TEST BANK FOR HUMAN ANATOMY AND PHYSIOLOGY 9TH EDITION BY MARIEB AND HOEHN

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1 Link download full: TEST BANK FOR HUMAN ANATOMY AND PHYSIOLOGY 9TH EDITION BY MARIEB AND HOEHN Chapter 16 Exam Name MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) Which of the following is not a change typically produced by a hormonal stimulus? 1) A) stimulates production of an action potential B) alters plasma membrane permeability C) induces secretory activity D) activates or deactivates enzymes Answer: A Explanation: A) B) C) D) 2) Regulating hormones from the hypothalamus. 2) A) first enter into the hypophyseal portal system B) enter the hepatic portal system, which feeds the pituitary C) enter venous circulation and travel to the heart, which pumps the hormonecontaining blood to the pituitary D) travel by arteries to the pituitary Answer: A Explanation: A) B) C) D) 3) Hormones often cause a cell to elicit multiple responses; this is because. 3) A) there are thousands of receptors on the cell membrane B) during protein kinase activation, enzymes phosphorylate many other enzymes C) the receptors bind to several hormones at the same time D) the protein kinases are rapidly metabolized into functional amino acids Answer: B Explanation: A) B) C) D) 4) Which of the following is not a type of hormone interaction? 4) A) permissiveness B) synergism C) feedback D) antagonism Answer: C Explanation: A) B) C) D) 1 5) Which of the following is not a steroid-based hormone? 5) A) aldosterone B) estrogen C) epinephrine D) cortisone Answer: C Explanation: A) B) C) D) 6) Thyroxine is a peptide hormone, but its mechanism is different from other peptide hormones.

2 Which of the following statements is true concerning this difference? 6) A) It is very specific in the cell type it targets. B) It is a stimulant of cellular metabolism and targets all cells. C) It does not require a second messenger to effect a response. D) It causes positive feedback. Answer: C Explanation: A) B) C) D) 7) Cells that respond to peptide hormones usually do so through a sequence of biochemical

3 reactions involving receptor and kinase activation. In order for cells to respond, it is necessary for first and second messengers to communicate. This is possible because. 7) A) hormones alter cellular operations through direct stimulation of a gene B) peptide hormones are converted by cell membranes enzymes into second messengers C) G protein acts as the link between first and second messengers D) the hormone receptor complex moves into the cytoplasm as a unit Answer: C Explanation: A) B) C) D) 8) The major targets of growth hormone are. 8) A) the liver B) the blood vessels C) bones and skeletal muscles D) the adrenal glands Answer: C Explanation: A) B) C) D) 2 9) How do glucocorticoids enable the body to deal appropriately with stress? 9) A) by releasing the neurotransmitters that prepare the body for the stress response B) by increasing blood glucose, fatty acid, and amino acid levels and enhancing blood pressure C) by decreasing the heart rate, thus decreasing blood pressure D) by stimulating the pancreas to release insulin Answer: B Explanation: A) B) C) D) 10) Which of the choices below is not a factor required for target cell activation by hormone receptor interaction? 10) A) strength of the bond between the receptor and hormone B) type of hormone C) blood levels of hormone D) number of receptors for that hormone Answer: B Explanation: A) B) C) D) 11) Gluconeogenesis occurs in the liver due to the action of. 11) A) cortisol B) aldosterone C) secretin D) insulin Answer: A Explanation: A) B) C) D) 12) Oxytocin. 12) A) controls milk production B) is an adenohypophyseal secretion C) release is an example of a positive feedback control mechanism D) exerts its most important effects during menstruation Answer: C Explanation: A) B) C) D) 3 13) Thyroid hormone (a small iodinated amine) enters target cells in a manner similar to. 13) A) insulin, because insulin is a small peptide B) growth hormone, because the thyroid works synergistically with thyroid hormone C) steroid hormones, because both diffuse easily into target cells D) glucagon, because the structure of glucagon is similar to that of thyroid hormone Answer: C Explanation: A) B) C) D) 14) Aldosterone. 14) A) production is greatly influenced by ACTH B) is secreted by the neurohypophysis C) functions to increase sodium reabsorption D) presence increases potassium concentration in the blood Answer: C Explanation: A) B) C) D) 15)

