Adv. Patho/ Physio Exam #3 (Test Questions)

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Thyroid carcinoma usually presents with the following thyroid tissue changes: A) small nodules. B) elevated T3 and T4. C) large, diffuse goiter. D) thyroid gland atrophy.

A) small nodules. Thyroid carcinoma usually presents with small thyroid nodules and normal levels of thyroid hormone.

Which female organ produces and releases the ovum? A) Ovary B) Uterus C) Fornix D) Vestibule

A) Ovary The ovary is the location where the ovum matures and is subsequently released. The uterus provides a cavity for a fertilized ovum to develop during pregnancy. A fornix is a space in the vagina. The vestibule is a component of a female's external genitalia.

What nodes drain lymph from the breast tissue? A) Axillary B) Cervical C) Mediastinal D) Inguinal

A) Axillary Lymph from breast tissue drains through the superficial lymph nodes in the axillary region. Inguinal nodes are associated with the groin; mediastinal with the chest; cervical, the neck.

Which of the following disorders can cause secondary hyperparathyroidism? A) Chronic renal failure B) Primary hyperparathryroidism C) A pituitary tumor D) Graves disease

A) Chronic renal failure In chronic renal failure, the kidney cannot activate vitamin D and cannot adequately reabsorb calcium from the tubules. Persistent hypocalcemia results in increased parathyroid hormone secretion. Graves disease affects the thyroid gland, not the parathyroid gland. The parathyroid glands are not under the control of the pituitary gland.

The condition in which one or both testes fail to descend from the abdomen into the scrotum in early childhood development is referred to by what term? A) Cryptorchidism B) Testicular torsion C) Orchitis D) Peyronie disease

A) Cryptorchidism With cryptorchidism, the testicle may remain in the abdomen or arrest in the inguinal canal instead of descending into the scrotum. Testicular torsion involves the rotation of the testes in the scrotum and can result in the obstruction of the vascular supply to the testes Orchitis is an acute inflammation of the testicles that usually results from a viral infection. Peyronie disease results in fibrosis of the fascia in the lateral penis.

Estrogen is associated with what function? A) Development of secondary sex characteristics B) Stimulating uterine smooth muscle contraction C) Maintaining the endometrium during pregnancy D) Stimulating ovum maturation during the menstrual cycle

A) Development of secondary sex characteristics Estrogen is responsible for the development of secondary sex characteristics during puberty. Progesterone helps maintain the thickened endometrium during pregnancy. Progesterone inhibits smooth muscle contraction to prevent premature uterine contractions during pregnancy. High follicle-stimulating hormone (FSH) levels stimulate follicle and ovum maturation.

As a result of excessive uterine contractions and endometrial shedding, painful menstruation can occur. This is a direct result of what factor? A) Excessive prostaglandin levels B) Excessive estrogen levels C) Prostaglandin-blocking medications D) Estrogen-blocking medications

A) Excessive prostaglandin levels Primary dysmenorrhea is the result of excessive prostaglandin F2α levels in the myometrium and endometrium. Prostaglandin-blocking medications such as nonsteroidal anti-inflammatory agents can help relieve menstrual symptoms. Estrogen is not generally associated with this situation.

Which of the following problems arises from primary hyperaldosteronism? A) Hypertension B) Hyperglycemia C) Hyperkalemia D) Hyponatremia

A) Hypertension Sodium and water retention from elevated aldosterone levels results in volume overload and hypertension. Aldosterone stimulates sodium reabsorption by the renal tubules; however, since water accompanies sodium molecules, the changes in serum sodium are generally isotonic. Aldosterone does not affect serum glucose levels.

What is the most important risk factor related to the development of cervical cancer? A) Infection with the human papillomavirus (HPV) B) Exposure to diethylstilbestrol (DES) C) Smoking D) Overuse of antibiotics

A) Infection with the human papillomavirus (HPV) Although smoking is a risk factor for cervical cancer, most cases of cervical cancer and cervical dysplasia are associated with HPV, a sexually transmitted infection. DES exposure in utero is associated with vaginal cancer in adolescence or early adulthood. Antibiotic use is associated with cervicitis, not cervical cancer.

What organ is primariy responsible for the production and secretion of estrogen and progesterone? A) Ovaries B) Uterus C) Anterior pituitary D) Posterior pituitary

A) Ovaries Estrogen and progesterone are secreted by the corpus luteum in the ovaries. Estrogen is also secreted by the follicle. The uterus has receptors for estrogen and progesterone but does not produce or secrete any hormones. The anterior pituitary secretes hormones that regulate the production of estrogen and progesterone in the ovaries. The posterior pituitary does not produce female sex hormones.

