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Internal Medicine > Assignments and quizzes for test 3 > Flashcards

Assignments and quizzes for test 3 Flashcards

1
Q

Which of the following tissues can be classified as an endocrine gland?

A

adipose tissue

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1
Q

Which region of the brain is the main integrative center for the endocrine and autonomic nervous systems, controls the function of endocrine organs by neural and hormonal pathways

A

Hypothalamus

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2
Q

In response to the hypothalamus, the posterior pituitary secretes

A

Oxytocin and ADH

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3
Q

What is the basic action of adrenocorticotropic hormone (ACTH)?

A

Stimulates secretory activity and synthesis of corticosteroids in adrenal cortex

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4
Q

The primary hormones produced by the thyroid are

A

thyroxine, triiodothyronine, and calcitonin

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5
Q

Which of the following hormone’s basic action is calcium and phosphorus metabolism, construct bone, and reduce serum calcium

A

Calcitonin

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6
Q

Which of the following disorders creates a generalized elevation of body metabolism, the effects of which are manifested in almost every system

A

Hyperthyroidism

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6
Q

Myxedema is the clinical manifestation of

A

hypothyroidism

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7
Q

Hyperparathyroidism is a disorder caused by overactivity of one or more of the four parathyroid glands that

A

disrupts calcium, phosphate, and bone metabolism

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8
Q

Which of the following medical diagnosis occurs because of a disorder within the adrenal gland itself, with insufficient cortisol release from the adrenal glands causing a wide range of problems

A

Addison disease

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9
Q

Hypercortisolism resulting from adrenal gland oversecretion or from hyperphysiologic doses of corticosteroid medications is called .

A

Cushing syndrome

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10
Q

Which of the following hormones is essential to norepinephrine-induced vasoconstriction and other physiologic phenomena necessary for survival under stress?

A

Cortisol

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10
Q

Which of the following medical diagnosis occurs when an adrenal lesion results in hypersecretion of aldosterone, the most powerful of the mineralocorticoids?

A

Conn syndrome

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11
Q

Which of the following is the characteristic of hypoparathyroidism

A

Decreased bone resorption

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12
Q

What is the hallmark of Addison disease

A

Decreased serum cortisol levels

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13
Q

Which of the following is the characteristic of hyperparathyrodism

A

Increased bone resorption

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14
Q

In response to the hypothalamus the anterior pituitary secretes

A

Mineralocorticoids (aldosterone)

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15
Q

Which of the following can be a cause for Cushing disease

A

An excess of corticosteroids medication

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16
Q

What is true for cortisol

A

It is essential to norepinephrine induced vasoconstriction and other physiologic phenomena necessary for survival under stress

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17
Q

What is the hallmark of Addison disease

A

Decreased serum cortisol levels

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18
Q

Which of the following lab blood tests is relevant to diagnose hyperthyroidism

A

Thyroid stimulating hormone (TSH)

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19
Q

Flexor tenosynovitis with stiffness can accompany carpal tunnel syndrome in persons with

A

Hypothyroidism

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20
Q

Dec levels of thyroid hormones lead to an overall slowing of the basal metabolic rate. This slowing of all body processes leads to

A

Bradycardia
Dec GI tract motility
Slowed neurological functioning

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21
Q

Which of the following occurs when an adrenal lesion results in hypersecretion of aldesterone the most powerful of the mineralocorticoids

A

Conn syndrome

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22
Q

Which region of the brain is the main integrative center for the endocrine and autonomic nervous systems, controls the function of endocrine organs by neural and hormonal pathways?