4 A man has been told that he is not synthesizing enough follicle-stimulating hormone (FSH), and for this reason he may be unable to father a child. Choose the correct statement to explain this problem. 15) A) FSH stimulates sperm production in the testes. B) FSH stimulates estrogen secretion by ovarian cells; therefore it is not synthesized by males. C) The man

5 must be producing progesterone, which inhibits the synthesis of FSH. D) A hormone made in the adenohypophysis cannot influence fertility. Answer: A Explanation: A) B) C) D) 16) ADH. 16) A) is inhibited by alcohol B) increases urine production C) promotes dehydration D) is produced in the adenohypophysis Answer: A Explanation: A) B) C) D) 4 17) Several hormones are synthesized in the hypothalamus and transported to the anterior pituitary gland. The mechanism of transportation from hypothalamus to anterior pituitary gland is through the. 17) A) feedback loop B) general circulatory system C) hypophyseal portal system D) hepatic portal system Answer: C Explanation: A) B) C) D) 18) In circumstances where the body requires prolonged or increased levels of a hormone, the DNA of target cells will specify the synthesis of more receptors on the surface of the cells of the target organ. This is known as. 18) A) a stressor reaction B) upregulation C) sensitivity increase D) cellular affinity Answer: B Explanation: A) B) C) D) 19) Mineralocorticoid is to aldosterone as glucocorticoid is to. 19) A) estrogen B) epinephrine C) testosterone D) cortisol Answer: D Explanation: A) B) C) D) 20) The hypothalamic-hypophyseal tract. 20) A) conducts aldosterone to the hypophysis B) is the site of prolactin synthesis C) is partly contained within the infundibulum D) connects the hypophysis to the pituitary gland Answer: C Explanation: A) B) C) D) 21) Virtually all of the protein or amino acid-based hormones exert their effects through intracellular. 21) A) nucleotides B) calcium C) second messengers D) deactivating ions Answer: C Explanation: A) B) C) D) 5 22) Cellular responses to hormones that initiate second-messenger systems include. 22) A) possible activation of several different second-messenger systems B) hormone binding to intracellular receptors C) formation of a specific protein kinase that acts on a series of extracellular intermediates D) cyclic AMP phosphodiesterase formation of an active second messenger Answer: A Explanation: A) B) C) D) 23) Which of the following is not a cardinal sign of diabetes mellitus? 23) A) polydipsia B) polycythemia C) polyuria D) polyphagia Answer: B

6 Explanation: A) B) C) D) 24) One of the least complicated of the endocrine control systems directly responds to changing blood levels of ions and nutrients. Which of the following describes this mechanism? 24) A)

7 humoral stimulation B) protein synthesis C) catabolic inhibition D) carbohydrate oxidation Answer: A Explanation: A) B) C) D) 25) Normal development of the immune response is due in part to hormones produced by the. 25) A) thymus gland B) pancreas C) adrenal medulla D) thyroid gland Answer: A Explanation: A) B) C) D) 26) When it becomes necessary to enlist the fight-or-flight response, a hormone that is released during the alarm phase of the general adaptation syndrome is. 26) A) angiotensinogen B) renin C) epinephrine D) estrogen Answer: C Explanation: A) B) C) D) 6 27) Steroid hormones exert their action by. 27) A) binding cell receptors and initiating camp activity B) activating the hypothalamic release of regulating hormones C) entering the cell and activating mitochondrial DNA D) entering the nucleus of a cell and initiating or altering the expression of a gene Answer: D Explanation: A) B) C) D) 28) Eicosanoids do not include. 28) A) paracrines B) leukotrienes C) prostaglandins D) hydrocortisones Answer: D Explanation: A) B) C) D) 29) The neurohypophysis or posterior lobe of the pituitary gland is not a true endocrine gland because. 29) A) embryonically it was an endocrine tissue, but in the adult human it is no longer functional B) it is strictly a part of the neural system and has little or nothing to do with hormonal release C) it is only a hormone storage area that receives hormones from the hypothalamus for release D) it is unable to function as an endocrine tissue because it is actually part of the neural system due to its location Answer: C Explanation: A) B) C) D) 30) Which organ does not produce hormones? 30) A) heart B) skin C) kidney D) spleen Answer: D Explanation: A) B) C) D) 31) What ion is sometimes used as a second messenger of amino acidnbased hormones? 31) A) sodium B) calcium C) iron D) chlorine Answer: B Explanation: A) B) C) D) 7 32)

