Chapter 20 - Alterations of Hormonal Regulation (Patho)
Which alteration would be expected in an individual who has untreated Cushing syndrome?
Truncal obesity Truncal obesity due to central fat deposition is a common physical manifestation of untreated Cushing syndrome.
Which hormone deficiency causes serum hyperosmolarity?
Antidiuretic hormone Deficiency in antidiuretic hormone levels lead to serum hyperosmolarity due to fluid and electrolyte imbalance
Which type of oral hypoglycemic drug is the drug of choice for type 2 diabetes?
Biguanide Biguanide (metformin) decreases hepatic glucose production and is currently the drug of choice for type 2 diabetes
Which piece of equipment would be used to assess an individual with pheochromocytoma?
Blood pressure cuff Pheochromocytoma can cause high blood pressure
Which assessment finding would be expected in a woman diagnosed with prolactinoma?
Galactorrhea Women with hyperprolactinemia from a prolactinoma generally present with galactorrhea (nonpuerperal milk production) and menstrual disturbance including amenorrhea
Which factors may cause endocrine abnormalities?
Gland dysfunction, faulty feedback system, altered metabolism of the hormones, and hormone production by nonendocrine tissues Elevated or depressed hormone levels result from (1) faulty feedback systems, (2) dysfunction of a gland or glands, (3) altered metabolism of hormones, or (4) production of hormones from nonendocrine tissues
Which diagnostic test is used to diagnose diabetes mellitus?
Glycosylated hemoglobin (HbA 1C) The diagnosis of diabetes mellitus is based on glycoslyated hemoglobin (HbA 1C) levels and reflects the average plasma glucose exposure over the life of a red blood cell (approximately 120 days).
Which diseases causes primary hyperthyroidism?
Graves disease, Solitary toxic adenoma, and Toxic multinodular goiter Graves disease, solitary toxic adenoma, and toxic multinodular goiter are the most common diseases that impair the function of the thyroid gland
Which condition may develop due to genetic risk factors?
Hashimoto disease Hashimoto disease is also called autoimmune thyroiditis. It results in the gradual destruction of thyroid tissue by infiltration of lymphocytes and circulating thyroid autoantibodies, and it has several genetic risk factors
Which adrenal medulla disorder would be suspected in an individual with tachycardia, diaphoresis, headache, and elevated excessive circulating catecholamines?
Pheochromocytoma A pheochromoyctoma is a catecholamine-secreting tumor that is usually located in the adrenal medulla and presents with headache, tachycardia, and diaphoresis that result from effects of the massive circulating catecholamine levels on the sympathetic nervous system
Which individual is most likely to develop hyperosmolar hyperglycemic nonketotic syndrome (HHKNS)?
older adult with type 2 diabetes mellitus and renal disease HHNKS is an uncommon but significant complication of type 2 diabetes mellitus, with a high overall mortality
Which statement describes insulin shock?
"Blood sugar is low"
Which statement indicates an understanding of the defects causing diabetes mellitus?
"Diabetes results due to a defect in insulin secretion or action" Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diabetes is a metabolic disorder affecting metabolism of fat, protein, and carbohydrates. Glycogen is the stored form of glucose.
Which statement is true regarding neurogenic diabetes insipidus?
"It results from low levels of antidiuretic hormone (ADH)." The neurogenic form is caused by low levels of ADH and occurs when a lesion of the hypothalamus, pituitary stalk, or posterior pituitary interferes with ADH synthesis, transport, or release
Which statement is correct regarding pituitary adenomas?
"Pituitary adenomas are usually microscopic" Most pituitary adenomas are microscopic. They arise from the anterior pituitary, are bening, and are usually slow growing in nature.
Which statement describes the cause of the development of neurologic symptoms in an individual with syndrome of inappropriate antidiuretic hormone (SIADH)
"This state results from decreased plasma sodium concentration" Antidiuretic hormone secretion in SIADH causes hyponatremia and decreased plasma osmolality, with cell swelling in the brain, causing neurologic symptoms
Which client would be screened on a regular basis for type 2 diabetes mellitus?
