Simulación 4

Exercise 4: Endocrine System Physiology: Activity 1: Metabolism and Thyroid Hormone Lab Report Pre-lab Quiz Results You scored 100% by answering 6 out of 6 questions correctly. 1. Which of the following statements about metabolism is false? You correctly answered: d. All of the energy from metabolism is ultimately stored in the chemical bonds of ATP. 2. Thyroxine is You correctly answered: c. the most important hormone for maintaining the metabolic rate and body temperature. 3. Thyroid-stimulating hormone (TSH) is You correctly answered: b. produced in the pituitary gland. 4. An injection of TSH to an otherwise normal animal will cause which of the following? You correctly answered: d. goiter development 5. Thyrotropin-releasing hormone (TRH) is You correctly answered: a. secreted by the hypothalamus. 6. Which of the following statements is true? You correctly answered: b. The hypothalamus primarily secretes tropic hormones that stimulate the secretion of other hormones.

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Experiment Results Predict Question: Predict Question 1: Make a prediction about the basal metabolic rate (BMR) of the remaining rats compared with the BMR of the normal rat you just measured. Your answer : c. The BMR of both remaining rats will be lower than the normal rat's BMR. Predict Question 2: What do you think will happen after you inject thyroxine into the three rats? Your answer : d. The normal rat will become hyperthyroidic but will not develop a goiter. Predict Question 3: What do you think will happen after you inject TSH into the three rats? Your answer : a. The normal rat will become hyperthyroidic and develop a goiter. Predict Question 4: Propylthiouracil (PTU) is a drug that inhibits the production of thyroxine by blocking the attachment of iodine to tyrosine residues in the follicle cells of the thyroid gland (iodinated tyrosines are linked together to form thyroxine). What do you think will happen after you inject PTU into the three rats? Your answer : d. The normal rat will become hypothyroidic and develop a goiter. Stop & Think Questions: 1h. Calculate the oxygen consumption per hour for this rat using the following equation. ml O2 consumed/1 minute x 60 minutes/hour = ml O2/hour Enter the oxygen consumption per hour in the field below and then click Submit to display your results in the grid. You answered: 420 ml O2/hr 1i. Now that you have calculated the oxygen consumption per hour for this rat, you can calculate the metabolic rate per kilogram of body weight with the following equation (note that you need to convert the weight data from grams to kilograms to use this equation). Metabolic rate = (ml O2/hr)/(weight in kg) = ml O2/kg/hr Enter the metabolic rate in the field below and then click Submit to display your results in the grid. You answered: 1680 ml O2/kg/hr 2h. Calculate the oxygen consumption per hour for this rat using the following equation. ml O2 consumed/1 minute x 60 minutes/hour = ml O2/hour Enter the oxygen consumption per hour in the field below and then click Submit to display your results in the grid. You answered: 384 ml O2/hr 2i. Now that you have calculated the oxygen consumption per hour for this rat, you can calculate the metabolic rate per kilogram of body weight with the following equation (note that you need to convert the weight data from grams to kilograms to use this equation). Metabolic rate = (ml O2/hr)/(weight in kg) = ml O2/kg/hr Enter the metabolic rate in the field below and then click Submit to display your results in the grid.