8 The most important mineralcorticoid regulator of electrolyte concentrations in extracellular fluids is. 32) A) insulin B) glucagon C) aldosterone D) cortisol Answer: C Explanation: A) B) C) D) 33) Which organ is responsible for synthesizing ANP? 33) A) the spleen B) the heart C) the kidney D) the skin Answer: B Explanation: A) B) C) D) 34) Which of the following is not a change that may be caused by hormonal stimulus? 34) A) a change in membrane potential B) an increase in enzymatic activity C) direct control of the nervous system D) the stimulation of a genetic event resulting in protein synthesis Answer: C

9 Explanation: A) B) C) D) 35) Leptin is secreted by. 35) A) adipocytes B) goblet cells C) lymphocytes D) fibroblasts Answer: A Explanation: A) B) C) D) 36) The ability of a specific tissue or organ to respond to the presence of a hormone is dependent on. 36) A) nothingnall hormones of the human body are able to stimulate any and all cell types because hormones are powerful and nonspecific B) the location of the tissue or organ with respect to the circulatory path C) the membrane potential of the cells of the target organ D) the presence of the appropriate receptors on the cells of the target tissue or organ Answer: D Explanation: A) B) C) D) 8 37) Which of the following hormones suppresses appetite and increases energy expenditure? 37) A) leptin B) secretin C) renin D) gastrin Answer: A Explanation: A) B) C) D) 38) The second-messenger mechanism of hormone action operates by. 38) A) binding to specific receptors and employing the services of G proteins and camp B) synthesizing more than one hormone at a time C) increasing the basal metabolic rate in the target organ D) altering gene expression in the nuclear DNA Answer: A Explanation: A) B) C) D) 39) Chemical substances secreted by cells into the extracellular fluids and that regulate the metabolic function of other cells in the body are called. 39) A) hormones B) antibodies C) enzymes D) proteins Answer: A Explanation: A) B) C) D) 40) Which of the following is not a category of endocrine gland stimulus? 40) A) hormonal B) neural C) enzyme D) humoral Answer: C Explanation: A) B) C) D) 41) ACTH. 41) A) causes the release of hormones from the adrenal medulla B) is secreted by the posterior pituitary C) is not a tropic hormone D) secretion is regulated by a hypothalamic regulatory hormone Answer: D Explanation: A) B) C) D) 9 42) Which of the following is not a parathyroid gland mechanism to maintain adequate levels of blood calcium? 42) A) increase calcium ion reabsorption by the kidneys B) increase in intestinal absorption of calcium ions C) inhibition of calcitonin synthesis D) activation of osteoclasts Answer: C Explanation: A) B) C) D) 43) The single most important regulator of calcium levels in the blood is. 43) A) calcitonin B) parathyroid hormone C) gonadotropic hormones D) thyroid hormone Answer: B

10 Explanation: A) B) C) D) SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 44) The largest pure endocrine gland in the body is the. 44) Answer: thyroid Explanation: 45) Give an example of synergism in hormones. 45) Answer:

11 The liver will release glucose in the presence of glucagon or epinephrine. If both hormones are present the amount of glucose released is increased 150%. Explanation: 10 Figure 16.2 Using Figure 16.2, match the following hypothalamic hormones with the pituitary hormone targets: 46) Thyroid stimulating hormone 46) Answer: D Explanation: 47) What is the difference between autocrines and paracrines? 47) Answer: Autocrines are self-regulating chemical messengers because their target is the cell from which they are manufactured. Paracrines are chemical messengers that act locally. They tend to affect only the cells immediately around them. Explanation: 48) How is the heart involved as an endocrine gland? 48) Answer: A few cardiac cells secrete atrial natriuretic peptide (ANP), which helps regulate salt output by the kidney. ANP inhibits aldosterone and signals the kidney to remove more salt. Explanation: 11 Figure 16.1 Using Figure 16.1, match the following: 49) Produces the hormones that direct the production of the secondary male sex characteristics. 49) Answer: E Explanation: 12 Figure 16.2 Using Figure 16.2, match the following hypothalamic hormones with the pituitary hormone targets: 50) Prolactin 50) Answer: B 51) Storehouse for the hormones produced by the hypothalamus of the brain. 51) Answer: B Explanation: 52) Hypersecretion of growth hormone after epiphyseal plate closure can result in a condition called. 52) Answer: acromegaly Explanation: 53) Compare the structure and function of endocrine and exocrine glands. 53) Answer: Endocrine glands are ductless glands that release hormones into the blood to be transported to other organs. Exocrine glands have ducts through which products are released. Explanation: 14 54) Briefly discuss target cell activation by hormone-receptor interaction. 54) Answer: The first step is hormone-receptor binding to target cells, but interaction depends on blood levels of the hormone, relative number of receptors for that hormone on or in the target cells, and the affinity of the union between the hormone and the receptor. Explanation: 55)

12 As a result of stress the adenohypophysis releases, which stimulates release of hormones from the adrenal cortex that retain sodium and water, increase blood sugar, and begin breaking down fats. 55) Answer: ACTH Explanation: 56)

13 Why should the hypothalamus instead of the adenohypophysis be called the master endocrine gland? 56) Answer: Although the adenohypophysis has many hormonal products, the hypothalamus controls anterior pituitary activity through regulatory factors. Explanation: 57) Basal metabolism declines with age. What factors contribute to that decline? 57) Answer: Thyroid follicles fill with colloid and gland fibrosis occurs, resulting in a decline in hormone synthesis and release. Increase in body fat relative to muscle also contributes because muscle tissue is more active metabolically than fat. Explanation: 15 Figure 16.1 Using Figure 16.1, match the following: 58) Produce steroid hormones and glucocorticoids and mineralocorticoids. 58) Answer: C Explanation: 59) A person who drinks a lot of alcoholic beverages must urinate frequently. Why? 59) Answer: Alcohol inhibits ADH secretion. Explanation: 16 Figure 16.3 Using Figure 16.3, match the following: 60) Produces androgens. 60) Answer: C Explanation: 61) Produces glucocorticoids. 61) Answer: B Explanation: 62) Acromegaly and gigantism are the result of of growth hormone. 62) Answer: hypersecretion Explanation: 17 Figure 16.2 Using Figure 16.2, match the following hypothalamic hormones with the pituitary hormone targets: 63) Follicle stimulating hormone 63) Answer: C Explanation: 64) Which hormone stimulates production of RBCs? 64) Answer: erythropoietin Explanation: 65) Alpha islet cells produce, an extremely potent hyperglycemic hormone. 65) Answer: glucagon Explanation: 66) The gland may influence our day/night cycles and even regulate the onset of sexual maturity. 66) Answer: pineal Explanation: 18 Figure 16.1 Using Figure 16.1, match the following: 67) Produces hormones and is considered a neuroendocrine organ. 67) Answer: A Explanation: 68) Growth hormones act indirectly to make the epiphyseal plate cartilage grow. What then acts directly to make it grow? 68) Answer: Growth hormone stimulates the liver to release a growth factor called somatomedin, which in turn controls the epiphyseal plate cartilage growth. Explanation: 19 Figure 16.2

14 Using Figure 16.2, match the following hypothalamic hormones with the pituitary hormone targets: 69) Adrenocorticotropic hormone 69) Answer: E Explanation: 70) Why would one not expect to continue increasing in height with age? 70) Answer: The amount of growth hormone secreted declines with age and the closure of the