Which of the following is a serious complication of SIADH? A) Permanent neurological damage B) Renal failure C) Myocardial infarction D) Panhypopituitarism

A) Permanent neurological damage Hyponatremia in SIADH can lead to severe, irreversible neurological damage In SIADH the renal tubules are responsive to ADH and are active in reabsorbing large volumes of water. Increased secretion of ADH from the posterior pituitary does not affect other pituitary hormones. Myocardial infarction is not a complication of SIADH, although excessive fluid overload can lead to heart failure.

To prevent prostate cancer, men should be encouraged to consume a diet low in what component? A) Salt B) Fiber C) Fat D) Calcium

A) Salt A diet high in fat is a risk factor for prostate cancer. Neither dietary salt, fiber, nor calcium has an impact on the development of prostate cancer

What structure is not considered a component of the penis? A) Scrotum B) Glans C) Corpus spongiosum D) Prepuce

A) Scrotum The scrotum is a skin-covered fibromuscular sac that contains the testes. The glans is the tip of the penis. The corpus spongiosum is a body of erectile tissue in the penis and contains the urethra. The prepuce is the skin of the glans and is also known as the foreskin.

Growth hormone is secreted into the bloodstream by the: A) anterior pituitary. B) posterior pituitary. C) hypothalamus. D) thymus.

A) anterior pituitary. Growth hormone from the anterior pituitary regulates metabolic processes related to cellular growth. The posterior pituitary releases antidiuretic hormone and oxytocin. The hypothalamus releases hormones that control the release of anterior pituitary hormones, including growth hormone. The thymus is not an endocrine gland.

When evaluating the kidney function of an individual with diabetes insipidus (DI), the nurse would observe: A) high volume urine output. B) high urine osmolarity. C) blood in the urine. D) protein in the urine.

A) high volume urine output. In DI, the kidneys are unable to conserve water in the distal and collecting tubules, resulting in the production of large volumes of dilute urine.

Classic symptoms of diabetes insipidus (DI) include all of the following except: A) hypertension. B) dehydration. C) low urine osmolarity. D) thirst.

A) hypertension. Absence of ADH secretion in DI leads to increased urine output, volume depletion, and hypotension.

High levels of glucocorticoids such as cortisol can result in: A) immunosuppression. B) hypoglycemia. C) weight loss. D) all of the above.

A) immunosuppression. High levels of glucocorticoids can inhibit the immune and inflammatory responses by suppressing the activity of white blood cells, lymphokines, and inflammatory mediators. High levels of cortisol cause hyperglycemia by decreasing glucose use in muscle tissue and promoting gluconeogenesis. High levels of glucocorticoids tend to cause weight gain because of fat deposition and fluid retention. Of the responses provided, immunosuppression is the only effect of elevated cortisol. Other effects include elevated blood glucose and weight gain.

The level of thyroid-stimulating hormone (TSH) in Graves disease is: A) low. B) high. C) normal. D) variable.

A) low. In Graves disease, the presence of TSI mimics the activity of TSH at the thyroid receptor. The result is increased thyroid hormone production that suppresses TSH production from the anterior pituitary.

An endocrinologist orders a series of lab tests to assess thyroid function. Low levels of thyroid hormone (T3 and T4) and high levels of thyroid-stimulating hormone (TSH) are indicative of: A) primary hypothyroidism. B) secondary hypothyroidism. C) primary hyperthyroidism. D) secondary hyperthyroidism.

A) primary hypothyroidism. Low levels of T3 and T4 production caused by the destruction or removal of the thyroid gland (primary hypothyroidism) stimulate the anterior pituitary to increase the production of TSH. Low levels of T3 and T4 production cause hypothyroidism. Secondary hypothyroidism manifests with decreased TSH production, leading to decreased T3 and T4 secretion.

Causes of myxedema coma include: A) untreated hypothyroidism. B) subclinical hyperthyroidism. C) thyroid storm. D) a reaction to abnormally high levels of thyroid autoantibodies.

A) untreated hypothyroidism. Myxedema coma is caused by severe hypothyroidism. Symptoms include hypothermia, hypotension, and hypoglycemia. Symptoms include hypothermia, hypotension, and hypoglycemia. Thyroid storm is caused by severe hyperthyroidism.

The primary effect of antidiuretic hormone (ADH) in the kidneys is to stimulate: A) water reabsorption. B) sodium reabsorption. C) sodium and water excretion. D) acid secretion.

