APEA endocrinology Flashcards
CUSHING’S DISEASE IS CHARACTERIZED BY PHYSICAL ABNORMALITIES THAT OCCUR WHEN THE ADRENAL GLANDS SECRETE EXCESS:
Glucocorticoids
(cortisol)
cushings = moon face = steroids
A SIMPLE NONTOXIC GOITER:
MAY BE ENLARGED SECONDARY TO:
A lack of iodine in the diet
GOITER = IODINE DEFICIENCY
sporadic goiter means r/t ingestion of drugs of roof that contain things that decrease T4 production
A COMMON CHARACTERISTIC OF A PERSON WITH GRAVES’ DISEASE IS:
Ophthalmophathy
GRAVES = AUTOIMMUNE
other symptoms of hyperthyroidism
The most common cause of secondary hypothyroidism is:
Pituitary tumor, often decreases available TSH, usually benign.
Patients with Graves disease may experience comorbid diseases including:
peptic ulcer disease.
iron deficiency anemia.
lupus erythematosus.
thyroid cancer.
lupus erythematosus.
Increased risk for multiple autoimmune conditions
Hypofunction of the adrenal cortex that results in an inadequate release of glucocorticoids is:
Sprue syndrome.
Cushing syndrome.
Addison’s disease.
hypoparathyroidism.
Addison’s disease results from inadequate production of cortisol.
Diabetes is the leading cause of:
urosepsis.
end-stage renal disease.
acute coronary syndrome.
pancreatitis.
end-stage renal disease
Diabetes is a leading cause of end-stage renal disease, adult-onset blin
An autoimmune disorder characterized by abnormal stimulation of the thyroid gland by antibodies that act through normal TSH receptors is:
celiac disease.
Graves’ disease.
Multiple sclerosis.
Sjogren’s syndrome.
Graves’ disease,
one of the autoimmune thyroid diseases, is caused by the production of
In a patient with hyperglycemia, the nurse practitioner knows that hyperosmolar hyperglycemic nonketotic syndrome (HHNS) will NOT produce:
dehydration
glycosuria.
high glucose levels.
ketogenesis.
ketogenesis
I
In the patient with hyperosmolar hyperglycemic nonketotic state (HHNS),
The thyroid hormone that is responsible for calcium regulation is:
triiodothyronine (T3).
thyroxine (T4).
thyrocalcitonin (calcitonin).
thyroid-stimulating hormone.
thyrocalcitonin (calcitonin)
Hyperglycemia in patients who have Type 2 diabetes can cause:
anorexia.
hematuria.
thirst.
hyperphagia.
thirst
Thirst results from the intracellular dehydration that occurs as blood g
Risk factors that predispose a patient to Graves disease include:
a family history of Graves’ disease in men of the family.
female sex.
a history of alcoholism.
being in the first trimester of pregnancy.
female sex
The disorder that is caused by a deficiency of antidiuretic hormone is known as:
hypercalcemia.
histiocytosis.
Type 1 diabetes mellitus.
diabetes insipidus.
T
diabetes insipidus.
Diabetes insipidus (DI) is a disorder of water metabolism caused by a de
The most common signs of newly diagnosed diabetes include:
peripheral neuropathy.
polyuria.
hyperphagia.
blurred vision.
polyuria
In thyrotoxic crisis, T3 and T4 are overproduced, causing hypermetabolism from the overproduction of:
dopamine.
catecholamines.
epinephrine.
norepinephrine.
epi
Hyperglycemia in patients who have Type 2 diabetes can cause:
anorexia.
hematuria.
thirst.
hyperphagia.
thirst
Thirst results from the intracellular dehydration that occurs as blood g
Risk factors that predispose a patient to Graves disease include:
a family history of Graves’ disease in men of the family.
female sex.
a history of alcoholism.
being in the first trimester of pregnancy.
female sex
The disorder that is caused by a deficiency of antidiuretic hormone is known as:
hypercalcemia.
histiocytosis.
Type 1 diabetes mellitus.
diabetes insipidus.
diabetes insipidus
Diabetes insipidus (DI) is a disorder of water metabolism caused by a de
In thyrotoxic crisis, T3 and T4 are overproduced, causing hypermetabolism from the overproduction of:
dopamine.
catecholamines.
epinephrine.
norepinephrine.
epinephrine
In thyrotoxic crisis (also known as thyroid storm), the thyroid gland se
Type 1 diabetes mellitus is caused by:
resistance to insulin action in target tissues.
abnormal insulin secretion.
beta cell destruction.
inappropriate hepatic glycogenesis.
beta cell destruction
Symptoms of thyrotoxicosis include:
hypotension.
bradycardia.
low cardiac output.
cardiac arrythmia.
cardiac arrhythmia
An increase in metabolism causes a rise in oxygen consumption and production of metabolic end products, with an accompanying increase in vasodilation.
