Bonus points block 1

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Feb 20, 2024

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For this first exercise, identify the gland (or region of a gland) that produces the indicated hormone. All other exercises contain instructions 1. ACTH- Anterior Pituitary 2. ADH- Hypothalamus 3. Aldosterone-Adrenal Cortex 4. Calcitonin-Thyroid 5. Cortisone-Adrenal Cortex 6. Epinephrine-Adrenal Medulla 7. Estrogen-Ovaries 8. FSH-Pituitary Gland 9. Glucagon-Alpha Cells of pancreatic islets 10. Growth Hormone-Pituitary Gland 11. Insulin- Pancreatic beta cells 12. LH-Anterior Pituitary Gland 13. Melatonin- Pineal Gland 14. MSH- Intermediate lobe of the pituitary gland 15. Oxytocin- Hypothalamus 16. --- 17. Prolactin- Pituitary gland 18. PTH- Parathyroid glands 19. Testosterone- Testes, Ovaries 20. Thymosin-Thymus gland 21. Thyroxine-Thyroid gland 22. TSH- Anterior pituitary 4. Parathyroid hormone has multiorgan effects. Indicate its effects on the organs listed below. 1. Kidneys- Enhances the kidneys reabsorption of Ca from the forming urine into the blood and excretion of phosphates. 2. Intestine- Promotes activation of vitamin D, thereby increasing absorption of Ca by intestinal mucosal cells. 3. Bones- Stimulates osteoclasts to digest some of the calcium-rich bony matrix and release ionic calcium and phosphates to the blood. 3. Indicate the major stimulus for release of each of the hormones listed below (Hormonal, Humoral, Neural) 1. Adrenocorticotropic hormone- Hormonal 2. Parathyroid hormone- Humoral 3. Insulin-Humoral 4. Thyroxine and triiodothyronine- Hormonal 5. Epinephrine- Neural

6. Oxytocin and antidiuretic hormone- Neural 7. Estrogen and Progesterone- hormonal 8. Calcitonin- Humoral 1. Complete the following statements by choosing answers from the key choices. Record the answers in the answer blanks. A. Circulatory system, B. Electrolyte, C. Growth and development, D. Hormones, E. Metabolism, F. More rapid, G. Nerve impulses, H. Nervous system, I. Nutrient, J. Reproduction, K. Slower and more prolonged, L. Water 1. Slower and more prolonged 2. Nervous System 3. Hormones 4. Nerve Impulses 5. Circulatory system 6. Growth and development 7. Electrolyte 8. Nutrient 9. Metabolism 10. Reproduction Figure 16.1 is a diagram of the various endocrine organs of the body. Next to each letter on the diagram, write the name of the endocrine-producing organ (or area). Then select different colors for each and color the illustration. To complete your identification of the hormone-producing organ, name the organs described J. Parathyroid Gland K. Placenta I. Pituitary gland A. Pineal Gland B. Posterior Pituitary C. Anterior Pituitary D. Thyroid Gland E. Thymus F. Adrenal Gland G. Pancreas

H.- Ovaries I. Testes Complete the following statements by choosing answers from the key choices. A. Altering activity, B. Anterior pituitary, C. Hormonal, D. Humoral, E. Hypothalamus, F. Negative feedback, G. Neural, H. Neuroendocrine, I. Receptors, J. Releasing and inhibiting factors, K. Steroid or amino acid based, L. Stimulating new or unusual activities, M. Sugar or protein, N. Target cells 1. Receptors 2. Target cells 3. Stimulating new or unusual activities 4. Altering activity 5. Steroid or Amino Based 6. Neural 7. Hormonal 8. Humoral 9. Negative Feedback 10. Anterior Pituitary 11. Releasing and inhibiting factors (hormones) 12. Hypothalamus 13. Neuroendocrine 2. Differentiate clearly between a circulating hormone and an autocrine or paracrine. Autocrine-short-distance chemical signals that exert their effects on the same cells that secrete them. Paracrine-short-distance chemical signals that act within the same tissue but affect cell types other than those releasing the paracrine chemicals. The concentration of a circulating hormone in blood at any time reflects its rate of release and the speed at which it is inactivated and removed from the body. 8. For each of the hormones listed below, indicate its effect on blood glucose, blood calcium, and/or blood pressure by using the key choices. 1. Cortisol- Increases blood glucose 2. Insulin- Decreases blood glucose 3. Parathyroid hormone- Increases blood calcium 4. Aldosterone- Increases blood pressure 5. Growth hormone- Increase blood glucose 6. Antidiuretic hormone- Increases blood pressure 7. Glucagon- Increases blood glucose 8. Thyroxine- Decreases blood calcium 9. Epinephrine- Increases blood pressure 10. Calcitonin-Decreases blood calcium

