Week 14 - Ch 32, 33 Flashcards

0
Q

Advances in technology have made it possible to assess hypothalamic-pituitary function by newly developed imaging and radioimunoassay methods. When baseline tests are not sufficient, what suppression test gives information about combined hypothalamic-pituitary function?

a. GH suppression test
b. ACTH suppression test
c. Cortisol suppression test
d. Prolactin suppression test

A

a. GH suppression test

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1
Q

Growth hormone is secreted by adults as well as by children. Growth hormone deficiency in children is treated by injections of GH on a daily basis. When teaching a family or child to give injections of GH, what is it important to teach them?

a. Give the injections in the morning so the peak effect is before noon, like the body does.
b. Give the injections at bedtime to produce the greatest effect at night, like the body does.
c. Give the injections about 3 in the afternoon to produce the greatest effect in the evening, like the body does.
d. Give the injections in te early afternoon to produce the greatest effect at dinner time, like the body does.

A

b. Give the injections at bedtime to produce the greatest effect at night, like the body does.

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2
Q

Growth hormone exerts its effects on the body in many ways. Which of these are effects of GH? (Mark all that apply.)

a. Enhances fatty acid mobilization
b. Increases insulin levels
c. Facilitates the rate of protein synthesis
d. Decreases ACTH production
e. Decreases use of fatty acids for fuel

A

a, b, c (enhances fatty acid mobilization, increases insulin levels, facilitates the rate of protein synthesis)

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3
Q

Acromegaly is a disorder that is caused by the production of excessive GH in the adult. Because the person cannot grow taller, the soft tissues continue to grow, presenting a very distinctive appearance. What is it that is distinctive in a person with acromegaly?

a. Small hands and feet compared to length of arms and legs
b. Broad, bulbous nose and a protruding lower jaw
c. Slanting forehead and a receding lower jaw
d. Protruding lower jaw and forehead

A

b. Broad, bulbous nose and a protruding lower jaw

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4
Q

Precocious puberty is a disorder that occurs in both boys and girls. What does precocious puberty cause in adults?

a. Early menopause in females
b. Early erectile dysfunction problems in males
c. Short stature in adults
d. Gigantism in adults

A

c. Short stature in adults

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5
Q

When the assessment of thyroid autoantibodies is performed, what is the suspected diagnosis?

a. Goiter
b. Thyroid tumor
c. Congenital hypothyroidism
d. Hashimoto thyroiditis

A

d. Hashimoto thyroiditis

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6
Q

An elderly woman is brought to the emergency department by her family. They relate to the nurse that the client has had mental status changes and cannot remember her grandchildren’s names. They go on to say that she is intolerant of cold and is lethargic. On physical examination the nurse notes that the client has a husky voice, her face is puffy around the eyes, and her tongue appears to be enlarged. What diagnosis would the nurse suspect?

a. Myxedema
b. Hashimoto thyroiditis
c. Hyperthyroidism
d. Congenital hypothyroidism

A

a. Myxedema

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7
Q

Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as a thyroid storm. What are the manifestations of a thyroid storm? (Mark all that apply.)

a. Tachycardia
b. Very low fever
c. Delirium
d. Bradycardia
e. Very high fever

A

a, c, e (tachycardia, delirium, very high fever)

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8
Q

At times, it is necessary to give medications that suppress the adrenal glands on a long-term basis. When the suppression of the adrenals becomes chronic, the adrenal glands atrophy. What does the abrupt withdrawal of these suppressive drugs cause?

a. Acute adrenal hyperplasia
b. Acute adrenal insufficiency
c. Acute adrenal hypoplasia
d. Acute adrenal cortical hyperplasia

A

b. Acute adrenal insufficiency

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9
Q

Congenital adrenal hyperplasia is a congenital disorders in which a deficiency exists in any of the enzymes necessary for the synthesis of cortisol. Infants of both sexes are affected, although boys are not diagnosed at birth unless of enlarged genitalia. Female infants often have ambiguous genitalia because of the oversecretion of adrenal androgens. What are the manifestations of the ambiguous genitalia caused by congenital adrena hyperplasia?

a. Small clitoris, fused labia, and urogenital sinus
b. Small clitoris, open labia, and urogenital sinus
c. Enlarged clitoris, fused labia, and urogenital sinus
d. Enlarged clitoris, open labia, and urogenital sinus

A

c. Enlarged clitoris, fused labia, and urogenital sinus

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10
Q

In Addison disease the majority of the adrenal cortex has been destroyed. This causes a lack of mineralocorticoids and glucocorticoids. Therapy consists of oral replacement with what drug?

a. Cortisol
b. Aldosterone
c. Glucocorticoid
d. Hydrocortisone

A

d. Hydrocortisone

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11
Q

In an acute adrenal crisis, the onset of symptoms is sudden, and in the case of Addison disease, can be precipitated by exposure to a minor illness or stress. What are the manifestations of acute adrenal crisis? (Mark all that apply.)

a. Hypertension
b. Muscle weakness
c. Dehydration
d. Altered mental status
e. Vascular collapse

A

a, b, c, e (hypertension, muscle weakness, dehydration, vascular collapse)

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12
Q

The hallmark manifestations of Cushing syndrome are a moon face, a “buffalo hump” between the shoulder blades, and a protruding abdomen. What other manifestations of Cushing syndrome occur?

a. Thin extremities and muscle weakness
b. Muscle wasting and thickened extremities
c. Muscle weakness and thickened extremities
d. Thin extremities and increased strength

A

a. Thin extremities and muscle weakness

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13
Q

The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?

a. Alpha cells
b. Beta cells
c. Delta cells
d. PP cells

A

b. Beta cells

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14
Q

Hormones that counteract insulin’s storage function when regulating blood glucose during times when glucose intake is limited or glucose stores are depleted called counter-regulatory hormones. What are the counter regulatory hormones? (Mark all that apply.)