15 epiphyseal plates prohibits further growth in length of the long bones. Explanation: 71) Which hormones are synthesized from cholesterol? 71) Answer: Steroids Explanation: 72) A woman with excessive body hair, a deep voice, and an enlarged clitoris shows the outward symptoms of which hormonal dysfunction? 72) Answer: The hormonal dysfunction is hypersecretion of androgens. Explanation: 73) Glucagon and insulin both target the cells of the liver and are both made in the pancreas, yet they have very different effects on the cells they target. What accounts for this fact? 73) Answer: Glucagon and insulin use different cell surface receptors. Explanation: 20 Figure 16.2 Using Figure 16.2, match the following hypothalamic hormones with the pituitary hormone targets: 74) Growth hormone 74) Answer: A 75) Produces aldosterone. 75) Answer: A Explanation: 76) Produces epinephrine. 76) Answer: D Explanation: 77) List the four mechanisms involved in the regulation of aldosterone secretion. 77) Answer: The four mechanisms are: (1) the renin-angiotensin mechanism, (2) plasma concentration of sodium and potassium ions, (3) control exerted by ACTH, and (4) plasma concentration of atrial natriuretic peptide. Explanation: 22 Figure 16.1 Using Figure 16.1, match the following: 78) Produces the hormones that promote the development of the female secondary sexual characteristics at puberty. 78) Answer: D Explanation: 23 Figure 16.3 Using Figure 16.3, match the following: 79) Excess hormone levels result in Cushing s syndrome. 79) Answer: B Explanation: 80) Which hormone has only one known effect: to stimulate milk production by the breasts? 80) Answer: Prolactin Explanation: 81) The gland is especially large in early childhood, then declines in size and function with age. 81) Answer: thymus Explanation: 24 Figure 16.3

16 Using Figure 16.3, match the following: 82) Hormones mimic sympathetic nervous system neurotransmitters. 82) Answer: D Explanation: TRUE/FALSE. Write T if the statement is true and F if the statement is false. 83) The endocrine gland that is probably malfunctioning if a person has a high metabolic rate is the

17 parathyroid. 83) Answer: True False Explanation: 84) Both turn on factors (hormonal, humoral, and neural stimuli) and turn off factors (feedback inhibition and others) may be modulated by the activity of the nervous system. 84) Answer: True False Explanation: 85) Oxytocin is a strong stimulant of uterine contractions. 85) Answer: True False Explanation: 86) Enteroendocrine cells of the GI tract produce some hormones that are chemically identical to neurotransmitters. 86) Answer: True False Explanation: 25 87) All peptide hormone synthesis requires gene activation that produces mrna. 87) Answer: True False Explanation: 88) LH is also referred to as a gonadotropin. 88) Answer: True False Explanation: 89) Glucocorticoids are steroid hormones that usually enhance the immune responses when an individual is suffering from severe stress. 89) Answer: True False Explanation: 90) The beta cells in the pancreatic islets produce insulin. 90) Answer: True False Explanation: 91) Most type 2 diabetics do not produce insulin. 91) Answer: True False Explanation: 92) Hypersecretion of catecholamines can result in hypertension. 92) Answer: True False Explanation: 93) The hormone that raises blood sugar levels is insulin. 93) Answer: True False Explanation: 94) All adenohypophyseal hormones except GH affect their target cells via a cyclic AMP second messenger. 94) Answer: True False Explanation: 95) Oxytocin and ADH are produced in the posterior pituitary. 95) Answer: True False Explanation: 96) Aldosterone is the most potent mineralocorticoid produced in the adrenals but the least abundant. 96) Answer: True False Explanation: 97) In aged individuals, chronic stress may increase blood levels of cortisol and possibly contribute to memory deterioration. 97) Answer: True False Explanation: 26 98) Atrial natriuretic peptide is a hormone that controls blood pressure in part by increasing the urinary excretion of sodium. 98) Answer: True False Explanation: 99) The pineal gland is used as a brain orientation landmark for brain X rays. 99) Answer: True False Explanation: 100) Type 2 diabetics may reflect declining receptor sensitivity to insulin rather than decreased insulin

