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WorksheetsThyroid and Adrenal Glands/ Hypothalamus Pituitary Axis
Total questions: 60
Worksheet time: 31mins
Which hormone’s secretion is primarily inhibited by hypothalamic dopamine under baseline conditions?
Growth hormone (GH)
Prolactin (PRL)
Oxytocin
Thyroid-stimulating hormone (TSH)
During dehydration, osmoreceptors in the hypothalamus stimulate release of which hormone, and what is its action?
ADH
Oxytocin
Aldosterone
ACTH
Which scenario best represents negative feedback in the hypothalamic-pituitary-adrenal axis?
High cortisol's effects on CRH and ACTH release
GnRH's effects on FSH and LH secretion
Oxytocin release increasing uterine contractions
TRH's effects on TSH secretion
Which two hormones are secreted by the posterior pituitary?
Oxytocin and ADH
TSH and ACTH
Prolactin and GH
FSH and LH
Which hormone is released from the anterior pituitary in response to CRH?
TSH
ACTH
GH
Prolactin
What hormone stimulates the thyroid gland to release T3 and T4?
TRH
TSH
GnRH
ACTH
Which hormone is released by the posterior pituitary during dehydration to conserve water?
Aldosterone
ADH
Cortisol
Oxytocin
Which hormone is responsible for stimulating spermatogenesis in males?
FSH
LH
Prolactin
TSH
Which hormone stimulates the adrenal cortex to release cortisol?
TSH
ACTH
GH
FSH
Which of the following inhibits the release of GHRH?
GH
IGF-1
Somatostatin
Dopamine
Which axis regulates reproduction through LH and FSH release?
HPA axis
HPT axis
HPG axis
HPP axis
Which hormone is secreted in pulses throughout the day and in response to stressful stimuli with a peak in the early morning?
TSH
GH
Cortisol
ADH
Which hormone stimulates gluconeogenesis in the liver?
GH
Cortisol
Prolactin
ADH
Which hormone is secreted by Sertoli cells in males to inhibit FSH release?
Insulin
Estrogen
Inhibin
Oxytocin
Which statement best describes the relationship between the hypothalamus and pituitary gland?
The pituitary controls the hypothalamus by releasing tropic hormones
The hypothalamus controls the pituitary by releasing regulatory hormones
Both glands act independently without communication
The posterior pituitary produces hormones that regulate the hypothalamus
Which pair correctly matches the hypothalamic hormone with its pituitary target?
CRH → ACTH release from anterior pituitary
TRH → Oxytocin release from posterior pituitary
Dopamine → FSH release from anterior pituitary
GnRH → ADH release from posterior pituitary
Which of the following pairs correctly shows hypothalamus → pituitary → target gland?
TRH → TSH → Thyroid
CRH → GH → Bone
GnRH → ACTH → Adrenal cortex
Dopamine → Oxytocin → Uterus
Which hormone is released due to the fetal head pressing against the cervix?
Cortisol
Oxytocin
Somatostatin
Dopamine
Which common substance inhibits ADH release and leads to dehydration?
Alcohol
Caffeine
Nicotine
Barbiturates
Which factors increases GH secretion?
Hypoglycemia
High amino acid levels in the blood
Exercise
IGF-1
Stress
Which zone of the adrenal cortex produces aldosterone?
Zona fasciculata
Zona glomerulosa
Zona reticularis
Adrenal medulla
What stimulates the adrenal cortex to release cortisol during stress?
Renin
ACTH
Angiotensin II
Aldosterone
Which disorder is characterized by hypercortisolism?
Addison’s disease
Cushing’s syndrome
Hypothyroidism
Diabetes insipidus
A patient presents with weight loss, salt cravings, hyperpigmentation, and low blood pressure. Which condition is most likely?
Cushing’s syndrome
Addison’s disease
Diabetes mellitus
Pheochromocytoma
Which of the following is the most important mineralocorticoid secreted by the adrenal cortex?
Cortisol
Epinephrine
Aldosterone
Testosterone
Which of the following is not a function of cortisol?
Mobilization of glucose
Suppression of inflammation
Sodium and potassium balance
Mood regulation
Which of the following medications is an ACE inhibitor used to lower blood pressure by affecting the RAAS system?
Losartan
Lisinopril
Spironolactone
Hydrocortisone
Which of the following is the first-line treatment for Addison’s disease?
Hydrocortisone
ACTH injections daily
ACE inhibitors
Ketoconazole
Which of the following triggers renin release from the kidneys?
High blood pressure
High sodium levels
Low blood pressure
Hyperkalemia
Which enzyme is most commonly targeted by autoantibodies in autoimmune Addison’s disease?
11-beta hydroxylase
17-alpha hydroxylase
21-hydroxylase
Aromatase
Which adrenal cortex zone produces cortisol?
Zona glomerulosa
Zona fasciculata
Zona reticularis
Adrenal medulla
Which of the following correctly matches the adrenal hormone with its primary function?
Aldosterone → regulates glucose metabolism
Cortisol → increases blood sugar and suppresses inflammation
Epinephrine → promotes sodium retention
Androgens → regulate circadian rhythm
Which adrenal cortex zone produces gonadocorticoids (sex hormones)?
Zona glomerulosa
Zona fasciculata
Zona reticularis
Adrenal medulla
Which cytokines stimulate CRH release, increasing cortisol during infection?
IL-2 and IFN-γ
IL-1, IL-6, and TNF-α
TGF-β and IL-10
IL-4 and IL-13
Which drug blocks aldosterone receptors and is used in hyperaldosteronism?
