NURS 3320 Chapter 49- Disorders of Endocrine Control of Growth and Metabolism

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1. A female patient presented to her primary care physician with classic signs and symptoms of Cushing syndrome. Upon testing, it was discovered that the patient had vaginal small cell carcinoma. How ... can the health care providers explain her Cushing syndrome signs and symptoms to this patient? A) “Your tumor in your vagina is secreting a hormone called adrenocorticotropic hormone (ACTH), which is responsible for these signs and symptoms.” B) “We are going to have to run some more tests. We think you might have a problem with your pituitary gland.” C) “There is no connection between the Cushing syndrome and the vaginal carcinoma. You have two very distinct problems occurring at the same time.” D) “We need to check your thyroid. Your Cushing syndrome may be caused by hypofunction of this gland.” Ans: A Feedback: Hyperfunction is usually associated with excessive hormone production. This can result from excessive stimulation and hyperplasia of the endocrine gland or from a hormone-producing tumor. A clinical example of this phenomenon is evidenced by the case of a woman with vaginal small cell carcinoma who also presented with Cushing syndrome. After testing, it was determined that the tumor is secreting ACTH. In this situation, the cause is not related to a pituitary problem. There is a connection between Cushing syndrome and the carcinoma. The thyroid gland is not responsible for Cushing syndrome. 2. Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to stimulate the adrenal glands, the adrenals' production of cortisol drops. This is an example of which type of endocrine disorder? A) Primary B) Secondary C) Tertiary D) Somatic Ans: B Feedback: In secondary disorders of endocrine function, the target gland is essentially normal, but defective levels of stimulating hormones or releasing factors from the pituitary system alter its function. 3. Following a long history of fatigue, weakness, and poor appetite, a 39-year-old male has been diagnosed with hypopituitarism. Which of the following clinical findings would most likely cause his care team to suspect that the man has an additional endocrine disorder from a different source? A) The man has a low sperm count and has been unable to have children. B) The man has a chronic platelet deficiency and is occasionally anemic. C) The client is 52 tall and was consistently short for his age as a child. D) The man displays the signs and symptoms of hypothyroidism. Ans: B Feedback: Low platelets and low hemoglobin are unlikely to be a manifestation of hypopituitarism. A low sperm count, small stature, and hypothyroidism are all noted manifestations of pituitary hypofunction. 4. Growth hormone (GH) secretion is inhibited by A) hypoglycemia. B) starvation. C) heavy exercise. D) obesity. Ans: D Feedback: GH is inhibited by increased glucose levels, free fatty acid release, cortisol, and obesity. It is stimulated by hypoglycemia, fasting starvation, increased blood levels of amino acids, and stress conditions such as trauma, excitement, emotional stress, and heavy exercise. [Show More]

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