18 production. 100) Answer: True False Explanation: 101) Growth hormone solely exerts its influence by targeting other endocrine glands to produce hormones. 101) Answer: True False Explanation: 102) The prime metabolic effect of cortisol is gluconeogenesis. 102) Answer: True False Explanation: 103) Many hormones synthesized in the gastrointestinal tract are chemically identical to brain

19 neurotransmitters. 103) Answer: True False Explanation: 104) Thyroid hormone production requires the presence of iodine and calcium. 104) Answer: True False Explanation: 105) Iodine is an essential element required for the synthesis of thyroxine. 105) Answer: True False Explanation: 106) Direct gene activation involves a second-messenger system. 106) Answer: True False Explanation: 107) Addison s disease is due to a insufficient output of glucocorticoids only. 107) Answer: True False Explanation: 108) ACTH stimulates the adrenal cortex to release corticosteroid hormones. 108) Answer: True False Explanation: ) The antagonistic hormones that regulate the blood calcium level are calcitonin-parathormone. 109) Answer: True False Explanation: MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 110) Hyposecretion of the pancreas. Answer: A A) Diabetes mellitus 110) Match the following: 111) Hyposecretion of the thyroid in infants. Answer: A A) Cretinism 111) Match the following: 112) Hyposecretion of growth hormone. Answer: A A) Pituitary dwarfism 112) Match the following: 113) Aldosterone production Answer: A 114) Testosterone production Answer: A A) Hormonal stimulus 113) 114) Match the following: 115) Produces a hormone that controls blood levels of calcium and potassium by their removal from bone tissue. Answer: A A) Parathyroid 115) Match the following: 116) Hypersecretion of growth hormone. Answer: A A) Acromegaly 116) Match the following: 117) The gland that controls the fight-or-flight reaction. Answer: A A) Adrenal medulla 117) Match the following: 118) Hyposecretion of the adrenal cortex. Answer: A A) Addison s disease 118) Match the following: 119) Hypersecretion of the adrenal cortex. Answer: A A) Cushing s disease 119) 28 Match the following: 120) Hypersecretion of growth hormone. Answer: A A) Acromegaly 120) Match the following: 121) The size and shape of a pea; produces hormones that stimulate other

20 endocrine glands. Answer: B 122) Produces hormones that regulate glucose levels in the body. Answer: A A) Pancreas B) Hypophysis 121) 122) Match the following: 123) Hyposecretion of the thyroid in adults. Answer: A

21 A) Myxedema 123) Match the following: 124) Parathyroid hormone production Answer: A A) Humoral stimulus 124) Match the following: 125) An autoimmune problem involving the thyroid gland. Answer: A A) Graves disease 125) Match the following: 126) Produces the body s major metabolic hormones. Answer: A A) Thyroid 126) Match the following: 127) Epinephrine production Answer: A A) Neural stimulus 127) ESSAY. Write your answer in the space provided or on a separate sheet of paper. 128) The parents of a 17-year-old boy are concerned about his height because he is only 5 feet tall and they are both close to 6 feet tall. After tests by their doctor, a certain hormone is prescribed for the boy. What is the probable diagnosis, and what hormones were prescribed? Why might the child still expect to reach his growth potential? Answer: The diagnosis is insufficient growth hormone. The prescription is recombinant DNA-produced pituitary growth hormone. The reason the child might reach his growth potential is that the epiphyseal plates of the long bones have not yet closed, allowing additional growth of the long bones. 129) Mr. Sanchez makes an appointment to see his doctor for pain in his abdominal area. Tests and X rays reveal kidney stones as well as bones with a moth-eaten appearance. Physical exam reveals hyporeflexia and hypotonis (weakness). What is the problem and what treatment would be recommended? Answer: The problem is hyperparathyroidism resulting from a parathyroid gland tumor. The treatment is removal of the tumor ) What is the most important nursing intervention when caring for a patient with Cushing s syndrome? Answer: Because of enhanced anti-inflammatory effects, infections may become overwhelmingly severe. Therefore the nurse should warn the patient to avoid shaving nicks and other sources of infection. 131) John is a 26-year-old man who begins to notice a progressive enlargement of feet, hands, cranium, nose, and

