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Chapter 49: Peptide Hormones

You are attending to your 51-year-old female patient who has come to you complaining that she is losing weight, yet is continuously hungry and eating more than usual. She also reports that she is experiencing irritability, insomnia, diarrhea, muscle weakness, heart palpitations, and intolerance to heat. You suspect your patient is suffering from Graves disease. Assay for which of the following in her blood would most likely confirm your diagnosis?

A. decreased growth hormone

B. decreased vasopressin

C. elevated insulin

D. insulin receptor autoantibodies

E. thyroid hormone receptor autoantibodies

Answer E: Graves disease is the most common autoimmune disease, affecting 0.5% of the population in the United States, and represents 50% to 80% of cases of hyperthyroidism. The disorder occurs more commonly in women, smokers, and patients with other autoimmune diseases. Graves hyperthyroidism results from the production of autoantibodies that bind to and activate the thyroid-stimulating hormone (TSH) receptor on the surface of thyroid follicular cells. This activation stimulates follicular cell growth, causing diffuse thyroid enlargement and increased production of thyroid hormones.

A 67-year-old postmenopausal woman is being examined by her physician due to back pain, an apparent loss of height, and the inability to stand erect. Her physician orders a spinal x-ray which shows vertebral thinning typical of osteoporosis. Which of the following hormones would be the most useful in attempting to treat this patient's condition?

A. ACTH

B. growth hormone

C. parathyroid hormone

D. thyroid hormone

E. vitamin D

Answer C: Although the primary function of PTH is to respond to reduced circulating Ca2+ levels and a portion of its action results in resorption of bone Ca2+, the use of recombinant PTH has proven beneficial in the treatment of osteoporosis. PTH increases bone turnover (resorption) but it also increases the formation of new bone and the latter effect on bone is more pronounced than resorption. Intermittent infusion of recombinant PTH results in new bone formation and has shown efficacy in the treatment of the bone loss associated with osteoporosis.

You are treating a 27-year-old male patient for recent onset of hypertension. The patient reports that he has not consumed any alcohol nor does he use any medications or illegal drugs. Analysis of serum electrolytes indicates a reduced level of potassium. You suspect the patient is experiencing a disruption in the normal responses to vascular ...

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