Hall: Guyton and Hall Textbook of Medical Physiology, 12th Edition
Chapter 77: Adrenocortical Hormones
Test Bank
1. A patient is administered cortisone for the treatment of an autoimmune disease. Which of
the following is most likely to occur?
A. Increased insulin secretion
B. Increased cortisol secretion
C. Increased growth hormone secretion
D. Hyperpigmentation
E. Hypoglycemia between meals
2. Which of the following would NOT be expected to increase aldosterone secretion?
A. Hemorrhage
B. A high sodium diet
C. An acute increase in plasma [ANG II]
D. A chronic increase in plasma [ANG II]
E. A chronic increase in plasma [K]
3. Over a period of several months, a patient has developed hyperpigmentation,
hyperkalemia, and a tendency for blood glucose concentration to decrease between
meals. However, blood pressure appears to be within the normal range. The patient most
likely has which of the following?
A. Addison’s disease
B. Cushing’s disease (pituitary adenoma)
C. Cushing’s syndrome (adrenal adenoma)
D. Panhypopituitarism
E. An ectopic ACTH secreting adenoma
4. Which of the following hormones increases hepatic glycogenolysis and promotes
gluconeogenesis?
A. Glucagon
B. Cortisol
C. Growth hormone
D. Insulin
5. Cortisol and GH are most dissimilar in their metabolic effects on which of the following?
A. Plasma glucose concentration
B. Lipolysis
C. Gluconeogenesis
D. Protein synthesis in muscle
E. Glucose uptake in peripheral tissues
6. Which of the following sets of hormonal responses would be expected in a subject
chronically maintained on a low sodium diet?
Plasma [Aldosterone] Plasma [ANP] Plasma [Cortisol]
A. ↑ ↓ ↑
B. ↑ ↓ ↔
C. ↑ ↔ ↑
D. ↔ ↑ ↑
E. ↔ ↓ ↔
7. Compared to the late evening values typically observed in normal subjects, plasma levels
of both ACTH and cortisol would be expected to be higher in which of the following
conditions?
A. In normal subjects after waking in the morning
B. In normal subjects administered dexamethasone
C. In patients with Cushing’s syndrome (adrenal adenoma)
D. In patients with Addison’s disease
E. In patients with Conn’s syndrome
8. A patient has Conn’s syndrome. Which of the following sets of physiological changes
would be expected?
Arterial Pressure Extracellular Fluid Volume Sodium Excretion
A.
B.
C.
D.
E.
9. Which of the following would be associated with parallel changes in aldosterone and
cortisol secretion?
A. Addison’s disease
B. Cushing’s disease
Test Bank
77-3
C. Cushing’s syndrome (adrenal tumor)
D. A low sodium diet
E. Administration of a converting enzyme inhibitor
10. A sodium depleted subject is administered an angiotensin-converting enzyme inhibitor
for two weeks. Which of the following sets of physiological changes would be expected
after two weeks, compared to control conditions before drug administration?
Plasma [Aldosterone] Plasma [Cortisol] Sodium Excretion
A.
B.
C.
D.
E.
11. In humans, the major circulating adrenal steroids that produce the three main types of
adrenal steroid actions are which of the following?
Glucocorticoid Mineralocorticoid Adrenal Androgen
A. Cortisol Aldosterone DHEA
B. Cortisone Deoxycorticosterone (DOC) Androstenedione
C. Cortisol Aldosterone Testosterone
D. Corticosterone Aldosterone Androstenedione
E. Cortisol DOC Testosterone
12. During a physical examination, a patient has been diagnosed with osteoporosis,
hypertension, and hirsutism. There are no other apparent abnormalities. Which of the
following is the most likely diagnosis?
A. Cushing’s disease
B. A hypothalamic CRH secreting tumor
C. An ectopic ACTH secreting tumor
D. An adrenal adenoma
E. Addison’s disease
Questions 13 – 15: Match each of the patients in questions 13-15 with the correct set of
blood values in the table below (the same values may be used for only one patient). Normal
values: plasma [aldosterone] = 5.0 ng/dL; plasma [cortisol] = 10 g/dL; plasma [K] = 4.5
mEq/L
[ALDO] [CORTISOL] [K]
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A. 2.0 10.0 4.5
B. 5.0 30.0 2.5
C. 15.0 30.0 2.5
D. 2.0 5.0 6.0
E. 2.0 5.0 4.5
13. A patient with Addison’s disease.
14. A patient chronically administered a converting enzyme inhibitor.
15. A patient with Cushing’s disease (pituitary tumor).
16. Which of the following would be expected in a patient with Conn’s syndrome? Normal
values: [PNa] = 140 mEq/L; [PK] = 4.5 mEq/L; [P aldosterone] = 5.0 ng/dL; plasma renin
activity = 1.0 ng ANG I/mL/h.
[PNa] [PK] [PALDO] PRA
mEq/L mEq/L ng/dL ng ANG I/ml/h
A. 142 3.3 5.0 1.0
B. 142 6.5 2.5 0.5
C. 135 6.5 2.5 3.0
D. 142 3.3 25.0 0.5
E. 135 3.5 25.0 0.5
17. Which of the following sets of physiological changes would be expected in a non-
diabetic patient with Cushing’s disease?
Plasma [Aldosterone] Plasma [Cortisol] Plasma [Insulin]
A. ↑ ↑ ↑
B. ↑ ↑ ↔
C. ↑ ↔ ↔
D. ↔ ↔ ↑
E. ↔ ↑ ↔
F. ↔ ↑ ↑