A) water reabsorption. The presence of ADH makes the renal tubules more permeable to water, which enhances water reabsorption. ADH does not affect sodium reabsorption in the kidneys. The presence of ADH makes the renal tubules more permeable to water, which enhances water reabsorption and decreases water excretion. The presence of ADH makes the renal tubules more permeable to water, which enhances water reabsorption. The presence of aldosterone will stimulate hydrogen ion (acid) secretion.

Premenstrual syndrome (PMS) is the cyclic recurrence associated with what conditions? (SATA) A) Depression B) Headache C) Irritabiltiy D) Nipple discharge E) Infertility

A, B, C Changes occurring with PMS are behavioral, physical, and psychological. Common problems include depression, headache, and irritability, but nipple discharge and infertility are not commonly identified with this condition.

Penile cancer is associated with which of the following risk factors? (SATA) A) Human papillomavirus infection B) Smoking C) African or South American country of origin D) Ultraviolet/psoralen-treated psoriasis E) Infant circumcision

A, B, C, D Major risk factors for developing penile cancer are human papillomavirus infection, smoking, psoriasis treated with a combination involving the drug psoralen and ultraviolet (UV) light, and African or South American country of origin. Men circumcised at birth have less than half the chance of getting penile cancer than those who were not.

Causes of secondary amenorrhea include which of the following? (SATA) A) Pregnancy B) Thyroid disorders C) Extreme weight loss D) Menopause E. Turner syndrome

A, B, C. D Primary amenorrhea is associated with Turner syndrome, whereas secondary amenorrhea results extreme weight loss, pregnancy, menopause, and thyroid disorders Primary amenorrhea is associated with Turner syndrome, whereas secondary amenorrhea results extreme weight loss, pregnancy, menopause, and thyroid disorders. Primary amenorrhea is associated with Turner syndrome, whereas secondary amenorrhea results extreme weight loss, pregnancy, menopause, and thyroid disorders. Primary amenorrhea is associated with Turner syndrome, whereas secondary amenorrhea results extreme weight loss, pregnancy, menopause, and thyroid disorders. Turner syndrome would be a primary cause of amenorrhea

Which cells in the pancreas secrete insulin? A) Alpha B) Beta C) Delta D) Acinar

B) Beta Alpha cells secrete glucagon. Beta cells secrete insulin. Delta cells secrete somatostatin. Acinar cells secrete pancreatic digestive enzymes.

What portion of the uterus descends into the vagina? A) Fundus B) Cervix C) Fornix D) Isthmus

B) Cervix The inferior portion of the uterus that descends into the vagina is the cervix. The fundus is the portion of the uterus that pushes up toward the abdominal cavity. The fornix is a recessed space in the superior part of the vagina. The isthmus is the narrowest part of the uterus and is located just above the cervix.

What is the cause of exophthalmos in Graves disease? A) Decreased blood flow to the eye B) Degenerative changes in the muscle and orbital edema C) High levels of TSH causing retinal toxicity D) Optic nerve damage

B) Degenerative changes in the muscle and orbital edema Increased secretion of hyaluronic acid, orbital fat accumulation, inflammation, and edema of the orbital contents result in exophthalmos (bulging of the eyes), a classic sign of Graves disease.

What structure transports sperm from the tubules in the testes to the vas deferens? A) Rete testis B) Epididymis C) Seminiferous tubules D) Tunica vaginalis

B) Epididymis The epididymis transports sperm from the tubules in the testes to the vas deferens. The rete testis is the central portion of the testes. The seminiferous tubules are the site of sperm production in the testes. The tunica vaginalis is the outer covering of the testes.

Which estrogen is both the most potent and the most abundant? A) Estriol B) Estradiol C) Estrone D) Estrase

B) Estradiol Estriol, estrone, and estrase are all types of estrogen, but estradiol is the most potent and abundant.

Which hormone functions as an antagonist to insulin? A) Aldosterone B) Glucagon C) Somatostatin D) Amylin

B) Glucagon Aldosterone does not have any physiologic effects that are antagonistic to insulin. Glucagon increases blood sugar levels by stimulating glycogenolysis and gluconeogenesis. Although somatostatin can inhibit the secretion of insulin, the hormone that has the opposite effect of insulin is glucagon. Amylin is co-secreted with insulin to suppress glucagon secretion after a meal. Glucagon is insulin's antagonist.

Which of the following nutrients is essential for thyroid hormone synthesis? A) Iron B) Iodine C) Phosphate D) Calcium

B) Iodine An essential ingredient for thyroid hormone synthesis is iodine.

