Understanding anterior pituitary hormones and their pharmacologic analogues is essential for B.Pharm students studying endocrine therapeutics. This review covers physiology, receptor mechanisms, signal transduction, and clinical pharmacology of growth hormone, prolactin, ACTH, TSH, FSH, LH and common analogues such as somatropin, octreotide, lanreotide, bromocriptine and cabergoline. Emphasis is on indications, mechanisms of action, adverse effects, monitoring parameters and clinical scenarios including acromegaly, GH deficiency, prolactinomas and steroid testing. These keyword-rich MCQs will deepen your knowledge of peptide hormone pharmacokinetics, hypothalamic regulation, pituitary pathology and modern therapeutic analogues. Questions integrate pharmacodynamics, adverse reactions and case-based monitoring to prepare you for exams and clinical practice. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which hormones are secreted by the anterior pituitary?
- Oxytocin and vasopressin
- Growth hormone, prolactin, ACTH, TSH, FSH and LH
- Thyroxine and triiodothyronine
- Insulin and glucagon
Correct Answer: Growth hormone, prolactin, ACTH, TSH, FSH and LH
Q2. Somatotrophs, the cells that secrete growth hormone (GH), are classified as which pituitary cell type?
- Chromophobes
- Basophils
- Acidophils (somatotrophs)
- Pars intermedia cells
Correct Answer: Acidophils (somatotrophs)
Q3. The primary peripheral mediator of many growth hormone effects is:
- Direct activation of insulin receptors
- Hepatic production of IGF-1 (somatomedin C)
- Increased thyroid hormone secretion
- Activation of renin–angiotensin system
Correct Answer: Hepatic production of IGF-1 (somatomedin C)
Q4. Which second messenger system is primarily used by TSH, LH and FSH receptors?
- cGMP via guanylyl cyclase
- Tyrosine kinase autophosphorylation
- Gq → IP3/DAG
- Gs → increased cAMP
Correct Answer: Gs → increased cAMP
Q5. Prolactin secretion from the anterior pituitary is physiologically inhibited by which hypothalamic factor?
- Thyrotropin-releasing hormone (TRH)
- Dopamine (prolactin-inhibiting factor)
- Somatostatin
- Growth hormone-releasing hormone (GHRH)
Correct Answer: Dopamine (prolactin-inhibiting factor)
Q6. Which somatostatin analogue is commonly used to treat acromegaly and neuroendocrine tumors?
- Somatropin
- Octreotide
- Cosyntropin
- Leuprolide
Correct Answer: Octreotide
Q7. The recombinant human growth hormone preparation used for GH deficiency is called:
- Filgrastim
- Somatropin
- Octreotide
- Cabergoline
Correct Answer: Somatropin
Q8. First-line pharmacologic therapy for a symptomatic prolactinoma is usually:
- Transsphenoidal surgery
- Cabergoline (dopamine D2 agonist)
- Somatostatin analogue
- Glucocorticoid replacement
Correct Answer: Cabergoline (dopamine D2 agonist)
Q9. Cosyntropin, an ACTH analogue, is primarily used clinically to:
- Shrink pituitary adenomas
- Diagnose adrenal insufficiency by stimulating cortisol release
- Treat hypothyroidism
- Suppress prolactin secretion
Correct Answer: Diagnose adrenal insufficiency by stimulating cortisol release
Q10. Administration of a GnRH agonist (e.g., leuprolide) produces which short- and long-term effects on gonadotropin secretion?
- Immediate suppression with sustained increase
- Initial flare of LH/FSH followed by receptor downregulation and suppression
- No change in gonadotropin levels
- Permanent enhancement of LH/FSH secretion
Correct Answer: Initial flare of LH/FSH followed by receptor downregulation and suppression
Q11. Compared with GnRH agonists, GnRH antagonists (e.g., degarelix) differ by:
- Causing a prolonged initial flare before suppression
- Directly blocking GnRH receptors and producing rapid suppression without flare
- Increasing LH secretion chronically
- Stimulating prolactin release
Correct Answer: Directly blocking GnRH receptors and producing rapid suppression without flare
Q12. A common adverse effect of long-term somatostatin analogue therapy is:
- Renal stone formation
- Development of cholelithiasis (gallstones)
- Hyperthyroidism
- Excessive hair growth
Correct Answer: Development of cholelithiasis (gallstones)
Q13. Peptide anterior pituitary hormones and their analogues are usually administered by which route?
- Oral tablet
- Transdermal patch
- Parenteral routes (subcutaneous or intramuscular)
- Inhalation
Correct Answer: Parenteral routes (subcutaneous or intramuscular)
Q14. The best biochemical parameter to monitor efficacy of GH therapy is:
- Serum cortisol
- IGF-1 (insulin-like growth factor-1) levels
- Serum TSH
- Serum prolactin
Correct Answer: IGF-1 (insulin-like growth factor-1) levels
Q15. Which anterior pituitary hormone is structurally most similar to growth hormone?