A

Hypothalamus

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23
Q

Which of the following tissues can be classified as an endocrine gland

A

Adipose tissue

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24
Q

In response to the hypothalamus, the posterior pituitary secretes

A

Oxytocin and ADH

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25
Q

What is the basic action of adrenocorticotropic hormone (ACTH)

A

Stimulates secretory activity and synthesis of corticosteroids in adrenal cortex

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25
Q

The primary hormones produced by the thyroid are

A

thyroxine, triiodothyronine, and calcitonin

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26
Q

Which of the following hormone’s basic action is calcium and phosphorus metabolism, construct bone, and reduce serum calcium

A

Calcitonin

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27
Q

Hyperparathyroidism is a disorder caused by overactivity of one or more of the four parathyroid glands that

A

disrupts calcium, phosphate, and bone metabolism

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27
Q

Myxedema is the clinical manifestation of

A

hypothyroidism

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28
Q

Which of the following disorders creates a generalized elevation of body metabolism, the effects of which are manifested in almost every system

A

Hyperthyroidism

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29
Q

Which of the following medical diagnosis occurs because of a disorder within the adrenal gland itself, with insufficient cortisol release from the adrenal glands causing a wide range of problems?

A

Addison disease

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30
Q

Which of the following clinical manifestations is commonly seen in a person with diabetes

A

Impaired cognitive function
Infection
Balance and gait abnormalitites

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31
Q

When a person has hypoglycemia episode, what clinical manifestation he/she may have

A

Tachycardia and shallow respirations

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32
Q

What is TRUE about insulin resistance

A

The endogenous insulin levels can be high during the diagnosis, and it may become low as the diabetes progress

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33
Q

Which of the following is TRUE in a person with hyperglycemia

A

High Ketones

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34
Q

What will be an ideal A1C target for a person with type 2 diabetes

A

< 7.0%

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35
Q

Which of the following is TRUE on diabetes

A

Type 2 diabetes can develop at any age.

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36
Q

Which of the following decreases blood glucose levels?

A

Insulin released by beta cells in the islet of Langerhans

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37
Q

If an individual has a fasting plasma glucose of 80 mg/dL, what can physical therapist infer from this information

A

Normal fasting plasma glucose level

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38
Q

The National Institutes of Health clinical guidelines and the WHO define overweight in adults as a BMI equal to or greater than

A

25 kg/m2

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39
Q

Prediabetes is diagnosed in people with an A1C greater than or equal to but less than or equal to .

A

5.7% ; 6.4%

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40
Q

In children, BMI greater than or equal to the percentile signifies risk for being obese

A

95th

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41
Q

What is metabolic syndrome?

A

Abdominal obesity and atherogenic dyslipidemia
Elevated blood pressure and insulin resistance
Prothrombotic and proinflammatory state of the blood

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42
Q

Which of the following is precipitating causes of diabetic ketoacidosis?

A

Trauma
Medications i.e., Beta blockers
Pregnancy

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43
Q

In the United States, about have been diagnosed with diabetes.

A

1 in every 10 people

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44
Q

In diabetes,_____ causes dehydration, which causes thirst. Excessive thirst is called _____ .

A

polyuria; polydipsia

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45
Q

According to the natural history of type 2 diabetes, which of the following complications may already exist when people are diagnosed with diabetes?

A

Macrovascular

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46
Q

Hulk checked his blood glucose levels two hours after eating a Chinese buffet last night. The glucometer showed 299 mg/dL. What would be the clinical indication from this information?

A

Hulk may have developed hyperglycemia

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47
Q

Which of the following diseases is considered a microvascular complication for diabetes?

A

Retinopathy

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48
Q

Which of the following are precipitation causes of diabetic ketoacidosis

A

Trauma
Inadequate insulin under stressful conditions
Medications such as beta blockers

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49
Q

What is true about insulin resistance

A

Commonly being seen in people with type 2 diabetes

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50
Q

Which of the following clinical manifestation is commonly seen in a person with diabetes

A

Numbness of the limbs

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51
Q

What clinical manifestation may a patient have if his/her blood glucose is 62mg/dL

A

Convulsion coma

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52
Q

What is the A1C recommendation for non pregnant adults with diabetes

A

Less than 7.0%

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53
Q

Releasing a series of multiple function mediators,_______ is involved in a wide spectrum of diseases including not only cardiovascular and metabolic conditions, such as atherosclerosis and type 2 diabetes but also inflammatory and immune related disorders such as rheumatoid arthritis and osteoarthritis