Which of the following statements about the menstrual cycle is false? A) Progesterone levels rise during the luteal phase of the ovarian cycle and the secretory phase of the uterine cycle B) Menstruation occurs just after LH and FSH levels peak C) Menstruation occurs after progesterone levels drop D) Estrogen levels rise before ovulation, while progesterone levels rise after

B) Menstruation occurs just after LH and FSH levels peak

What is the correct sequence of the transport of sperm cells? A) Rete testis → Vasa efferentia → Vas deferens → Seminiferous tubules → Epididymis → Ejaculatory duct → Urethral meatus → Urethra B) Seminiferous tubules → Rete testis → Vasa efferentia → Epididymis → Vas deferens → Ejaculatory duct → Urethra → Urethral meatus. C) Vasa efferentia → Vas deferens → Rete testis → Seminiferous tubules → Epididymis → Ejaculatory duct → Urethral meatus → Urethra D) Ejaculatory duct → Seminiferous tubules → Rete testis → Vasa efferentia → Epididymis → Vas deferens → Urethra → Urethral meatus.

B) Seminiferous tubules → Rete testis → Vasa efferentia → Epididymis → Vas deferens → Ejaculatory duct → Urethra → Urethral meatus.

What is the most common cause of pelvic inflammatory disease (PID)? A) Elevated estrogen B) Sexually transmitted infections C) Ectopic pregnancy D) Cervical tumors

B) Sexually transmitted infections (STIs) Most cases of pelvic inflammatory disease are caused by sexually transmitted infections and are not generally related to altered hormone levels, ectopic pregnancy, or cervical tumors.

What effect does the presence of advanced glycosylation end products (AGEs) have in diabetes? A) Increased ketone formation B) Tissue injury C) Dawn phenomenon D) Reduction of chronic complications

B) Tissue injury AGEs cause tissue injury through a variety of mechanisms, including the production of free radicals and the induction of microvascular/macrovascular disease. AGEs do not affect ketone formation. Dawn phenomenon is an early morning rise in blood glucose concentrations.

A clinician would suspect thyrotoxicosis if a patient presented with which of the following symptoms? A) Confusion and gait disturbances B) Weight loss and enlarged thyroid gland C) Slow tendon reflexes and muscle stiffness D) Peripheral edema and dry skin

B) Weight loss and enlarged thyroid gland Weight loss and enlarged thyroid gland are common signs of hyperthyroidism in thyrotoxicosis. Confusion and gait disturbances are neurological signs of hypothyroidism. Slow tendon reflexes and muscle stiffness are neuromuscular signs of hypothyroidism. Peripheral myxedema and dry skin are signs of hypothyroidism.

Which of the following statements about ovarian cancer is false? A) In the early stages, ovarian cancer is usually asymptomatic. B) Women 45 years and younger are at the greatest risk of developing ovarian cancer C) Ovarian cancer results in ascites caused by seeding of cancer cells in the peritoneal cavity D) Ovarian cancer accounts for the most deaths of all cancers of the female reproductive tract

B) Women 45 years and younger are at the greatest risk of developing ovarian cancer One reason for the poor prognosis for ovarian cancer is that it is usually asymptomatic. The highest incidence of ovarian cancer is in women older than 80 years. Ovarian cancers arise from the surface epithelium of the ovary and spread intra-abdominally over the surface of the peritoneum. Seeded cancer cells secrete fluid in the peritoneal cavity, resulting in the development of ascites. Although endometrial cancer has the highest incidence, ovarian cancer accounts for the most deaths of all cancers of the female reproductive tract.

The most common cause of Addison disease is: A) adrenal cancer. B) autoimmune injury to the adrenal cortex. C) viral infection of the pituitary gland. D) bacterial infection of the adrenal medulla.

B) autoimmune injury to the adrenal cortex. In idiopathic Addison disease, antibodies against the adrenal cortex cause immunologic damage to the gland, resulting in hypocortisolism and hypoaldosteronism. Adrenal tumors tend to cause Cushing syndrome because of hypersecretion of cortisol by the tumor cells. Viral infection of the pituitary leading to decreased ACTH secretion is not a common cause of Addison disease. Infection of the adrenal medulla would primarily affect the release of catecholamines. Cortisol is released from the adrenal cortex.

Calcitonin and parathyroid hormone strictly regulate serum levels of: A) potassium. B) calcium. C) iron. D) magnesium.

B) calcium. Together, calcitonin and parathyroid hormone regulate calcium levels in the blood.