The majority of patients with simple goiters are expected to have:
elevated triiodothyronine (T3) levels.
elevated thyroxine (T4) levels.
a euthyroid state.
a low level of serum thyroid stimulation hormone.
a euthyroid state
caused by low TSH (which is produced by the pituitary gland)
TSH is produced when T3& T4 is low.
Euthyroid state (d) “normal”
The most common cause of hypothyroidism is:
Hashimoto’s thyroiditis.
Graves’ disease.
thyroid storm.
abnormal iodine metabolism.
hashimoto’s thyroiditis
The complication associated with Type 1 and Type 2 diabetes that is NOT a microvascular complication is:
nephropathy.
neuropathy.
retinopathy.
peripheral arterial disease.
PAD
The adrenal glands are responsible for producing:
testosterone.
leukotrienes.
epinephrine.
prostaglandins.
epinephrine
The adrenal glands produce steroidal hormones (aldosterone and cortisol; adrenal androgens and estrogens) and catecholamines (epinephrine, norepinephrine).
Which of the following laboratory findings are present after adrenal stimulation in a patient with early stage Addison’s disease?
Increased sodium levels
Decreased potassium levels
Increased cortisol levels
Increased bicarbonate
increased cortisol levels
The early stages of Addison’s disease are characterized by a rise in cortisol levels after adrenal stimulation with adrenocorticotropic hormone (ACTH).
This is followed by a decrease in serum sodium, chloride, and bicarbonate.
A negative feedback system regulates the endocrine system by:
stimulating hormone production.
increasing the uptake of the target tissue.
increasing the hormone transport system.
inhibiting hormone overproduction.
inhibiting hormone overproduction
Which hormone is NOT one of the four types of trophic hormones released by the anterior pituitary gland?
Follicle-stimulating hormone
Luteinizing hormone
Growth hormone
Thyroid-stimulating hormone
growth hormone
Hypothalamus hormones stimulate the anterior pituitary gland to release trophic (gland-stimulating) hormones
A Tall Lanky Fish
ATCH
TSH
LH
FSH
Which of the following is NOT a common secondary cause of Type 2 diabetes?
Prolonged physical or emotional stress
Pregnancy
Use of hormonal contraceptives
Autoimmune diseases
autoimmune disease
There are 3 common secondary causes of Type II DM
1). prolonged physical or emotional stress that may cause elevation in levels of cortisol, epinephrine, glucagon, and ghrelin hormone. This increases blood glucose levels and increases demands on the pancreas. 2). Pregnancy, estrogen and placental hormones.
3). The use of adrenal corticosteroids, hormonal contraceptives,
Synthesis and secretion of the thyroid hormones depend on the presence of:
triiodothyronine.
thyroxine.
iodine.
luteinizing hormone.
iodine
The disease caused by hyperfunctioning of the thyroid gland is known as:
hypothyroidism.
hyperthyroidism.
nontoxic goiter.
Hashimoto’s disease.
hyperthyroidism
Patients with hypothyroidism are also likely to have elevated:
sodium levels.
potassium levels.
lipid levels.
cortisol levels.
Lipid levels
The release of antidiuretic hormone (ADH) from the posterior pituitary gland is stimulated by reduced circulating volume and:
decreased serum osmolality.
decreased urine osmolality.
increased serum osmolality.
increased urine osmolality.
increased serum osmolality
need to find a way to distinguish which hypo, hyper, etc…. problems cause which changes in hormones etc. maybe a chart??
A patient with an elevated thyroid-stimulating hormone (TSH) level most likely has:
subacute thyroiditis.
toxic adenoma.
Graves’ disease.
hypothyroidism.
hypothyroidism
In addition to elevated blood glucose levels, the initial laboratory findings in a patient with diabetic ketoacidosis would include:
elevated pH levels.
decreased bicarbonate levels.
decreased potassium levels.
elevated glomerular filtration rate.
decreased bicarbonate levels
acidosis = decreased ph, DECREASED BICARB
A simple nontoxic goiter:
is caused by inflammation.
is likely secondary to a neoplasm.
may be enlarged secondary to a lack of iodine in the diet.
is an autoimmune disease process.
may be enlarged secondary to a lack of iodine in the diet
NONTOXIC GOITER: not caused by inflammation or neoplasm. Aren’t initially associated with hyper or hypothyroidism. ARE ENDEMIC OR SPORATIC.
SIMPLE MEANS THAT IT IS ENLARGED NOT THAT THERE IS ANYTHING WRONG WITH THE TSH, T3 OR T4
Endemic: LACK OF IODINE
Sporatic: ingestion of drugs or foods that decrease T4 production
Which one of the following is decreased in Addison’s disease?
Aldosterone
Potassium
Creatinine
Calcium
Aldosterone
Diabetes mellitus is NOT a disorder in the metabolism of:
carbohydrates.
iron.
fats.
proteins.
iron
Which one of the following is necessary for linear bone growth in children?