22 lower jaw bone. His doctor recommends a pituitary gland operation. What is the most likely diagnosis? Why? Answer: The diagnosis is acromegaly. The condition results from excess secretion of growth hormone from the

23 pituitary gland postpuberty and after the epiphyseal plates of the long bones have fused. 132) Following workup for symptoms of decreased libido and erectile dysfunction, a patient is told that his pituitary is hypersecreting prolactin. Is there need for concern about this young man? Answer: Yes; there should be great concern, because hypersecretion of prolactin will lead to impotence. 133) Thomas is a diabetic. While at work, he began to tremble, was somewhat disoriented, and showed signs similar to that of a drunk. One of his colleagues gave him some hard candy, which seemed to help him return to normal functions. Why? Was this a proper action, considering that Thomas is diabetic? Answer: Thomas was suffering from hypoglycemia. The low blood sugar level affected his brain resulting in his appearance of being drunk. The candy raised his blood sugar back up to a normal level. This was a proper action because he was hypoglycemic And the brain needs constant glucose fo proper function. 134) Mrs. James appeared at the clinic complaining of extreme nervousness and sweating, saying that she could feel and hear her heart thumping when she tried to sleep at night.she was found to have a severely elevated and fluctuating blood pressure. Although laboratory testing revealed hyperglycemia and increased basal metabolic rate, tests of thyroid function were normal. What is your diagnosis? What treatment should be used? Answer: The diagnosis is hypersecretion of catecholamines, sometimes arising from a rare chromaffin cell tumor called a pheochromocytoma. Treatment is surgical removal of the tumor. 135) It was often rumored that one of our deceased presidents was suffering from Addison s disease (inadequate synthesis of mineralocorticoids and glucocorticoids). What symptoms may have led to the diagnosis of this condition? Answer: Low body weight, low plasma glucose and sodium levels, high potassium levels, hypotension, severe dehydration, and hypotension might all have been observed in the patient. 136) A 25-year-old male was admitted to the medical/surgical unit with a blood glucose of 600 mg/dl. On assessment, the nurse observed his breathing was deep and rapid, and his breath smelled of acetone. His face

24 was flushed and his skin was dry. His ph was low. Describe the physiological response that is occurring. Answer:

25 In severe cases of diabetes mellitus, blood levels of fatty acids and their metabolites rise dramatically. The fatty acid metabolites, collectively called ketones, are strong organic acids. When they accumulate faster than they are used or excreted, the blood ph drops, resulting in ketoacidosis, and ketones begin to spill into the urine. The nervous system responds by initiating rapid deep breathing to blow off carbon dioxide from the blood and increase ph. 137) Explain how antidiuretic hormone can help regulate an abnormal increase in solute concentration in the extracellular fluid. Answer: The release of antidiuretic hormone can regulate an increase in solute concentration by causing reabsorption of water by the kidney. With reabsorption, blood water volume increases, decreasing solute concentration. 30 Answer Key Testname: C16 1) A 2) A 3) B 4) C 5) C 6) C 7) C 8) C 9) B 10) B 11) A 12) C 13) C 14) C 15) A 16) A 17) C 18) B 19) D 20) C 21) C 22) A

26 23) B 24) A

27 25) A 26) C 27) D 28) D 29) C 30) D 31) B 32) C 33) B 34) C 35) A 36) D 37) A 38) A 39) A 40) C 41) D 42) C 43) B 44) thyroid 45) The liver will release glucose in the presence of glucagon or epinephrine. If both hormones are present the amount of glucose released is increased 150%. 46) D 47) Autocrines are self-regulating chemical messengers because their target is the cell from which they are manufactured. Paracrines are chemical messengers that act locally. They tend to affect only the cells immediately around them. 31 Answer Key Testname: C16 48) A few cardiac cells secrete atrial natriuretic peptide (ANP), which helps regulate salt output by the kidney. ANP inhibits aldosterone and signals the kidney to remove more salt. 49) E 50) B 51) B 52) acromegaly 53) Endocrine glands are ductless glands that release hormones into the blood to be transported to other organs. Exocrine glands have ducts through which products are released. 54)

