Endocrinology Flashcards
Which of the following best explains the process of osmotic diuresis associated with hyperglycemia?
Question options:
A)
Glucose in the urine raises osmotic pressure inside the kidney tubule, drawing water into the tubule.
B)
Glucose in the urine lowers osmotic pressure inside the kidney tubule, preventing water reabsorption.
C)
Elevated blood glucose levels result in increased ADH secretion.
D)
Decreased insulin levels result in decreased ADH secretion.
glucose in the urine raises osmotic pressure inside the kidney tubule drawing water into the tubule
Which of the following statements about the epidemiology of Graves’ disease is TRUE?
Question options:
A)
Graves’ disease is about six times more common in women than in men.
B)
Heredity does not predispose people to Graves’ disease.
C)
Graves’ disease typically manifests late in adulthood.
D)
Obesity and poor dietary habits increase the risk of Graves’ disease.
Graves’ disease is about six times more common in women than men
Which of the following is NOT a modifiable risk factor for type II diabetes?
Question options:
A)
Poor diet
B)
Heredity
C)
Lack of exercise
D)
Obesity
Heredity
You encounter a patient complaining of polyuria, polyphagia, polydipsia, and abdominal pain. Based on these complaints, which of the following would you also expect to find?
Question options:
A)
Complaint of chest pain and shortness of breath
B)
Blood glucose of less than 70 mg/dL
C)
Blood glucose between 80 and 120 mg/dL
D)
Kussmaul’s respirations and a fruity breath odor
Kussmaul’s respirations and a fruity breath odor
Acute exacerbation of Addison’s disease can lead to ECG changes and cardiovascular collapse as a result of electrolyte imbalance secondary to:
Question options:
A)
decreased mineralocorticoid secretion with increased sodium and potassium excretion.
B)
fluid retention, potassium excretion, and sodium retention.
C)
increased mineralocorticoid secretion from the adrenal glands.
D)
potassium retention and sodium excretion.
potassium retention and sodium excretion
A type II diabetic with a blood glucose of 24 mg/dL would most likely be unconscious due to:
Question options:
A)
insulin shock.
B)
gluconeogenesis.
C)
diabetic ketoacidosis.
D)
cerebral hypoglycemia.
cerebral hypoglycemia
Your patient is a 72-year-old male who is conscious but lethargic and sitting in a chair. His son states that the patient has been a bit slow lately and has been gaining weight. The medical history includes hypothyroidism and myocardial infarction. The patient has been compliant with his Synthroid and has nitroglycerin for use as needed. The patient responds to verbal stimuli, is confused, has a large tongue, and pale, cold, doughy skin. His only complaint is constipation. HR = 60 and regular, BP = 112/80, RR = 10 and shallow, SaO2 = 92%, temperature = 88°F,blood glucose = 180 mg/dL. Your treatment of this patient should include:
Question options:
A)
oxygen, 4 lpm by nasal cannula.
B)
rewarm with heat packs.
C)
atropine 0.5 mg IV.
D)
infusion of 1 to 2 liters of warm normal saline.
oxygen 4LPM by nasal canula
Your patient is a 42-year-old male who is supine on the floor, responsive only to pain. His wife states that he has been extremely depressed recently and talked about suicide yesterday. The patient’s skin is hot and dry, pupils are dilated and reactive to light bilaterally, and there is vomit around his mouth. HR = 138 and regular, BP = 82/52, RR = 16 and shallow. Temperature is 105.5°F. The patient has a history of hypothyroidism, for which he takes Synthroid. Your partner suctions the airway and initiates BVM ventilations with 100 percent oxygen and an oropharyngeal airway. In addition to monitoring the cardiac rhythm and starting an IV of normal saline, you should:
Question options:
A)
perform synchronized cardioversion and intubate if the rhythm does not convert.
B)
administer 25 g of 50 percent dextrose and intubate if the level of responsiveness does not improve.
C)
intubate the trachea and request orders for diltiazem.
D)
intubate the trachea and request orders for propranolol, IV.
intubate the trachea and request orders for propranolol
Hyperglycemia is most likely a result of damage to the pancreatic ________ cells.
Question options:
A)
delta
B)
alpha
C)
beta
D)
acinar
beta
A three-year-old male patient has a history of an underdeveloped cell-mediated immune system. Which of the following most likely contribute to this deficiency?
Question options:
A)
Hypoadrenalism
B)
Type I diabetes mellitus
C)
Thymus gland insufficiency and a lack of thymosin secretion
D)
HIV infection
thymus gland insufficiency and lack of thymosin secretion
A patient presents with a history of frequent urination, signs and symptoms of dehydration, and a blood glucose of 958 mg/dL. There is no acetone odor on his breath. To which of the following can the absence of an acetone odor most likely be attributed?
Question options:
A)
The ability to use enough glucose to meet metabolic needs
B)
The ability to convert to the use of amino acids for energy metabolism
C)
Elimination of ketoacids through Kussmaul’s respirations
D)
Elimination of ketoacids by the blood buffer system
the ability to use enough glucose to meet metabolic needs
Your patient is a 56-year-old male who is conscious and exhibits slurred speech, irritability, and cool, clammy skin. Blood glucose is 54 mg/dL. Proper treatment for this patient could include all of the following EXCEPT:
Question options:
A)
administration of oral glucose if the patient is able to swallow.
B)
5 to 10 mg of glucagon IM.
C)
consideration of D50 IV if the patient cannot follow simple commands.
D)
IV of NS.