Growth hormone
Renin
Testosterone
Thyroid-Stimulating Hormone
Growth hormone
Which one of the following is NOT a cause of short stature in children?
Turner syndrome
Growth hormone deficiency
Hypothyroidism
Early estrogen and androgen secretion
Early estrogen and androgen secretion
A 54-year-old patient with diabetes presents with fatigue and the nurse practitioner suspects diabetic ketoacidosis (DKA). Other symptoms related to DKA include:
dysuria.
metallic taste in the mouth.
fruity breath.
bradycardia.
fruity breath
In addition to decreased plasma cortisol levels, the laboratory findings of a patient in adrenal crisis would include:
increased serum sodium.
decreased serum potassium.
decreased serum sodium levels.
decreased blood urea nitrogen levels.
decreased serum sodium levels
Addison’s disease causes decreased or absent aldosterone levels. Aldosterone is a mineralocorticoid. It regulates the reabsorption of sodium and the excretion of potassium by the kidneys. When aldosterone is absent or very low, sodium and water loss occur, and potassium is retained by the kidneys.
The macrovascular disease that is the leading cause of death in patients with diabetes is:
cardiovascular disease.
cerebrovascular disease.
diabetic nephropathy.
peripheral vascular disease.
cardiovascular disease
Guillain-Barre syndrome is most commonly triggered by recent:
surgery.
digestive tract infection.
immunization.
acute hepatitis.
digestive tract infection
As a result of prolonged exposure to high levels of cortisol, the patient with Cushing’s syndrome is likely to develop:
gynecomastia.
moon facies.
protruding eyes.
fruity smell.
moon face
Which of the following hormones is NOT essential for normal body growth and maturation in children?
Growth hormone
Insulin
Adrenalin
Androgen
adrenaline
Which diagnosis is associated with T cell-mediated destruction of beta cells in the pancreas?
Diabetes insipidus
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Gestational diabetes
Type 1 diabetes mellitus
In a patient with diabetes insipidus, the resorption of water by the renal tubular collecting ducts can lead to:
increased urine glucose.
increased serum potassium.
increased serum sodium.
increased urine calcium.
increased serum sodium
In the presence of acute adrenal insufficiency, the underproduction of cortisol by the adrenal glands may cause the patient to experience:
hyperglycemia.
hypoglycemia.
hypertension.
headaches
hypoglycemia
Cortisol (a glucocorticoid) normally stimulates gluconeogenesis, but when it is absent or very low, the liver decreases hepatic glucose output, leading to hypoglycemia
difference between addisons and cushings
both adrenal diseases
Addisons = low cortisol / aldesterone (low Na & High K)
Cushings = HIGH cortisol
Adrenal tumors can cause cushings by producing cortisol
Addisons
difference between addosonian crisis and thyrotoxic crisis
low adrenal cortisol/aldoesterone
HIGH thyroid
where is TSH produced?
pituitary
(anterior pituitary)
The characteristic features of Graves disease do NOT include:
hyperthyroidism.
goiter.
orbitopathy.
constipation.
constipation
Acute complications of untreated diabetes insipidus would NOT include:
hypovolemia.
hypervolemia.
circulatory collapse.
loss of consciousness.
Hypervolemia
Untreated diabetes insipidus (DI) can produce complications such as hypovolemia, hyperosmolality, circulatory collapse, loss of consciousness, and central nervous system damage
A 42-year-old woman complains of palpitations, anxiety and weight loss. Which two lab tests would be most helpful in diagnosing this patient?
Follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
Cortisol and ACTH levels
Insulin-like growth factor and prolactin levels
Free T3 and T4
Free T3 & T4
The complication associated with Type 1 and Type 2 diabetes that is a macrovascular complication is:
coronary artery disease.
neuropathy.
nephropathy.
retinopathy.
Coronary Artery Disease
An extreme and life-threatening form of thyrotoxicosis is called:
Graves’ disease.
thyroid storm.
thyroiditis.
hypothyroidism.
thyroid storm
An acute metabolic complication that occurs in patients with diabetes is:
nephropathy.
retinopathy.
autonomic neuropathy.
ketoacidosis.
ketoacidosis
Cushing’s disease is characterized by physical abnormalities that occur when the adrenal glands secrete excess:
triiodothyronine.
glucocorticoids.
oxytocin.
antidiuretic hormone.
glucocorticoids
Antidiuretic hormone (ADH) and oxytocin are produced in the:
adrenal glands.
parathyroid gland.
thyroid gland.
hypothalamus.
hypothalamus
When calcium levels are low, the negative feedback system:
stimulates the parathyroid gland to release parathyroid hormone.
stimulates the hormone receptors to release calcium into the serum.
inhibits the transport of calcium levels to the bloodstream.
inhibits the uptake of calcium in the bones.
stimulates the parathyroid gland to release parathyroid hormone.
stimulates the parathyroid gland to release parathyroid hormone.
