Hw exam 1 Anwsers

I. Multiple Choice. Select the letter corresponding to the best selection for each question. Where indicated in the question, some of the following questions may have multiple correct answers requiring more than one letter to be selected. 1. A patient presents with all the symptoms of hypothyroidism. Blood tests show elevated plasma TRH but depressed plasma TSH and TH. The etiology (source of the problem) is the__( a-c)__, which is __( d-e)___. hypothalamus thyroid adenophyphysis oversecreting undersecreting 2. The reason plasma TRH levels are elevated, in the question above, is ___the TRH-secreting gland. failure of positive feedback mechanisms to stimulate overstimulation by positive feedback mechanisms of failure of negative feedback mechanisms to inhibit overinhibition by negative feedback mechanisms of 3. Graves Disease is an autoimmune disorder; antibodies stimulate the thyroid gland. In this case, we’d expect elevated TH, elevated TSH, elevated TRH elevated TH, depressed TSH, depressed TRH depressed TH, elevated TSH, elevated TRH depressed TH, depressed TSH, elevated TRH none of the above ___________________________________________________ More than one choice may be correct. Choices may be used more than once. a) Pernicious/megalobastic anemia b) Sickle Cell anemia c) Thalassemia d) Iron deficiency anemia e) Aplastic Anemia Cooley’s anemia- C megaloblastosis- A gastric atrophy- A erythropoietic failure- E hereditary, genetic defect, valine - B hereditary, genetic defect, failure to make one type of globin chain C Select one from the choices (a-e) for each of the following. Choices may be used more than once. a) tyrosine b) thymidine c) thyroglobulin d) uracil e) thyroxine ab) T3 in RNA D also known as T4 E Nucleoside that should be in DNA B amino acid A colloidal protein, storage molecule C nucleotide when found in DNA is considered to be "damage" D ______________________________________________________________________________ HbF has an oxygen affinity that is ____ that of HbA. In the absence of any globin chains, heme’s affinity for oxygen would be excessively____. Less than, high Less than, low Higher than, high Higher than, low The cellular role of vitamins is to act as cofactors act as apoenzymes act as coenzymes act as substates for enzyme reactions provide cellular metabolic energy Which of the following statements is true? Persons with malaria are unable to inherit sickle cell traits. Persons with sickle cell disease are immune to malaria. Persons with malaria are resistant to sickle cell disease. Persons with sickle cell trait are resistant to malaria. The event that triggers erythrocyte sickling in HbS is Reproduction of parasite within the erythrocyte Low oxygen pressure at the erythrocyte Contraction of malaria Being bitten by the mosquito Parasite entering the erythrocyte Which one of the following statements about the reticulocyte is false? It is an erythrocyte precursor It contains residual endoplasmic reticulum It is never found in circulation It lacks a nucleus It contains hemoglobin The hematocrit is expressed as the ratio of Plasma volume / volume of packed cells Plasma volume / volume of whole blood Volume of packed red blood cells / volume of plasma Volume of packed red blood cells / volume of whole blood The hemocytoblast is considered the stem cell to all future blood cells. Substances, known as _____, are responsible for directing populations of cells down the various cell lines. Differentiation inducers Growth inducers Antigen inducers Hormones Erythropoiesis in the older, normal adult (over 40 yrs) occurs mainly in _____. The axial skeleton The liver and spleen The appendicular skeleton The site of erythropoiesis changes during development. Embryonic synthesis occurs predominantly in the ____ and gradually shifts to the _____ in the fetus. Yolk sac, spleen and liver Yolk sac, bone marrow Bone marrow, yolk sac Spleen and liver, yolk sac Spleen and liver, bone marrow Which one of the following is not a role of the macrophage? Conjugate bilirubin. Degrade globin chains to amino acids. Convert heme to bilirubin. Release free iron Which one of the following best exemplifies a positive feedback system? The blood clotting pathways Maintaining the RBC count Maintaining blood pressure levels Regulating plasma levels of thyroid hormone The liver plays several vital roles. Which of the following is not a function of hepatocytes? They conjugates molecules. are at the site of erythrocyte removal from circulation. manufacture