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You answered: 1567.35 ml O2/kg/hr 3h. Calculate the oxygen consumption per hour for this rat using the following equation. ml O2 consumed/1 minute x 60 minutes/hour = ml O2/hour Enter the oxygen consumption per hour in the field below and then click Submit to display your results in the grid. You answered: 384 ml O2/hr 3i. Now that you have calculated the oxygen consumption per hour for this rat, you can calculate the metabolic rate per kilogram of body weight with the following equation (note that you need to convert the weight data from grams to kilograms to use this equation). Metabolic rate = (ml O2/hr)/(weight in kg) = ml O2/kg/hr Enter the metabolic rate in the field below and then click Submit to display your results in the grid. You answered: 1567.35 ml O2/kg/hr Judging from their basal metabolic rates (an indicator of thyroid function), categorize the rats as hypothyroid (low thyroid levels; BMR below 1600), euthyroid ("good," or normal, thyroid levels; BMR = 1650-1750), or hyperthryoid (high thyroid levels; BMR above 1800). The normal rat is You correctly answered: b. euthyroid Judging from their basal metabolic rates (an indicator of thyroid function), categorize the rats as hypothyroid (low thyroid levels; BMR below 1600), euthyroid ("good," or normal, thyroid levels; BMR = 1650-1750), or hyperthryoid (high thyroid levels; BMR above 1800). The thyroidectomized (Tx) rat is You correctly answered: a. hypothyroid Judging from their basal metabolic rates (an indicator of thyroid function), categorize the rats as hypothyroid (low thyroid levels; BMR below 1600), euthyroid ("good," or normal, thyroid levels; BMR = 1650-1750), or hyperthryoid (high thyroid levels; BMR above 1800). The hypophysectomized (Hypox) rat is You correctly answered: a. hypothyroid Judging from their basal metabolic rates (an indicator of thyroid function), categorize the rats as hypothyroid (low thyroid levels; BMR below 1600), euthyroid ("good," or normal, thyroid levels; BMR = 1650-1750), or hyperthryoid (high thyroid levels; BMR above 1800) after the thyroxine injection. The normal rat is You correctly answered: c. hyperthyroid Judging from their basal metabolic rates (an indicator of thyroid function), categorize the rats as hypothyroid (low thyroid levels; BMR below 1600), euthyroid ("good," or normal, thyroid levels; BMR = 1650-1750), or hyperthryoid (high thyroid levels; BMR above 1800) after the thyroxine injection.

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The thyroidectomized (Tx) rat is You correctly answered: c. hyperthyroid Judging from their basal metabolic rates (an indicator of thyroid function), categorize the rats as hypothyroid (low thyroid levels; BMR below 1600), euthyroid ("good," or normal, thyroid levels; BMR = 1650-1750), or hyperthryoid (high thyroid levels; BMR above 1800) after the thyroxine injection. The hypophysectomized (Hypox) rat is You correctly answered: c. hyperthyroid Which of the rats developed a goiter after injection with thyroxine (select all that apply)? You correctly answered: d. None of the rats developed a goiter with this injection. Judging from their basal metabolic rates (an indicator of thyroid function), categorize the rats as hypothyroid (low thyroid levels; BMR below 1600), euthyroid ("good," or normal, thyroid levels; BMR = 1650-1750), or hyperthryoid (high thyroid levels; BMR above 1800) after the TSH injection. The normal rat is You correctly answered: c. hyperthyroid Judging from their basal metabolic rates (an indicator of thyroid function), categorize the rats as hypothyroid (low thyroid levels; BMR below 1600), euthyroid ("good," or normal, thyroid levels; BMR = 1650-1750), or hyperthryoid (high thyroid levels; BMR above 1800) after the TSH injection. The thyroidectomized (Tx) rat is You correctly answered: a. hypothyroid Judging from their basal metabolic rates (an indicator of thyroid function), categorize the rats as hypothyroid (low thyroid levels; BMR below 1600), euthyroid ("good," or normal, thyroid levels; BMR = 1650-1750), or hyperthryoid (high thyroid levels; BMR above 1800) after the TSH injection. The hypophysectomized (Hypox) rat is You correctly answered: c. hyperthyroid Which of the rats developed a goiter after injection with TSH (select all that apply)? You correctly answered: a. the normal rat c. the hypophysectomized rat Judging from their basal metabolic rates (an indicator of thyroid function), categorize the rats as hypothyroid (low thyroid levels; BMR below 1600), euthyroid ("good," or normal, thyroid levels; BMR = 1650-1750), or hyperthryoid (high thyroid levels; BMR above 1800) after the PTU injection. The normal rat is You correctly answered: a. hypothyroid Judging from their basal metabolic rates (an indicator of thyroid function), categorize the rats as hypothyroid (low thyroid levels; BMR below 1600), euthyroid ("good," or normal, thyroid levels; BMR = 1650-1750), or hyperthryoid (high thyroid levels; BMR above 1800) after the PTU injection. The thyroidectomized (Tx) rat is You correctly answered: a. hypothyroid

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Judging from their basal metabolic rates (an indicator of thyroid function), categorize the rats as hypothyroid (low thyroid levels; BMR below 1600), euthyroid ("good," or normal, thyroid levels; BMR = 1650-1750), or hyperthryoid (high thyroid levels; BMR above 1800) after the PTU injection. The hypophysectomized (Hypox) rat is You correctly answered: a. hypothyroid Which of the rats developed a goiter after injection with PTU (select all that apply)? You correctly answered: a. the normal rat Experiment Data: Rat

