Endocrine

How does the hypothalamus communicate with the anterior pituitary gland? A. Neurons directly linked from the hypothalamus to the anterior pituitary gland B. Hormones released from the hypothalamus into the blood C. They don't communicate with each other

B.

Insulin is released by A. alpha cells of the pancreas B. beta cells of the pancreas C. delta cells of the pancreas D. gamma cells of the pancreas

B.

Which of the following is NOT a typical finding in HHNS (Hyperosmolar Nonketotic Syndrome)? A. Dehydration B. Blood pH < 7.35 C. Mental status changes D. Osmotic diuresis

B.

Which of the following patients is most at risk for developing Type 2 diabetes? A. A 6 year old female recovering from a viral infection with a family history of diabetes. B. A 28 year old male with a BMI of 49. C. A 76 year old female with a history of cardiac disease. D. None of the above

B.

Which substance is a water-soluble protein hormone? a. Thyroxine c. Follicle-stimulating hormone b. Aldosterone d. Insulin

ANS: D Peptide or protein hormones, such as insulin, pituitary, hypothalamic, and parathyroid, are water soluble and circulate in free (unbound) forms. All the remaining options are fat-soluble hormones.

What effect does hyperphosphatemia have on other electrolytes? a. Increases serum calcium. c. Decreases serum magnesium. b. Decreases serum calcium. d. Increases serum magnesium.

ANS: B Hyperphosphatemia leads to hypocalcemia; the other options are incorrect.

Which compound or hormone is secreted by the adrenal medulla? a. Cortisol c. Androgens b. Epinephrine d. Aldosterone

ANS: B Of the available options, the catecholamine epinephrine (adrenaline) is the only major product secreted.

Which form of diabetic insipidus (DI) will result if the target cells for antidiuretic hormone (ADH) in the renal collecting tubules demonstrate insensitivity? a. Neurogenic c. Psychogenic b. Nephrogenic d. Ischemic

ANS: B Only nephrogenic DI is associated with an insensitivity of the renal collecting tubules to ADH.

Which hormone triggers uterine contractions? a. Thyroxine c. Growth hormone b. Oxytocin d. Insulin

ANS: B Oxytocin is responsible for the contraction of the uterus and milk ejection in lactating women and may affect sperm motility in men. The remaining options are not capable of triggering uterine contractions.

Glucagon is released by A. alpha cells of the pancreas B. beta cells of the pancreas C. delta cells of the pancreas D. gamma cells of the pancreas

A.

How does the hypothalamus communicate with the posterior pituitary gland? A. Neurons directly linked from the hypothalamus to the posterior pituitary gland B. Hormones released from the hypothalamus into the blood C. They don't communicate with each other

A.

The common cause of elevated levels of antidiuretic hormone (ADH) secretion is: a. Ectopically produced ADH c. Posterior pituitary tumor b. Inflammation of the hypothalamus d. Inflammation of the nephrons

ANS: A A common cause of elevated levels of ADH secretion is ectopically produced ADH, which makes the other options incorrect.

Which is an expected hormonal change in an older patient? a. Thyroid-stimulating hormone secretion below normal b. Triiodothyronine level below normal c. Cortisol level below normal d. Adrenocorticotropic hormone level above normal

ANS: A Aging causes overall thyroid-stimulating hormone secretion to diminish but does not bring about the other changes.

Which hormone does the second messenger calcium (Ca++) bind to activate phospholipase C through a G protein? a. Angiotensin II c. Estrogen b. Thyroxine d. Testosterone

ANS: A Ca++ is considered an important second messenger that facilitates the binding of a hormone (e.g., norepinephrine, angiotensin II) to a surface receptor, activating the enzyme phospholipase C through a G protein inside the plasma membrane. None of the other options acts on its target cell via a second messenger.

Which of the following is a lipid-soluble hormone? a. Cortisol c. Epinephrine b. Oxytocin d. Growth hormone

ANS: A Cortisol and adrenal androgens are lipid-soluble hormones and are primarily bound to a carrier or transport protein in circulation. The other options are water-soluble hormones.

