Patho endocrine system Chapter 40 mechanisms of endocrine control chapter 41 disorders of endocrine control

While reviewing the major actions of follicle-stimulating hormone (FSH), the faculty points out that in males this hormone is responsible for the:

sperm production.

A client is diagnosed with Addison disease. What statement by the client indicates an understanding of the discharge instructions by the nurse?

"I will have to take my medication for the rest of my life."

When hormones act locally rather than being secreted into the bloodstream, their actions are termed:

Autocrine and paracrine

Which hormone is produced by the anterior pituitary gland?

Growth hormone (GH)

Which hormone will elicit a more rapid response than the others?

Norepinephrine

While teaching a science class, the instructor mentions that both autocrine and paracrine hormonal actions occur without entering the bloodstream. A student asks, "What cells do paracrine actions affect?" Which response is correct?

Paracrine actions are hormonal interactions with local cells other than those that produce the hormone; autocrine actions are with self-cells (cells from which they were produced). Both autocrine and paracrine hormonal actions affect target cells. Neither paracrine nor autocrine actions affect cell storage.

Secondary diabetes occurs because of disorders that produce hyperglycemia by stimulating the hepatic production of glucose or decrease the cellular use of glucose. Which disorders can be causes of secondary diabetes?

Pheochromocytoma and Cushing syndrome

A client receives steroids for several months to treat an inflammatory condition. Which action by the primary health care provider indicates an understanding of the negative feedback mechanism when the client no longer needs the medication?

Prescribing a tapering dose of the medication over weeks

Graves disease

an autoimmune disorder that is caused by hyperthyroidism and is characterized by goiter and/or exophthalmos

When explaining about structural classifications to a group of students, the instructor discusses the peptides and proteins. The instructor talks about small hormones and hormones as large and complex as growth hormone (GH), which has approximately how many amino acids involved?

200 amino acids

Cyclic adenosine monophosphate (cAMP) performs which role in the functioning of the endocrine system?

Acting as a second messenger to mediate hormone action on target cells cAMP is one of the most common second messengers, whose role is to generate an intracellular signal in response to cell surface receptor activation by a hormone. cAMP does not mediate hormone synthesis, act as a receptor itself, or inactivate hormones.

The nurse is assessing a client with thyrotoxicosis and the nurse is explaining how the thyroid gland is stimulated to release thyroid hormones. The nurse should describe what process?

Action of releasing hormones from hypothalamus

The number of hormone receptors on a cell may be altered for any of several reasons. The most appropriate response would be:

Antibodies may destroy or block the receptor proteins.

The release of insulin from the pancreatic beta cells can inhibit further release of insulin from the same cells. This is an example of which type of hormone action?

Autocrine

A nurse caring for a client who has undergone an antithyroid peroxidase (anti-TPO) antibody test with elevated results should be prepared to educate the client about which disease process?

Diagnosis of Hashimoto thyroiditis is usually made by detecting elevated levels of anti-thyroid peroxidase antibodies (TPOAb) in the serum. Gigantism is diagnosed as an excessive secretion of growth hormone. There may be high levels of insulin-like growth factor 1 (IGF-1), which also stimulates excessive skeletal growth. States of hyperparathyroidism are associated with increased levels of 1,25-(OH)2D3. Parathyroid hormone (PTH) is an important regulator of calcium and phosphate levels in the blood. Diabetes is diagnosed following fasting plasma glucose test level of 126 mg/dL (6.99 mmol/L) or greater. Glycated hemoglobin testing (Hemoglobin A1C) is a test that measures the quantity of a subtype of hemoglobin that has been glycated, meaning glucose molecules have become bound to the hemoglobin molecule. In conditions of hyperglycemia, the A1C level is increased.

While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best?

Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.

After having a very stressful day in pathophysiology class, the student knows that which hormone (secreted by the adrenal cortex) will help decrease the effects of stress?

Glucocorticoids, mainly cortisol, affect metabolism of all nutrients; regulate blood glucose levels; affect growth; have anti-inflammatory action; and decrease effects of stress. The other hormones do not affect stress levels.

Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:

Graves disease is an autoimmune disorder characterized by abnormal stimulation of the thyroid gland by thyroid-stimulating antibodies (TSH-receptor antibodies) that act through the normal TSH receptors.

A health care provider is assessing a client for a potential endocrine disorder. Assessment findings identify abnormalities with emotion, pain, and body temperature. Which mechanism of endocrine control will require further laboratory/diagnostic assessment?

Hypothalamus

Release and synthesis of anterior pituitary hormones are mainly regulated by which part of the body?

Hypothalamus

While reviewing the concept of nuclear receptors with a group of pathophysiology students, the instructor uses the example of clients with type 2 diabetes mellitus taking pioglitazone, a thiazolidinedione medication. Because of the peroxisome proliferator-activated receptors (PPARs), the drug has which effect on the clients' diabetes?

Promotes glucose uptake and increase the synthesis of certain proteins involved in fat metabolism, which reduces levels of certain types of lipids.

During the follicular stage of menstruation, increased estradiol production causes an increase in FSH production. This increase in FSH production by the anterior pituitary gland will have what effect on the follicle?

The follicle will die, which results in a fall of FSH.

A middle-aged woman has acromegaly as a result of a pituitary adenoma that was found and removed when she was a teenager. The physician is suspecting that the tumor has returned and has ordered a diagnostic work-up. A glucose load is ordered. If the tumor has returned, the nurse would expect which result?

The growth hormone level will not be suppressed following glucose load.

The nurse is teaching a client about a sulfonylurea medication. Which teaching points should be included in the discussion? Select all that apply.

These medications cause insulin to be released from the pancreas. Hypoglycemia may result from this type of medication

A client with a new diagnosis of an endocrine disorder is unclear how the body can control the levels of different hormones over time. Which statement most accurately underlies the dominant regulation process of hormone levels in the body?

With input from various sensors, hormone production and release are adjusted based on existing hormone levels.

The nurse administers a glucocorticoid medication to a client with pneumonia. Which of these does the nurse teach the client is the purpose of the medication?

To decrease airway inflammation