Weight (g)

ml O2/min

ml O2/hr

Normal Tx Hypox Normal Tx Hypox Normal Tx Hypox Normal Tx Hypox

250 245 245 250 245 245 250 245 245 250 245 245

7 6.4 6.4 8.4 7.9 7.8 8 6.2 7.8 6.3 6.4 6.2

420 384 384 504 474 468 480 372 468 378 384 372

BMR (ml O2/kg/hr) 1680 1567.35 1567.35 2016 1935 1910 1920 1518 1910 1512 1567 1518

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Palpation

Injected

No mass No mass No mass No mass No mass No mass Mass No mass Mass Mass No mass No mass

none none none Thyroxine Thyroxine Thyroxine TSH TSH TSH PTU PTU PTU

Post-lab Quiz Results You scored 100% by answering 7 out of 7 questions correctly. 1. How would you treat a thyroidectomized animal so that it functions like a "normal" animal? You correctly answered: c. Provide the animal T4 supplements. 2. As a result of the missing hormone(s) in the hypophysectimized rat, what would be some expected symptoms? You correctly answered: d. decreased basal metabolic rate 3. An injection of thyroxine to an otherwise normal rat will cause which of the following? You correctly answered: b. hyperthyroidism 4. Why didn't any of the rats develop a goiter after thyroxine injection? You correctly answered: a. In all cases, TSH levels were not elevated by the thyroxine injection. 5. Why did the normal rat develop a palpable goiter with the TSH injection? You correctly answered: c. The TSH receptors on the thyroid gland were excessively stimulated. 6. An injection of propylthiouracil to an otherwise normal animal will cause which of the following? You correctly answered: b. goiter development 7. Why did the normal rat develop a palpable goiter with the propylthiouracil injection? You correctly answered: d. The injection decreased the negative feedback mechanism on TSH.

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Review Sheet Results 1. Part 1: Determining the Basal Metabolic Rates Which rat had the fastest basal metabolic rate (BMR)? Your answer: La rata con la velocidad metabilica basal (BMR) más rapida es la rata normal. 2. Why did the metabolic rates differ between the normal rat and the surgically altered rats? How well did the results compare with your prediction? Your answer: La prediccion fue acertada. La rata normal posee las glandulas endocrinas completas pero las ratas alteradas quirúrjicamente, como la rata tiroidectomizada (glandula tiroides extirpada) y la rata hipofidectomizada (glandula hipofisis extirpada) sufren alteraciones en su metabolismo por no poseer la glandulas reguladoras del metabolismo, disminuyendo su BMR. 3. If an animal has been thyroidectomized, what hormone(s) would be missing in its blood? Your answer: El animal que perdio su glandula tiroides, no produciria y por tanto no circularian en la sangre, las hormonas: -Tiroxina (T4); mantiene la tasa metabolica basal (BMR) a un nivel normal y tambien hace que los tejidos se desarrollen en las formas y proporciones adecuadas. -Triyodotironina (T3): incrementa el metabolismo basal. 4. If an animal has been hypophysectomized, what effect would you expect to see in the hormone levels in its body? Your answer: En un animal hipofisectomizado, sus niveles hormonal serian bajos por no tener la glandula hipofisis, la cual es secretoras de varias hormonas como: TSH, GH , LH , FSH , vasopresina o la oxitocina. 5. Part 2: Determining the Effect of Thyroxine on Metabolic Rate What was the effect of thyroxine injections on the normal rat's BMR? Your answer: La rata normal inyectada con tirodoxina desarrollara hipertoroidismo pero no presento hinchazon en el cuello, por tanto no hubo bocio. 6. What was the effect of thyroxine injections on the thyroidectomized rat's BMR? How does the BMR in this case compare with the normal rat's BMR? Was the dose of thyroxine in the syringe too large, too small, or just right? Your answer: La rata tiroidectomizada inyectada con tiroxina desarrollara hipertiroidismo, pero no presentará bocio. El BMR de la rata tiroidectomizada fue menor de la rata normal,

7. What was the effect of thyroxine injections on the hypophysectomized rat's BMR? How does the BMR in this case compare with the normal rat's BMR? Was the dose of thyroxine in the syringe too large, too small, or just right? Your answer: La rata hipofisectomizada inyectada con tiroxina desarrollara hipertiroidismo.