A

White fat

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54
Q

Fat accumulated in the lower body results _____ figure, whereas fat in the abdominal area produces more of an ______

A

Pear shape, apple shaped

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55
Q

_____ is the branch of medicine concerned with the management of obesity

A

Bariatrics

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56
Q

In children BMI greater than or equal to the _______ percentile signifies risk of being obese

A

95th

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57
Q

Which of the following islet cells produce insulin in the pancreas

A

Beta cells

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58
Q

Which type of diabetes is an autoimmune type of diabetes that begins in middle to late adulthood, also referred to as latent autoimmune diabetes in adults (LADA)?

A

Type 1.5

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59
Q

Pre-diabetic is diagnosed in people with a fasting glucose greater than or equal to______ but less than or equal to ________

A

100mg/dl; 125 mg/dl

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60
Q

How to manage diabetes

A

Work with a health professional
Eat healthy
Stay active

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61
Q

In diabetes, _______ causes dehydration, which causes thirst. Excessive thirst is called______

A

Polyuria; polydipsia

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62
Q

The term was often applied to opioid compounds because when taken, they tend to have sedative or sleep-inducing side effects, and high doses can produce a state of unresponsiveness and stupor.

A

narcotic

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63
Q

The source of the naturally occurring opioid (narcotic) analgesics is from

A

the opium poppy

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64
Q

Opioid drugs exert their analgesics effects by binding to the same receptors as

A

endogenous opioids (endorphins, enkephalins)

65
Q

Morphine and many other powerful opioids exert their primary analgesic effects by binding to the

A

mu opioid receptor

66
Q

Drugs such as butorphanol, nalbuphine, and pentazocine may stimulate certain opioid receptors while blocking or only partially activating other receptors. These drugs

A

may produce more psychotropic effects (hallucinations, vivid dreams) than other opioids
may have fewer addictive qualities than strong opioids such as morphine
may produce adequate analgesia with less risk of side effects such as respiratory depression
are known as mixed agonist-antagonists

67
Q

By blocking all opioid receptors, opioid antagonists such as nalmefene and naloxone are used primarily to

A

treat opioid overdose

68
Q

Opioid drugs exert their effects on afferent pain pathways by binding to neuronal receptors that in turn

A

decrease transmitter release from presynaptic terminals

69
Q

Preliminary studies on animals suggest that opioids can exert analgesic effects when administered directly into peripheral tissues (e.g., injected into an inflamed joint) because

A

opioids may bind to receptors located on the distal (peripheral) ends of primary afferent (sensory) neurons.

70
Q

When used to treat pain, opioids can be administered by all the following routes EXCEPT

A

inhalation

71
Q

In addition to their use as analgesics, opioid drugs can also be administered

A

as a preoperative medication
as a general anesthetic
as a cough suppressant
to treat severe diarrhea

72
Q

Which of the following side effects is NOT associated with opioid drugs?

A

increased respiration

73
Q

Certain patients can develop “tolerance” to opioid analgesics, which is indicated by

A

the need to progressively increase the dosage of the drug to achieve a therapeutic effect when the drug is used for prolonged periods

74
Q

Methadone is often used to treat opioid addiction because methadone

A

has mild withdrawal symptoms

75
Q

The onset of withdrawal symptoms (body aches, shivering, sweating, and so forth) after sudden discontinuation of opioid analgesics is an example of

A

physical dependence

76
Q

Certain patients may fail to respond to opioids or may report increased pain (hyperalgesia) when given opioid drugs. This opioid-induced hyperalgesia is likely due to _____ in nociceptive pathways in susceptible patients.

A

increased activity of glutamate

77
Q

NSAIDs such as aspirin exhibit all of the following effects EXCEPT

A

the ability to increase bronchodilation in conditions such as asthma

78
Q

Aspirin and other NSAIDs exert their primary therapeutic effects by interfering with the biosynthesis of

A

prostaglandins

79
Q

Prostaglandins are

A

a group of lipidlike compounds that exhibit a wide range of physiological activities

80
Q

NSAIDs exert their therapeutic effects by _____ the ______ enzyme.

