Quiz 3 - Endocrine Disorders

Question 1

A 10-year-old male was diagnosed with glomerulonephritis. History reveals that he had an infection 3 weeks before the onset of this condition. The infection was most likely located in the:

a. external ear.
b. bowel.
c. pharynx.
d. stomach.

Answer 1

c. pharynx. (Strep Throat)

Question 2

Type 1 diabetes mellitus

a. is characterised by the incomplete destruction of islet cells.
b. is characterised by the complete destruction of islet cells.
c. is characterised by insulin resistance
d. is characterised by insufficient insulin release and insulin resistance.

Answer 2

b. is characterised by the complete destruction of islet cells.

Question 3

A person with diabetes may develop peripheral vascular disease leading to lower leg disease and amputation. This is a result of:

a. increased tissue perfusion leading to endothelial hyperplasia.
b. thickening of the capillary basement membrane and endothelial damage.
c. thinning of the capillary basement membrane and endothelial hyperplasia.
d. increased sweating and heightened sensation.

Answer 3

b. thickening of the capillary basement membrane and endothelial damage.

Question 4

Which of the following patients would be considered to have a significant risk of developing postrenal acute renal injury?

a. A 78-year old male with diagnoses of poorly controlled diabetes mellitus and heart failure.
b. A 20-year old male who is admitted for treatment of an overdose of a nephrotoxic drug.
c. A 41-year old female who is admitted for intravenous antibiotic treatment of pyelonephritis.
d. A 68-year old male with a diagnosis of benign prostatic hyperplasia.

Answer 4

d. A 68-year old male with a diagnosis of benign prostatic hyperplasia. (going to cause blockage in prostate)

Question 5

Which of the patients below is considered hypernatraemic?

a. a patient with a plasma sodium level of 155 mmol/L
b. a patient with a plasma sodium level of 136 mmol/L
c. a patient with a plasma sodium level of 120 mmol/L
d. a patient with a plasma sodium level of 145 mmol/L

Answer 5

a. a patient with a plasma sodium level of 155 mmol/L (anything over 145 mmol/L)

Question 6

Older people are at a higher risk for developing dehydration because they have:

a. a higher total body water volume.
b. a decreased lean body mass.
c. a decreased intravascular volume.
d. an increased tendency towards developing oedema.

Answer 6

b. a decreased lean body mass.

Question 7

Visual disturbances are a common occurrence in patients with untreated Graves’ disease. The main cause of these complications is:

a. decreased blood flow to the eye.
b. orbital oedema and extraocular muscle paralysis.
c. thyroid-stimulating hormone neurotoxicity to retinal cells.
d. localised lactic acidosis.

Answer 7

b. orbital oedema and extraocular muscle paralysis.

Question 8

When the adrenal gland produces excess cortisol due to hypersecretion of adrenocorticotrophic hormone (ACTH), this would be an example of:

a. primary hypersecretion.
b. primary hyposecretion.
c. secondary hypersecretion.
d. tertiary hypersecretion.

Answer 8

c. secondary hypersecretion (Cushing’s syndrome)

Question 9

The most common cause of elevated levels of antidiuretic hormone (ADH) secretion is:

a. autoimmune disease.
b. cancer.
c. pregnancy.
d. heart failure.

Answer 9

b. cancer.

Question 10

Which of the following buffer pairs is considered the major plasma buffering system?

a. NaCl/KPO4
b. HCO3-/H2CO3
c. HPO4/H2PO4
d. NH3/NH4

Answer 10

b. HCO3-/H2CO3

Question 11

A 19-year-old female with type 1 diabetes mellitus was admitted to hospital with the following lab values: serum glucose 18 mmol/L (high); serum K+ 2 mmol/L (low); serum Na+ 130 mmol/L (low). Her parents state that she has been sick with the ‘flu’ for a week. What relationship do these values have with her insulin deficiency?

a. increased glucose utilisation causes the shift of fluid from the intravascular to the intracellular space
b. decreased insulin causes hyperglycaemia and osmotic diuresis
c. increased glucose and fatty acid metabolism stimulates renal diuresis and electrolyte loss
d. increased insulin use results in protein catabolism, tissue wasting and electrolyte loss

Answer 11

b. decreased insulin causes hyperglycaemia and osmotic diuresis

Question 12

Oedema is due to excess fluid in the:

a. intracellular fluid compartment.
b. interstitial fluid compartment.
c. intravascular fluid compartment.

