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Identify the thyroid gland.
A The thyroid gland is located in the lower anterior throat superficial to the trachea at the level of the cricoid cartilage.
Identify the pancreas.
D The pancreas occupies a retroperitoneal position partially behind the stomach.
Which of these glands is responsible for regulating minerals in the body but is also part of the sympathetic division of the autonomic nervous system?
C The adrenal glands have a medulla that contains postganglionic neurons of the sympathetic division of the autonomic nervous system. Its cortex helps regulates mineral levels in the body, along with other functions.
Which of the following is NOT representative of endocrine glands?
They drain into blood vessels. They have ducts. They drain into lymph vessels.
They produce hormones.
They have ducts.
Which of the following is NOT an endocrine gland? thyroid adenoid adrenal
pituitary
adenoid
What is the primary function of hormones? cause allergic reactions influence metabolic activity of glands by electrochemical impulses alter cell activity
activate extracellular enzymes
alter cell activity
Steroid hormones are synthesized from amino acids.
False
What property of a hormone would allow it to pass unassisted through a plasma membrane?
protein-based bound to a protein complex charged
lipid-soluble
lipid-soluble
At which point has the hormone bound to its intracellular receptor but not yet entered the nucleus?
B The receptor-hormone complex has formed and is about to enter the nucleus.
What amino acid-based hormone uses the direct gene activation method illustrated in this image?
mineralocorticoids glucocorticoids thyroxine
growth hormone
Thyroxine
The benefit of using a second messenger signaling system is rapid speed of communication.
False
Which of the following is NOT a major type of stimulus that triggers endocrine glands to manufacture and release hormones?
humoral neural hormonal
enzymatic
enzymatic
Which of the following occurs in situations where more than one hormone produces the same effects at the target cell and their combined effects are amplified?
antagonism permissiveness summation
synergism
synergism
Water-soluble hormones are metabolized quickly by the liver.
False
What allows a cell to respond to a hormone? the gland that releases the hormone the location of the cell the presence of a specific hormone receptor
the structure of the hormone
the presence of a specific hormone receptor
Which of the following is NOT characteristic of water-soluble hormones?
short half-life in blood free in plasma act through second messengers
intracellular receptors
intracellular receptors
Up-regulation involves the loss of receptors and prevents the target cells from overreacting to persistently high hormone levels.
False
__________ is the situation when one hormone exaggerates the effects of another hormone at the target cell?
Permissiveness Antagonism Activism
Synergism
Synergism
A blow to the head may cause diabetes insipidus by ______.
triggering the hypersecretion of hypothalamic-inhibiting hormones triggering the hyposecretion of hypothalamic-inhibiting hormones interfering with the normal transmission of ADH to the posterior pituitary via the axons of hypothalamic neurons
causing hypersecretion of ADH
interfering with the normal transmission of ADH to the posterior pituitary via the axons of hypothalamic neurons
Acromegaly may be caused by all EXCEPT which of the following?
hypersecretion of GHRH (growth hormone-releasing hormone) pancreatic tumor lack of negative feedback by insulin-like growth factors
positive feedback by GH (growth hormone) on the anterior pituitary
positive feedback by GH (growth hormone) on the anterior pituitary
Hyperprolactinemia may be caused by ______.
hyposecretion of dopamine negative feedback by gonadotropins on the anterior pituitary hypersecretion of milk
negative feedback by PIH (prolactin-inhibiting hormone) on the anterior pituitary
hyposecretion of dopamine
What area of the brain is designated by letter A?
hypothalamus thalamus pineal gland
limbic system
hypothalamus
What hormone released into the blood (shown by letter D) by the posterior pituitary inhibits or prevents urine formation? thyroid-stimulating hormone (TSH) cortisol antidiuretic hormone (ADH)
oxytocin
antidiuretic hormone (ADH)
Where are the hormones oxytocin and antidiuretic hormone (ADH) stored?
C The axon terminals of neurons of the hypothalamic-hypophyseal tracts store and secrete ADH and oxytocin in the capillaries of the inferior hypophyseal artery.
Hypersecretion of what hormone can produce the effects of gigantism in the individual in the center of this image?
