Chapter 32 Patho - Endocrine
One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisol-releasing hormone (CRH) and: GH. TSH. DHEA. ACTH.
ACTH.
The signs and symptoms of abrupt cessation of pharmacologic glucocorticoids closely resemble those of: Addison disease. Cushing disease. Cushing syndrome. Graves disease.
Addison disease.
Which of the following individuals is experiencing the effects of a primary endocrine disorder? A patient with adrenal cortical insufficiency due to pituitary hyposecretion of ACTH A patient who has hypothyroidism as a result of low TSH production A patient whose dysfunctional hypothalamus has resulted in endocrine imbalances A patient who has low calcium levels because of the loss of his parathyroid gland
A patient who has low calcium levels because of the loss of his parathyroid gland
Which of the following residents of a long-term facility is exhibiting signs and symptoms that are indicative of hypothyroidism? An 80-year-old woman who has uncharacteristically lost her appetite of late and often complains of feeling cold A 90-year-old woman with a history of atrial fibrillation whose arrhythmia has recently become more severe An 88-year-old man with a history of Alzheimer disease who has become increasingly agitated and is wandering more frequently A 91-year-old man with a chronic venous ulcer and a sacral ulcer who has developed sepsis
An 80-year-old woman who has uncharacteristically lost her appetite of late and often complains of feeling cold
Which of the following individuals displays the precursors to acromegaly? An adult with an excess of growth hormone due to an adenoma A girl who has been diagnosed with precocious puberty An adult who has a diagnosis of Cushing syndrome A patient who has recently developed primary adrenal carcinoma
An adult with an excess of growth hormone due to an adenoma
A 33-year-old patient has been admitted to the hospital for the treatment of Graves disease. Which of the following assessments should the patients care team prioritize? Assessment of the patients level of consciousness and neurologic status Assessment of the patients peripheral vascular system and assessing for thromboembolism Assessment of the patients vision and oculomotor function Cardiac monitoring and assessment of peripheral perfusion
Assessment of the patients vision and oculomotor function
Which of the following pathophysiologic phenomena may result in a diagnosis of Cushing disease? Hypopituitarism Excess ACTH production by a pituitary tumor Autoimmune destruction of the adrenal cortex Malfunction of the HPA system
Excess ACTH production by a pituitary tumor
Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of: Cushing syndrome. Graves disease. Addison disease. Cushing disease.
Graves disease.
Which of the following physiologic processes is a direct effect of the release of growth hormone by the anterior pituitary? Development of cartilage and bone Production of insulin-like growth factors (IGFs) by the liver Increase in overall metabolic rate and cardiovascular function Positive feedback of the hypothalamic-pituitary-thyroid feedback system
Production of insulin-like growth factors (IGFs) by the liver
A patient who has been taking 80 mg of prednisone, a glucocorticoid, each day has been warned by his primary care provider to carefully follow a plan for the gradual reduction of the dose rather than stopping the drug suddenly. What is the rationale for this directive? Sudden changes in glucocorticoid dosing may reverse the therapeutic effects of the drug. Stopping the drug suddenly may shock the HPA axis into overactivity. Sudden cessation of a glucocorticoid can result in adrenal gland necrosis. Stopping the drug suddenly may cause adrenal insufficiency.
Stopping the drug suddenly may cause adrenal insufficiency.
A patient has developed the facial appearance that is characteristic of myxedema, along with an enlarged tongue, bradycardia, and voice changes. Which of the following treatment modalities is most likely to benefit this patient? Synthetic preparations of T3 or T4 b-Adrenergic blocking drugs and antithyroid drugs Corticosteroid replacement therapy Oral or parenteral cortisol replacement
Synthetic preparations of T3 or T4
The most common cause of hypothyroidism is: goiter. myxedema. thyroidectomy. autoimmune thyroiditis.
autoimmune thyroiditis.
The major adrenal cortical hormones are steroids and are synthesized from acetate and: ACTH. albumin. amino acids. cholesterol.
cholesterol.
Thyroid hormone deficit ___________, which alters the function of all major organs in the body. decreases metabolism increases protein synthesis causes vitamin deficiencies enhances absorption of glucose
decreases metabolism
Primary adrenal insufficiency is manifested by: truncal obesity and edema. hypokalemia and hypervolemia. hyponatremia and hypoglycemia. hypopigmentation and hypertension.
hyponatremia and hypoglycemia.
A predominant effect of a prolonged excessive growth hormone level is: short stature with obesity. high androgen hormone levels. increased blood glucose levels. insulin-like growth factor (IGF) depletion.
increased blood glucose levels.
The immune suppressive and anti-inflammatory effects of cortisol cause: moderate insulin resistance. increased capillary permeability. increased cell-mediated immunity. inhibition of prostaglandin synthesis.
inhibition of prostaglandin synthesis.
The iatrogenic form of Cushing syndrome is caused by: long-term cortisone therapy. pituitary tumor-secreting ACTH. benign or malignant adrenal tumor. ectopic ACTH secreting lung tumor.
long-term cortisone therapy.
The most common cause of thyrotoxicosis is Graves disease, which has the distinguishing characteristic of _____ in addition to a diffuse goiter. muscle fatigue facial myxedema ophthalmopathy decreased cholesterol
ophthalmopathy
The major manifestations of Cushing syndrome include: excessive salt loss. muscle hypertrophy. overt diabetes mellitus. hair and weight loss.
overt diabetes mellitus.