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El BMR de rata hipofisectomizada fue menor al BMR de la rata normal

8. Part 3: Determining the Effect of TSH on Metabolic Rate What was the effect of thyroid-stimulating hormone (TSH) injections on the normal rat's BMR? Your answer: La rata normal inyectada con la TSH desarrollara hipertiroidismo debido a su alto BMR y adquirio el bocio. 9. What was the effect of TSH injections on the thyroidectomized rat's BMR? How does the BMR in this case compare with the normal rat's BMR? Why was this effect observed? Your answer: La rata tiroidectomizada inyectada con la TSH desarrollara hipotiroidismo. El BMR de la rata tiroidectomizada fue menor que la rata normal. En este caso no hubo la presencia de bocio, porque la rata fue extirpada de su glandula tiroide. 10. What was the effect of TSH injections on the hypophysectomized rat's BMR? How does the BMR in this case compare with the normal rat's BMR? Was the dose of TSH in the syringe too large, too small, or just right? Your answer: La rata hipofisectomizada inyectada con la TSH desarrollara hipertiroidismo. El BMR de rata hipofisectomizada fue mayor al BMR de la rata.

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Exercise 4: Endocrine System Physiology: Activity 2: Plasma Glucose, Insulin, and Diabetes Mellitus Lab Report Pre-lab Quiz Results You scored 100% by answering 5 out of 5 questions correctly. 1. Which of the following statements is false? You correctly answered: d. Insulin is a hormone secreted into the stomach to aid with starch digestion. 2. Which of the following statements is true? You correctly answered: d. All of these statements are true. 3. A diagnosis of type 1 diabetes mellitus implies that You correctly answered: b. the pancreas is not producing sufficient insulin. 4. A diagnosis of type 2 diabetes mellitus implies that You correctly answered: c. the cells of the body are unresponsive to circulating insulin. 5. Glucagon is a hormone You correctly answered: b. that opposes the action of insulin.

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Experiment Results Predict Question: Predict Question: To measure the amount of plasma glucose in a patient sample Your answer : b. the optical density of the sample will be measured and the glucose concentration will be extrapolated from the glucose standard curve. Stop & Think Questions: Why does the color in the tubes vary? You correctly answered: c. The tubes contain different amounts of glucose. Experiment Data:

Part 1

Part 2

Tube 1 2 3 4 5 1 2 3 4 5

Optical Density 0.30 0.50 0.60 0.80 1.00 0.73 0.79 0.89 0.83 0.96

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Glucose (mg/deciliter) 30 60 90 120 150 104 114 133 122 160

Post-lab Quiz Results You scored 100% by answering 6 out of 6 questions correctly. 1. A male patient has had successive fasting plasma glucose readings of 115, 110, and 122 mg/dl. The healthcare provider will inform him that You correctly answered: c. he appears to have impairment or borderline impairment of insulin-mediated glucose uptake by his cells. 2. To obtain an accurate spectrophotometric measurement of the glucose concentration in the sample You correctly answered: d. heparin is added to prevent blood clots. 3. In the spectrophotometric assay used in this experiment, the __________ as the glucose concentration in the sample increases. You correctly answered: b. optical density increases 4. A female patient has had successive fasting plasma glucose readings of 130, 140, and 128 mg/dl. The healthcare provider will inform her that You correctly answered: a. she has developed diabetes. 5. To maintain plasma glucose homeostasis You correctly answered: d. insulin-mediated transport of glucose into cells acts as negative feedback when plasma glucose levels rise. 6. A laboratory technician withdraws a blood sample from a vein in your upper arm knowing that You correctly answered: b. the plasma glucose concentration will be the same in both the arm vein and the index finger.

