1. 1
   A student is walking home when a dog suddenly barks and lunges towards them. Their heart begins to pound, their face turns pale, and their muscles feel primed to move quickly. A doctor later explains that this reaction was triggered by a hormone released from a gland situated above the kidneys.

   (a)

   Which gland released the hormone responsible for this reaction?

   [1 mark]

   • APancreas
   • BPituitary gland
   • CThyroid gland
   • DAdrenal gland

   (b)

   Which of the following is NOT a direct effect of the hormone released in this situation?

   [1 mark]

   • AIncreased heart rate
   • BIncreased blood flow to the muscles
   • CLowered blood sugar level
   • DRaised blood pressure

   (c)

   Explain how the hormone identified in part (a) raises the student's blood sugar level.

   [2 marks]

   Total for question 1: 4 marks

2. 2
   A 45-year-old patient visits her doctor feeling constantly tired and cold, and complaining of weight gain. Blood tests show her thyroxine level is lower than normal, but the level of a hormone released from her pituitary gland is much higher than normal. The doctor explains this is because her body is trying to correct the low thyroxine level through a mechanism that keeps internal conditions constant.

   (a)

   What is the name of the pituitary hormone that is raised in this patient, as described in the passage?

   [1 mark]

   • ALH
   • BFSH
   • CTSH
   • DTRH

   (b)

   What type of control mechanism is described in the passage?

   [1 mark]

   • AOsmoregulation
   • BPositive feedback
   • CReflex arc
   • DNegative feedback

   (c)

   Explain how a fall in thyroxine level leads to the release of TSH from the pituitary gland.

   [2 marks]

   Total for question 2: 4 marks

3. 3
   A woman tracks her hormone levels across a 28-day menstrual cycle. She notes that in the first half of the cycle, one pituitary hormone stimulates an egg to mature in the ovary, while ovarian hormone levels rise and cause the uterus lining to thicken. Around day 14, a surge in a second pituitary hormone triggers the release of the mature egg. In the second half of the cycle, another ovarian hormone maintains the uterus lining, but if pregnancy does not occur, hormone levels fall and the lining breaks down.

   (a)

   Describe the roles of FSH and LH in the first half of the menstrual cycle described.

   [3 marks]

   (b)

   Explain the roles of oestrogen and progesterone in maintaining the uterus lining, and explain why the lining breaks down if pregnancy does not occur.

   [4 marks]

   Total for question 3: 7 marks

4. 4
   A couple who do not wish to have children yet are deciding between hormonal contraception and barrier methods of contraception. Two years later, after trying unsuccessfully to conceive naturally, the same couple visit a fertility clinic, where the doctor recommends a course of clomifene therapy followed by IVF treatment.

   (a)

   Evaluate the use of hormonal contraception compared with barrier methods of contraception for the couple described.

   [6 marks]

   (b)

   Explain how clomifene therapy and IVF could help the couple to conceive.

   [6 marks]

   Total for question 4: 12 marks

End of questions