antibodies. synthesize important plasma proteins. produce bile. ________________________________________________________________ a) transferrin b) ferric c) ferritin d) ferrous e) hemosiderin ab) methemoglobin The form of intracellular iron that is less soluble and prone to form visible crystals in iron overload. E Is the plasma protein carrier for iron A a hepatocyte intracellular protein that is bound to iron and is part of the normal "blood iron buffer"C Iron in the +3 state B Hgb with iron in the +3 state AB Iron in the +2 state D _______________________________________________________________ Gene transciption refers to conversion of information from ___. This occurs in the ____. mRNA to protein, nucleus DNA to mRNA, nucleus mRNA to protein, cytoplasm DNA to mRNA, cytoplasm Both the nervous system and the endocrine system are involved in maintaining homeostasis. One major difference between these two systems is the time frame over which they work. lack of a sensory component to the endocrine system. lack of a motor component to the nervous system. nervous system works by negative feedback, while the endocrine system works by positive feedback. More than one selection may be correct. Select all correct choices. Leukemias vary greatly in the types of white cells that are affected. Which of the following statement is not true of the leukemic state? Bones become painful and easy to fracture. White cells invade spleen, liver and lymph nodes, destroying those tissues. The affected person suffers from anemia and tendency to bleeding episodes. The patient is more resistant to infections and disease. White cells grow in great numbers An increase in hemolytic rate will eventually result in Increased HCT Decreased plasma bilirubin levels Increased plasma EPO levels Decreasing the levels of circulating reticulocytes Thymidine is important for synthesis of _____. In the case of developing cells, a lack of this can limit the rate of ____. DNA, cell division DNA, protein synthesis RNA, cell division RNA, protein synthesis Both DNA and RNA, division and protein synthesis The adrenal cortex produces aldosterone, a hormone that regulates our body’s handling of _____. steroid hormones sugar salts, particularly sodium and potassium Which one of the following is a hypophyseal hormone that regulates adrenal secretion of cortisol? TH CRF GH ACTH MSH Approximately what percentage of body weight is plasma volume? 25% 12% 8% 5% 2% The figure represents a capillary and nearby cells. (not drawn to scale) X Select from the following choices. Choices may be used more than once, and more than one choice may apply to each description. a) Plasma fluid b) Intracellular fluid c) Interstitial fluid d) Transcellular fluid Compartment lined by epithelium; includes GI tract, synovial joints and ocular fluid.D Compartment that is rich in sodium, chloride and protein.A Compartment concentration is normally 300 mOsmolal.ABCD The largest body fluid compartment, overall.B Compartment X in the diagram C Consider this: If a person ingests a non-absorbable solute into the gastrointestinal tract, (before any redistribution occurs) solute concentration is____ and the relative water concentration is _____. decreased, increased decreased, decreased increased, increased increased, decreased As a result of the disturbance (in the above question), there will be a net diffusion of water _____. into the gastrointestinal tract out of the gastrointestinal tract equally into and out of the gastrointestinal tract, so that there will be no net change in volume __________________________________________ Conjugated b) Unconjugated Liver disease, such as hepatitis, may result in elevated levels of circulating______ bilirubin. B Gallstones and blocked biliary secretion may result in elevated levels of circulating ___ bilirubin.A _______________________________________________________________________________ The hypothalamus is the site of temperature regulation. If the hypothalamic set point for body temperature is suddenly readjusted to 34oC, then the temperature that was earlier considered "normal" (that is, 37o) is now perceived by the hypothalamus to be a _____. deviation variable setpoint correction In the question above, the consequence of the change in set point to 34oC will be to Initiate shivering Initiate sweating Return the set point to the original value Bring the set point to a value lower than the original value. Choices may be used more than once a) Bacterial endotoxins b) Prostaglandin E2 