APEA- Endocrine Patho

What percent of beta cells in the pancreas must be destroyed before hyperglycemia develops? 10 20 50 80

80

Hypofunction of the adrenal cortex that results in an inadequate release of glucocorticoids is: Sprue syndrome. Cushing syndrome. Addison's disease. hypoparathyroidism.

Addison's disease Addison's disease results from inadequate production of cortisol.

Which of the following hormones is NOT essential for normal body growth and maturation in children? Growth hormone Insulin Adrenalin Androgen

Adrenalin

Which one of the following is decreased in Addison's disease? Aldosterone Potassium Creatinine Calcium

Aldosterone

Which of the following is NOT a common secondary cause of Type 2 diabetes? Prolonged physical or emotional stress Pregnancy Use of hormonal contraceptives Autoimmune diseases

Autoimmune diseases There are 3 common secondary causes of Type II DM 1). prolonged physical or emotional stress that may cause elevation in levels of cortisol, epinephrine, glucagon, and ghrelin hormone. This increases blood glucose levels and increases demands on the pancreas. 2). Pregnancy causes weight gain and high levels of estrogen and placental hormones. 3). The use of adrenal corticosteroids, hormonal contraceptives, and other drugs that antagonize the effects of insulin can cause secondary diabetes.

Which one of the following is NOT a cause of short stature in children? Turner syndrome Growth hormone deficiency Hypothyroidism Early estrogen and androgen secretion

Early estrogen and androgen secretion usually causes tall stature in children

A 42-year-old woman complains of palpitations, anxiety and weight loss. Which two lab tests would be most helpful in diagnosing this patient? Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) Cortisol and ACTH levels Insulin-like growth factor and prolactin levels Free T3 and T4

Free T3 & T4 Thyrotoxicosis (hyperthyroidism) is hypermetabolic state caused by elevated circulating levels of free T3 & T4

The most common cause of hyperthyroidism is: Cushing syndrome. precocious puberty. Graves' disease. menopause.

Graves' disease

An autoimmune disorder characterized by abnormal stimulation of the thyroid gland by antibodies that act through normal TSH receptors is: celiac disease. Graves' disease. Multiple sclerosis. Sjogren's syndrome.

Graves' disease, one of the autoimmune thyroid diseases, is caused by the production of IgG autoantibodies directed against the thyrotropin receptor. These antibodies bind to and activate the receptor, causing the autonomous production of thyroid hormones.

Which one of the following is necessary for linear bone growth in children? Growth hormone Renin Testosterone Thyroid-Stimulating Hormone

Growth hormone

Which hormone is NOT one of the four types of trophic hormones released by the anterior pituitary gland? Follicle-stimulating hormone Luteinizing hormone Growth hormone Thyroid-stimulating hormone

Growth hormone Hypothalamus hormones stimulate the anterior pituitary gland to release trophic (gland-stimulating) hormones ACTH, THS, LH, & FSH are the 4 trophic hormones

The most common cause of hypothyroidism is: Hashimoto's thyroiditis. Graves' disease. thyroid storm. abnormal iodine metabolism.

Hashimoto's thyroiditis.

Which of the following laboratory findings are present after adrenal stimulation in a patient with early stage Addison's disease? Increased sodium levels Decreased potassium levels Increased cortisol levels Increased bicarbonate

Increased cortisol levels The early stages of Addison's disease are characterized by a rise in cortisol levels after adrenal stimulation with adrenocorticotropic hormone (ACTH). This is followed by a decrease in serum sodium, chloride, and bicarbonate.

As a result of prolonged exposure to high levels of cortisol, the patient with Cushing's syndrome is likely to develop: gynecomastia. moon facies. protruding eyes. fruity smell.

Moon facies

Which diagnosis is associated with T cell-mediated destruction of beta cells in the pancreas? Diabetes insipidus Type 1 diabetes mellitus Type 2 diabetes mellitus Gestational diabetes

Type 1 diabetes mellitus

The majority of patients with simple goiters are expected to have: elevated triiodothyronine (T3) levels. elevated thyroxine (T4) levels. a euthyroid state. a low level of serum thyroid stimulation hormone.

a euthyroid state

Type 1 diabetes mellitus is caused by: resistance to insulin action in target tissues. abnormal insulin secretion. beta cell destruction. inappropriate hepatic glycogenesis.

beta cell destruction

Symptoms of thyrotoxicosis include: hypotension. bradycardia. low cardiac output. cardiac arrythmia.

cardiac arrhythmia An increase in metabolism causes a rise in oxygen consumption and production of metabolic end products, with an accompanying increase in vasodilation.