A

inhibiting; cyclooxygenase

81
Q

The _____ form of the cyclooxygenase enzyme seems to be responsible for producing beneficial prostaglandins that help maintain or protect function in specific tissues such as the stomach and kidneys.

A

COX-1

82
Q

In addition to its analgesic and anti-inflammatory effects, it appears that regular use of low-dose aspirin may also help prevent

A

Ischemic strokes
Heart attacks
Colorectal cancer

83
Q

In theory, a COX-2 selective drug such as celecoxib will be less likely to cause gastric irritation because

A

COX-2 drugs do not inhibit the production of beneficial prostaglandins in the stomach.

83
Q

Aspirin ______ be used to treat fever in children because this drug may cause _____

A

should not; Reye syndrome

84
Q

It has been suggested that aspirin and other NSAIDs _______ be used to treat pain following surgeries such as spinal fusion because these drugs may ______.

A

should not; inhibit bone healing

85
Q

Several COX-2 selective inhibitors such as rofecoxib (Vioxx) and valdecoxib (Bextra) have been taken off the market because these drugs can cause serious side effects such as

A

heart attack and stroke

86
Q

Gastric irritation caused by aspirin and other NSAIDs can be treated with

A

Drugs that mimic prostaglandins (PGs) such as PGE1 (e.g., misoprostol [Cytotec])
Histamine type 2 (H2) blockers such as cimetidine (Tagamet) and ranitidine (Zantac)
Gastric proton pump inhibitors (PPIs) such as omeprazole (Prilosec) and esomeprazole (Nexium)

87
Q

Which of the following is a commonly encountered problem with the use of corticosteroids?

A

Hyperglycemia

88
Q

The lower GI tract includes the .

A

small and large intestines

89
Q

occurs when nerve endings in the stomach and other parts of the body are irritated and usually precedes vomiting.

A

Nausea

90
Q

Which of the following is a gastrointestinal sign or symptom associated with strenuous exercise?

A

Abdominal cramping

91
Q

Which of the following is the most common neurogenic cause of diarrhea?

A

Hyperthyroidism

92
Q

Which of the following medications is a common cause of constipation?

A

Diuretics and opioids

93
Q

What drugs are the most common causes of reactive gastritis?

A

Aspirin and NSAIDs

94
Q

Which of the following is a failure to relax the smooth muscle fibers of the gastrointestinal tract?

A

Achalasia

95
Q

Which of the following is least likely to refer pain to the left shoulder?

A

Liver cancer

96
Q

What type of hiatal hernia is the most common?

A

Sliding

97
Q

What types of exercise would increase intraabdominal pressure?

A

Straining
Lifting
Bending over

98
Q

One of the most common symptoms of a hiatal hernia is .

A

heartburn or reflux

99
Q

Which of the following exercises is contraindicated for an individual with a known hiatal hernia?

A

Any exercise that causes Valsalva in the supine position

100
Q

What is the common cause of gastroesophageal reflux disease?

A

Carbonated drinks, alcohol and coffee
Nicotine or cigarette smoke
Peppermint, fatty foods, citrus products (including tomatoes), spicy foods, garlic, onions

101
Q

What type of medication is used to treat gastroesophageal reflux disease, blocks acid pumps and prevent stomach acid production?

A

Proton pump inhibitor (PPI)

102
Q

Which of the following is not considered an extraesophageal manifestation of gastroesophageal reflux disease?

A

Heartburn

103
Q

occurs when the peptic ulcer erodes into adjacent organs such as the small bowel, pancreas, or liver.

A

Penetration

104
Q

is a chronic inflammatory disorder of the mucosa of the colon, typically involving the rectum, which can then advance proximally in a continuous manner to involve the entire colon.

A

Ulcerative colitis

105
Q

In ulcerative colitis, intestinal lesions are usually found in which locations?