Answer 12

b. interstitial fluid compartment.

Question 13

A 50-year-old male patient presents with polyuria and extreme thirst. He was given exogenous antidiuretic hormone. For which of the following would this treatment be effective?

a. central/neurogenic diabetes insipidus
b. psychogenic diabetes insipidus
c. nephrogenic diabetes insipidus
d. syndrome of inappropriate antidiuretic hormone

Answer 13

a. central/neurogenic diabetes insipidus

Question 14

Endocrine hypofunction can be associated with hormone hyposecretion due to:

a. autoimmune destruction of endocrine tissue.
b. ischaemic damage to endocrine tissue.
c. defective hormone synthesis due to dietary deficiency.
d. all the above.

Answer 14

d. all the above.

Question 15

A 35-year-old female took corticosteroid therapy for several months. Which of the following is most likely to result from this therapy?

a. renal toxicity
b. episodes of hypoglycaemia
c. increased bone density
d. type 2 diabetes mellitus

Answer 15

d. type 2 diabetes mellitus

Question 16

A 25-year-old female presents with burning urination. She was diagnosed with a urinary tract infection. Which of the following statements is NOT true concerning urinary tract infections?

a. once cystitis develops, pyelonephritis will certainly occur.
b. the patient may be asymptomatic.
c. organisms probably enter the bladder by way of the urethra.
d. they are usually caused by coliforms, especially Escherichia coli.

Answer 16

a. once cystitis develops, pyelonephritis will certainly occur.

Question 17

Common long-term complications of diabetes mellitus include all of the following, except:

a. retinopathy.
b. peripheral neuropathy.
c. nephropathy (kidney disease).
d. respiratory distress.

Answer 17

d. respiratory distress.

Question 18

A patient has a plasma sodium level of 130 mmol/L. What is this condition called?

a. hypernatraemia
b. hyponatraemia
c. hyperkalaemia
d. hypokalaemia

Answer 18

b. hyponatraemia

Question 19

A 42-year-old male is involved in a motor vehicle accident during which he loses a lot of blood. He develops acute kidney injury caused by:

a. kidney stones.
b. immune complex deposition in the glomerulus.
c. inadequate renal blood flow.
d. obstruction of the proximal tubule.

Answer 19

c. inadequate renal blood flow.

Question 20

One cause of metabolic alkalosis is:

a. retention of metabolic acids.
b. excessive diarrhoea.
c. excessive vomiting.
d. hyperventilation.

Answer 20

c. excessive vomiting.

Question 21

Management of diabetes mellitus involves measuring glycated (glycosylated) haemoglobin (haemoglobin A1c) levels. The purpose of this test is to:

a. measure fasting glucose levels.
b. monitor long-term serum glucose control.
c. detect acute complications of diabetes.
d. check for hyperlipidaemia.

Answer 21

b. monitor long-term serum glucose control.

Question 22

Which of the following patients is considered hyperkalaemic?

a. a patient with a plasma potassium level of 155 mmol/L
b. a patient with a plasma sodium level of 155 mmol/L
c. a patient with a plasma potassium level of 2.5 mmol/L
d. a patient with a plasma sodium level of 2.5 mmol/L

Answer 22

a. a patient with a plasma potassium level of 155 mmol/L

Question 23

A 28-year-old female presents with fever, chills and flank pain. She is diagnosed with pyelonephritis. Her infection is located in the:

a. bladder.
b. renal pelvis.
c. ureters
d. lower intestines.

Answer 23

b. renal pelvis.