c) IL-1 d) COX-1 e) Arachadonic acid Leukocyte cytokine C Fatty acid, membrane-derived, precursor molecule E Considered an exogenous pyrogen A Antipyretic agents block the enzymatic activity of this molecule D Molecule that acts directly on cells of the central nervous system to alter temperature B _____________________________________________________________ Which one of the following is not a building block of hormones? Carbohydrates Amino acids Proteins or peptides Steroids Specific, direct and "one-on-one" communication between an endocrine gland and its target cells is determined by ______. The distance between the endocrine gland and its target The anatomical connections between the endocrine gland and its target The chemical nature of the hormone (i.e. the class of molecule it is) The presence of receptors for the hormone on or in the target cell Which of the following adrenal hormones plays a major negative feedback role on secretion from the hypothalamus? cortisol aldosterone testosterone epinephrine Which one of the following would be increased in a person with hypothyroidism? Basal metabolic rate Cardiac output Food intake Neural excitability Body weight “Anisocytotic, hypochromic, microcytic” are words that might characterize erythrocytes in this disease: Pernicious anemia Sickle cell disease HDN Iron deficiency anemia Polycythemia vera A person climbs to high altitude. There, the concentration of gases in the air is ___ than normal. This means that after several weeks, this person will be ____. Lower, anemic Lower, polycythemic Higher, anemic Higher, polycythemic Methemoglobin is a form of Hb that lacks iron, and is due to an iron deficiency. True b) False Blood viscosity, or “thickness” of blood, is mainly a function of RBC count WBC count Hb concentration Albumin concentration An erythrocyte's biconcave shape is an advantage over a spherical shape because this gives the cell a(n) ___ surface to volume ratio, _____ gas exchange. Increased, enhancing Decreased, enhancing Increased, limiting Decreased, limiting Shape does not affect surface/volume ratio Antibodies or immunoglobulins are Proteins capable of attacking specific foreign antigens Able to bind to the specific antigen which induced their production Typically contain two (and sometimes more) "variable" regions that bind antigen Classified into 5 groups based on their size and structure All of the above True or false. Sickle cell disease is a hereditary disease and its effects can be observed in the fetus carrying these genes. This disease may even affect fetal development and the viability of the pregnancy (ie. failure of the fetus to come to full term.) . A) true B) False Sickle cell "disease" is indicative of a patient who is _____ for the defect. This patient ______. heterozygous, will most likely suffer from a sickling "crisis" during his lifetime heterozygous, is said to have an evolutionary advantage in the population homozygous, will most likely suffer from a sickling "crisis" during his lifetime homozygous, is said to have an evolutionary advantage in the population Which of the following is most associated with allergies and hypersensitivity? a) Ig A b) Ig D c) Ig E d) Ig G e) Ig M More than one selection may be correct. Select all correct choices. Even though a mature erythrocyte does not have a nucleus, its cytoplasmic enzymes keep that cell viable for its limited lifespan. These enzymes are responsible for allowing the cell to carry out protein synthesis maintaining the flexibility of the membrane allowing the cell to carry out membrane transport allowing the cell to carry out mitosis keeping the iron in hemoglobin in the correct redox state In the embryo, Hb formed is composed of the following chains: 22 2?2 22 22 22 More than one selection may be correct. Select all correct choices. Our immune system protects and defends us against invading pathogens. It is our population of T cells that engage in humoral immunity engage in cellular immunity produce antibodies when activated complete their maturation and "education" in the bone marrow recognize and target foreign surface antigens presented to them The hemocytoblast is considered the stem cell to all future blood cells. Substances, known as __1st___, are responsible for directing populations of cells down the various cell lines. The hemocytoblast is considered to be ____2nd__. 