Chapter 32

7. One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisol-releasing hormone (CRH) and:

ACTH.

19. The signs and symptoms of abrupt cessation of pharmacologic glucocorticoids closely resemble those of:

Addison disease.

11. Which of the following individuals is experiencing the effects of a primary endocrine disorder?

A patient who has low calcium levels because of the loss of his parathyroid gland

14. 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

13. Which of the following individuals displays the precursors to acromegaly?

An adult with an excess of growth hormone due to an adenoma

17. A 33-year-old patient has been admitted to the hospital for the treatment of Graves disease. Which of the following assessments should the patient's care team prioritize?

Assessment of the patient's vision and oculomotor function

20. Which of the following pathophysiologic phenomena may result in a diagnosis of Cushing disease?

Excess ACTH production by a pituitary tumor

15. Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:

Graves disease.

12. Which of the following physiologic processes is a direct effect of the release of growth hormone by the anterior pituitary?

Production of insulin-like growth factors (IGFs) by the liver

18. 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?

Stopping the drug suddenly may cause adrenal insufficiency.

16. 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

2. The most common cause of hypothyroidism is:

autoimmune thyroiditis.

5. The major adrenal cortical hormones are steroids and are synthesized from acetate and:

cholesterol.

3. Thyroid hormone deficit ___________, which alters the function of all major organs in the body.

decreases metabolism

6. Primary adrenal insufficiency is manifested by:

hyponatremia and hypoglycemia.

1. A predominant effect of a prolonged excessive growth hormone level is:

increased blood glucose levels.

10. The immune suppressive and anti-inflammatory effects of cortisol cause:

inhibition of prostaglandin synthesis.

8. The iatrogenic form of Cushing syndrome is caused by:

long-term cortisone therapy.

4. The most common cause of thyrotoxicosis is Graves disease, which has the distinguishing characteristic of _____ in addition to a diffuse goiter.

ophthalmopathy

9. The major manifestations of Cushing syndrome include:

overt diabetes mellitus.