The macrovascular disease that is the leading cause of death in patients with diabetes is: cardiovascular disease. cerebrovascular disease. diabetic nephropathy. peripheral vascular disease.

cardiovascular disease

The characteristic features of Graves disease do NOT include: hyperthyroidism. goiter. orbitopathy. constipation.

constipation

The complication associated with Type 1 and Type 2 diabetes that is a macrovascular complication is: coronary artery disease. neuropathy. nephropathy. retinopathy.

coronary artery disease

In addition to elevated blood glucose levels, the initial laboratory findings in a patient with diabetic ketoacidosis would include: elevated pH levels. decreased bicarbonate levels. decreased potassium levels. elevated glomerular filtration rate.

decreased bicarbonate levels

In addition to decreased plasma cortisol levels, the laboratory findings of a patient in adrenal crisis would include: increased serum sodium. decreased serum potassium. decreased serum sodium levels. decreased blood urea nitrogen levels.

decreased serum sodium levels Addison's disease causes decreased or absent aldosterone levels. Aldosterone is a mineralocorticoid. It regulates the reabsorption of sodium and the excretion of potassium by the kidneys. When aldosterone is absent or very low, sodium and water loss occur, and potassium is retained by the kidneys.

The disorder that is caused by a deficiency of antidiuretic hormone is known as: hypercalcemia. histiocytosis. Type 1 diabetes mellitus. diabetes insipidus.

diabetes insipidus Diabetes insipidus (DI) is a disorder of water metabolism caused by a deficiency in antidiuretic hormone (ADH). ADH is also referred to as vasopressin. The absence of ADH allows filtered water to be excreted in the urine instead of reabsorbed. This causes excessive urination, thirst, and fluid intake.

Guillain-Barre syndrome is most commonly triggered by recent: surgery. digestive tract infection. immunization. acute hepatitis.

digestive tract infection.

Diabetes is the leading cause of: urosepsis. end-stage renal disease. acute coronary syndrome. pancreatitis.

end-stage renal disease Diabetes is a leading cause of end-stage renal disease, adult-onset blindness, and nontraumatic lower extremity amputations in the United States. The chronic hyperglycemia that is associated with diabetes mellitus and a dysregulated metabolic system may be associated with secondary damage in multiple organ systems, especially the kidneys, eyes, nerves, and blood vessels.

In thyrotoxic crisis, T3 and T4 are overproduced, causing hypermetabolism from the overproduction of: dopamine. catecholamines. epinephrine. norepinephrine.

epinephrine In thyrotoxic crisis (also known as thyroid storm), the thyroid gland secretes the thyroid hormones triiodothyronine (T3) and/or thyroxine (T4). When T3 and/or T4 are overproduced, systemic adrenergic activity increases. The result is epinephrine overproduction and severe hypermetabolism, leading rapidly to cardiac, GI, and sympathetic nervous system decompensation.

The adrenal glands are responsible for producing: testosterone. leukotrienes. epinephrine. prostaglandins.

epinephrine The adrenal glands produce steroidal hormones (aldosterone and cortisol; adrenal androgens and estrogens) and catecholamines (epinephrine, norepinephrine).

Risk factors that predispose a patient to Graves disease include: a family history of Graves' disease in men of the family. female sex. a history of alcoholism. being in the first trimester of pregnancy.

female sex

A 54-year-old patient with diabetes presents with fatigue and the nurse practitioner suspects diabetic ketoacidosis (DKA). Other symptoms related to DKA include: dysuria. metallic taste in the mouth. fruity breath. bradycardia.

fruity breath

Cushing's disease is characterized by physical abnormalities that occur when the adrenal glands secrete excess: triiodothyronine. glucocorticoids. oxytocin. antidiuretic hormone.

glucocorticoids

The disease caused by hyperfunctioning of the thyroid gland is known as: hypothyroidism. hyperthyroidism. nontoxic goiter. Hashimoto's disease.

hyperthyroidism

Acute complications of untreated diabetes insipidus would NOT include: hypovolemia. hypervolemia. circulatory collapse. loss of consciousness.

hypervolemia Untreated diabetes insipidus (DI) can produce complications such as hypovolemia, hyperosmolality, circulatory collapse, loss of consciousness, and central nervous system damage

In the presence of acute adrenal insufficiency, the underproduction of cortisol by the adrenal glands may cause the patient to experience: hyperglycemia. hypoglycemia. hypertension. headaches

hypoglycemia Cortisol (a glucocorticoid) normally stimulates gluconeogenesis, but when it is absent or very low, the liver decreases hepatic glucose output, leading to hypoglycemia.

