exam 3 Neurology Flashcards
A 63-year-old female with a history of type II diabetes presents with a four-day history of increased urination and thirst. She called EMS this morning when she experienced a brief period of dizziness while getting out of bed. Your assessment reveals a BP of 108/60, RR of 14 and regular, and a HR of 122 and regular. You also note that the patient is slightly confused and has warm, dry skin and mucous membranes. Based on this patient presentation, what other finding could you expect? Answers: Atrial flutter Fruity breathodor A blood glucose of 68 mg/dL Glucosuria
Glucosuria
You have administered glucagon to a diabetic patient. Which of the following should occur?Answers: Stimulation of the pancreatic alpha cells, resulting in lipolysis
Stimulation of the pancreatic beta cells, resulting in a decreased blood glucose level
Glycogenesis, resulting in a decreased blood glucose level
Glycogenolysis, resulting in an increased blood glucose level
Stimulation of the pancreatic beta cells, resulting in a decreased blood glucose level
Your diabetic patient asks you why he “passes out” when his blood sugar gets too low. Which of the following responses is most accurate?
Answers:
“When the blood sugar is low, the brain does not get enough oxygen.”
“Brain cells need a constant supply of glucose, or sugar, to function. Without sugar the brain cells cannot work to maintain consciousness.”
“When the blood sugar is low, the blood vessels relax and the blood pressure drops, causing you to faint.”
“The cells of the heart can only use glucose, or sugar, for energy. Without sugar the heart cannot effectively pump blood to the brain.”
Selected Answer: “Brain cells need a constant supply of glucose, or sugar, to function. Without sugar the brain cells cannot work to maintain consciousness.”
Acute exacerbation of Addison’s disease can lead to ECG changes and cardiovascular collapse as a result of electrolyte imbalance secondary to:
Answers: Increased mineralocorticoid secretion from the adrenal glands
Potassium retention and sodium excretion
Fluid retention, potassium excretion, and sodium retention
Decreased mineralocorticoid secretion with increased sodium and potassium excretion
Potassium retention and sodium excretion
Which of the following is the most direct cause of polyuria in untreated diabetes?
Hyperglycemia
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?
A puffy face, an enlarged tongue, and pale, doughy skin
Which of the following findings would be atypical in a patient with a history of Cushing’s syndrome?
Temperature of 101°F
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):
Hormone
Hyperglycemia is most likely a result of damage to the pancreatic ________ cells.
Beta
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?
Glucagon, 1.0 mg, and thiamine, 100 mg, both IM
A finding of exophthalmos and goiter should increase your suspicion for a problem with the:
Thyroid gland
Which of the following should occur with the administration of insulin?
Hepatic glycogen synthesis
A patient has a fever of 105°F, irritability, delirium, tachycardia, vomiting, and hypotension. These signs and symptoms are most consistent with:
thyrotoxic crisis
Which of the following statements about the epidemiology of Graves’ disease is TRUE?
Graves’ disease is about six times more common in women than in men
A type I diabetic presents with deep, rapid respirations and a fruity odor on her breath. Which of the following would best help correct the underlying physiologic disturbance?
:
Insulin
A 34-year-old female, conscious, alert, and oriented, is complaining of a three-week history of increased appetite, weight loss, weakness, insomnia, and inability to tolerate heat. She has recently been frequently agitated and prone to mood swings. Based on these signs and symptoms, which of the following best describes the additional findings you could expect?
Exophthalmos and goiter
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:
5 to 10 mg of glucagon IM
Cushing’s syndrome is a disorder of the:
Adrenal glands
