NR 283 FINAL EXAM EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED)

NR 283 FINAL EXAM EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) 1. What regulates the release of hormones?: feedback systems 2. Positive Feedback: tells a hormone to make more 3. Negative Feedback: stops making a hormone 4. Secreting Cells: what is pumped out of the cells (ADH released from the posterior pituitary gland) 5. Receiving Cells: what cells the hormones target (ADH targets the kidney) 6. Why are hormones are released?: -altered cell environment (increases intake of glucose leads to a release of insulin) -maintaining levels of other hormones (cascades trigger the release of other hormones, ex: TRH) -neural control (autonomic NS - not in control) 7. Non-steroidal hormones: -water soluble, can float around blood stream with no issues since the blood stream is made up of water, but cannot get through phospholipid bilayer - which is why we need receptors on the cells and second messengers (proteins that live inside the cells to help get the message to the nucleus) -ex: insulin: freely moves around bloodstream but has to connect with a second messenger 8. Steroidal Hormones: -lipid soluble, fatty hormones floating around bloodstream cannot float around easily so they need carrier proteins to carry them. When they get to the cell, they dont have any issues getting into the cell they can deliver the message straight to the nucleus ex: sex hormones (estrogen, testosterone) 9. regulation: refers to the receptivity of cells, how open is that cell to allow a hormone in 10. Upregulation: if we starve a cell of a hormone, they will be much more likely to get a hormone in -this is why type II diabetes can be reversible, if the cells haven't seen insulin in a while, the pancreas isn't overworking to pump out insulin 11. Downregulation: -happens with type II diabetes, have tons of glucose in bloodstream, in response the pancreas (beta cells) pump out insulin, in a normal state the pancreas is able to pump out insulin, but since there is so much excess glucose in the blood, insulin comes to the cell receptor and they wont let glucose in because they have become sensitized.Now it will take more insulin to do the same job. -also happens with narcotic addiction 12. Thyroid Cascade: thyroid hormone helps us make ATP, the target cells for thyroid hormone is every cell in the body so it affects many things. -need more ATP? positive feedback loop is started. Hypothalamus release TRH which reaches pituitary gland and then releases TSH, TSH reaches thyroid and the thyroid gland release TH and then goes to target cells (all cells in the body), once we have enough, negative feedback loop is initiated to stop making TRH 13. Cause of Endocrine Disorders: -autoimmune -most common cause is a tumor on gland (pituitary) -target cell resistance (type II diabetes) -congenital defect -hyperplasia (increase in cell number - goiter) 14. Hyperthyroidism: (graves disease) -only affects women, autoimmune -body produces antibodies (normally fight infection), but this AB's instead will go to the thyroid and will mimic the cascade. They tell the thyroid to produce more thyroid hormone, even when negative feedback is taking place -Sx: exophalmos (bulging of the eyes caused by inflammation from cell mediators), toxic goiter, symptoms are also due to everything speeding up (hot because of increased metabolism which makes more ATP - ATP releases heat, shaky: everything is moving fast through body, weight loss: crazy fast metabolism, tachycardia, increased BP: thyroid hormone helps maintain BP -Tx: iodine (kill part of thyroid) or surgically remove part of thyroid 15. Hypothryoidism: -common, autoimmune -thyroid does not make enough TH - AB's are attacking the thyroid so it is not able to make as much TH -usually affects women -Sx: due to lowered metabolism, everything slows down. Cold: not making a lot of ATP, super tired, apathy (disinterest) -Tx: synthroid which acts as a superficial TH, easy treatment that has to be regulated very closely as metabolism needs change 16. SIADH: -syndrome of inappropriate antidiuretic hormone -high levels of ADH (ADH helps keep water) -if we have too much ADH, we have too much water in the blood stream, end of with tons of water and not enough sodium -hyponatremia: imbalance of water to salt, brain is super sensitive to this, the brain will know that this is off -problems happen from being in a hypo-osmolar state (not enough solutes in blood) -ADH works on last part of nephron so it gets the last say on deciding on how much water to pull back -causes: tumor on pituitary gland, occasionally after surgery -Sx: irrational thirst: ratio of solute to water is off so the brain wants us to drink more water, but we already have all this water in the bloodstream. Anorexia and GI problems: wont want to eat when carrying around all this extra water. Dyspnea: extra fluid in blood stream so increase in hydrostatic pressure, fluid could exit into lungs. -Severe Sx: changes in LOC, confusion, lethargy, muscle twitching, convulsions -NOT A SODIUM PROBLEM, this is a water problem -Tx: IV fluids or a hypertonic solution, important to give fluids slowly since a if there is a sudden increase in solutes, water will be attracted from the brain cells so they will shrink and die and will put you into a coma OR water can be rushed into the brain cells too quickly and the brain can burst or die, which leads to coma or death 17. diabetes insipidus (DI): -rare -causes by trauma, tumor on pituitary, craniotomy -Sx: polyuria (frequent urination) and polydipsia (increases thirst) -not enough ADH so dumping tons of water into urine, so pt. is severely dehydrated. All of the water is exiting through the kidneys and now have an inability to concentrate urine (ability to pick and choose what we want in the nephron) -increased plasma osmolality: blood vessel with not enough water and tons of solutes, hyperosmolar state, blood is thick and viscous, syrupy due to lots of solutes -hypernatremia not related with intake of salt, all a water problem -Sx: increased thirst due to losing a lot, urinating at night, can lose up to 20 L of urine in a day (hypovolemic), tachycardic: super dehydrated so heart has to work harder and there isnt a lot of volume tx: vasopressin (artificial ADH) 18. Diabetes: -common -important to note that insulin is dangerous -beta cells in pancreas produce insulin -normally: when there is glucose in the blood, insulin gets released from the beta cells into the blood stream. insulin acts a key to get glucose inside the cells. insulin is water soluble so it needs a second messenger to take it to the nucleus. -hyperglycemia: tons of sugar in blood -type 1: dont make enough insulin -type 2: insulin resistant, down regulation -Diagnose: hemoglobin A1C or HbA1c - draw blood and look at RBC's, look at how blood sugar levels have fluctuated in the last 3 months, want this to be below 7. 19. Type 1 Diabetes: -insulin deficient -hypoglycemia that is caused by autoimmune -childhood disease -For some reason our body produces AB's that attack pancreas and we stop making insulin. We become deficient, lose ability for beta cells to pump out insulin. If we don't have insulin we end up with tons of glucose molecules in blood stream and none of it is making it into cells -RF: family history, environment, asians, african americans Sx: 3 p's, weight loss initially since sugar is not entering into cells, starving, fatigue (no ATP), increased infection (bugs love sugar), rapid onset. -will need external insulin forever 20. 3 P's of diabetes: -polyuria: increased urination due to body trying to get rid of excess sugar, kidneys are helping out, trying to get rid of sugar molecules, but its not a good thing for glucose to up in urine and nephron (indicator that something is off) -polyphagia: increased hunger - glucose is not making its way into cells, staying in blood stream so cells are starving polydipsia: increased thirst - a lot of solutes in blood (syrup blood), brain is going to increase thirst mechanism to try and balance osmolality of the blood, also due to increased urination 21. Type II Diabetes: -problem is insulin resistance, pancreas is pumping out so much insulin to make up for tons of glucose