1st 2nd A Differentiation inducers differentiated B Differentiation inducers determined C hormones totipotent D hormones determined The site of erythropoiesis changes during development. Fetal synthesis occurs predominantly in the ____ and gradually shifts to the _____ in the newborn. Yolk sac, spleen and liver Yolk sac, bone marrow Spleen and liver, yolk sac Spleen and liver, bone marrow Bone marrow, yolk sac Which of the following statements about peptide or protein hormones is usually true? They have longer half-lives than steroid hormones they have receptors on their target cell membrane they require protein carriers in the plasma they are not stored in endocrine-producing glands. A 40-year old woman is placed on a high-potassium diet for several weeks. Which of the following hormonal changes is most likely to occur? increased secretion of dehydroepiandrosterone (DHEA) increased secretion of aldosterone increased secretion of cortisol increased secretion of adrenocorticotropic hormone decreased secretion of corticotropin releasing hormone A woman is taking birth-control pills with a high amount of estrogen and progesterone. What best explains why her ENDOGENOUS HPG axis would have low amounts of GnRH, low FSH and LH, and low estrogen and progesterone release. Negative feedback inhibition Failure of negative feedback inhibition Failure of positive feedback inhibition positive feedback inhibition She should just get pregnant so I don't have to figure this out. Which of the following pairs of hormones and the corresponding action is INCORRECT? Glucagon-- increased glycogenolysis in liver glucagon --decreased lipolysis growth hormone- increased amino acid intake in skeletal muscle cortisol--increased gluconeogenesis cortisol-- decreased glucose uptake in muscle Which of the following is inconsistent with the diagnosis of Graves' disease? increased heart rate exophthalamos increased plasma levels of triiodothyronine (T3) increased plasma levels of thyroxine (T4) increased plasma levels of thyroid-stimulating hormone. The coagulation pathway that begins with the release of tissue factor III from damaged tissue is: A. extrinsic pathway B. intrinsic pathway C. common pathway Consider a patient with Hashimoto's disease. The best explanation for hormone profiles of high TRH, and high TSH but low TH is due to: Failure of negative feedback inhibition Negative feedback inhibition Failure of positive feedback inhibition positive feedback inhibition A 2-year-old boy bruises easily and has previously had bleeding gums. The maternal grandfather has a bleeding disorder. His physical examination shows several small bruises on the legs. Of which coagulation factor would you suspect this patient to be deficient? A. Factor II B. Factor VIII C. Factor III D. Factor X You have just given a blood donation. We would expect to see an ___1st ____ in erythropoietin and an increase in red blood cells in the blood within ___2nd____days. 1st 2nd A Increase 5-7 days B Increase 2 weeks C Decrease 5-7 days D Decrease 2 weeks A 62-year-old female arrives for her annual physical. She complains of itching in her hands along with headaches and vertigo. A routine complete blood count reveals a RBC of 8.2 million cells/l. Her erythropoietin levels are lower than normal. The primary diagnosis would be: thrombocytopenia relative polycythemia secondary polycythemia polycythemia vera (Primary polycythemia) What would be the appropriate therapy for massive pulmonary embolism? A. Heparin B.Warfarin C. Aspirin D. Tissue plasminogen activator Which of the following is not increased during exercise induced hyperthermia? body temperature vasodilation sweating hypothalamic set point for body temperature Consider the plasma compartment of a person with uncontrolled diabetes mellitus. We recognize that the osmotic pressure of their plasma compartment has ____1st___ and there will be a resulting movement of water ___2nd___ the surrounding tissues and ____ the plasma. 1st 2nd 3rd A. Decreased Into Out of B. Decreased Out of Into C. Increased Into Out of D. Increased Out of into Continuing with the above question, as a result of this net movement of water called ____1st___ the tissue cells will ___2nd____. 1st 2nd A. osmosis Crenate/shrivel B. Osmosis Swell/burst C. Diffusion Crenate/shrivel D. Diffusion Swell/burst When considering homeostasis, a _1st___ is something that can be measured and is usually maintained in a healthy range, or set point, which is the same as saying it is __2nd_. 