A patient presents with tiredness, weakness, anorexia, apathy, abdominal pain, hyperpigmentation and postural hypertension. Upon infection he appears to be in cardiogenic shock and his blood volume is depleted. His sodium levels are low, potassium levels are high. Which of the following would also be elevated?

Correct Answer: D

Rationale: The correct answer is D: ACTH. In this scenario, the patient is exhibiting symptoms of adrenal insufficiency, specifically Addison's disease. ACTH levels would be elevated due to the lack of negative feedback from cortisol, which is typically low in adrenal insufficiency. TSH (A) and T4 (B) would be normal or low due to the hypofunction of the adrenal gland, not the thyroid. Adrenal hormones (C) would be low in adrenal insufficiency, not elevated.

Correct Answer: B

Rationale: The correct answer is B: Follicle stimulating hormone. The pituitary gland produces luteinizing hormone and follicle stimulating hormone to regulate reproductive cells. Luteinizing hormone triggers ovulation and testosterone production, while follicle stimulating hormone stimulates egg development in females and sperm production in males. Choice A (Androgens) are male sex hormones produced by the testes, not by the pituitary gland. Choices C (Epinephrine) and D (Norepinephrine) are hormones produced by the adrenal glands and are not involved in regulating reproductive cells.

Correct Answer: C

Rationale: The correct answer is C: homeostasis. Homeostasis refers to the body's ability to maintain a stable internal environment despite external changes. It involves various physiological mechanisms to regulate temperature, pH, blood sugar levels, and more. Negative feedback (choice A) is a key component of homeostasis, where the body reverses a deviation from the set point to restore balance. Positive feedback (choice B) amplifies a response and does not contribute to maintaining stability. Metabolism (choice D) is the sum of all chemical processes in the body and is necessary for homeostasis but does not directly regulate the internal environment.

Correct Answer: D

Rationale: The correct answer is D: Somatomedins. Somatomedins, also known as insulin-like growth factors (IGFs), inhibit the secretion of growth hormone by negative feedback on the anterior pituitary. When somatomedins are present in sufficient levels, they signal to the pituitary gland to decrease the secretion of growth hormone. A: Sleep does not directly inhibit the secretion of growth hormone. In fact, growth hormone is predominantly secreted during sleep. B: Stress can stimulate the secretion of growth hormone, rather than inhibit it. C: Puberty is a stage of development where growth hormone secretion is typically increased, not inhibited.

Correct Answer: D

Rationale: The correct answer is D because alcohol inhibits the release of antidiuretic hormone (ADH) from the pituitary gland. ADH helps regulate water balance by promoting water reabsorption in the kidneys, reducing urine output. Alcohol impairs this process, leading to increased urine production and dehydration. Choices A, B, and C are incorrect because ADH decreases urine production, prevents dehydration, and is produced in the neurohypophysis (posterior pituitary), not the adenohypophysis (anterior pituitary).