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Review Sheet Results 1. What is a glucose standard curve, and why did you need to obtain one for this experiment? Did you correctly predict how you would measure the amount of plasma glucose in a patient sample using the glucose standard curve? Your answer: La curva de glucosa estandar es una grafica de densidad optica versus de concentracion de glucosa (mg/dL). Esta grafica nos sirve para diagnosticar intolerancia a la glucosa o incluso diabetes, y asi se podra determinar cual de las 5 muestras de sangre de los pacientes presenta diabetes. 2. Which patient(s) had glucose reading(s) in the diabetic range? Can you say with certainty whether each of these patients has type 1 or type 2 diabetes? Why or why not? Your answer: Para que un paciente padesca de diabetes, su muestra de sangre tendra que poseer una concentracion de mayor o igual a 126mg/dL de glucosa. Dado los resultados de las 5 muestras, los pacientes de las muestras 3 y 5 obtuvieron 132 y 143 mg/dL respectivamente, lo que significa que padecen de diabetes. No se puede decir con certeza que tipos de diabetes presenta cada uno de esto pacientes. 3. Describe the diagnosis for patient 3, who was also pregnant at the time of this assay. Your answer: El examen del paciente 3 dio como resultado una concentracion de glucosa de 132 mg/dL. esto quiere decir que el paciente padece de diabetes. Si la paciente estuvo embarazada, existe el riesgo que el embazaro pueda agravar complicaciones ya existentes de la diabetes, especialmente problemas visuales, debido a que las hormonas del embarazo reducen la capacidad que tiene el cuerpo de utilizar y responder a la acción de la insulina. El resultado es un alto nivel de glucosa en la sangre (hiperglucemia). 4. Which patient(s) had normal glucose reading(s)? Your answer: El paciente de la muestra de sangre 1 salio con una concentracion de glucosa de 104 mg/dL, el cual es una lectura de concentracion normal de glucosa, por lo tanto no padece de diabetes. 5. What are some lifestyle choices these patients with normal plasma glucose readings might recommend to the borderline impaired patients? Your answer: Los pacientes con problemas limítrofes a padecer diabetes se le puede recomendar algunos estilos de vida saludables para prevenir la diabetes, tales como: - Comer porciones más pequeñas es una gran manera de perder el peso. - Tomar el desayuno diario y alimentarte regularmente y a la misma hora siempre que puedas. - Limitarte a comer carne de aves y pescados - Elimina los postres y azúcares refinadas. - Evita todo producto frito o asado con mucha grasa. - Aumentar el ejercicio. Al lado de dieta, el ejercicio es vital especialmente para los diabéticos.

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Exercise 4: Endocrine System Physiology: Activity 3: Hormone Replacement Therapy Lab Report Pre-lab Quiz Results You scored 100% by answering 4 out of 4 questions correctly. 1. Follicle-stimulating hormone (FSH) You correctly answered: d. stimulates ovarian follicle development. 2. Estrogen You correctly answered: d. is produced by developing ovarian follicles. 3. Calcitonin You correctly answered: b. works against the development of osteoporosis. 4. Which of the following statements is true? You correctly answered: c. The ovaries stop secreting estrogen after menopause.

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Experiment Results Predict Question: Predict Question 1: What effect will the saline injections have on the control rat's vertebral bone density? Your answer : c. The saline injections will not change the rat's vertebral bone density (indicated by an unchanging T score). Predict Question 2: What effect will the estrogen injections have on the estrogen-treated rat's vertebral bone density? Your answer : a. The estrogen injections will increase the rat's vertebral bone density (indicated by a less-negative T score).

Predict Question 3: What effect will the calcitonin injections have on the calcitonin-treated rat's vertebral bone density? Your answer : a. The calcitonin injections will increase the rat's vertebral bone density (indicated by a less-negative T score). Experiment Data: Rat

Elapsed Days

Saline injections

Estrogen injections

Control Estrogen Calcitonin

7 7 7

7 0 0

0 7 0

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Calcitonin injections 0 0 7

T score -2.82 -1.71 -2.29

Post-lab Quiz Results You scored 100% by answering 4 out of 4 questions correctly. 1. Saline injections were used in this experiment to measure the effect of You correctly answered: c. a placebo on bone density. 2. In the ovariectomized rats used in this experiment You correctly answered: d. osteoporosis was evident prior to the injections of estrogen. 3. Injection of calcitonin into an ovariectomized rat will You correctly answered: b. inhibit osteoclast activity and stimulate calcium uptake and deposition in long bones. 4. As the rat's bone density increases You correctly answered: a. the X-ray scanning assay reports a less-negative T-score.