a. Glucocorticoids
b. Growth hormone
c. Catecholamines
d. Mineralocorticoids
e. Glucagon

A

a, b, c, e (glucocorticoids, growth hormone, catecholamines, glucagon)

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15
Q

During periods of fasting and starvation, the glucocorticoid and other corticosteroid hormones are critical for survival because of their stimulation of gluconeogenesis by the liver. When the glucocorticoid hormones remain elevated for extended periods of time what can occur?

a. Hepatomegaly
b. Portal hypertension
c. Hyperglycemia
d. Adrenal hyperplasia

A

c. Hyperglycemia

16
Q

Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur?

a. Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta cell antigen
b. Genetic predisposition, physiologic triggering event, allergic reaction to pancreatic alpha cells
c. Diabetogenic gene from both parents, physiologic triggering event, and an allergic reaction to pancreatic delta cells
d. Diabetogenic gene from both parents, environmental triggering event, and a B-lymphocyte reaction to alpha cell antigens

A

a. Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta cell antigen

17
Q

Type 2 diabetes is caused by metabolic abnormalities in the presence of insulin. What are these metabolic abnormalities? (Mark all that apply.)

a. Deranged secretion of insulin
b. Decreased glucose production by the liver
c. Insulin resistance
d. Increased glucose production by the lver
e. Hypersensitivity to insulin

A

a, c, d (deranged secretion of insulin, insulin resistance, increased glucose production by the liver)

18
Q

Secondary diabetes occurs because of disorders that produce hyperglycemia by stimulating the hepatic production of glucose or decrease the cellular use of glucose. Which disorders can be causes of secondary diabetes?

a. Pheochromocytoma and Cushing syndrome
b. Pancreatic disease and dwarfism
c. Acromegaly and pancreatic hyperplasia
d. Hepatomegaly and pheochromocytoma

A

a. Pheochromocytoma and Cushing syndrome

19
Q

Gestational diabetes mellitus is a disorder of glucose intolerance that occurs during pregnancy. It is associated with increased risk for developng type 2 diabetes and with fetal abnormalities. What fetal abnormalities are associated with gestational diabetes mellitus?

a. Microsomia and polycythemia
b. Macrosomia and hypocalcemia
c. Hypercalcemia and hyperbilirubinemia
d. Hypoglycemia and hypercalcemia

A

b. Macrosomia and hypocalcemia

20
Q

What are the hallmark signs of diabetes mellitus?

a. Polyuria, polydipsia, and pheochromocytoma
b. Polyuria, polyphagia, and polycythemia
c. Polyuria, polydipsia, and polyphagia
d. Polycythemia, polydipsia, and pheochromocytoma

A

c. Polyuria, polydipsia, and polyphagia

21
Q

Diabetic ketoacidosis is a condition that mostly occurs in type 1 diabetics. What are the definitive diagnostic criteria for DKA?
a. Blood glucose level > 350 mg/dL; bicarbonate 250 mg/dL; bicarbonate 350 mg/dL; bicarbonate 250 mg/dL; bicarbonate

A

d. Blood glucose level >250 mg/dL; bicarbonate

22
Q

A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says she has not eaten since yesterday. He is wearing a medic alert type bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis?

a. Hypoglycemia
b. Hyperglycemia
c. Hyponatremia
d. Hypernatremia

A

a. Hypoglycemia

23
Q

Hypoglycemia has a sudden onset with a progression of symptoms. What are the signs and symptoms of hypoglycemia?

a. Difficulty problem solving and muscle spasms
b. Altered cerebral function and headache
c. Muscle spasms and headache
d. Altered cerebral function and muscle spasms

A

b. Altered cerebral function and headache

24
Q

Research has identified a cycle of insulin-induced posthypoglycemic episodes. What is this phenomenon called?

a. Dawn phenomenon
b. Joslin phenomenon
c. Somogyi effect
d. Sunset effect

A

c. Somogyi effect

25
Q

Peripheral neuropathies occur in people with diabetes mellitus. With the loss of sensation in the lower extremities diabetics become predisposed to what?

a. Denervation of the large muscles of the foot and bunions
b. Displacement of the submetatarsal fat pad posteriorly and hammer toes
c. Impairment of temperature and touch sensations
d. Clawing of toes and denervation of the small muscles of the foot

A

d. Clawing of toes and denervation of the small muscles of the foot

26
Q

Diabetics are at higher risk than the majority of the population for injury to organ systems in the body. Which organs are most at risk?

a. Kidneys and eyes
b. Kidneys and liver
c. Liver and eyes
d. Pancreas and eyes

A

a. Kidneys and eyes

27
Q

Macrovascular disease includes coronary artery disease, cerebrovascular disease, and peripheral vascular disease. People with both type 1 and type 2 diabetes are at high risk for developing macrovascular disease. What are the risk factors for macrovascular disease in diabetics? (Mark all that apply.)

a. Elevated fibrinogen levels and hyperinsulinemia
b. Hyperlipidemia and hypotension
c. Hyperglycemia and hypoinsulinemia
d. Decreased fibrinogen levels and systemic inflammation

A

a. Elevated fibrinogen levels and hyperinsulinemia

28
Q

Diabetics are hospitalized for a number of reasons. What is the most common complication of diabetes requiring hospitalization?

a. Diabetic ketoacidosis
b. Foot problems
c. Hypertensive crisis
d. Macrovascular disease

A

b. Foot problems

29
Q

Infections are common in people with diabetes. Which infection is thought to be related to a neurogenic bladder?

a. Nephrotic syndrome
b. Urinary retention
c. Pyelonephritis
d. Urinary incontinence

A

c. Pyelonephritis