Undersecretion of anterior pituitary hormones in children causes several of the following conditions. Which of these would NOT be linked to insufficient hormones form the anterior pituitary?
failure to sexually mature possible disproportion of body parts pituitary dwarfism
All of the listed responses are correct
All of the listed responses are correct.
Where is thyrotropin-releasing hormone (TRH) made?
posterior pituitary follicular cells of the thyroid gland anterior pituitary
hypothalamus
hypothalamus
What is the target organ of thyroid hormones’ metabolic effects?
hypothalamus thyroid cells of the body
anterior pituitary
cells of the body
Which of these would be an effect of an excess of thyroid hormones?
A would release less TRH. B would release more TSH. The thyroid would swell and produce a goiter.
More thyroid hormone would be produced.
A would release less TRH
Which of the following hormones helps the body avoid dehydration and water overload?
The hypothalamus is known to control the activity of the thyroid, which has traditionally been called the master endocrine gland.
False
Which of the following is a hormone produced by the posterior pituitary?
oxytocin ADH prolactin
None of the listed responses is correct.
None of the listed responses is correct.
What is required for the production of anterior pituitary gland hormones?
humoral stimuli neural stimuli (from the sympathetic division of the ANS) hormonal stimuli
All of the listed responses are correct.
hormonal stimuli
Which hormone aids in water resorption? antidiuretic hormone parathyroid hormone thyroid hormone
adrenocorticotropic hormone
antidiuretic hormone
Which of the following hormones has a different effect when it is released in males instead of females? insulin follicle-stimulating hormone thyroid hormone
parathyroid hormone
follicle-stimulating hormone
You would predict that iodized salt would have no effect on any cases of ____________.
cretinism Graves’ disease endemic goiter
myxedema
Graves’ disease
What type of cell is shown at letter C? parathyroid cells beta cells parafollicular cells
follicular cells
follicular cells
What material is stored in the thyroid follicles?
thyroid hormones, ready to be immediately released enzymes that produce thyroglobulin pure iodine, so the thyroid has a constant supply
iodinated thyroglobulin, from which thyroid hormone can be released
iodinated thyroglobulin, from which thyroid hormone can be released
What hormone is released by the cells pictured in letter D?
calcitonin These humorally-stimulated cells respond to increasing levels of calcium in the blood and secrete calcitonin to counteract it.
Hypocalcemia could be caused by the ______.
apoptosis of parathyroid cells failure of osteoclasts to respond to PTH (parathyroid hormone/parathormone) malfunction of the parathormone receptors in kidney tubule cells
All of the listed responses are correct.
All of the listed responses are correct.
What type of stimulation controls parathyroid release? hormonal paracrine neural
humoral
humoral
Which of the following would result from hypoparathyroidism?
neurons becoming more excitable and producing tingling sensations depression of the nervous system skeletal muscle weakness
excess calcium deposits in the kidneys forming kidney stones
neurons becoming more excitable and producing tingling sensations
If a person’s parathyroids are responding properly to a drop in blood calcium, which of the following should result?
Vitamin D levels in the blood drop. More calcium is present in feces.
Less calcium is placed in the urine by the kidneys.
Less calcium is placed in the urine by the kidneys
Which of the following glands increases blood calcium levels?
thyroid pituitary adrenal
parathyroid
parathyroid
Aldosteronism will cause ______.
decreased secretion of renin decreased secretion of ANP (atrial naturetic peptide) decreased loss of K+ in the urine
None of the listed responses is correct.
decreased secretion of renin
Cushing’s syndrome and aldosteronism have the same effects on ______.
Two adrenal glands make hormones that are essential for life. However, in adrenogenital syndrome, females develop a beard and a masculine pattern of body hair distribution; this occurs due to ______.
negative feedback that inhibits estrogen production conversion of estrogens into testosterone lack of enzymes the adrenal gland needs to make cortisol and aldosterone
increased testosterone secretion
lack of enzymes the adrenal gland needs to make cortisol and aldosterone
Pheochromocytoma produces symptoms of uncontrolled sympathetic nervous system activity. Which of the following is common to both adrenal chromaffin cells and adrenergic fibers of the sympathetic nervous system?
the presence of axons capable of secreting substances that are capable of increasing heart rate secretion of epinephrine secretion of norepinephrine
All of the listed responses are correct.
secretion of norepinephrine
What hormone, indicated by letter B, is released by the anterior pituitary to target the adrenal cortex when we are under stress?
adrenocorticotropic hormone (ACTH) atrial natriuretic peptide (ANP) angiotensin II
corticotropin-releasing hormone (CRH)
adrenocorticotropic hormone (ACTH)
Which of these conditions would promote aldosterone release from the adrenal glands?