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10. Concerning the histology of the pure endocrine glands, match each endocrine gland in Column B with the best approximation of its histology in column A 1. Spherical clusters of cells- Zona glomerulosa of adrenal cortex 2. Parallel cords of cells- Zona fasciculata 3. Follicles-Thymus gland 4. Nervous tissue- Posterior Pituitary 11. Name the hormone that would be produced in inadequate amounts in each of the following conditions 1. Malnutrition failure of reproductive organs- estrogen and progesterone 2. Tetany (death due to respiratory paralysis)- PTH 3. Polyuria without high blood glucose levels, causes dehydration and tremendous thirst- ADH 4. Goiter- Thyroxine 5. Cretinism, a type of dwarfism in which the individual retains childlike proportions and is mentally retarded- Thyroxine 6. Excessive thirst, high blood glucose levels, acidosis- Insulin 7. Abnormally small statute, normal proportions, a “Tom Thumb”- Growth Hormone 8. Spontaneous abortion- Estrogen and Progesterone 9. Myxedema in the adult- Thyroid 12. Name the hormone that would be produced in excessive amounts in each of the following conditions 1. Acromegaly in the adult-Growth Hormone 2. Bulging eyeballs, nervousness, increased pulse rate, weight loss (Grave’s disease)-Thyroxine 3. Demineralization of bones, spontaneous fractures- PTH 4. Cushing’s syndrome: moon face, hypertension, edema- Cortisol 5. Abnormally large stature, relatively normal body proportions- Growth Hormone 6. Abnormal hairiness, masculinization- Testosterone (Androgen) 3. Lauralee, a middle-aged woman, comes to the clinic and explains in an agitated way that she is very troubled by excessive urine output and consequent thirst. What two hormones might be cause the problem and what urine tests will be done to identify the problem? Hyposecretion of ADH and insufficiency of insulin. A glucose test of the urine 4. A 2 year old boy is brought to the clinic by his anguished parents. He is developing sexually and shows an obsessive craving for salt. Blood tests reveal hyper-glycemia. What endocrine gland is hypersecreting? The adrenal cortex gland 5. Lester, a 10 yr old has been complaining of sever lower back pains. The nurse notices that he seems weak and a reflex check shows abnormal response. Kidney stones are soon diagnosed. What abnormality is causing these problems? Hyperparathyroidism (excessive PTH)

6. Bertha Wise, age 30, is troubled by swelling in her face and unusual fat deposition on her back and abdomen. She reports that she bruises easily. Blood tests show elevated glucose levels. What is your diagnosis and what glands might be causing the problem? She may have Cushing’s syndrome, which is hypersecretion of glucocorticoids from the middle region of the adrenal cortex Case Study 1 A 19-year-old BCTC student was admitted to the UK Medical Center because of extreme fatigue and weight loss. For the previous year he had tired easily and was no longer able to study anatomy and physiology as he should to get a decent grade. He had lost 64 pounds in the last 2 years in spite of an increased food intake. His present height is 71 inches and his weight 140 pounds. About 4 years previously, he began to urinate frequently at night, and since then had increasing thirst and high urine output. He came to the hospital because during the last 24 hours he felt “awful”, was extremely thirsty and irritable, and drank about twelve 360 ml glasses of water. He was urinating hourly during the last 24-hour period and seemed unable to get enough to drink. His gums were sore, and he had recent difficulty eating because of the gum tenderness. Results of physical exam: Plasma glucose : 435 mg/dl (normal: 60-100) Urine: specific gravit y: 1.035 (normal: 1.015 – 1.022); 4+ reaction for glucose- moderate reaction for acetone Plasma : pH = 7.25 (normal: 7.35-7.45) PCO2 = 30 mmHg (normal: 35-45) HCO3- = 14 mEq/L (normal: 22-26) Hematocrit : 55% (normal: 40-50) Blood pressure : 105/50 standing; 130/68 lying down Standing pulse 104/min (normal: < 80) Respiration: 20 breaths/min (normal: 12) 1. What condition does our BCTC student have? Diabetes Mellitus 2. Why might he lose weight when his plasma glucose is up? Polyphagia causes body to consume its fat and protein storage for metabolism instead of glucose 3. What is his acid-base disturbance? Metabolic acidosis/Ketoacidosis 4. Explain his respiratory rate, how does it relate to question “3”? Respiratory compensation for ketoacidosis, makes it more rapid Case Study 2 A 45-year-old male from the Midwest presented with the following symptoms during February: weakness, fatigue, orthostatic hypotension, weight loss, dehydration, and decrease cold tolerance. His blood chemistry values follow:

Serum sodium 128 mEq/L normal 136-139 Serum potassium 6.3 mEq/L normal 3.5-5.0 Fasting blood glucose 65 mg/dL normal 70-110 Hematocrit : 50 % Leukocytes : 5,000 mm3 He also noticed increased pigmentation (tanning) of both exposed and nonexposed portions of this body and back. A plasma cortisol determination indicated a low cortisol level. Following administration of ACTH, plasma cortisol did not rise significantly after sixty to ninety minutes. Endogenous circulating levels of ACTH were later determined to significantly elevated. 1. What endocrine organ is the site of the malfunction? Adrenal Cortex 2. Is this a primary or secondary disturbance? How do you know? Primary. Plasms cortisol did not rise with ACTH 3 . What is the name of this disorder? Addisons disease 4 . Discuss the electrolyte disturbances resulting from this disorder (normal vs. diseased). Low sodium levels, low blood volume, high potassium levels 5 . Discuss the glucose disturbances resulting from this disorder (normal vs. diseased). Cortisol is not being released from the adrenal cortex; normally cortisol levels increase BS Case Study 3 Sharon went to her doctor with the following symptoms: dull facial expressions; droopy eyelids; puffiness of the face; sparse, dry hair; scaly skin; evidence of intellectual impairment; lethargy; a change of personality; bradycardia (60 b/min); a blood pressure of 90/70; anemia (Hct 27); constipation and hypothermia. Plasma concentrations of T3 and T4 were low and TSH levels were elevated. Following administration of exogenous TSH, plasma T3 and T4 did not rise after 2 hours. 1. What is the disorder? Is this a primary or secondary disorder? Hypothyroidism 2. Would you expect to find a palpable goiter? Explain . Yes, high TH and low T3 &T4 levels the follicles keep producing more and more colloid causing the swelling. 3. Describe the feedback loop involved. Where is the loop broken? Hypothalamus triggers release of TRH which stimulates thyroid to release T3 & T4 to target cells, TH hormones then shut off anterior pituitary or hypothalamus when there’s enough. The loop is broken at the thyroid gland. Case Study 4 A 38-year-old female visits her doctor complaining of chronic fatigue and weakness, especially in her legs. Upon greeting the patient, the doctor notes that although she is mildly obese, there is an unusually round contour to her face. During questioning, he learns that at her recent 20-year high school reunion, nobody recognized her because her face looked so different. Physical examination yields an unusual fat distribution

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consisting of a hump on the upper back and marked centripedal obesity. Blood pressure is also abnormally high. A. What is your diagnosis? Cushing disease B. Explain how you reached this diagnosis . Increase BP, centripetal obesity, moon face and hump on back Case Study 5 Mr. Jessup, a 55-year old man, is operated on for a cerebral tumor. About a month later, he appears in his physician’s office complaining of excessive thirst. He claims to have been drinking about 20 liters of water daily for the past week and voiding nearly continuously. A urine sample is collected, its specific gravity is reported at 1.001. A. What is your diagnosis? Diabetes Insipidus B. Explain both types of diabetes and how they are different. Use your text- both renal and endocrine chapters. Diabetes insipidus-ADH deficiency causes huge urine output and thirst. Diabetes Mellitus- Insulin deficiency causes loss of glucose in urine, increased urine osmolality C. Explain both types of diabetes insipidus. Nephrogenic- decreased response to ADH at the kidneys, retain fluid, headache, disorientation due to brain edema. Hypothalamic-neurogenic- decreased ADH secretion, kidney not stimulated to retain water. Case Study 6 Mary Francis had a total thyroidectomy followed by thyroid hormone replacement therapy. A few days later she developed laryngeal spasms, a mild tetany, and cramps in the muscles of the hands and arms. The following tests were performed: Urinary calcium 20 mg/dL Urine phosphorus 0.1 g/day Plasma calcium 7.0 mg/dL Plasma phosphorus 5.0 mg/dL Calcium and vitamin D were given orally each day and the tetany and laryngeal spasms were alleviated. a. What endocrine disorder does Mary Francis have? Hypoparathyrodism b . What caused the tetany and laryngeal spasms? Hypocalcemia increased activities of neurons c . What is the purpose of the vitamin D administration with the calcium? It increases calcium absorption and acts as a co-factor to facilitate the absorption of calcium in the intestine.

Bonus points block 1

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