A

Rectum and left colon

106
Q

What is the most common extraintestinal finding in inflammatory bowel disease?

A

Arthritis

107
Q

What is the primary indication or desired effect of Omeprazole?

A

To treat gastric ulcers

108
Q

Which of the following is Bisphosphonates that can treat osteoporosis?

A

Alendronate

109
Q

What is the common cause of gastroesophageal reflux disease?

A

Calcium channel blockers
Pregnancy (last trimester)
Caffeine

110
Q

What is the common cause of gastroesophageal reflux disease?

A

Scleroderma
Central nervous system depressants
Estrogen therapy

111
Q

What is the primary indication of proton pump inhibitors

A

Gastric ulcers

111
Q

Which of the following is the most common causes of constipation

A

Hydrocodone (semi-synthetic opioid)

112
Q

Opioid drugs exert their effects on afferent pain pathways by binding to neuronal receptors that in turn

A

decrease transmitter release from presynaptic terminals

112
Q

Which of the following medications is a common cause of diarrhea?

A

Antibiotics

113
Q

Which of the following are the most common symptoms of a hiatal hernia?

A

Heartburn

114
Q

The most common presenting symptoms of acute appendicitis occur in a classic sequence of abdominal pain over .

A

right lower quadrant

115
Q

Why is the stool normally brown?

A

Bile converted from bilirubin causes brown coloration of the stool

115
Q

What do light-colored stools and urine the color of tea or cola most likely indicate?

A

Liver dysfunction

116
Q

Which of the following is one of the most common signs and symptoms of hepatic disease?

A

Hepatic osteodystrophy

117
Q

What is the cause of jaundice?

A

Defects in bilirubin metabolism (in uptake by the liver or conjugation)

118
Q

Progressive loss of normal tissue that is replaced with fibrosis and nodular regeneration is a characteristic of .

A

Cirrhosis

119
Q

Bile helps in alkalinizing the intestinal contents and plays a role in the emulsification, absorption, and digestion of .

A

fat

120
Q

What is the treatment of choice for tense ascites?

A

Paracentesis and diuretics

121
Q

What is the 5-year survival rate for compensated cirrhosis?

A

Greater than 90%

121
Q

Which of the following occur in association with jaundice?

A

Dark urine and light stools

122
Q

The liver is the major site of production proteins that are associated with _____

A

acute inflammatory reactions

122
Q

Which of the following is associated with overproduction of bilirubin?

A

Autoimmune hemolytic anemia

123
Q

What type of hepatitis virus currently has no vaccine available?

A

Hepatitis C virus (HCV)

124
Q

What is the most common cause of fulminant hepatitis?

A

Acetaminophen toxicity

125
Q

Which of the following laboratory tests are both for liver function?

A

Gamma-glutamyl transferase (GGT) and lactate dehydrogenase (LDH)

126
Q

Which of the following is true when a person ages?

A

Liver requires more time to process medications

127
Q

What is also called flapping tremors or liver flap?

A

Asterixis

128
Q

What is Cholecystitis?

A

Inflammation of gallbladder

129
Q

Skin is the largest body organ, constituting ________ of the body weight.

A

15% to 20%

130
Q

What is the primary function of fibroblasts in the dermis?

A

Collagen synthesis for skin strength and wound healing

131
Q

Which of the following is true about skin lesions?

A

Skin lesions can result from the reaction to radiotherapy or medication.

132
Q

Which of the following lab values are the most relevant to skin lesions and wound healing?

A

Prealbumin and hematocrit

132
Q

Which of the following is true about aging and the integumentary system?

A

For women, excessive facial hair may occur along the upper lip and around the chin.
Gray hair and balding are visible indications of skin changes associated with aging.
With aging, blood vessels within the dermis are reduced in number, and the walls are thinned.

133
Q

Which of the following is true for first-degree burn?

A

Ultraviolet exposure can be the cause

133
Q

Which of the following is true about skin infection?

A

Athlete’s foot (Tinea Pedis) is fungal infection.

