A patient is having blood glucose problems. Plasma glucose levels are very low, a condition called
hypoglycemia. The problem is not associated with insulin, but with the secretion of glucocorticoids.
How would you evaluate the patient to determine where in the feedback system the problem is
located?
What will be an ideal response?
The adrenal cortex secretes glucocorticoids under the control of ACTH from the anterior pituitary. The
anterior pituitary is under the control of CRH from the hypothalamus. The patient could be given an
injection of ACTH and then monitor blood glucose levels. Next, the patient could be given an injection
of CRH and blood glucose levels evaluated. Another way to address the problem would be to measure
the levels of ACTH and CRH in the patient. If the CRH were elevated, then the problem would be
ACTH production from the pituitary.
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