Hypoglycemia, followed by rebound hyperglycemia, is observed in those with: a. The Somogyi effect b. The dawn phenomenon c. Diabetic ketoacidosis d. Hyperosmolar hyperglycemic nonketotic syndrome

ANS: A Hypoglycemia, followed by rebound hyperglycemia, is observed only in the Somogyi effect.

Which condition may result from pressure exerted by a pituitary tumor? a. Hypothyroidism c. Diabetes insipidus b. Hypercortisolism d. Insulin hyposecretion

ANS: A If the tumor exerts sufficient pressure, then thyroid and adrenal hypofunction may occur because of lack of thyroid-stimulating hormone (TSH) and adrenocorticotropic hormone (ACTH). These result in the symptoms of hypothyroidism and hypocortisolism. The remaining options are not associated with the pressure exerted by a pituitary tumor.

Insulin transports which electrolyte in the cell? a. Potassium c. Sodium b. Calcium d. Phosphorus

ANS: A Insulin facilitates the intracellular transport of potassium, phosphate, and magnesium. Insulin does not facilitate the transport of the other electrolytes.

Lipid-soluble hormone receptors are located: a. Inside the plasma membrane in the cytoplasm b. On the outer surface of the plasma membrane c. Inside the mitochondria d. On the inner surface of the plasma membrane

ANS: A Lipid-soluble hormone receptors are located inside the plasma membrane and easily diffuse across the plasma membrane to bind to either cytosolic or nuclear receptors. The other options are not true statements.

Which form of diabetes insipidus (DI) is treatable with exogenous antidiuretic hormone (ADH)? a. Neurogenic c. Nephrogenic b. Psychogenic d. Ischemic

ANS: A Neurogenic DI is treated with ADH replacement therapy. The other options are incorrect.

Diabetes insipidus is a result of: a. Antidiuretic hormone hyposecretion c. Insulin hyposecretion b. Antidiuretic hormone hypersecretion d. Insulin hypersecretion

ANS: A Of the available options, diabetes insipidus is a result of insufficient antidiuretic hormone.

Where is antidiuretic hormone (ADH) synthesized, and where does it act? a. Hypothalamus; renal tubular cells c. Anterior pituitary; posterior pituitary b. Renal tubules; renal collecting ducts d. Posterior pituitary; loop of Henle

ANS: A Once synthesized in the hypothalamus, ADH acts on the vasopressin 2 (V2) receptors of the renal duct cells to increase their permeability. This information helps eliminate the other options.

Type 2 diabetes mellitus is best described as a(an): a. Resistance to insulin by insulin-sensitive tissues b. Need for lispro instead of regular insulin c. Increase of glucagon secretion from α cells of the pancreas d. Presence of insulin autoantibodies that destroy β cells in the pancreas

ANS: A One of the basic pathophysiologic characteristics of type 2 diabetes is the development of insulin-resistant tissue cells. None of the remaining options appropriately describes type 2 diabetes.

Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake? a. Biguanide (metformin) c. Meglitinides (glinides) b. Sulfonylureas (glyburide) d. α-Glycosidase inhibitor (miglitol)

ANS: A Only biguanides decrease hepatic glucose production and increase insulin sensitivity and peripheral glucose uptake.

The portion of the pituitary that secretes oxytocin is: a. Posterior c. Anterior b. Inferior d. Superior

ANS: A Only the posterior pituitary secretes oxytocin.

The term used to describe a person who experiences a lack of all hormones associated with the anterior pituitary is: a. Panhypopituitarism c. Hypopituitarism b. Adrenocorticotropic hormone deficiency d. Anterior pituitary failure

ANS: A Panhypopituitarism is the only available term that is correctly associated with the lack of all anterior pituitary hormones.

Target cells for parathyroid hormone are located in the: a. Tubules of nephrons c. Glomeruli of nephrons b. Thyroid gland d. Smooth and skeletal muscles

ANS: A Parathyroid hormone acts on its plasma membrane receptor only in the distal and proximal tubules of the kidney's nephron.