An increase in blood pressure is sensed in the heart. A drop in blood pressure is sensed in the kidney. Blood potassium levels fall.
The body becomes parasympathetically activated.
A drop in blood pressure is sensed in the kidney.
Which letter represents the hormone that promotes a decrease in blood pressure and a loss of sodium and water in urine?
D The letter D indicates atrial natriuretic peptide, which is released from the heart when high blood pressure is sensed. It causes more sodium ("natrium") to be placed in the urine ("uretic").
Which of the following adrenal gland homeostatic imbalances is characterized by persistent elevated blood glucose levels, dramatic losses in muscle and bone protein, and water and salt retention, leading to hypertension and edema?
Cushing’s syndrome cretinism Graves’ disease
Addison’s disease
Cushing’s syndrome
The adrenal medulla is stimulated to release catecholamines during sympathetic autonomic nervous responses.
True
Which of the following hormones is stimulated by stress?
Which of the following best describes the hypoglycemic effect of insulin?
Insulin allows entry of glucose into most body cells. Insulin encourages release of glucose into the blood by liver cells. Insulin encourages catabolism of glycogen into glucose.
Insulin encourages synthesis of glucose from lactic acid and noncarbohydrate molecules.
Insulin allows entry of glucose into most body cells.
All of the following conditions would stimulate the pancreatic beta cells to release insulin EXCEPT one. Which one? a rise in blood amino acid levels sympathetic activation a rise in blood glucose levels
acetylcholine release on the pancreatic cells
sympathetic activation
Variance in which of the following hormones is responsible for diabetes mellitus (DM)?
glucagon insulin antidiuretic hormone (ADH)
aldosterone
insulin
Which of the following triggers the release of glucagon?
somatostatin hyperglycemia release of insulin
a decrease in blood glucose levels
a decrease in blood glucose levels
Which of the following is NOT believed to be linked to the onset of type 2 diabetes (non-insulin dependent diabetes mellitus)?
predisposing genetic factors weight gain poor diet
regular cardiovascular exercise
regular cardiovascular exercise
Which of the following best describes gluconeogenesis?
conversion of glucose to fat synthesis of glucose from noncarbohydrate sources creation of glycogen from glucose
breakdown of glycogen into glucose
synthesis of glucose from noncarbohydrate sources
Which of the following exhibits an antagonistic relationship?
insulin/glucagon PTH/aldosterone TSH/thyroxin
renin/ANP
insulin/glucagon
Which pancreatic hormone functions to raise blood glucose levels?
glucagon somatostatin gastrin
insulin
glucagon
Adult onset diabetes, diabetes type 2, can best be described using which of the following concepts?
Constantly high blood sugar leads to high insulin release. High amounts of insulin lead to down-regulation of insulin receptors. Constantly high blood sugar leads to the release of glucagon. Glucagon causes gluconeogenesis, which makes blood sugar higher. Constantly high blood sugar leads to high insulin release. High levels of insulin cause up-regulation of insulin receptors.
Constantly high blood sugar leads to glucagon release. Glucagon is an antagonist to insulin, leading to a decrease in insulin.
Constantly high blood sugar leads to high insulin release. High amounts of insulin lead to down-regulation of insulin receptors.
The Role of Insulin
Diabetes mellitus is a disease of sugar balance. In type 1 diabetes, the body’s immune system gradually destroys the cells that produce insulin. In type 2 diabetes, the body’s cells become less responsive to the hormone insulin.
Insulin plays a vital role in carbohydrate metabolism. What is its role?
Choose the answer that best describes the role of insulin.
Insulin controls the rate of carbohydrate digestion; without insulin, less sugar enters the blood. Insulin is necessary for digested carbohydrates to be absorbed from the digestive tract into the blood; without insulin, less sugar enters the blood. Insulin is needed for cells to pick up glucose from the blood; without insulin, more glucose will remain in the blood.
