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Internal Medicine Test 3 > quiz/assignment questions > Flashcards

quiz/assignment questions Flashcards

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

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

A

adipose tissue

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3
Q

In response to the hypothalamus, the posterior pituitary secretes

A

oxytocin and ADH

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4
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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5
Q

The primary hormones produced by the thyroid are

A

thyroxine, triiodothyronine, and calcitonin

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6
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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7
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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8
Q

Myxedema is the clinical manifestation of

A

hypothyroidism

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9
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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10
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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11
Q

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

A

Cushing Syndrome

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12
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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13
Q

Which of the following is the characteristic of hypoparathyroidism?

A

Decreased bone resorption

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14
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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15
Q

What is the hallmark of Addison disease?

A

Decreased serum cortisol levels

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16
Q

which of the following is the characteristic of hyperparathyroidism

A

increased bone resorption

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17
Q

what can the medical diagnosis and symptoms of this patient with an enlarged neck area

A

Goiter: an enlargement of the thyroid gland

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18
Q

In response to the hypothalamus, the anterior pituitary secretes

a. adrenocorticotropic hormone
b. epinephrine
c. thyroxine (T4) and triiodothyronine (T3)
d. mineralocorticoids

A

a. adrenocorticotropic hormone

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19
Q

this patient presents the signs and symptoms of Myxedema, what can be her medical diagnosis

A

hypothyroidism

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20
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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21
Q

which of the following can be a cause for cushing’s disease

a. an excess of corticosteroid medication
b. an adrenal lesion results in hypersecretion of aldosterone
c. excessive circulating of parathyroid hormone
d. calcium pyrophosphate dihydrate (CPPD) crystal deposition

A

a. an excess of corticosteroid medication

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22
Q

what is TRUE for cortisol?

a. it is secreted from the posterior lobe of the pituitary
b. it is essential to norepinephrine-induced vasoconstriction and other physiologic phenomena necessary for survival under stress
c. it is essential for calcium and phosphorus metabolism and calcification of bone
d. it induces inflammation response

A

b. it is essential to norepinephrine-induced vasoconstriction and other physiologic phenomena necessary for survival under stress

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23
Q

what is the hallmark of addison disease

A

decreased serum cortisol levels

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24
Q

which of the following lab tests is relevant to diagnose hyperthyroidism

A

thyroid-stimulating hormone

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25
Q

flexor tenosynovitis with stiffness can accompany carpal tunnel syndrome in persons with ….

A

hypothyroidism

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26
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

which of the following 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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28
Q

which of the following is true

a. hyposecretion of human growth hormone results in dwarfism
b. hypersecretion of human growth hormone causes gigantism in children
c. hypersecretion of human growth hormone causes acromegaly in adults
d. all of the above

A

d. all of the above

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29
Q

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

A

bradycardia, decreased GI tract motility, and slowed neurologic functioning

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30
Q

which of the following occurs when an adrenal lesion results in hypersecretion of aldosterone, the most powerful of the mineralocorticoids

A

conn syndrome

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31
Q

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

a. Impaired cognitive function

b. Infection

c. Balance and gait abnormalities

d. All the above

A

all the above

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32
Q

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

A

Tachycardia and shallow respirations

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33
Q

What is TRUE about insulin resistance?

a. Commonly being seen in people with type 1 diabetes

b. Insulin binds to glucose transporter (GLUT4) in the pancreatic beta cell

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

d. Glucose is stored in the liver instead of skeletal muscles.

A

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

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34
Q

Which of the following is TRUE in a person with hyperglycemia?

a. High Ketones

b. Labile, irritable, nervous, weepy mood

c. Normal urine output

d. Tremors

A

a. High Ketone

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35
Q

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

A

< 7.0%

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36
Q

Which of the following is TRUE on diabetes?

a. Most people with diabetes are type 1

b. The onset of type 2 diabetes is normally abrupt

c. Only children will develop type 1 diabetes

d. Type 2 diabetes can develop at any age

A

d. Type 2 diabetes can develop at any age

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37
Q

Which of the following decreases blood glucose levels?

a. Glucagon released by alpha cells in the islet of Langerhans

b. Insulin released by beta cells in the islet of Langerhans

c. ACTH released by the anterior pituitary gland.

d. Epinephrine released by the medulla of the adrenal gland.

A

b. Insulin released by beta cells in the islet of Langerhans

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38
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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39
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/m^2

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40
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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41
Q

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

A

95th

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42
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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43
Q

Which of the following is precipitating causes of diabetic ketoacidosis?

A

trauma
medications
pregnancy

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44
Q

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

A

1 in every 10 people

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45
Q

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

A

polyuria
polydipsia

46
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

47
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

48
Q

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

A

white fat

49
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

50
Q

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

A

retinopathy

51
Q

what is true about insulin resistance

A

commonly being seen in people with type 2 diabetes

52
Q

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

a. numbness of the limbs
b. low blood pressure
c. decreased appetite
d. all of the above

A

a. numbness of the limbs

53
Q

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

a. high ketones
b. deep and rapid respirations
c. convulsion/coma
d. all the above

A

c. convulsion/coma

54
Q

what is the A1C recommendation for non-pregnant adults with diabetes

A

less than 7.0%

55
Q

fat accumulated in the lower body (subcutaneous fat) results in a ____ figure, whereas fat in the abdominal area (visceral fat) produces more of an _____

A

pear-shape
apple-shape

56
Q

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

A

bariatrics

57
Q

which of the following cells produce insulin in the pancreas

A

beta cells

58
Q

prediabetes is diagnosed in people with a fasting plasma glucose greater than or equal to ____ but less than or equal to ____

A

100 mg/dL
125 mg/dL

59
Q

how to manage diabetes?