134
Q

You are working in an ICU and treating a 34-year-old female patient who has sustained second- and third-degree burns over her front chest, abdomen, and front left upper extremity. Using the Wallace rule of nines, total body surface area (TBSA) is

A

22.5%

135
Q

account for approximately 75% (43% flame or fire; 34% scalding) of all burn center admissions

A

Thermal burns

136
Q

Extensive burns result in generalized body ______ in both burned and nonburned tissues and a ______ in circulating intravascular blood volume

A

edema;decrease

137
Q

is the most common and life-threatening complication of burn injuries.

A

infection

138
Q

Which of the following is true on skin transplantation for person with burn?

A

Biosynthetic grafts are a combination of collagen and synthetics

139
Q

What are the three classic determinants of burn mortality?

A

TBSA, age, and inhalation injury

140
Q

Which of the following are the common medical complications of gastrointestinal system on a person with burn?

A

paralytic ileus

141
Q

Which of the following body parts would get pressure injuries the most easily?

A

Scapula and elbow

142
Q

Partial-thickness skin loss with exposed dermis is considered ______ pressure injury.

A

Stage 2

143
Q

Which of the following patient populations may have higher risk of infection if they develop pressure injuries on the skin, because they are unable to mount a sufficient inflammatory response to start the healing?

A

Type 2 diabetes

144
Q

Which of the following is appropriate medical management for a patient with pressure injuries?

A

Negative pressure wound therapy
Adequately redistribute the pressure
Electrical stimulation

145
Q

Which if the following is true on skin transplantation for person with burn

A

Autographs are the persons own skin

146
Q

The two primary causative factors for the development of pressure injuries are

A

Interface pressure (externally) and pressure with shearing forces

147
Q

Whichbof the following is true about clinical manifestation for pressure injuries

A

Pressure injuries occur over bony prominence
Proteolytic enzymes from bacteria and macrophages dissolve necrotic tissue which can lead to foul smelling discharge
Pressure injuries often manifest with a circular pattern shaped like an inverted volcano

148
Q

Which if the following are intrinsic factors most associated with pressure injury development

A

Impaired mobility, incontinence, diaphoresis, and impaired nutritional status

149
Q

Which of the following is true about treatment for pressure injuries

A

Therauptiic modalities such as ultrasound and electrical stimulation can be used
Elimination or limiting associated risk factors as much as possible is the first step in preventing the occurrence of pressure injuries
In stage 3 pressure injuries undamaged tissue near the wound can be rotated to cover the ulcer

150
Q

What is the primary function of mast cells in the dermis

A

Provide histamine for vasodialation and chemotatic factors for inflammatory responses

151
Q

Which of the following lab values are the most relevant to skin lesions and wound healing

A

Hemoglobin and totoal protein

152
Q

Which of the following is true about integumentary system

A

Epidermis is one of the body’s principal supplier of vitamin D
Wrinkling signifies loss of elastic fibers weakened collagen and Dec subcutaneous fat
Hormonal abnormalities may result in excessive facial and body hair and male pattern baldness in men

153
Q

Which of the following is true about skin infection

A

Impetigo is bacterial infection

154
Q

Which kf the following js true for partial thickness burn

A

Painful

155
Q

A 42 yr old male with history of schizophrenia suffered extensive burns after pouring gasoline down his pants and lightning a match. The self-inflicted injury resulted in full thickness burns on his bilateral lower extremity. Using the Wallace rule of nines, total body surface area (TBSA)

A

Over 30%

156
Q

Why do children have a higher risk of burns

A

Inadequate supervision and abuse with scald injuries

157
Q

Obscured full thickness skin and tissue loss us considered ______ pressure injury

A

Unstagable

158
Q

Fir bed bound and chair bound patients with impaired ability to reposition themselves which of the following tools can be used for risk assessment evaluating both sensation and physiologic risk of pressure injuries

A

Braden scale

159
Q

Which of the following are the common medical complication in a burn injured adult

A

Stres induced gastric ulcer

Internal Medicine (6 decks)

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