28 The first step is hormone-receptor binding to target cells, but interaction depends on blood levels of the hormone, relative number of receptors for that hormone on or in the target cells, and the affinity of

29 the union between the hormone and the receptor. 55) ACTH 56) Although the adenohypophysis has many hormonal products, the hypothalamus controls anterior pituitary activity through regulatory factors. 57) Thyroid follicles fill with colloid and gland fibrosis occurs, resulting in a decline in hormone synthesis and release. Increase in body fat relative to muscle also contributes because muscle tissue is more active metabolically than fat. 58) C 59) Alcohol inhibits ADH secretion. 60) C 61) B 62) hypersecretion 63) C 64) erythropoietin 65) glucagon 66) pineal 67) A 68) Growth hormone stimulates the liver to release a growth factor called somatomedin, which in turn controls the epiphyseal plate cartilage growth. 69) E 70) The amount of growth hormone secreted declines with age and the closure of the epiphyseal plates prohibits further growth in length of the long bones. 71) Steroids 72) The hormonal dysfunction is hypersecretion of androgens. 73) Glucagon and insulin use different cell surface receptors. 74) A 75) A 76) D 77) The four mechanisms are: (1) the renin-angiotensin mechanism, (2) plasma concentration of sodium and potassium ions, (3) control exerted by ACTH, and (4) plasma concentration of atrial natriuretic peptide. 78) D 79) B 80) Prolactin 81) thymus 82) D 83) FALSE 84) TRUE 85) TRUE 86) TRUE 87) TRUE 88) TRUE 32 Answer Key Testname: C16 89) FALSE 90) TRUE 91) FALSE 92) TRUE 93) FALSE 94) TRUE 95) FALSE 96) FALSE 97) TRUE 98) TRUE 99) TRUE 100) TRUE 101) FALSE 102) TRUE 103) TRUE 104) FALSE 105) TRUE 106) FALSE 107) FALSE 108) TRUE 109) TRUE 110) A 111) A

30 112) A 113) A 114) A

31 115) A 116) A 117) A 118) A 119) A 120) A 121) B 122) A 123) A 124) A 125) A 126) A 127) A 128) The diagnosis is insufficient growth hormone. The prescription is recombinant DNA-produced pituitary growth hormone. The reason the child might reach his growth potential is that the epiphyseal plates of the long bones have not yet closed, allowing additional growth of the long bones. 129) The problem is hyperparathyroidism resulting from a parathyroid gland tumor. The treatment is removal of the tumor. 130) Because of enhanced anti-inflammatory effects, infections may become overwhelmingly severe. Therefore the nurse should warn the patient to avoid shaving nicks and other sources of infection. 131) The diagnosis is acromegaly. The condition results from excess secretion of growth hormone from the pituitary gland postpuberty and after the epiphyseal plates of the long bones have fused. 132) Yes; there should be great concern, because hypersecretion of prolactin will lead to impotence. 33 Answer Key Testname: C16 133) Thomas was suffering from hypoglycemia. The low blood sugar level affected his brain resulting in his appearance of being drunk. The candy raised his blood sugar back up to a normal level. This was a proper action because he was hypoglycemic And the brain needs constant glucose fo proper function. 134) The diagnosis is hypersecretion of catecholamines, sometimes arising from a rare chromaffin cell tumor called a pheochromocytoma. Treatment is surgical removal of the tumor. 135)

32 Low body weight, low plasma glucose and sodium levels, high potassium levels, hypotension, severe dehydration, and hypotension might all have been observed in the patient. 136)

33 In severe cases of diabetes mellitus, blood levels of fatty acids and their metabolites rise dramatically. The fatty acid metabolites, collectively called ketones, are strong organic acids. When they accumulate faster than they are used or excreted, the blood ph drops, resulting in ketoacidosis, and ketones begin to spill into the urine. The nervous system responds by initiating rapid deep breathing to blow off carbon dioxide from the blood and increase ph. 137) The release of antidiuretic hormone can regulate an increase in solute concentration by causing reabsorption of water by the kidney. With reabsorption, blood water volume increases, decreasing solute concentration. 34