Which serum glucose level would indicate hypoglycemia in a newborn? a. 28 mg/dl c. 60 mg/dl b. 40 mg/dl d. 80 mg/dl

ANS: A Serum glucose <30 mg/dl in newborn (first 2 to 3 days) and <55 to 60 mg/dl in adults is associated with hypoglycemia.

A person who has experienced physiologic stresses will have increased levels of which hormone? a. Adrenocorticotropic hormone c. Somatostatin b. Thyroid hormone d. Alpha endorphin

ANS: A Stress has been shown to increase adrenocorticotropic hormone secretion. The other options are not increased with stress.

Which laboratory value is consistently low in a patient with diabetes insipidus (DI)? a. Urine-specific gravity c. Urine protein b. Serum sodium d. Serum total protein

ANS: A The basic criteria for diagnosing DI include a low urine-specific gravity while sodium levels are high. Protein levels are not considered.

Pathologic changes associated with Graves disease include: a. High levels of circulating thyroid-stimulating immunoglobulins b. Diminished levels of thyrotropin-releasing hormone c. High levels of thyroid-stimulating hormone d. Diminished levels of thyroid-binding globulin

ANS: A The only option that correctly describes the changes associated with Graves disease identifies high levels of circulating thyroid-stimulating immunoglobulins that are found in more than 95% of individuals diagnosed with the disease.

What imbalance lessens the rate of secretion of parathyroid hormone (PTH)? a. Increased serum calcium levels b. Decreased serum magnesium levels c. Decreased levels of thyroid-stimulating hormone d. Increased levels of thyroid-stimulating hormone

ANS: A The overall effect of parathyroid hormone (PTH)is to increase serum calcium and to decrease serum phosphate concentration. The other presented imbalances will not affect PTH in the described fashion.

Which hormone is involved in the regulation of serum calcium levels? a. Parathyroid hormone (PTH) b. Thyroxine (T4) c. Adrenocorticotropic hormone (ACTH) d. Triiodothyronine (T3)

ANS: A The parathyroid glands produce PTH, a regulator of serum calcium; therefore the other options are incorrect.

A patient who is diagnosed with a closed head injury has a urine output of 6 to 8 L/day. Electrolytes are within normal limits, but his antidiuretic hormone (ADH) level is low. Although he has had no intake for 4 hours, no change in his polyuria level has occurred. These symptoms support a diagnosis of: a. Neurogenic diabetes insipidus b. Syndrome of inappropriate antidiuretic hormone c. Psychogenic polydipsia d. Osmotically induced diuresis

ANS: A The stated symptoms are reflective of neurogenic diabetes insipidus and not of the remaining options.

What are the effects of aging on pancreatic cells? a. Pancreatic cells are replaced by fat cells. b. Increased insulin production is typical. c. Beta cell production increases. d. No appreciable change occurs on pancreatic cells.

ANS: A With aging, the pancreatic cells are increasingly replaced with fat tissue. Dysfunction of the pancreas with decreased insulin secretion of the beta cells, insulin receptors, and insulin resistance have all been documented.

A person may experience which complications as a result of a reduction in parathyroid hormone (PTH)? (Select all that apply.) a. Muscle spasms b. Tonic-clonic seizures c. Laryngeal spasms d. Hyporeflexia e. Asphyxiation

ANS: A, B, C, E Symptoms associated with hypoparathyroidism are related to hypocalcemia. Hypocalcemia causes a lowering of the threshold for nerve and muscle excitation so that a slight stimulus anywhere along the length of a nerve or muscle fiber may initiate a nerve impulse. This creates tetany manifested as muscle spasms, hyperreflexia, tonic-clonic convulsions, laryngeal spasms, and, in severe cases, death from asphyxiation.