1st 2nd A. Deviation At equilibrium B. Deviation In a steady state C. Variable At equilibrium D. Variable In a steady state Consider a person exposed to high heat and humidity. In this case we would expect the person to: lose heat through radiation and evaporation mechanisms gain heat and is at risk of hyperthermia. Lose heat by evaporation only. lose heat by radiation, evaporation and conductive mechanisms. Move from Florida to somewhere cooler, like Alaska. A woman presents in your clinic with moon face, striae, hirsutism, masculine features, hypokalemia, hypertension, hyperglycemia (elevated blood glucose levels), and low levels of ACTH. This person likely has: Primary hyperadrenalism Primary adrenal insufficiency secondary adrenal insufficiency secondary hyperadrenalism Eaten too much sugar, takes steroids and lacks a razor. Which of the following substances cannot prevent coagulation when directly added to a blood sample (i.e., in a test tube)? A. heparin B. citrate C. coumadin D. oxalate E. EGTA What is the cause of hyperpigmentation in the Addison's Disease patient? The destruction of the anterior pituitary leads to the hypothalamus over-secreting melanocyte stimulating hormone (MSH). The lack of negative feedback inhibition leads to excessive POMC production from which both ACTH and MSH are produced. These patients have a tendency to spend too much time sunbathing. These patients have hemochromatosis causing a reddish hue. These patients have a problem with clearing the conjugated bilirubin from their body so they have jaundice. You are trying to develop a therapeutic drug for osteoporosis. Osteoporosis is a disease in which the osteoclasts are overly active in bone resorption. Which of the following chemical signals would you want to increase in your patient? Parathyroid hormone osteoprotegerin ligand (OPGL) (a.k.a. RANK-L) release by osteoblasts osteoprotegerin release by osteoblasts growth factors for osteoclasts A patient comes to her physician because she notices her stool has lost its brown appearance and now looks white. Her skin and sclera have a yellow color. Her blood is drawn and sent to the lab for analysis. What predictions could we make about her blood values (1st response) and what could be the problem (second response)? 1st 2nd A. The patient’s conjugated bilirubin will be high Bile duct obstruction B. The patient’s unconjugated bilirubin will be high. Liver failure C. The patient will have polycythemia Kidney failure D. The patient’s EPO will be high due to hypoxia Kidney tumor Continuing with the above previous patient, you notice that her PT time is longer than normal. Why can this happen (first response) and what can you do to help the patient (second response)? 1st 2nd A. Increased vit K absorption Give the patient coumadin B. Increased vit K absorption Give the patient a shot of Vit. K C. Decreased vit K absorption Give the patient coumadin D. Decreased vit K absorption Give patient a shot of Vit. K In order to have proper hormone function, a hormone needs to be appropriately synthesized and released, and have a functional receptor on a functional target tissue. Which of the following represents a loss of a functional receptor for a particular hormone? The African Pygmies The Laron Dwarfs gigantism A person with acromegaly ___1st __ feedback is often referred to as a “vicious cycle” because it leads to ___2nd __ instability and sometimes death. 1st 2nd A Positive progressive B Positive diminished C Negative progressive D Negative diminished The most abundant substance in the human body and the approximate percentage of that substance in the body is which of the following? water, 30% water, 60% protein, 30% protein, 60% A child has kwashiokor. The reason for her distended belly is because: Her transcellular osmotic pressure is low compared to the plasma’s. Her plasma osmotic pressure is high compared to transcellular’s. Her plasma osmotic pressure is low compared to the transcellular’s. Two of the above. A 46-year-old woman has a decreased metabolic rate and is lethargic. Her plasma TRH levels are high but her blood TH concentration is low. However, her TH increases markedly when she is given TSH. Which of the following is the most likely diagnosis? Hypothyroidism due to an abnormality in the hypothalamus Hypothyroidism due to an abnormality in the pituitary. Hyperthyroidism due to an abnormality in the hypothalamus Hypothyroidism due to an abnormality in the thyroid Congenital adrenal hyperplasia results from a deficiency of any of the five enzymes necessary for cortisol production. In this case, we’d expect: Depressed CRH, depressed ACTH, depressed cortisol Elevated CRH, elevated ACTH, depressed