Lisinopril
Spironolactone
Fludrocortisone
Prednisone
A patient with hypertension is prescribed an ACE inhibitor. Which is the primary mechanism by which this drug lowers blood pressure?
Blocking renin release from the kidney
Preventing angiotensin I conversion to angiotensin II
Inhibiting aldosterone receptor binding
Suppressing cortisol production in the adrenal cortex
A patient with suspected Addison’s disease receives an ACTH stimulation test. Cortisol levels remain low after ACTH injection. Which is the best interpretation?
The pituitary gland is failing to release ACTH
The adrenal glands are unable to produce cortisol
The hypothalamus is not releasing CRH
Excess cortisol is suppressing ACTH secretion
Which drug is used to block cortisol synthesis in patients with Cushing’s syndrome?
Hydrocortisone
Ketoconazole
Fludrocortisone
Prednisone
Which of the following is the primary effect of epinephrine secreted from the adrenal medulla?
Increase sodium retention in the kidney
Mobilize glucose and increase heart rate
Suppress the immune system
Stimulate pigmentation of the skin
Which laboratory abnormality is most consistent with primary hyperaldosteronism (Conn’s syndrome)?
Hyponatremia and hyperkalemia
Hypernatremia and hypokalemia
Hypercalcemia and hypoglycemia
Hyponatremia and hypoglycemia
Which hormone is secreted by the thyroid gland’s C-cells?
T3
T4
Calcitonin
TRH
What is the primary regulator of T3 and T4 secretion?
ACTH from the pituitary
TRH and TSH from hypothalamus and pituitary
Calcitonin from the thyroid
Iodine levels in the blood
A patient presents with tachycardia, sweating, anxiety, and weight loss. Labs show elevated T3 and T4 with low TSH. Which disorder is most likely?
Hashimoto’s thyroiditis
Grave’s disease
Addison’s disease
Toxic nodular goiter
Which medication inhibits thyroid hormone synthesis by blocking thyroid peroxidase?
Levothyroxine
Methimazole
Fludrocortisone
Hydrocortisone
Which lab result best confirms primary hypothyroidism?
Low TSH, low T3/T4
High TSH, low T3/T4
High TSH, high T3/T4
Normal TSH, low T3/T4
A patient treated for Grave’s disease with radioactive iodine develops hypothyroidism. Which medication should be started?
Methimazole
Levothyroxine
Propranolol
Prednisone
Which feature distinguishes Hashimoto’s thyroiditis from Grave’s disease?
Hyperthyroidism
Autoimmune cause
Hypothyroidism due to thyroid peroxidase antibodies
Treatment with radioactive iodine
Which enzyme is essential for thyroid hormone synthesis and is inhibited by methimazole?
5′-deiodinase
Thyroid peroxidase
Monoamine oxidase
Adenylate cyclase
What is the primary function of calcitonin?
Stimulates bone resorption
Inhibits osteoclasts
Decrease intestinal calcium absorption
Promotes renal reabsorption of calcium
Which of the following is the first-line treatment for hypothyroidism?
Methimazole
Propranolol
Levothyroxine
Radioactive iodine
A patient with hyperthyroidism is prescribed propranolol. What is the purpose of this medication?
Inhibits thyroid hormone synthesis
Blocks conversion of T4 to T3
Controls symptoms such as tachycardia and tremor
Replaces deficient thyroid hormone
Which of the following explains why T4 is used as replacement therapy in hypothyroidism instead of T3?
T4 has a shorter half-life and more rapid effect
T4 has a longer half-life
T3 is inactive until converted to T4
T4 suppresses CRH more strongly than T3
Which of the following patients should receive radioactive iodine therapy?
A pregnant woman with hyperthyroidism
A patient with Grave’s disease who fails antithyroid therapy
A patient with primary hypothyroidism
A patient with Hashimoto’s thyroiditis
What is the mechanism of action of radioactive iodine therapy?
Blocks thyroid peroxidase activity
Destroys thyroid tissue
Prevents TSH receptor antibody binding
Suppresses TRH release from hypothalamus
Which one of these is not commonly associated with Toxic Nodular Goiter?
Iodine Deficiency
Iodine Excess
Autoimmune Disorders
Inflammation of the thyroid
Hypoglycemia
Which of the following best describes thyroid hormone effects on the liver?
Increases glycolysis and cholesterol synthesis
Decreases gluconeogenesis and glycogenolysis
Suppresses sensitivity to epinephrine
Reduces bile salt production
What is the primary effect of thyroid hormones on adipose tissue?
Increase triglyceride storage only
Stimulate lipolysis and release of fatty acids and glycerol
Reduce sensitivity to epinephrine
Inhibit glucose uptake
In muscle tissue, thyroid hormones promote which combination of effects?
Decrease protein synthesis and increase glycogen storage
Increase glucose uptake, glycolysis, and protein synthesis
Decrease glycolysis but increase fatty acid oxidation
Reduce sensitivity to epinephrine
Thyroid hormones affect the pancreas primarily by:
Decreasing β-cell sensitivity to insulin release stimuli
Increasing β-cell sensitivity to stimuli for insulin release
Directly inhibiting insulin secretion
Blocking glucose uptake into β-cells
Which of the following best describes the calorigenic effect of thyroid hormones?
Inhibition of Na⁺/K⁺ ATPase activity to reduce ATP use
Increased thermogenesis through stimulation of uncoupling proteins and Na⁺/K⁺ ATPase
Direct suppression of oxidative phosphorylation
Reduced sensitivity to norepinephrine in brown adipose tissue