Insulin is needed for cells to metabolize glucose; without insulin, cells will fill with unused glucose.
Insulin is needed for cells to pick up glucose from the blood; without insulin, more glucose will remain in the blood.
Where is the thyroid gland located?
adjacent to the trachea in the neck
Krista’s treatment will likely involve destroying or surgically removing her thyroid gland. What effect will this have on her level of TSH?
TSH will increase.
Suppose Krista’s hyperthyroidism was a result of a tumor that causes the anterior pituitary gland to become overactive. Which of the following would Krista’s lab reports likely show?
high thyroid hormone, high TSH
Under normal conditions, increased levels of thyroid hormone in the blood will cause _______.
a decrease in TSH levels
What is the significance of the slight swelling (called a goiter) in Krista’s neck?
It is a sign that her thyroid gland is overactive.
Which of the following is NOT secreted by the thyroid?
thyroid-stimulating hormone
How is the adrenal gland related to glucose levels?
If the adrenal does not produce cortisol, the child will not be able to increase blood glucose during illness or stress.
The doctor also ordered measurement of Wally’s Na+ and K+ levels. How is the adrenal gland related to these?
If the adrenal does not produce aldosterone, Na+ cannot be reabsorbed from the urine, and K+ cannot be secreted into it. K+ will build up in the blood, and Na+ will be lost in the urine.
The adrenal glands produce several hormones. Based on what Wally’s mother has told you, which hormone(s) are not being produced normally in Wally’s case? Choose all the correct answers. Androgens Aldosterone Epinephrine
Cortisol
Aldosterone Cortisol
As a child grows, his medication doses may need to be increased. The doctor has ordered glucose, sodium, and potassium measurements on Wally’s blood. If Wally’s medications are inadequate, what will happen to his blood glucose, sodium, and potassium levels, and why?
Choose all the lab values that would indicate inadequate treatment of Wally’s problem.
You are discussing Wally’s case with the other nurses when one of them says it does not make any sense. "It’s called adrenal hypertrophy," she says. "That means the adrenal is bigger than normal! So why are they giving him cortisol? His adrenal should be making more cortisol if it’s bigger than normal."
How is the adrenal cortex controlled?
Drag the components of the system controlling the adrenal cortex into position.
Look at picture
One of the other nurses has questioned why Wally’s producing less cortisol than normal although his adrenal cortex is enlarged.
Wally’s primary problem is that he cannot synthesize cortisol. Drag the changes this will cause in the system controlling the adrenal cortex into position. You may use the same term in more than one place on the diagram and it might be easier to start at the bottom, with the adrenal cortex and what it cannot do.
Look at picture
When you go back to the office, the doctor is looking Wally’s chart over again. "I’m a little worried about his height. Did you notice anything else out of the ordinary?" What are cortisol’s other functions in the body? Do they suggest anything about Wally that you should bring to the doctor’s attention?
Choose the best answer.
Cortisol helps control the hypothalamus, so Wally might not be able to maintain homeostasis. Cortisol helps adapt the body to stresses like illness, so Wally might not be able to cope with an infection. The hypothalamus controls many other glands beside the adrenal cortex. Wally’s hoarseness might indicate that it is also overstimulating the thyroid, which is situated over the larynx.
Aldosterone controls blood volume and water reabsorption; Wally’s drippy nose might indicate too much water reabsorption.
Cortisol helps adapt the body to stresses like illness, so Wally might not be able to cope with an infection.
On the follow-up exam, the doctor checks Wally for axillary hair growth and signs of puberty. How is the adrenal related to male sexual development? Why might a boy who cannot make his own cortisol go into puberty early?
Wally cannot synthesize cortisol. Let’s review the changes that will cause in his hypothalamo-pituitary axis again − and this time, let’s add the hormones his adrenal cortex CAN make!
Look at picture
Insulin and glucagon release from the pancreas is a vital part of the negative feedback loop that regulates blood glucose levels. Let’s review how insulin and glucagon release change in response to plasma glucose levels and how that helps keep plasma glucose constant.
Drag the labels onto the figure to create a flow chart of how insulin and glucagon release change in different circumstances to keep blood glucose within a normal range.