cortisol Depressed CRH, elevated ACTH, depressed cortisol Elevated CRH, depressed ACTH, depressed cortisol Which of the following is a function of TSH? Increase of iodine trapping in follicular cells Increased thyroglobulin synthesis Increased release of T3 and T4 All of these. A patient presents with all the symptoms of hyperthyroidism. One way to determine if the cause is Graves’ Disease or an over-secreting hypophyseal tumor is to check: A. For a goiter B. Blood TRH levels C. Blood TSH levels D. Blood TH levels Which of the following would be decreased in hyperthyroidism? Basal metabolic rate Body weight Mental alertness Heart rate A patient is undergoing open-heart surgery. His blood is diverted through a heart-lung bypass machine. The tubing is lined with ____1___, which binds to anti-thrombin III making it a ____2___ thrombin inhibitor. 1st 2nd A. Heparin More potent B. coumadin more potent C. heparin Less potent D. coumadin Less potent Continuing with the above question, at the end of the surgery ___1___ should be administered to the patient and his clotting times should be checked with the ____2___ until his clotting times __3__ toward a normal value. 1st 2nd 3 A. protamine PT test Decrease B. prostacyclin PT test increase C. protamine aPTT test decrease D. prostacyclin aPTT test increase All of the body fluid compartments, under normal, stable conditions, are of the same __1__, but are of different _2__. 1 2 A. osmolalities Composition and volume B. Composition osmolalities and volume C. Volume osmolalities and composition D. Composition and volume osmolalities __1__ cells make a product required in the absorption of Vitamin B12. The vitamin is absorbed into the bloodstream across the lining of the __2__. 1 2 A Hepatic Bile ducts B Chief Gastric mucosa C Parietal Ileum D Parietal Gastric mucosa A patient, vacationing in the mountains (at a high elevation), is being seen by a physician. Among his blood lab results is the finding that his HCT and EPO are markedly elevated. The physician should: consider bleeding him to contribute to the local blood bank. see this as secondary polycythemia and do nothing to treat his condition. consider giving him EPO consider chemotherapy to stop the stem cell cancer in the medullary cavities I've just decided I don't want to be a nurse or study science, so I don't need to answer this question. A child has eaten a large amount of rat poison. What is the most appropriate action for the physician to take? tell the parents to plan the child’s funeral. Give the child a blood transfusion. Give the child an injection of vitamin K. Give the child heparin. Which of the following is not a natural, endogenous, anti-coagulant? A. Heparin B. Prostacyclin C. Anti-thrombin III D. Thromboxane A2 Taking baby aspirin on a daily basis will block the ability of COX-1 to cleave __1___ into various prostaglandins. This means clotting times will ___2___. 1st 2nd A. Thromboxane A2 Increase B. Arachidonic acid Increase C. Thromboxane A2 Decrease D. Arachidonic acid decrease Continuing with the above question, a person who needs to have surgery will need to stop taking their aspirin in order to allow for ____1___ in order to ____2___ their clotting times. 1st 2nd A. Platelet turn-over Increase B. Red blood cell turn-over Increase C. Platelet turn-over Decrease D. Red blood cell turn-over decrease A patient with rheumatoid arthritis has been given high (pharmacologic) doses of cortisol to suppress his immune system. The patient is strongly warned that he must taper off the cortisol gradually. A sudden withdrawal of the cortisol would most likely result in which of the following? Hypothyroidism: Weight gain, somnolence, and intolerance to cold temperatures Adrenal insufficiency: dehydration, low blood sugar levels, low plasma volumes Cushings disease: immune suppression, moon face, striae, high blood sugar levels Adrenogenital syndrome: increased hair (hirsutism), enlargement of genitalia What condition leads to a deficiency in factor IX that can be corrected by intravenous injection of vitamin K? Classic hemophilia Von Willebrand's Disease Bile duct obstruction Genetic deficiency in antithrombin III Consider the process of inflammation. In this case, macrophages would release a cytokine (interleukin-1), which would cause the surrounding tissues to induce gene expression of __1st__. This enzyme cleaves arachidonic acid into ___2nd___which allows more blood flow to the damaged area leading to redness, swelling, pain, and heat. 1st