A chronic complication of diabetes mellitus is likely to result in microvascular complications in which areas? (Select all that apply.) a. Eyes b. Coronary arteries c. Renal system d. Peripheral vascular system e. Nerves

ANS: A, C, E Of the options provided, the areas most often affected are the retina, kidneys, and nerves.

What are actions of glucocorticoids? (Select all that apply.) a. Decreasing muscle cell reuptake of glucose b. Fat storage c. Decreased blood glucose d. Carbohydrate metabolism e. Liver gluconeogenesis

ANS: A, D, E The term glucocorticoid refers to those steroidal hormones that have direct effects on carbohydrate metabolism. These hormones increase blood glucose concentration by promoting gluconeogenesis in the liver and by decreasing uptake of glucose into muscle cells, adipose cells, and lymphatic cells. Glucocorticoids are not capable of fat storage.

Which disorder is caused by hypersecretion of the growth hormone (GH) in adults? a. Cushing syndrome c. Giantism b. Acromegaly d. Myxedema

ANS: B Acromegaly is a term for adults who have been exposed to continuously high levels of GH, whereas the term giantism is reserved for children and adolescents. The other options do not apply to hypersecretion of GH.

Which human physiologic system is believed to be an integral factor in unhealthy aging? a. Cardiac c. Central nervous b. Endocrine d. Urinary

ANS: B Because the endocrine system is integral to health, changes in endocrine function have been used as biomarkers for unhealthy aging. The other systems, although contributing to the unhealthy aging, are not as integral.

Renal failure is the most common cause of which type of hyperparathyroidism? a. Primary c. Exogenous b. Secondary d. Inflammatory

ANS: B Chronic renal failure is the most common cause of secondary hyperparathyroidism because of the resulting hyperphosphatemia that stimulates parathyroid hormone secretion. Although the other options may occur, they are not the most common types of the disorder.

A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500 mg/dl; positive urine glucose and ketones; serum potassium (K+) 2 mEq/L; serum sodium (Na+) 130 mEq/L. The patient reports that he has been sick with the "flu" for 1 week. What relationship do these values have to his insulin deficiency? a. Increased glucose use causes the shift of fluid from the intravascular to the intracellular space. b. Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis. c. Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis. d. Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss.

ANS: B Decreased glucose causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis, which have resulted in the symptoms listed in the question. The relationship between the stated assessment values and insulin deficiency is not effectively described by any of the other options.

Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormone (TH) and is inhibited when plasma levels of TH are adequate. This is an example of: a. Positive feedback c. Neural regulation b. Negative feedback d. Physiologic regulation

ANS: B Feedback systems provide precise monitoring and control of the cellular environment. Negative feedback occurs because the changing chemical, neural, or endocrine response to a stimulus negates the initiating change that triggered the release of the hormone. Thyrotropin-releasing hormone (TRH) from the hypothalamus stimulates TSH secretion from the anterior pituitary. Secretion of TSH stimulates the synthesis and secretion of THs. Increasing levels of T4 and triiodothyronine (T3) then generate negative feedback on the pituitary and hypothalamus to inhibit TRH and TSH synthesis. The described example is not accurately identified by any of the other options.

Giantism occurs only in children and adolescents because their: a. Growth hormones are still diminished. b. Epiphyseal plates have not yet closed. c. Skeletal muscles are not yet fully developed. d. Metabolic rates are higher than in adulthood.

ANS: B Giantism is related to the effects of growth hormones on the growth of long bones at their epiphyseal plates. This information makes the other options incorrect.

Most protein hormones are transported in the bloodstream and are: a. Bound to a lipid-soluble carrier b. Free in an unbound, water-soluble form c. Bound to a water soluble-binding protein d. Free because of their lipid-soluble chemistry

ANS: B Peptide or protein hormones, such as insulin, pituitary, hypothalamic, and parathyroid, are water soluble and circulate in free (unbound) forms. The other options are not true statements related to the transport of protein hormones.

What is the target tissue for prolactin-releasing factor? a. Hypothalamus c. Mammary glands b. Anterior pituitary d. Posterior pituitary

ANS: B Prolactin-releasing factor targets the anterior pituitary gland to stimulate the secretion of prolactin. The other remaining options are incorrect.

