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1. How do the mechanisms of action of peptide hormones differ from those of steroid or thyroid hormones?

2. How does negative feedback regulate hormone secretion?

3. Name the thyroid hormones. Which one has the highest activity? How and where is it produced?

4. Name the two parts of the adrenal gland and the major hormones secreted by each part?

5. For what hormones is androstenedione a prohormone?

6. Describe the pathophysiological sequence that follows acute insulin deficiency?

7. A victim of accidental trauma requires emergency surgery, goes into shock in the operating room, and receives 10 pints of whole blood rapidly. The citrate in the blood binds calcium and decreases the plasma ionized calcium level. Describe the endocrine responses and the mechanism of their action in restoring the ionized calcium level to normal.

8. How are the mechanisms of bone formation and resorbtion linked? Does this linkage contribute to calcium homeostasis?

9. What does hypercalcemia do to neuronal membrane potential and why does that suppress neuromuscular excitability?

10. A patient undergoes major abdominal surgery, during which there were several decreases in blood pressure that required extra administration of fluid intravenously. He is found to have a serum sodium level of 122 mEq/L and a serum osmolality of 250 mOsm/kg 24 hours later. He shows no evidence of dehydration. Describe the sequence that led to this abnormality and its possible consequences.

11. A patient who receives a glucocorticoid to prevent rejection of a renal transplant suffers staphylococcal contamination of an accidental penetrating wound of the abdomen. How will the glucocorticoid influence his defensive response to the infection?

12. For primary, secondary, and iatrogenic hypercorticosolism, tell whether the ACTH level will be normal, greater than normal, or less than normal.

13. Would someone with Addison's disease have normal, low or high levels of ACTH in the blood?

14. Which hormones are essential for normal growth and development?

15. Why don't adults with hypersecretion of growth hormone grow taller?

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