Question 24

Causes of acute renal injury include:

a. cholecystitis.
b. stones and strictures to kidneys or ureters.
c. heart failure leading to poor renal perfusion.
d. a., b. and c are correct.

Answer 24

d. a., b. and c are correct.

Question 25

The blood pH is maintained near 7.4 by buffering systems. The sequence from the fastest acting to the slowest acting buffering system is:

a. lungs, kidneys, blood buffers.
b. blood buffers, lungs, kidneys.
c. blood buffers, kidneys, lungs.
d. lungs, blood buffers, kidneys.

Answer 25

b. blood buffers, lungs, kidneys.

Question 26

A 35-year-old female with Graves’ disease is admitted to a medical-surgical unit. Laboratory tests would most likely reveal:

a. high levels of circulating thyroid-stimulating autoantibodies.
b. ectopic secretion of thyroid-stimulating hormone (TSH).
c. low circulating levels of thyroid hormones.
d. stimulation of thyroid-binding globulin.

Answer 26

a. high levels of circulating thyroid-stimulating autoantibodies.

Question 27

Your neighbor, not previously diagnosed as a diabetic, has gained 30 kg in the past year and can produce some insulin. Her fasting blood glucose is always elevated. She is being treated with drugs that promote the release of insulin from the pancreas. Your neighbor is most likely suffering from:

a. diabetes insipidus
b. type 1 diabetes mellitus.
c. type 2 diabetes mellitus.
d. Cushing’s disease.

Answer 27

c. type 2 diabetes mellitus.

Question 28

A 60-year-old female is diagnosed with mild hyperkalaemia. Which of the following would be expected?

a. weak pulse
b. excessive thirst
c. diarrhoea
d. constipation

Answer 28

c. diarrhoea

Question 29

A 4-year-old male is diagnosed with nephrotic syndrome. Which of the following accompanies this condition?

a. proteinuria
b. decreased BUN
c. haematuria
d. sodium loss

Answer 29

a. proteinuria

Question 30

A 22-year-old male is admitted to the intensive care unit with a closed head injury sustained in a motorcycle accident. The injury has caused severe damage to the posterior pituitary gland. Which of the following complications should be anticipated?

a. dilutional hyponatraemia
b. dehydration from polyuria
c. cardiac arrest from hyperkalaemia
d. metabolic acidosis

Answer 30

b. dehydration from polyuria

Question 31

A 25-year-old male has a severe kidney obstruction leading to removal of the affected kidney. Which of the following would be expected to occur?

a. atrophy of the remaining kidney
b. compensatory hypertrophy of the remaining kidney
c. dysplasia in the remaining kidney
d. renal failure

Answer 31

b. compensatory hypertrophy of the remaining kidney

Question 32

Chronic compensation for respiratory alkalosis includes:

a. increased renal excretion of H+.
b. decreased renal reabsorption of HCO3-.
c. prolonged exhalations to blow off CO2.
d. protein buffering.

Answer 32

b. decreased renal reabsorption of HCO3-.

Question 33

The goal of treatment for diabetes mellitus is:

a. hyoplglycaemia
b. euglycaemia
c. hyperglycaemia
d. anaemia

Answer 33

b. euglycaemia

Question 34

Insulin resistance is defined as:

a. An effective response to insulin at the target cells.
b. An ineffective response to insulin at the target cells.
c. An ineffective response to insulin in the blood stream.
d. Increased insulin sensitivity.

Answer 34

b. An ineffective response to insulin at the target cells.

Question 35

Water balance is closely related to ________ balance.

a. potassium
b. chloride
c. bicarbonate
d. sodium

Answer 35

d. sodium

Question 36

A 10-year-old male was brought into the emergency room comatose, suffering from metabolic acidosis with a blood glucose level of 23 mmol/L (high). The most probable disease causing his condition is:

a. cretinism
b. type 1 diabetes mellitus
c. type 2 diabetes mellitus
d. Cushing’s disease

Answer 36

b. type 1 diabetes mellitus

Question 37

The level of triiodothyronine (T3) in Graves’ disease is usually abnormally:

a. low.
b. high.
c. variable.
d. absent.