A 12-year-old who has been diagnosed with metabolic syndrome The 12-year old is at risk for developing diabetes mellitus. Metabolic syndrome develops during childhood, and individuals with this syndrome should be screened on a regular basis for diabetes mellitus
Which individual would be closely monitored for the development of diabetic ketoacidosis?
A client with a type 1 diabetes with an infection A client with type 1 diabetes with an infection is the most predisposed to develop diabetic ketoacidosis. A client with type 2 diabetes with an infection is predisposed to hyperglycemic nonketotic syndrome, not diabetic ketoacidosis. A client with type 2 or type 1 diabetes with excessive physical exercise may experience hypoglycemia, not ketoacidosis.
The identification of which manifestation indicates correct understanding of the cause for acromegaly in adults and giantism in children?
Adenoma in the pituitary gland Growth hormone excess is nearly always caused by a growth-hormone-secreting pituitary adenoma
Which treatment would be appropriate for an individual with hypoparathyroidism?
Administration of calcium Treatment of hypoparathyroidism is directed toward alleviation of the hypocalcemia
In which population is acromegaly found?
Adults Acromegaly occurs in adults, usually in the age group of 40 to 59 years. Infants, children, and adolescents are too young
Which individual is most predisposed to hypoparathyroidism?
An individual returning from thyroid surgery Hypoparathyroidism (abnormally low parathyroid hormone levels) is most commonly caused by damage to the parathyroid glands during thyroid surgery
Which individual would be treated with an oral hypoglycemic agent?
An individual with type 2 diabetes Oral hypoglycemic agents are useful in many individuals with type 2 diabetes
Which type of immunity is responsible destruction of beta cells in an individual with type 1 diabetes mellitus?
Autoimmunity Two distinct types of type 1 diabetes have been identified: autoimmune and nonimmune. Autoimmune diabetes is a T cell-mediated disease that destroys beta cells of the pancreas. Destruction of beta cells is not related to innate or passive immunity. There is no such term as inflammatory immunity; rather, it is the inflammatory response
Which type of diabetes insipidus (DI) results from damage to the posterior pituitary caused by a cerebrovascular accident (stroke)?
Central When DI develops from injury to the central nervous system (CNS), it is called neurogenic or central DI
Which medication is used to treat a patient who has incomplete antidiuretic hormone deficiency (ADH)?
Clofibrate Clofibrate potentiates the action of endogenous antidiuretic hormone and alleviates the symptoms associated with insufficient antidiuretic hormone levels, so it is useful in treating patients with incomplete ADH
Which term would be used to describe an individual who has clinical manifestations resulting from chronic exposure to hypercortisolism, regardless of the cause?
Cushing syndrome Cushing syndrome refers to the clinical manifestations resulting from chronic exposure to excess cortisol (hypercortisolism). Cushing syndrome is used to describe the clinical features of hypercortisolism, not a specific cause
Which statement indicates an understanding regarding the cause of Cushing syndrome?
Cushing syndrome is caused by the excessive production of cortisol
Which finding is associated with diabetic neuropathy?
Decreased peripheral sensation Sensory deficits such as loss of pain sensation are common with diabetic neuropathy
Which clinical manifestation is associated with Graves disease?
Double vision Graves disease is an autoimmune disease that can cause goiter (diffuse thyroid enlargement) and ohthalmopathy, which may lead to double vision (diplopia)
Which manifestations are signs and symptoms of syndrome of inappropriate antidiuretic hormone (SIADH)?
Dyspnea, Anorexia, and dulled sensorium An individual with SIADH has dyspnea, anorexia, dulled sensorium, impaired taste, and fatigue
Which pathologic change is associated with stage III diabetic retinopathy>
Fibrous tissue formation within the retina During stage III of diabetic retinopathy, fibrous tissue is formed within the retina or optic disc
Which are the signs of diabetic ketoacidosis?