Antidiuretic hormone (ADH) and oxytocin are produced in the: adrenal glands. parathyroid gland. thyroid gland. hypothalamus.

hypothalamus

A patient with an elevated thyroid-stimulating hormone (TSH) level most likely has: subacute thyroiditis. toxic adenoma. Graves' disease. hypothyroidism.

hypothyroidism

The release of antidiuretic hormone (ADH) from the posterior pituitary gland is stimulated by reduced circulating volume and: decreased serum osmolality. decreased urine osmolality. increased serum osmolality. increased urine osmolality.

increased serum osmolality.

In a patient with diabetes insipidus, the resorption of water by the renal tubular collecting ducts can lead to: increased urine glucose. increased serum potassium. increased serum sodium. increased urine calcium.

increased serum sodium

A negative feedback system regulates the endocrine system by: stimulating hormone production. increasing the uptake of the target tissue. increasing the hormone transport system. inhibiting hormone overproduction.

inhibiting hormone overproduction

Synthesis and secretion of the thyroid hormones depend on the presence of: triiodothyronine. thyroxine. iodine. luteinizing hormone.

iodine

Diabetes mellitus is NOT a disorder in the metabolism of: carbohydrates. iron. fats. proteins.

iron

An acute metabolic complication that occurs in patients with diabetes is: nephropathy. retinopathy. autonomic neuropathy. ketoacidosis.

ketoacidosis

In a patient with hyperglycemia, the nurse practitioner knows that hyperosmolar hyperglycemic nonketotic syndrome (HHNS) will NOT produce: dehydration.term-3 glycosuria. high glucose levels. ketogenesis.

ketogenesis In the patient with hyperosmolar hyperglycemic nonketotic state (HHNS), glucose levels are significantly higher (>600 mg/dL) than in diabetic ketoacidosis (DKA; >250 mg/dL). Glycosuria is also higher in HHNS than DKA because blood glucose levels are higher. In addition, renal dysfunction is more marked

Patients with hypothyroidism are also likely to have elevated: sodium levels. potassium levels. lipid levels. cortisol levels.

lipid levels due to alterations in metabolism

The most common cause of secondary hypothyroidism is: increased secretion of thyrotropin-releasing hormone by the hypothalamus. low intake of dietary iodine or abnormal iodine metabolism. increased secretion of thyrotropin hormone by the pituitary gland. low secretion of thyrotropin hormone by the pituitary gland.

low secretion of thyrotropin hormone by the pituitary gland.

Patients with Graves disease may experience comorbid diseases including: peptic ulcer disease. iron deficiency anemia. lupus erythematosus. thyroid cancer.

lupus erythematosus Increased risk for multiple autoimmune conditions

A simple nontoxic goiter: is caused by inflammation. is likely secondary to a neoplasm. may be enlarged secondary to a lack of iodine in the diet. is an autoimmune disease process.

may be enlarged secondary to a lack of iodine in the diet

A common characteristic of a person with Graves disease is: ophthalmopathy. humped back. moon face. peripheral neuropathy.

ophthalmopathy

The complication associated with Type 1 and Type 2 diabetes that is NOT a microvascular complication is: nephropathy. neuropathy. retinopathy. peripheral arterial disease.

peripheral arterial disease.

The most common signs of newly diagnosed diabetes include: peripheral neuropathy. polyuria. hyperphagia. blurred vision.

polyuria

When calcium levels are low, the negative feedback system: stimulates the parathyroid gland to release parathyroid hormone. stimulates the hormone receptors to release calcium into the serum. inhibits the transport of calcium levels to the bloodstream. inhibits the uptake of calcium in the bones.

stimulates the parathyroid gland to release parathyroid hormone.

Hyperglycemia in patients who have Type 2 diabetes can cause: anorexia. hematuria. thirst. hyperphagia.

thirst Thirst results from the intracellular dehydration that occurs as blood glucose levels rise and water is pulled out of body cells, including those in the thirst center.

The thyroid hormone that is responsible for calcium regulation is: triiodothyronine (T3). thyroxine (T4). thyrocalcitonin (calcitonin). thyroid-stimulating hormone.

thyrocalcitonin (calcitonin)

An extreme and life-threatening form of thyrotoxicosis is called: Graves' disease. thyroid storm. thyroiditis. hypothyroidism.

thyroid storm