle stimulating hormone
C. Estrogen (Correct Answer)
D. Luteinizing hormone

Explanation: ***Estrogen*** - **Estrogen** is a **steroid hormone** that mediates its action by binding to intracellular receptors, forming a complex that directly influences gene transcription. - Steroid hormones, due to their **lipophilicity**, can cross the cell membrane and do not typically rely on cell surface receptors or second messengers like cAMP. *Glucagon* - **Glucagon** acts on a **G protein-coupled receptor (GPCR)**, specifically a Gs-coupled receptor, leading to the activation of adenylyl cyclase. - This activation increases the intracellular concentration of **cAMP**, which then activates protein kinase A to mediate its effects, primarily on glucose metabolism. *Follicle stimulating hormone* - **FSH** binds to a **GPCR** on target cells, activating the Gs protein pathway. - This activation stimulates **adenylyl cyclase** and increases intracellular **cAMP** levels, which are critical for its role in gamete development. *Luteinizing hormone* - **LH**, like FSH, binds to a cell surface **GPCR** that activates the Gs protein. - This leads to the stimulation of **adenylyl cyclase** and an increase in **cAMP**, mediating its effects on steroidogenesis and ovulation.

Question 817: Which hormone is primarily inhibited by the hypothalamus?

A. TSH
B. FSH
C. CRH
D. Prolactin (Correct Answer)

Explanation: ***Prolactin*** - The hypothalamus secretes **dopamine** (Prolactin Inhibiting Hormone), which tonically inhibits prolactin release from the anterior pituitary. - Unlike most other anterior pituitary hormones, prolactin's primary hypothalamic control is **inhibitory** rather than stimulatory. *TSH* - **Thyroid-stimulating hormone (TSH)** is *stimulated* by **Thyrotropin-Releasing Hormone (TRH)** from the hypothalamus. - The hypothalamus does not primarily inhibit TSH; rather, it promotes its release, which is then regulated by negative feedback from thyroid hormones. *FSH* - **Follicle-stimulating hormone (FSH)** is *stimulated* by **Gonadotropin-Releasing Hormone (GnRH)** from the hypothalamus. - The hypothalamus promotes FSH release, which is essential for gamete production and ovarian follicle development. *CRH* - **Corticotropin-Releasing Hormone (CRH)** is a hormone secreted by the **hypothalamus** itself. - CRH acts on the anterior pituitary to *stimulate* the release of **ACTH**, not inhibit another hormone.

Question 818: For how long is Thyroxine stored in the thyroid follicle?

A. 1-2 weeks
B. 1-2 days
C. 2-3 months (Correct Answer)
D. 3-4 years

Explanation: ***2-3 months*** - The thyroid gland stores a substantial amount of **thyroglobulin**, a precursor to **thyroid hormones**, within the **follicular lumen**. - This large storage capacity ensures a **reserve of hormones** sufficient for approximately **2 to 3 months** of normal physiological needs, even if thyroid hormone synthesis were to cease. *1-2 weeks* - This duration is too short for the thyroid's actual storage capacity; the gland is designed for a much longer reserve of **thyroid hormones**. - A 1-2 week supply would make the body highly vulnerable to **rapid onset of hypothyroidism** if synthesis were disrupted. *1-2 days* - This period is extremely short and does not reflect the significant storage capabilities of the thyroid gland, which is unique among endocrine glands for its large **extracellular storage** of hormones. - Such a limited reserve would lead to immediate and severe **hypothyroidism** with any interruption in hormone production. *3-4 years* - While the thyroid does store a considerable amount of hormone, a 3-4 year supply is an **overestimation of its storage capacity**. - The metabolic turnover and requirements of the body for thyroid hormones necessitate replenishment within a few months, rather than years.

Question 819: The primary site of vasopressin synthesis is

A. Supraoptic nucleus (Correct Answer)
B. Preoptic nucleus
C. Paraventricular nucleus
D. Posterior pituitary

Explanation: ***Supraoptic nucleus*** - The **supraoptic nucleus** of the hypothalamus is the **primary site** for the synthesis of **vasopressin** (also known as antidiuretic hormone or ADH). - Approximately **80% of vasopressin** is produced by the neurosecretory cells in this nucleus. - The synthesized vasopressin is transported down axons to the posterior pituitary for storage and release. *Preoptic nucleus* - The **preoptic nucleus** is involved in various homeostatic functions, including **thermoregulation** and **sleep regulation**, but not the synthesis of vasopressin. - While it has neuronal connections to the hypothalamus, it does not produce ADH. *Paraventricular nucleus* - The **paraventricular nucleus** also synthesizes **both vasopressin and oxytocin**, accounting for approximately **20% of vasopressin production**. - While it does produce vasopressin, the **supraoptic nucleus remains the primary site**, making it the correct answer to this question. - The PVN also plays important roles in stress response and various autonomic functions. *Posterior pituitary* - The **posterior pituitary** (neurohypophysis) is responsible for the **storage and release** of vasopressin and oxytocin, not their synthesis. - These hormones are produced in the hypothalamic nuclei (supraoptic and paraventricular) and then transported down axonal tracts to the posterior pituitary.

Question 820: Growth hormone level is highest during

A. Sleep (Correct Answer)
B. Hypoglycemia
C. Fasting
D. Exercise

Explanation: ***Sleep*** - Growth hormone (GH) secretion is **pulsatile**, with the largest and most consistent pulses occurring during **slow-wave sleep** (deep sleep). - This nocturnal surge contributes significantly to the overall daily GH output and is crucial for growth and metabolic regulation. *Hypoglycemia* - While **hypoglycemia** is a potent stimulus for GH release, it is an acute stress response rather than a state where GH levels are consistently highest. - The body's primary response to hypoglycemia is to raise blood glucose, and while GH helps, it is not the peak physiological secretion time. *Fasting* - **Prolonged fasting** can increase GH secretion as a mechanism to mobilize fat stores and conserve glucose. - However, the peak levels due to fasting are generally less pronounced than the dramatic surge observed during deep sleep. *Exercise* - **Vigorous exercise** can acutely stimulate GH release, particularly with sustained effort. - This increase is typically transient and not as high or consistently cyclical as the secretion during nocturnal sleep.

Practice by Chapter

Principles of Endocrine Regulation

Practice Questions

Hypothalamus and Pituitary Gland

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Thyroid Physiology

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Adrenal Cortex and Medulla

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Pancreatic Hormones and Glucose Metabolism

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Calcium and Phosphate Homeostasis

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Growth Hormone and Growth Factors

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Endocrine Regulation of Metabolism

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Hormone Receptors and Signaling

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Assessment of Endocrine Function

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