Which disorder is considered a co-morbid condition of acromegaly? a. Hypotension c. Brain cancer b. Diabetes d. Thyroid cancer

ANS: B Symptoms of type 2 diabetes mellitus, such as polyuria and polydipsia, may occur. Acromegaly-associated hypertension is usually asymptomatic until symptoms of heart failure develop. Neither thyroid nor brain cancer has been associated with acromegaly.

The level of thyroid-stimulating hormone (TSH) in individuals with Graves disease is usually: a. High c. Normal b. Low d. In constant flux

ANS: B The hyperfunction of the thyroid gland leads to suppression of TSH because of the normal negative feedback mechanism, thus eliminating the other options as being correct.

A deficiency of which chemical may result in hypothyroidism? a. Iron c. Zinc b. Iodine d. Magnesium

ANS: B The only cause of hypothyroidism from among the provided options is a deficiency of endemic iodine.

Which laboratory value would the nurse expect to find if a person is experiencing syndrome of inappropriate antidiuretic hormone (SIADH)? a. Hypernatremia and urine hypoosmolality b. Serum potassium (K+) level of 5 mEq/L and urine hyperosmolality c. Serum sodium (Na+) level of 120 mEq/L and serum hypoosmolality d. Hypokalemia and serum hyperosmolality

ANS: C A diagnosis of SIADH requires a serum sodium level of less than 135 mEq/L, serum hypoosmolality less than 280 mOsm/kg, and urine hyperosmolarity. Potassium levels are not considered a factor.

Polyuria occurs with diabetes mellitus because of the: a. Formation of ketones c. Elevation in serum glucose b. Chronic insulin resistance d. Increase in antidiuretic hormone

ANS: C Glucose accumulates in the blood and appears in the urine as the renal threshold for glucose is exceeded, producing an osmotic diuresis and the symptoms of polyuria and thirst. None of the other options appropriately describes the pathologic features of diabetes mellitus-induced polyuria.

The control of calcium in cells is important because it: a. Is controlled by the calcium negative-feedback loop. b. Is continuously synthesized. c. Acts as a second messenger. d. Carries lipid-soluble hormones in the bloodstream.

ANS: C In addition to being an important ion that participates in a multitude of cellular actions, Ca++ is considered an important second messenger. The other options are not true statements related to the control of calcium within the cells.

Aldosterone directly increases the reabsorption of: a. Magnesium c. Sodium b. Calcium d. Water

ANS: C In the kidney, aldosterone primarily acts on the epithelial cells of the nephron-collecting duct to increase sodium ion reabsorption. This action cannot be said of the other options.

The first laboratory test that indicates type 1 diabetes is causing the development of diabetic nephropathy is: a. Dipstick test for urine ketones b. Increase in serum creatinine and blood urea nitrogen c. Protein on urinalysis d. Cloudy urine on the urinalysis

ANS: C Microalbuminuria is the first manifestation of this form of renal failure. Although the other options may develop, they occur after protein is found in the urine.

What causes the microvascular complications in patients with diabetes mellitus? a. The capillaries contain plaques of lipids that obstruct blood flow. b. Pressure in capillaries increase as a result of the elevated glucose attracting water. c. The capillary basement membranes thicken, and cell hyperplasia develops. d. Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries.

ANS: C Microvascular complications are a result of capillary basement membranes thickening and endothelial cell hyperplasia. None of the remaining options appropriately describes the cause of microvascular complications in patients with diabetes mellitus.

The cause of neurogenic diabetes insipidus (DI) is related to an organic lesion of the: a. Anterior pituitary c. Posterior pituitary b. Thalamus d. Renal tubules

ANS: C Neurogenic DI is a result of dysfunctional antidiuretic hormone synthesis, caused by a lesion of the posterior pituitary, hypothalamus, or pituitary stalk.