Look at picture
You are working in the free clinic when Father X comes in. You know him well; he is a type 2 diabetic who keeps his sugar under control with diet and exercise but is often in the clinic with homeless patients from the shelter he runs in the Episcopalian church down the block. On this visit, Father X has brought in a thin man in his twenties named Joe. Joe appears confused and lethargic. He is breathing heavily and has a strong fruity odor. Father X tells you he is concerned about Joe because last night Joe was up every half-hour or so to use the bathroom and get water. Father X knows these are signs of diabetes, so he wants to get Joe checked out. He also tells you that Joe has not been drinking; they have a breathalyzer at the shelter, and Joe tested clean when he checked in the night before.
Joe’s blood pressure is a little low at 95/60 mm Hg and his heart rate is a little high at 96 bpm. When you take his pulse, you notice that his skin is dry and "tents" up when pinched − a sign of dehydration. His respirations are more rapid than normal, 25 breaths/min, and heavy. His blood glucose is elevated at 320 mg/dL. His urine also contains glucose, and has a lower pH than normal. When you take his history he tells you that type 1 diabetes runs in his family.
Many of Joe’s signs and symptoms can be related to the loss of glucose in his urine. Normally, urine does not contain glucose. When plasma glucose levels are elevated, however, some of the glucose from the plasma passes into the urine. Apply the principle of osmosis to explain why Joe was getting up all night to use the bathroom and why he has low blood pressure and signs of dehydration.
Choose the most accurate explanation for Joe’s problem.
The frequent urination is happening because when glucose moved into his urine, water also followed it. This removed water from his plasma, decreasing his blood volume and dehydrating him.
You have explained Joe’s dehydration and low blood pressure. But he had some other unusual signs and symptoms. Let’s look again:
Joe appears confused and lethargic. He is breathing heavily and has a strong fruity odor. His respirations are more rapid than normal, 25 breaths/min, and heavy. His blood glucose is elevated at 240 mg/dL. His urine also has a lower pH than normal.
Insulin does not explain these problems. They are due to a hormone from the alpha cells of the pancreas − glucagon. This hormone is released in response to many stimuli, including the sympathetic nervous system. Let’s apply the functions of glucagon to explain why Joe has a low urine pH and a fruity odor.
Drag the steps of the pathway into the proper positions.
One of the more experienced nurses says it is easy to spot a patient with ketoacidosis because of his/her heavy breathing. Why would somebody with ketones and fatty acids in his/her blood breathe heavily?
Joe’s heavy breathing is a response to the acid in his blood. By exhaling more, he will remove CO2 from his blood and bring the blood’s pH up.
The doctor wants to give Joe an insulin injection, but Joe is unwilling to take it. He tells you that his little sister was on insulin and died in the night after taking her shot. How could insulin hurt somebody with diabetes?
Giving too much insulin can lower plasma glucose levels until the brain and heart do not get enough glucose to function properly.
Joe is becoming more confused and uncoordinated. When he tries to get up to leave the examination room, he stumbles and falls down. He is semiconscious and breathing even more heavily. One of the aides says he needs some orange juice, right away. "That’s just the wrong thing to do," the doctor answers. "Don’t you see his heavy breathing and smell the ketones on his breath? Give him the insulin, stat!"
Who is right?
The doctor is right − Joe’s plasma glucose is elevated, so he cannot have hypoglycemia.
What do steroids and amino acid-based hormones have in common?
Steroids and amino acid-based hormones are secreted by endocrine glands.
What is the role of the protein kinases in a cell?
When activated, they phosphorylate other proteins, including other enzymes
Which of the following is a characteristic of thyroid hormone?
Thyroid hormone is lipid soluble.
How do steroid hormones and thyroid hormone affect change in their target cells?
The hormone passes through the cell membrane and activates intracellular receptors that enter the nucleus to activate genes.
Which of the following hormones has the greatest effect on the overall metabolic rate? ACTH PRL TSH
FSH
TSH
If the anterior pituitary failed to produce LH appropriately, what might be the result?
lowered levels of testosterone or ovarian hormones poor milk production in nursing women dwarfism
cretinism
lowered levels of testosterone or ovarian hormones
The anterior pituitary gland does NOT produce __________. prolactin follicle-stimulating hormone thyroid hormone