A

work with a health professional
eat healthy
stay active
(all of the above)

60
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

61
Q

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

A

the opium poppy

62
Q

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

A

endogenous opioids (endorphins, enkephalins)

63
Q

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

A

Mu opioid receptor

64
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 have fewer addictive qualities than strong opioids such as morphine
b. may produce more psychotropic effects (hallucinations, vivid dreams) than other opioids
c. may produce adequate analgesia with less risk of side effects such as respiratory depression
d. are known as mixed agonist-antagonists
e. all of the above

A

e. all of the above

65
Q

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

A

treat opioid overdose

66
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

67
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.

68
Q

When used to treat pain, opioids can be administered by all the following routes EXCEPT
a. intrathecally
b. transdermally
c. inhalation
d. intravenously

A

inhalation

69
Q

In addition to their use as analgesics, opioid drugs can also be administered
a. as a general anesthetic
b. as a cough suppressant
c. as a preoperative medication
d. to treat severe diarrhea
e. all the above are true

A

e. all the above are true

70
Q

Which of the following side effects is NOT associated with opioid drugs?
a. mood changes (euphoria)
b. orthostatic hypotension
c. increased respiration
d. sedation
e. constipation

A

c. increase respiration

71
Q

Certain patients can develop “tolerance” to opioid analgesics, which is indicated by
a. the fact that the patient may still crave the drug several years after he/she has ceased taking it
b. the onset of withdrawal symptoms if the drug is suddenly discontinued
c. the need to progressively increase the dosage of the drug to achieve a therapeutic effect when the drug is used for prolonged periods
d. all the above are true

A

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

72
Q

Methadone is often used to treat opioid addiction because methadone

A

has mild withdrawal symptoms

73
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

74
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

75
Q

NSAIDs such as aspirin exhibit all of the following effects EXCEPT
a. the ability to relieve mild-to-moderate pain (analgesia)
b. the ability to decrease the elevated body temperature associated with fever (antipyresis)
c. the ability to decrease inflammation
d. the ability to increase bronchodilation in conditions such as asthma
e. the ability to decrease blood clotting by inhibiting platelet aggregation (anticoagulation)

A

d. the ability to increase bronchodilation in conditions such as asthma

76
Q

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

A

prostaglandins

77
Q

Prostaglandins are

A

a group of lipid-like compounds that exhibit a wide range of physiological activities

78
Q

NSAIDs exert their therapeutic effects by _____ the ______ enzyme.

A

inhibiting; cyclooxygenase

79
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

80
Q

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

A

colorectal cancer, heart attacks, and ischemic strokes

81
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

82
Q

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

A

should not; Reye syndrome

83
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

84
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

85
Q

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

A

Drugs that mimic prostaglandins (PGs) such as PGE1

Histamine type 2 (H2) blockers such as cimetidine (Tagamet) and ranitidine (Zantac)

Gastric proton pump inhibitors (PPIs) such as omeprazole (Prilosec) and esomeprazole (Nexium)

86
Q

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

A

Hyperglycemia

87
Q

The lower GI tract includes the

A

small and large intestines

88
Q

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

A

nausea

89
Q

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

A

Abdominal cramping

90
Q

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

A

hyperthyroidism

91
Q

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

A

diuretics and opioids

92
Q

What drugs are the most common causes of reactive gastritis?

A

Aspirin and NSAIDs

93
Q

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

A

achalasia

94
Q

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

a. A laparoscopic procedure
b. Perforation of the viscus
c. Liver cancer
d. Ruptured spleen

A

liver cancer

95
Q

What type of hiatal hernia is the most common?

A

sliding

96
Q

What types of exercise would increase intraabdominal pressure?

A

bending over
lifting
straining

97
Q

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

A

heartburn or reflux

98
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

99
Q

What is the common cause of gastroesophageal reflux disease?

A

Peppermint, fatty foods, citrus products (including tomatoes), spicy foods, garlic, onions

Carbonated drinks, alcohol and coffee

Nicotine or cigarette smoke

100
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)

101
Q

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

A

heartburn

102
Q

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

A

penetration

103
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

104
Q

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

A

rectum and left colon

105
Q

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

A

arthritis

106
Q

What is the primary indication or desired effect of Omeprazole?

A

to treat gastric ulcers

107
Q

Which of the following is Bisphosphonates that can treat osteoporosis?

a. Chlorpropamide
b. Alendronate
c. Lansoprazole
d. Cimetidine

A

b. Alendronate

108
Q

what is the common cause of gastroesophageal reflux disease

A

cns depressants
scleroderma
estrogen therapy
(all of the above)

109
Q

which of the following is the most common causes of constipation?

a. proton pump inhibitors
b. antibiotics
c. hydrocodone
d. laxative abuse

A

c. hydrocodone

110
Q

what is the primary indication of proton pump inhibitors?

A

gastric ulcers

111
Q

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

A

antibiotics

Internal Medicine Test 3 (5 decks)

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