Visual disturbances are a result of a pituitary adenoma because of the: a. Liberation of anterior pituitary hormones into the optic chiasm b. Pituitary hormones clouding the lens of the eyes c. Pressure of the tumor on the optic chiasm d. Pressure of the tumor on the optic and oculomotor cranial nerves

ANS: C Of the available options, pressure on the optic chiasm is the only cause for visual disturbances resulting from a pituitary adenoma.

Amenorrhea, galactorrhea, hirsutism, and osteoporosis are each caused by a: a. Posterior pituitary adenoma c. Prolactinoma b. Thymoma d. Growth hormone adenoma

ANS: C Of the options available, the hallmark of a prolactinoma is the sustained elevation of serum prolactin that is responsible for the symptoms listed in the question.

The secretion of adrenocorticotropic-stimulating hormone (ACTH) will result in the increased level of which hormone? a. Thyroxine c. Cortisol. b. Insulin d. Antidiuretic hormone

ANS: C Psychologic and physiologic stress (e.g., hypoxia, hypoglycemia, hyperthermia, exercise) increases ACTH secretion, leading to increased cortisol levels. Only cortisol describes the appropriate feedback loop.

Which mineral is needed for thyroid-stimulating hormone (TSH) to stimulate the secretion of thyroid hormone (TH)? a. Iron c. Iodide b. Zinc d. Copper

ANS: C TSH, which is synthesized and stored in the anterior pituitary, stimulates secretion of TH by activating intracellular processes, including the uptake of iodine necessary for the synthesis of TH. This supports the elimination of the other options.

The most probable cause of low serum calcium after a thyroidectomy is: a. Hyperparathyroidism, secondary to Graves disease b. Myxedema, secondary to surgery c. Hypoparathyroidism caused by surgical injury d. Hypothyroidism caused by the lack of thyroid replacement

ANS: C The most common cause of hypoparathyroidism is damage caused during thyroid surgery, resulting in a lack of circulating PTH and causing a depressed level of serum calcium. This information supports the elimination of the other options.

The most common cause of hypoparathyroidism is: a. Pituitary hyposecretion c. Parathyroid gland damage b. Parathyroid adenoma d. Autoimmune parathyroid disease

ANS: C The most common cause of hypoparathyroidism is damage caused during thyroid surgery, thus eliminating the other options as being correct.

A person diagnosed with type 1 diabetes experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. The most probable cause of these symptoms is: a. Hyperglycemia caused by incorrect insulin administration b. Dawn phenomenon from eating a snack before bedtime c. Hypoglycemia caused by increased exercise d. Somogyi effect from insulin sensitivity

ANS: C The most likely cause of these symptoms is hypoglycemia, which is often caused by a lack of systemic glucose as a result of muscular activity. None of the remaining options appropriately describes why a person diagnosed with type 1 diabetes experiences the described symptoms.

Graves disease develops from a(n): a. Viral infection of the thyroid gland that causes overproduction of thyroid hormone b. Autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue c. Thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones d. Ingestion of goitrogens that inhibits the synthesis of the thyroid hormones, causing a goiter

ANS: C The pathologic features of Graves disease indicates that normal regulatory mechanisms are overridden by abnormal immunologic mechanisms that result in the stimulation of excessive TH. The remaining options are incorrect statements.

Regulation of the release of catecholamines from the adrenal medulla is an example of which type of regulation? a. Negative feedback c. Neural b. Positive feedback d. Physiologic

ANS: C The release of hormones occurs either in response to an alteration in the cellular environment or in the process of maintaining a regulated level of certain hormones or certain substances. Several different mechanisms, one of which is neural control (e.g., stress-induced release of catecholamines from the adrenal medulla), regulate the release of hormones. The remaining options do not accurately describe the example given.

The effects of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion include solute: a. Retention and water retention c. Dilution and water retention b. Retention and water loss d. Dilution and water loss

ANS: C The symptoms of SIADH secretion are a result of dilutional hyponatremia and water retention. This information supports the elimination of the other options.

