Quiz#9 endocrine Flashcards
What pathology causes diabetes mellitus type 1 to develop?
inadequate digestion of dietary nutrients
daily consumption of sweets
pancratic amylase deficiency
pancreatic insulin deficiency
pancreatic insulin deficiency
T1DM (Type 1 Diabetes Mellitus) is caused by deficient insulin resulting from T-cell-mediated autoimmune destruction of the insulin-secreting beta cells of the pancreas.
What are three common physical signs of new-onset type 1 diabetes mellitus?
diaphoresis, diarrhea and intense thirst
increased thirst, increased hunger and increased urine output
anorexia, fatigue and chest pain
weight gain, forgetfulness and hair loss
increased thirst, increased hunger and increased urine output
, Initial symptoms of T1DM include the classic triad (three “Ps”): polydipsis (constant thirst), polyuria (excessive urination), and polyphagia (increased appetite)
What symptom would cause the ER nurse to suspect diabetic ketoacidosis?
weight gain of 5 pounds in one week
confusion with slow, shallow breathing
palpitations and profound diaphoresis
fruity breath with rapid, deep respirations
fruity breath with rapid, deep respirations.
The individual with uncontrolled diabetes can develop ketonemia (ketones in the blood), ketonuria (ketones in the urine), ketone breath, and ketone body odor, which can be identified as a fruity odor.” When ketones are high, the person can become acidotic, and develop DKA (Diabetic ketoacidosis). “The characteristic rapid, deep respirations exhibited by the patient in DKA are called ‘Kussmaul’s respirations’.
The major risk factor for NIDDM (Type 2 DM) is:
Gender.
Age:
Obesity
Occupation
Obesity
The risk of developing this form of diabetes increases with age, obesity, and lack of physical activity.” “Clinical Concept: Obesity is a major contributing factor to the development of T2DM. Fat cells are particularly resistant to insulin; the greater the adiposity of an individual, the greater the insulin resistance.
What effect will growth hormone deficit have in a child?
Correct answer:
short stature or dwarfism
distorted and twisted joints
cretinism
acromegaly
Short stature or dwarfism
Correct! “Growth hormone stimulates the growth plates of long bones”, so if there is a deficit (shortage) of growth hormone, the child will not grow properly. This can result in short stature or dwarfism. Overproduction of growth hormone in children, in addition to other endocrine problems, can lead to gigantism, where the individual may grow to 7 feet or more.
If excessive thyroid is consistently present, what symptoms will be seen?
flat facial features and protuberant abdomen
myxedema and uncordinated movements:
exopthalmos and rapid heart rate
cold intolerance and significant hair loss
exopthalmos and rapid heart rate
The effects of release of too much thyroid hormone, or hyperthyroidism, will cause accelerated metabolic activities, including nervousness, insomnia, rapid heart rate, weight loss, and in Graves’ disease, esophthalmos (a wide-eyed stare caused by increased sympathetic tone
Excessive amounts of ADH in circulation will result in what fluid balance changes?
marked dehydration with weight loss
production of profuse amounts of very dilute clear urine
hyponatremia due to sodium loss in the kidney:
small amounts of very concentrated urine-
small amounts of very concentrated urine-
Correct! ADH is Anti-diuretic hormone. This tells the kidneys to hold onto water/fluid! “ADH stimulates reabsorption of water at the collecting duct of the nephron” (Pg. 573). Since the kidneys are keeping water, rather than releasing it in the urine, the urine becomes dark, very concentrated, and minimal in amount. This happens when the water is needed in the body, often because the blood pressure or blood volume is low and the body needs additional fluid. ADH helps the body conserve the fluid that is needed.
What is the characteristic appearance of a patient with excess glucocorticoids (Cushings syndrome)?
obese belly with thick bowed legs
edematous legs with thin torso:
round obese trunk with thin extremities
full round face with slanted eyes
round obese trunk with thin extremities
Cushing’s syndrome, also called hyperadrenalism or hypercortisolism, is an endocrine disorder caused by high levels of cortisol in the blood.” (Capriotti, 2nd ed., Pg. 581) Physical characteristics include weight gain with a redistribution of body fat to the face, trunk, and abdomen, puffy face (“moon face”), “buffalo hump”, abdominal stretch marks (striae), easy bruising, poor wound healing, hirsutism in women (male-pattern hair growth
What happens during a myxedema crisis? (Select all that apply)
Incorrect answer:
severe hypothyroidism
hypoventilation
fever
increased blood sugar
hypotension
severe hypothyroidism
hypoventilation
hypotension
Hypothyroidism causes “a decrease in the body’s various metabolic activities”, including alterations in pulmonary (lung) function, reduced kidney function, etc. (See Figure 24-5 on page 575.) “ALERT! When hypothyroidism is untreated, it can progress to myxedema coma, a serious illness with a high mortality rate. There are severe hypothyroid symptoms, as well as susceptibility to SIADH, hypoglycemia, and hyponatremia. If left untreated the symptoms will progress to confusion and coma.
Your adult patient presents with elevated levels of growth hormone. What assessment finding will you find in this patient?
impaired cognition:
acromegaly
weight loss
very tall stature
Acromegaly
In adults, excessive GH (Growth Hormone) stimulates a gradual growth of certain bones such as the jaw, hands, and feet, a condition called acromegaly.”