5-10 mg of glucagon IM
Which of the following pathologies would necessitate the use of increased care in the preparation of an IV site because of skin fragility and increased risk of infection?
Question options:
A)
Myxedema
B)
Graves’ disease
C)
Cushing’s syndrome
D)
Addison’s disease
Cushing’s syndrome
A chemical substance that is released into the blood by a gland and that controls or affects processes in other glands or body systems is a(n):
Question options:
A)
neurotransmitter.
B)
leukotriene.
C)
hormone.
D)
enzyme.
hormone
Prehospital management of an unresponsive patient with hypoglycemia should NOT include:
Question options:
A)
administration of D50 IV.
B)
administration of glucagon IM.
C)
BVM ventilations with 100 percent O2 and an OPA.
D)
administration of oral glucose.
administration of oral glucose
Which of the following is least likely to be a precipitating factor of thyrotoxic crisis?
Question options:
A)
Cold environment
B)
Overdose of thyroid hormone
C)
Infection
D)
Trauma
cold environment
A 36-year-old female is conscious and alert and complaining of palpitations. She denies chest pain, difficulty breathing, or loss of consciousness but becomes “dizzy” with exertion. She states that she has been experiencing agitation, insomnia, intolerance to heat, and weight loss. Physical exam reveals exophthalmos and an enlarged thyroid gland. HR = 142 and regular, BP = 110/70, RR = 14 and regular. Which of the following would be most effective in treating this patient?
Question options:
A)
50 percent dextrose IV
B)
250 cc fluid challenge
C)
Synchronized cardioversion
D)
Propranolol
propranolol
Which of the following best describes the relationship between the hypothalamus and the endocrine system?
Question options:
A)
The hypothalamus produces all of the releasing hormones that act on other endocrine organs.
B)
The hypothalamus is also known as the posterior pituitary gland.
C)
The hypothalamus is the link between the central nervous system and the endocrine system.
D)
The hypothalamus regulates most endocrine activities via positive feedback mechanisms.
the hypothalamus is the link between the central nervous system and the endocrine system
Immediately after birth, an infant is allowed to suckle at the mother’s breast. Palpation of the uterus suggests that the uterus is contracting. This finding can be attributed to:
Question options:
A)
secretion of estrogen and progesterone.
B)
inhibition of estrogen and progesterone.
C)
inhibition of oxytocin.
D)
secretion of oxytocin.
secretion of oxytocin
A 63-year-old female with a history of hypothyroidism presents in a stuporous state, responsive only to pain. Physical exam reveals thin hair, a puffy face, an enlarged tongue, and cold, doughy skin. Her heart rate is 70 and regular, RR is 10 and regular, BP is 90/62, blood glucose level is 60 mg/dL, and temperature is 86°F via a tympanic thermometer. Your treatment of this patient should NOT include:
Question options:
A)
active rewarming.
B)
IV fluids at a TKO rate.
C)
50 percent dextrose, IV.
D)
endotracheal intubation.
active rewarming
Your patient is a 72-year-old male patient who is conscious but slow to respond to questions and commands. He has become increasingly lethargic, unemotional, and easily fatigued over the past two months. He has had a decreased appetite and has gained weight over the same period. The patient further states, “I’m constipated and always cold.” Which of the following additional signs or symptoms would be consistent with this patient presentation?
Question options:
A)
A puffy face, an enlarged tongue, and pale, doughy skin
B)
Hypothermia, tachycardia, and hypertension
C)
A “moon-faced” appearance and hyperpigmentation of the skin
D)
Goiter, atrial fibrillation, nausea, and vomiting
a puffy face an enlarged tongue and pale doughy skin
Which of the following explains the profound protein catabolism and gluconeogenesis associated with Cushing’s syndrome?
Question options:
A)
Glucocorticoids cause sodium retention and increased blood volume.
B)
Increased epinephrine and norepinephrine release result in hypermetabolism.
C)
Cortisol is an antagonist to insulin.
D)
Cushing’s syndrome affects normal fat deposition.
cortisol is an antagonist to insulin
A patient has a fever of 105°F, irritability, delirium, tachycardia, vomiting, and hypotension. These signs and symptoms are most consistent with:
Question options:
A)
thyrotoxic crisis.
B)
myxedema.
C)
Graves’ disease.
D)
hypothyroidism.
thyrotoxic crisis
A 24-year-old male is supine on the floor and unconscious with snoring respirations. You note a weak, rapid pulse and cool, diaphoretic skin. HR = 124 and regular, BP = 136/88, RR = 12 and regular. Blood glucose is 24 mg/dL. After manually opening the airway and providing oxygen, which of the following should be performed next?
Question options:
A)
Administer glucagon, 1 mg IM.
B)
Start an IV and administer 0.3 mg glucagon, IV.
C)
Start an IV and administer 25 gm dextrose, IV.
D)
Intubate the trachea, start an IV, and administer 25 gm dextrose.
start an IV and administer 25 mg dextrose IV
Your patient is a 39-year-old male with a history of alcoholism. He is unresponsive, with cool, clammy skin and a weak, rapid pulse of 108. BP = 128/92, RR = 12 and regular. Your partner manages the airway and assists ventilations, but you are unable to start an IV after three attempts. Which of the following is most appropriate at this point?
Question options:
A)
Dextrose, 25 g, and thiamine, 100 mg, both IM
B)
Glucagon 1.0 mg IM
C)
Glucagon, 1.0 mg, and thiamine, 100 mg, both IM
D)
Reattempt the IV while en route.
glucagon, 1.0 mg , and thiamine, 100 mg both IM