Answer 37

b. high.

Question 38

A 54-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following electrolyte imbalances would be expected in this patient?

a. hyponatraemia
b. hyperkalaemia
c. hypernatraemia
d. hypercalcaemia

Answer 38

a. hyponatraemia

Question 39

Clinical manifestations of diabetes insipidus include:

a. polyuria and intense thirst.
b. concentrated urine and hypertension.
c. pitting oedema and dyspnoea.
d. low plasma osmolality and vomiting.

Answer 39

a. polyuria and intense thirst.

Question 40

Risk factors for developing type 2 diabetes do not include:

a. family history.
b. obesity
c. increased BMI
d. gender

Answer 40

d. gender

Question 41

The most common cause of primary hyperaldosteronism (Conn’s syndrome) is:

a. pituitary failure.
b. benign adrenal adenoma.
c. excessive salt ingestion.
d. chronic hypertension.

Answer 41

b. benign adrenal adenoma.

Question 42

Diagnostic testing of a patient with hyperaldosteronism, Conn’s syndrome, would reveal:

a. hypernatraemia and hypertension.
b. hyperkalaemia and hypertension.
c. hyponatraemia and hypotension.
d. hypokalaemia and hypotension.

Answer 42

a. hypernatraemia and hypertension.

Question 43

Characteristic physical features of individuals with Cushing’s syndrome include:

a. weight loss and muscle wasting.
b. truncal obesity and thin skin.
c. pallor and tachycardia.
d. depigmented skin and eyelid lag.

Answer 43

b. truncal obesity and thin skin.

Question 44

When the adrenal gland does not produce cortisol even though levels of adrenocorticotrophic hormone (ACTH) are normal or high, this would be an example of:

a. primary hypersecretion.
b. primary hyposecretion.
c. secondary hyposecretion.
d. tertiary hyposecretion.

Answer 44

b. primary hyposecretion.

Question 45

An individual with type 1 diabetes mellitus experiences hunger, lightheadedness, headache, confusion, and tachycardia while cross-country running. The likely cause of these manifestations are:

a. hyperglcaemia.
b. eating a snack before running.
c. hypoglycaemia because of running.
d. Both a and b are correct.

Answer 45

c. hypoglycaemia because of running.

Question 46

Common clinical manifestations of diabetes mellitus include all of the following except:

a. hyperglycaemia.
b. increased muscle anabolism.
c. persistent infection.
d. polyuria.

Answer 46

b. increased muscle anabolism.

Question 47

The most common cause of elevated levels of antidiuretic hormone (ADH) secretion is:

a. autoimmune disease.
b. cancer.
c. pregnancy.
d. heart failure.

Answer 47

b. cancer.

Question 48

Inadequate levels of thyroid hormones at birth may cause:

a. mental retardation.
b. acromegaly.
c. thyroid crisis.
d. Laron-type dwarfism.

Answer 48

a. mental retardation.

Question 49

A 62-year-old male suspected of having type 2 diabetes is most likely to present with:

a. cachexia and hypoglycaemia
b. hypoglycaemia and hyperlipidaemia
c. obesity and hyperlipidaemia
d. obesity and hypolipidaemia

Answer 49

c. obesity and hyperlipidaemia

Question 50

The following can be associated with development of a goiter except:

a. dietary deficiency of iodine.
b. goitrogen ingestion.
c. hypersecretion of thyroid-stimulating hormone.
d. normal size thyroid.

Answer 50

d. normal size thyroid.

Question 51

A side effect of some general anesthetic agents that damage the renal tubules is ___________ diabetes insipidus.

a. central/neurogenic
b. nephrogenic
c. psychogenic
d. allogenic

Answer 51

b. nephrogenic

Question 52

Antibodies that bind to specific hormone receptors can induce hyper-responsiveness by mimicking the binding of a specific tropic hormone.

True
False

Answer 52

True