The signs of thyrotoxic crisis include: a. Constipation with gastric distention c. Hyperthermia and tachycardia b. Bradycardia and bradypnea d. Constipation and lethargy

ANS: C The systemic symptoms of thyrotoxic crisis include hyperthermia and tachycardia. The remaining options are not associated with this disorder.

Which hormone inhibits the secretion of growth hormone (GH)? a. Somatostatin c. Thyroid-stimulating hormone b. Thyroxine d. Calcitonin

ANS: C Two hormones from the hypothalamus control GH secretion: (1) GH-releasing hormone (GHRH), which increases GH secretion; and (2) somatostatin, which inhibits it. The other options would not produce the necessary effect.

Where is oxytocin synthesized? a. Hypothalamus c. Anterior pituitary b. Paraventricular nuclei d. Posterior pituitary

ANS: D ADH and oxytocin are synthesized in hypothalamic neurons but are stored and secreted by the posterior pituitary. The other options do not synthesize oxytocin.

Antidiuretic hormone acts to cause vasoconstriction when: a. Urine output is less than 20 ml/hr. b. Serum osmolality is increased. c. Osmotic and oncotic pressures are increased. d. Vasopressin is pharmacologically administered.

ANS: D ADH was originally named vasopressin because, in extremely high doses, it causes vasoconstriction and a resulting increase in arterial blood pressure. However, significant vasoconstriction may only be achieved pharmacologically. Antidiuretic hormone induced vasoconstriction is not a result of the other options.

What is the action of calcitonin? a. Increases metabolism. c. Increases serum calcium. b. Decreases metabolism. d. Decreases serum calcium.

ANS: D Calcitonin, also called thyrocalcitonin, acts to lower serum calcium levels by inhibiting bone-resorbing osteoclasts, making the other options incorrect.

When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is an example of what type of effect by a hormone? a. Pharmacologic c. Synergistic b. Permissive d. Direct

ANS: D Direct effects are the obvious changes in cell function that specifically result from the stimulation by a particular hormone. The other options are not used to identify the described effect.

Diagnosing a thyroid carcinoma is best performed with: a. Measurement of serum thyroid levels c. Ultrasonography b. Radioisotope scanning d. Fine-needle aspiration biopsy

ANS: D Fine-needle aspiration of a thyroid nodule is generally performed to diagnose this condition; this method is best for early detection, thus eliminating the other options.

When comparing the clinical manifestations of both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS), which condition is associated with only DKA? a. Fluid loss c. Increased serum glucose b. Weight loss d. Kussmaul respirations

ANS: D Kussmaul respirations are only observed in those with DKA.

How does a faulty negative-feedback mechanism result in a hormonal imbalance? a. Hormones are not synthesized in response to cellular and tissue activities. b. Decreased hormonal secretion is a response to rising hormone levels. c. Too little hormone production is initiated. d. Excessive hormone production results from a failure to turn off the system.

ANS: D Negative-feedback systems are important in maintaining hormones within physiologic ranges. The lack of negative-feedback inhibition on hormonal release often results in pathologic conditions. Excessive hormone production, which is the result of the failure to turn off the system, can cause various hormonal imbalances and related conditions. The correct option is the only accurate description of this hormonal function.

The releasing hormones that are made in the hypothalamus travel to the anterior pituitary via the: a. Vessels of the zona fasciculata c. Hypophyseal stalk b. Infundibular stem d. Portal hypophyseal blood vessels

ANS: D Releasing and inhibitory hormones are synthesized in the hypothalamus and are secreted into the portal blood vessels through which they travel to the anterior pituitary hormones. The releasing hormones do not enter the anterior pituitary gland via any of the other options.

Retinopathy develops in patients with diabetes mellitus because: a. Plaques of lipids develop in the retinal vessels. b. Pressure in the retinal vessels increase as a result of increased osmotic pressure. c. Ketones cause microaneurysms in the retinal vessels. d. Retinal ischemia and red blood cell aggregation occur.