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Review Sheet Results 1. Why were ovariectomized rats used in this experiment? How does the fact that the rats are ovariectomized explain their baseline T scores? Your answer: Ratas ovariectomizadas se refiere a aquellas ratas que con la pérdida ósea inducida por deficiencia de estrógenos, en particular durante las primeras etapas de la osteoporosis Se utilizan porque son el modelo más preciso para la osteoporosis humano adulto , y tienen muchas ventajas debido a su pequeño tamaño y su corto periodo de vida 2. What effect did the administration of saline injections have on the control rat? How well did the results compare with your prediction? Your answer: Las inyecciones de solución salina se utilizaron como un placebo , como predije 3. What effect did the administration of estrogen injections have on the estrogen-treated rat? How well did the results compare with your prediction? Your answer: Las inyecciones de estrógeno aumentan las lecturas de densidad ósea, como predije 4. What effect did the administration of calcitonin injections have on the calcitonin-treated rat? How well did the results compare with your prediction? Your answer: Las inyecciones de calcitonina aumento de la densidad ósea, también como predije 5. What are some health risks that postmenopausal women must consider when contemplating estrogen hormone-replacement therapy? Your answer: Algunos de los riesgos de salud asociados con la terapia de estrógeno en la fase postmenopáusica son el desarrollo de cáncer de mama, endometrio , ovario y otros tipos de cáncer , así como otras condiciones de salud graves como la coagulación de la sangre

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Exercise 4: Endocrine System Physiology: Activity 4: Measuring Cortisol and Adrenocorticotropic Hormone Lab Report Pre-lab Quiz Results You scored 100% by answering 5 out of 5 questions correctly. 1. Cortisol You correctly answered: d. is a hormone important in the body's response to stress. 2. ACTH You correctly answered: d. is a tropic hormone that stimulates cortisol release. 3. CRH You correctly answered: b. has a tropic effect on the anterior pituitary gland. 4. Cushing's syndrome refers to You correctly answered: c. a hypercortisolism, which could be iatrogenic. 5. A condition of hypocortisolism You correctly answered: d. refers to low levels of cortisol in the blood.

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Experiment Results Stop & Think Questions: Normally high levels of cortisol would inhibit release of You correctly answered: c. both ACTH and CRH Which hormone(s) stimulate(s) the pituitary gland to release ACTH? You correctly answered: a. CRH Experiment Data: Patient 1 2 3 4 5

Cortisol (mcg/dl) 3.84 30.58 48.05 2.10 47.91

High/Low

ACTH (pg/ml) 17.68 12.40 84.47 99.29 19.84

Low High High Low High

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High/Low Low Low High High Low

Post-lab Quiz Results You scored 100% by answering 6 out of 6 questions correctly. 1. Under normal conditions, if the amount of secreted CRH increases, then You correctly answered: c. the amount of secreted ACTH will increase. 2. Under normal conditions, if the amount of secreted ACTH increases, then You correctly answered: d. the amount of secreted CRH will likely decrease. 3. Under normal conditions, if the amount of secreted cortisol increases, then You correctly answered: b. the amount of secreted ACTH will likely decrease. 4. If a hypersecreting pituitary tumor develops, then an expected outcome is You correctly answered: a. a diagnosis of Cushing's disease. 5. If a hypersecreting adrenal cortex tumor develops, then an expected outcome is You correctly answered: b. abnormally low levels of CRH due to negative feedback. 6. A patient's chart lists the diagnosis of Addison's disease. Therefore, you expect You correctly answered: b. abnormally high levels of ACTH.

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Review Sheet Results 1. Which patient would most likely be diagnosed with Cushing's disease (view Table 4.1 in Experiment Results)? Why? Your answer: Paciente 3 es probable que se le diagnostique la enfermedad de Cushing , debido a que presentan altos niveles de cortisol y ACTH en la sangre 2. Which two patients have hormone levels characteristic of Cushing's syndrome (view Table 4.1 in Experiment Results)? Your answer: Los pacientes 2 y 5 muestran signos del síndrome de Cushing 3. Patient 2 is being treated for rheumatoid arthritis with prednisone. How does this information change the diagnosis (view Table 4.1 in Experiment Results)? Your answer: Prednisona reduce los niveles de cortisol en la sangre, suprimiendo la función de las glándulas suprarrenales. Por lo tanto , esto podría disminuir la capacidad de cortisol para ser lanzado cuando son estimuladas por ACTH. Esto confirma con los resultados experimentales 4. Which patient would most likely be diagnosed with Addison's disease (view Table 4.1 in Experiment Results)? Why? Your answer: En caso del paciente 4 , el nivel de cortisol es bajo y ACTH es alto. Se trata de signos de insuficiencia suprarrenal bajo nivel primario de cortisol causado por el daño a la hipófisis anterior , y ACTH es elevado para compensar

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