response 2nd response A COX-1 PGE2 B COX-1 PGI2 (prostacyclin) C COX-2 PGE2 D COX-2 PGI2 (prostacylcin) Glucose is (select all that may apply): a polymer the monomer of glycogen can be used as an energy source by the body used in translation The plasma membrane is important for: it controls the movement of substances into and out of the cell It acts as a barrier to the external environment It acts as a site for receiving signals from the rest of the body It acts as a site for holding the cell in place All of the above are functions of the cell membrane Integral membrane proteins are: Used as receptors for hydrophilic hormones. Proteins that span/cross the cell membrane Proteins that are associated with only one side of the cell membrane (i.e., inner or outer surface). A and B are correct A and C are correct The simple chain of amino acids generated by the cell during protein synthesis is referred to as the: Primary structure Secondary structure Tertiary structure Quaternary structure Parking structure Phospholipids are amphipathic molecules. That means they have a polar region and a non-polar region. The polar region consists of _______1_____ and this region is considered to be _____2_________. First response Second response A. Fatty acid tails Hydrophilic B. Fatty acid tails Hydrophobic C. Phosphate heads Hydrophilic D. Phosphate heads hydrophobic Continuing with the question from above, the non-polar region of the cell membrane consists of ___1____ and this region is considered to be ____2____. First response Second response A. Fatty acid tails Hydrophilic B. Fatty acid tails Hydrophobic C. Phosphate heads Hydrophilic D. Phosphate heads Hydrophobic When translation occurs, it is characterized by _______1__________ and occurs in the ___2________. First response Second response A. DNA synthesis nucleus B. mRNA synthesis nucleus C. mRNA synthesis cytoplasm D Protein synthesis nucleus E. Protein synthesis cytoplasm What can be said about release of aldosterone? a.) It follows a typical hormonal release with ACTH causing its release. b.) It follows a typical neural release with the sympathetic nervous system stimulating its release. c.) It follows a typical humoral release with increased potassium levels stimulating its release. d.) It follows a typical movie release and should be in theaters by summer. A patient presents with all the symptoms of polycythemia. One way to determine if the cause is primary or secondary is to check for: A goiter as people with primary polycythemia do not have goiters The hematocrit level The patient’s hydration status The patient’s EPO levels. A patient presents with a goiter and complains of gaining weight and somnolence and has cold intolerance. This patient likely has __(1st)__________. One way to check the etiology (source) of the problem is to ___(_2nd)_____. 1st response 2nd Response A hypothyroidism Measure the patient’s levels of TSI B hypothyroidism Measure the patient’s levels of thyroid hormone, TSH, and TRH C hyperthyroidism Measure the patient’s levels of TSI D hyperthyroidism Measure the patient’s levels of thyroid hormone, TSH, and TRH Prostaglandin E2 synthesis can lead to a change in hypothalamic set point for body temperature. One way to block the synthesis of PGE2 is to take a ____1st_____ and decrease the amount of ___2nd _______ that is cleaved into PGE2. 1st response 2nd response A NSAID Cox B NSAID Arachadonic acid C Cox stimulator Cox D Cox stimulator Arachadonic acid True/False—(note: during an actual test, you will mark “A” for true and “B” for false on a scantron form). The loss of the entire stomach or atrophy of the stomach as a result of surgical gastrectomy can lead to megaloblastic anemia. Living at high altitudes would lead to secondary polycythemia. Both mast cells and basophils release histamine, a substance that acts as a vasodilator. Coumarin binds to antithrombin III and makes it a more powerful thrombin inhibitor. Citrate and oxalate act on the blood by binding to calcium. The intrinsic pathway is faster and produces more amounts of PAS. t-PA activates plasminogen into plasmin for clot dissolution. Basal metabolic rate would increase in someone with hypothyroidism. Coumarin competes with vitamin K and can lead to longer clotting times due to a deficiency in factors 2,7,9, and 10. Reticulocytes, contain hemoglobin and some organelles, and are released into the blood stream to later mature into RBCs. Which points in the following graph most closely define the following conditions? Normal erythropoietin (EPO) levels are normally 10 units. 