Chapter 16 The Endocrine System

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Chapter 16 The Endocrine System, Fill-in-the-Blank/Short Answer Questions, Clinical questions
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1

1) ________ are hormones synthesized from cholesterol.

Answer: Steroids

2

2) ________ is a hormone that has only one known effect: to stimulate milk production by the
breasts.

Answer: Prolactin

3

3) ________ are the result of hypersecretion of growth hormone.

Answer: Acromegaly and gigantism

4

4) The largest pure endocrine gland in the body is the ________.

Answer: thyroid

5

5) Catecholamines are produced by ________ cells.

Answer: chromaffin

6

6) Alpha islet cells produce ________, an extremely potent hyperglycemic hormone.

Answer: glucagon

7

7) The ________ gland may influence our day/night cycles and even regulate the onset of sexual
maturity.

Answer: pineal

8

8) The ________ gland declines in size and function with age.

Answer: thymus

9

9) Endocrine gland stimuli include hormonal, ________, and ________ stimuli.

Answer: humoral; neural

10

10) 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.

Answer: ACTH

11

11) Compare the structure and function of endocrine and exocrine glands.

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.

12

12) Why should the hypothalamus instead of the adenohypophysis be called the ʺmaster endocrine glandʺ?

Answer: Although the adenohypophysis has many hormonal products, the hypothalamus controls anterior pituitary activity through regulatory factors.

13

13) Why would one not expect to continue increasing in height with age?

Answer: 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.

14

14) A woman with excessive body hair, a deep voice, and an enlarged clitoris shows the outward
symptoms of which hormonal dysfunction?

Answer: The hormonal dysfunction is hypersecretion of gonadocorticoids.

15

15) A person who drinks a lot of alcoholic beverages must urinate frequently. Why?

Answer: Alcohol inhibits ADH secretion.

16

16) How is the heart involved as an endocrine gland?

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.

17

17) Briefly discuss target cell activation by hormone-receptor interaction.

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 strength of the union between the hormone and the receptor.

18

18) 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?

Answer: Glucagon and insulin use different cell surface receptors.

19

19) A woman trying to lose weight buys diet pills off the shelf. She takes them as recommended
and notes a quick weight loss. What could cause this sudden weight loss? (The label on the
diet pills lists a chemical known to be a strong diuretic.)

Answer: The diuretic may have antagonized the effect of ADH, inhibited Na+ reabsorption, or
increased GFR, causing water to be flushed from the body. The ʺweight lossʺ was
simply water loss.

20

20) List the four mechanisms involved in the regulation of aldosterone secretion.

Answer: The four mechanisms are:
(1) the renin-angiotensin mechanism

(2) plasma concentration of sodium and potassium ions

(3) control exerted by ACTH

(4) plasma concentration of atrial natriuretic peptide.

21

21) What is the difference between autocrines and paracrines?

Answer: Autocrines are self-regulating chemical messengers because their target is the cell from
which they are manufactured. Paracrines are chemical messngers that act locally. They tend to affect only the cells immediately around them.

22

22) Give an example of synergism in hormones.

Answer: 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%.

23

23) How do pollutants such as industrial chemicals affect the endocrine system?

Answer: Exposure to pollutants has been shown to disrupt endocrine function. Sex hormones, thyroid hormones, and glucocorticoids are particularly susceptible. Glucocorticoids turn on many genes that may suppress cancer; therefore, any interference may help explain high cancer rates in certain areas of the country.

24

24) Growth hormones act indirectly to make the epiphyseal plate cartilage grow. What then acts
directly to make it grow?

Answer: The growth hormone stimulates the liver to release a growth factor called somatomedin, which in turn controls the epiphyseal plate cartilage.

25

Clinical Questions
1) 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. Laboratory
testing revealed hyperglycemia and increased basal metabolic rate. Although she also proved to have high blood pressure, 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 removal of the tumor and/or irradiation of the adrenal medulla.

26

2) 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. Further questioning reveals a medical history of abnormal reflexes and 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.

27

3) It was often rumored that one of our deceased presidents was suffering from Addisonʹs disease (inadequate synthesis of mineralocorticoids and glucocorticoids). What symptoms may have led to the diagnosis of this condition?

Answer: Hypoglycemia, a bronzing of the skin, low body weight, low plasma glucose and sodium levels, high potassium levels, hypotension, and some dehydration would all have been observed in the patient.

28

4) Due to a recent head injury, a client 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.

29

5) 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, certain hormones are
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 commercial 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.

30

6) John is a 26-year-old man who begins to notice a progressive enlargement of feet, hands, cranium, nose, and lower jaw bone. His doctor recommends irradiation of the pituitary gland.
What is the most likely diagnosis? Why?

Answer: 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.

31

7) 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.

32

8) What is the most important nursing intervention when caring for a patient with Cushingʹs
syndrome?

Answer: Because of enhanced anti-inflammatory effects, infections may become overwhelmingly
severe. Therefore the nurse should protect the client from infection.

33

9) 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 was flushed and his skin was dry. His pH was low. Describe the
physiological response that is occurring.

Answer: In severe cases of diabetes mellitus, blood levels of fatty acids and their metabolites rise dramatically. The fatty acid metabolite, 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.

34

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