- TSH
- Prolactin
- ACTH
- FSH
Correct Answer: Prolactin
Q16. The therapeutic action of cabergoline in hyperprolactinemia is mediated by:
- Antagonism of dopamine D2 receptors
- Agonism of dopamine D2 receptors on lactotrophs
- Activation of somatostatin receptors
- Stimulation of TSH receptors
Correct Answer: Agonism of dopamine D2 receptors on lactotrophs
Q17. Bromocriptine is primarily indicated in which pituitary-related condition?
- Acromegaly as first-line monotherapy
- Hyperprolactinemia and suppression of lactation
- Primary hypothyroidism
- Adrenal insufficiency
Correct Answer: Hyperprolactinemia and suppression of lactation
Q18. Somatostatin analogues are useful in acromegaly because they:
- Increase GH receptor expression in liver
- Directly antagonize IGF-1 activity
- Inhibit GH secretion from pituitary somatotrophs
- Stimulate prolactin release to counteract GH
Correct Answer: Inhibit GH secretion from pituitary somatotrophs
Q19. Laron dwarfism is characterized by which endocrine defect?
- GH deficiency with low GH and low IGF-1
- GH receptor mutation causing high GH and low IGF-1
- Excessive IGF-1 production
- Primary hypothyroidism causing short stature
Correct Answer: GH receptor mutation causing high GH and low IGF-1
Q20. A notable metabolic adverse effect of therapeutic growth hormone administration is:
- Hypoglycemia due to increased insulin sensitivity
- Hyperglycemia and insulin resistance
- Severe hyponatremia
- Hyperkalemia
Correct Answer: Hyperglycemia and insulin resistance
Q21. TSH stimulates thyroid hormone synthesis primarily via which intracellular pathway?
- Activation of JAK-STAT pathway
- Inhibition of adenylate cyclase
- Gs-mediated increase in cAMP in thyroid follicular cells
- Opening of ligand-gated ion channels
Correct Answer: Gs-mediated increase in cAMP in thyroid follicular cells
Q22. ACTH acts mainly on which zone of the adrenal cortex to stimulate cortisol synthesis?
- Zona glomerulosa
- Zona fasciculata
- Zona reticularis only
- Adrenal medulla
Correct Answer: Zona fasciculata
Q23. The screening test commonly used to evaluate suspected Cushing’s syndrome is:
- High-dose ACTH stimulation test
- Low-dose dexamethasone suppression test
- TRH stimulation test
- Insulin tolerance test
Correct Answer: Low-dose dexamethasone suppression test
Q24. Excess growth hormone secretion prior to epiphyseal closure causes which clinical condition?
- Acromegaly
- Gigantism
- Dwarfism
- Hypopituitarism
Correct Answer: Gigantism
Q25. Which somatostatin analogue is available in long-acting depot formulations suitable for monthly dosing?
- Short-acting native somatostatin
- Lanreotide autogel (long-acting)
- Somatropin
- Cosyntropin
Correct Answer: Lanreotide autogel (long-acting)
Q26. A major contraindication to initiating growth hormone therapy is:
- Active malignancy or history of active cancer
- Short stature due to GH deficiency
- Turner syndrome without tumors
- Chronic renal failure-associated growth delay
Correct Answer: Active malignancy or history of active cancer
Q27. In males, persistent hyperprolactinemia commonly causes which reproductive effect?
- Increased libido and fertility
- Decreased GnRH and LH secretion leading to hypogonadism and infertility
- Enhanced spermatogenesis
- Elevated testosterone levels
Correct Answer: Decreased GnRH and LH secretion leading to hypogonadism and infertility
Q28. Why are GnRH agonists effective in treating advanced prostate cancer?
- They increase prolactin, which inhibits tumor growth
- They cause sustained downregulation of pituitary GnRH receptors and reduce testosterone production
- They directly block androgen receptors in tumor cells
- They stimulate LH and FSH to toxic levels for cancer cells
Correct Answer: They cause sustained downregulation of pituitary GnRH receptors and reduce testosterone production
Q29. In a cosyntropin stimulation test, a blunted cortisol response most likely indicates:
- Secondary hypothyroidism
- Primary adrenal insufficiency or adrenal failure
- Normal adrenal function
- Hyperaldosteronism
Correct Answer: Primary adrenal insufficiency or adrenal failure
Q30. Which class of drugs can antagonize the therapeutic effect of dopamine agonists used for hyperprolactinemia?
- Somatostatin analogues
- Dopamine antagonists such as typical antipsychotics (e.g., haloperidol)
- Beta-blockers
- ACE inhibitors
Correct Answer: Dopamine antagonists such as typical antipsychotics (e.g., haloperidol)
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