70 60 50 40 30 20 10 0 B Hematocrit C D A 1 10 100 1000 EPO polycythemia vera B aplastic anemia D End-stage renal disease A Matching. This will spell a word. A. anemic E. Ferritin M. Unconjugated bilirubin S. neutrophil B. polycythemic F. TSH-RH N. hemosiderin T. basophil C. leukemia G. thyroglobulin O. IgG U. extrinsic D. thrombocytopenia I. Conjugated bilirubin R. albumin W. eosinophil __A__ If there is NOT any erythropoietin present, a patient would ultimately become ________. ___N_ The form of intracellular iron that is less soluble and prone to form visible crystals in iron overload. ___E_ The preferred way to store intracellular iron. ___M_ The kind of bilirubin that would increase in premature babies due to an immature liver. ___I_ A blockage in the common bile duct would lead to increased amounts of this bilirubin __A__ If you have a reduced oxygen carrying capacity, you would be _________. Relationships. READ INSTRUCTIONS CAREFULLY. Below are 2 relationship essays questions. Provide the physiologic relationship between all terms in each problem. Explain how they are related functionally, be specific, and explain “how” and “why” things occur. Be “to the point.” Provide only information that is relevant to the question. NOTE: the answers below are merely quick responses. Your response is not necessarily wrong if you elaborated in greater detail. Write your first relationship selection here: TSH/ Graves Disease/ TRH The hypothalamus senses low levels of thyroid hormone and responds by releasing Thyrotropin Releasing Hormone (TRH). TRH stimulates the pituitary to produce Thyroid Stimulating Hormone (TSH). Graves Disease is an autoimmune disorder in which antibodies, thyroid stimulating immunoglobulins, are produced that bind to the TSH receptor. The antibodies stimulate the receptor and cause over production of Thyroid Hormone. Negative feedback inhibition is increased so levels of TRH and TSH decrease, but their decreased levels FAIL to inhibit the production of TH. Write your second relationship selection here: hirsutism/ ACTH/hypokalemia Hirsutism is facial hair growth in the female ACTH, Adrenocorticotropic Hormone, regulates levels of the steroid hormone cortisol which is released from the adrenal gland. Hypokalemia is a condition where blood potassium levels are low. Together these are the signs and symptoms of primary hyperadrenalism (a type of Cushing's syndrome) All 3 layers of the Adrenal Cortex (zona glomerulosa, zona fasciculata, zona reticularis) over- produce their hormones: High aldosterone leads to hypokalemia (zona glomerulosa) because aldosterone stimulates the nephron cells to reabsorb more sodium and water but secrete potassium into the urine, high cortisol (zona fasciculata) is produced and results in high amounts of blood glucose and muscle wasting. As a result of the high cortisol the CRH and ACTH levels will be low due to negative feedback inhibition. Lastly, the zona reticularis is releasing DHEA which leads to hirsutism. Caused by an adrenal tumor, which causes an excessive release of aldosterone, cortisol, and DHEA, the cortisol is the only hormone of the three that influences the HPA axis and leads to negative feedback inhibition of CRH and ACTH. The low levels of ACTH fail to inhibit the excessive release of cortisol due to the adrenal tumor. An experiment was conducted in which rats were injected with hormone X or saline (control) for 2 weeks. Autopsies were then performed, and organ weights were measured (in milligrams). Organ weighed Control Hormone X Pituitary 12.9 20.0 Thyroid 250 250 Adrenal glands 40 85 Body weight 300 250 Explain why Hormone X is CRH. Be sure to explain the changes in the organ weights and body weight of animal. CRH is Corticotropin Relasing Hormone. In the HPA pathway, CRH is required to stimulate the pituitary, which releases ACTH. If CRH is increased (injected as Hormone X), then (per the HPA pathway) the pituitary stimulation will also be increased and will over produce ACTH, explaining the increase in pituitary weight (likely by hypertrophy or hyperplasia). Increased ACTH leads to adrenal hypertrophy/hyperplasia. Hypertrophy is an enlargement of cells whereas hyperplasia is the enlargement of an organ or tissue caused by an increase in the reproduction rate of its cells. Increased adrenal stimulation also produces increased cortisol levels which are known to decrease an individual’s body weight due to utilization of adipose tissue and muscle wasting.