ANS: D Retinopathy appears to be a response to retinal ischemia and red blood cell aggregation. None of the remaining options appropriately describes the relationship between retinopathy and diabetes mellitus.

Which second messenger is stimulated by epinephrine binding to a β-adrenergic receptor? a. Calcium b. Inositol triphosphate (IP3) c. Diacylglycerol (DAG) d. Cyclic adenosine monophosphate (cAMP)

ANS: D Second-messenger molecules are the initial link between the first signal (hormone) and the inside of the cell (see Table 21-3). For example, the binding of epinephrine to a β adrenergic-receptor subtype activates (through a stimulatory G protein) the enzyme, adenylyl cyclase. Adenylyl cyclase catalyzes the conversion of adenosine triphosphate (ATP) to the second messenger, 3', and 5'-cAMP. The remaining messengers are not stimulated by epinephrine to bind as described.

What are clinical manifestations of hypothyroidism? a. Intolerance to heat, tachycardia, and weight loss b. Oligomenorrhea, fatigue, and warm skin c. Restlessness, increased appetite, and metrorrhagia d. Constipation, decreased heat rate, and lethargy

ANS: D The lower levels of thyroid hormone result in decreased energy metabolism, resulting in constipation, bradycardia, and lethargy, thus eliminating the remaining options.

Palpation of the neck of a person diagnosed with Graves disease would detect a thyroid that is: a. Left of midline c. Normal in size b. Small with discrete nodules d. Diffusely enlarged

ANS: D The only option that characterizes Graves disease is a diffused enlargement of the thyroid gland.

A person has acne, easy bruising, thin extremities, and truncal obesity. These clinical manifestations are indicative of which endocrine disorder? a. Hyperthyroidism c. Diabetes insipidus b. Hypoaldosteronism d. Cushing disease

ANS: D These symptoms are characteristic of Cushing disease and are caused by excessive ACTH secretion. The symptoms described are not characteristic of any of the other options.

Diabetes insipidus, diabetes mellitus, and syndrome of inappropriate antidiuretic hormone all exhibit which symptom? a. Polyuria c. Vomiting b. Edema d. Thirst

ANS: D Thirst is the only symptom common to all these conditions.

A patient is admitted with complaints of palpitations, excessive sweating, and unable to tolerate heat. In addition, the patient voices concern about how her appearance has changed over the past year. The patient presents with protruding eyeballs and pretibial myxedema of the legs and feet. Which of the following is the likely cause of the patient's signs and symptoms? A. Thyroiditis B. Deficiency of iodine consumption C. Grave's disease D. Hypothyroidism

C.

The pancreas has A. Endocrine function B. Exocrine function C. Both A and B D. None of the above

C.

Which of the following statements is incorrect about HHNS? A. HHNS mainly occurs in type 2 diabetics B. This condition presents without ketones in the urine. C. Metabolic alkalosis presents in severe HHNS D. Intravenous Regular insulin is used to treat hyperglycemia

C.

A patient reports they do not enough iodine in their diet. What condition are they most susceptible to? A. Pheochromocytoma B. Hyperthyroidism C. Thyroid storm D. Hypothyroidism

D.

Aldosterone synthesis and secretion are primarily regulated by the: A. Liver. B. Hypothalamus. C. Adrenal glands. D. Renin-angiotensin system.

D.

A. DKA occurs mainly in type 1 diabetics. B. Ketones are present in the urine in DKA. C. Cheyne-stokes breathing can present in DKA. D. Severe hypoglycemia is a hallmark sign in DKA E. C & D

E.

What are actions of glucocorticoids? A. Protein catabolism and liver gluconeogenesis B. Fat storage and glucose use C. Decreased blood glucose and fat mobilization D. Fat, protein, and carbohydrate anabolism

a.

Hormones are effective communicators because they: A. Are regularly synthesized in response to cellular and tissue activities. B. Increase their secretion in response to rising hormone levels. C. Are rapidly degraded once they enter the cell. D. Decrease their secretion in response to rising plasma hormone levels.

d.