Fruity breath and Kussmaul respirations A patient with diabetic ketoacidosis has fruity breath and Kussmaul respirations due to elevated blood glucose levels and reduced insulin production
Which finding is typical in an individual with syndrome of inappropriate antidiuretic hormone (SIADH) secretions?
Hyponatremia SIADH leads to hyponatremia when free water is inappropriately retained and dilutes the serum to a sodium concentration below the normal range
Which clinical manifestation would be expected in an individual diagnosed with myxedema coma?
Hypothermia Myxedema coma is a medical emergency with signs and symptoms including hypothermia without shivering, hypoventilation, hypotension, hypoglycemia, and lactic acidosis Myxedema coma is severe hypothyroidism
Which process contributes to polyuria in an individual with diabetes mellitus?
Increased glucose in the urine When the blood glucose concentration is high, the presence of glucose in the renal tubular fluid draws water into the tubules, causing an osmotic diuresis that is seen clinically as polyuria
Which manifestations are indicative of diabetes mellitus?
Increased thirst, increased hunger, and increased urine output Because of elevated blood glucose levels, water is osmotically attracted from body cells, resulting in intracellular dehydration and stimulation of thirst in the hypothalamus (polydipsia)
Which finding indicates that an individual with hypoparathyroidism is experiencing tetany?
Laryngeal spasm In hypoparathyroidism, hypocalcemia creates tetany, a condition characterized by muscle spams, hyperreflexia, clonic-tonic convulsions, laryngeal spasms, and in severe cases, death by asphyxiation
Which disorder occurs due to amyloidosis?
Nephrogenic diabetes insipidus? Amyloidosis results in impaired renal function and nephrogenic diabetes insipidus
Which finding would indicate that an individual with diabetes has a microvascular complication?
Nonproliferative retinopathy Nonproliferative retinopathy is a microvascular complication of diabetes
Which individual would be at risk for developing secondary hyperparathyroidism?
One with end-stage chronic renal disease In end-stage chronic renal disease, persistent hypocalcemia causes secondary hyperparathyroidism by decreased renal activation of D
Which individual would be closely monitored for the development of myxedema coma?
One with untreated hypothyroidism Myxedema coma is caused by untreated hypothyroidism or occurs after overuse of narcotics/sedatives or an acute illness in hypothyroid individuals
Which condition includes visual changes and field impairments that often begin in one eye and progresses to the other?
Pituitary adenoma With a pituitary adenoma, visual changes include visual field impairments (often beginning in one eye and progressing to the other) and temporary blindness
Which manifestation are consistent with hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)?
Poor skin tugor, no or slight ketosis, severe dehydration, and neurologic changes Hyperosmolar hyperglycemic nonketotic syndrome is characterized by severe dehydration with poor skin turgor, severe hyperglycemia, no or slight ketosis, and a high mortality rate. Neurologic changes, such as stupor, are involved
Which signs would indicate an electrolyte imbalance in an individual with a malignant tumor that secretes parathyroid hormone?
Serum calcium, renal stones, and urine pH Excess parathyroid hormones causes hypercalcemia, which manifests as hypercalciuria, alkaline urine, and hypercalcemia, predisposing to kidney stones
Which diagnostic test result supports the diagnosis of diabetic ketoacidosis (DKA)?
Serum glucose level of 345 mg/dL A glucose level of 345 is above tha criteria of 250 mg/dL for diabetic ketoacidosis
Which laboratory test would be used to determine the presence of primary or secondary hypothyroidism?
Throid-stimulating hormone TSH levels are helpful in differentiating between primary (high TSH) and secondary (low TSH) causes of hypothyroidism
Which statement describes the purpose for obtaining a glycosylated hemoglobin (hemoglobin A 1C) level in an individual with diabetes?
To monitor long-term blood glucose control Hemoglobin A 1C levels provide a measure of glucose control during the life span of the red blood cells, which is about 120 days.