Increased thyroid hormone levels in the blood result in: A) further stimulus to produce thyroid hormone. B) decreased release of thyroid-stimulating hormone from the anterior pituitary. C) increased secretion of thyrotropin-releasing hormone from the hypothalamus. D) inhibition of parathyroid hormone release from the parathyroid glands.

B) decreased release of thyroid-stimulating hormone from the anterior pituitary. Increased thyroid hormone levels provide negative feedback to the hypothalamus and anterior pituitary to shut off production of thyrotropin-releasing hormone and thyroid-stimulating hormone, respectively.

Neurological symptoms of SIADH are related to: A) hypotension and cellular dehydration B) decreased serum sodium concentrations. C) increased serum osmolarity. D) hypokalemia.

B) decreased serum sodium concentrations. ADH secretion in SIADH causes a dilutional hyponatremia and decreased serum osmolarity. Blood pressure in SIADH in elevated because of volume retention. Alterations in ADH secretion do not seriously affect potassium levels in the body since the majority of total body potassium is intracellular.

Signs and symptoms of hypothyroidism include all of the following except: A) weight gain. B) diarrhea. C) myxedema. D) lethargy.

B) diarrhea. Decreased bowel activity in hypothyroidism generally leads to constipation. Diarrhea is a symptom of hyperthyroidism. Decreased neuromuscular activity often makes individuals with hypothyroidism feel lethargic. Decreased metabolic rate in hypothyroidism often leads to weight gain. Myxedema is common in hypothyroidism.

Signs and symptoms that a person with type 1 diabetes has administered too much insulin include: A) Kussmaul respirations and acetone breath. B) dizziness and confusion. C) abdominal cramping and nausea. D) pain at the site of injection.

B) dizziness and confusion. Dizziness and confusion, combined with tachycardia, palpations, and visual disturbances are signs of hypoglycemia related to over administration of insulin. Insulin does not generally cause pain when injected. Overdose of insulin causes hypoglycemia. Kussmaul respirations and acetone breath are signs of ketoacidosis. Abdominal cramping and nausea are not specific signs of hypoglycemia related to over administration of insulin.

Cushing disease is commonly caused by: A) autoimmune destruction of the adrenal cortex. B) ectopic production of ACTH from a lung tumor. C) excessive production of cortisol from a tumor in the adrenal cortex. D) excessive production of aldosterone from a tumor in the adrenal cortex.

B) ectopic production of ACTH from a lung tumor. Cushing disease is excessive ACTH production most commonly caused by an adrenal adenoma or a non-pituitary adenoma as is often seen with lung cancer. Autoimmune destruction of the adrenal cortex results in hypocortisolism or Addison disease. Cushing syndrome occurs whenever there is an excessive level of cortisol regardless of cause. Excessive production of aldosterone from a tumor in the adrenal cortex causes hyperaldosteronism. Cushing disease is excessive cortisol secondary to increased ACTH.

Graves disease is characterized by: A) ectopic secretion of thyroid hormone by a tumor. B) excessive production of circulating thyroid-stimulating immunoglobulin. C) autoimmune destruction of the thyroid gland. D) injury to the pituitary, resulting in decreased thyroid-stimulating hormone secretion.

B) excessive production of circulating thyroid-stimulating immunoglobulin. Graves disease is caused by the production of antibodies to the TSH receptor called thyroid-stimulating immunoglobulins (TSIs). These antibodies stimulate the production of high levels of thyroid hormone.

A new diagnosis of type 1 diabetes is based on: A) random serum glucose levels. B) fasting plasma glucose levels and glucose tolerance tests. C) genetic testing. D) the presence of symptoms only.

B) fasting plasma glucose levels and glucose tolerance tests. The suspicion of diabetes-based clinical manifestations can be confirmed by evaluating fasting plasma glucose levels and glycosylated hemoglobin (A1c). Random glucose tests with results > 200 mg/dL and accompanied by s/s can be diagnostic for type 1 DM.

The first ovarian phase of the menstrual cycle is the: A) lunar phase B) follicular phase C) adrenarche phase D) luteal phase.

B) follicular phase The first ovarian phase of the menstrual cycle is the follicular phase, followed by ovulation and the luteal phase. Adrenarche occurs during puberty and is marked by the increased production of androgens.

Acromegaly is caused by increased secretion of: A) prolactin. B) growth hormone. C) insulin. D) glucocorticoids.

B) growth hormone. Acromegaly from increased growth hormone and insulin-like growth factor secretion results in gigantism as well as other structural and physiological problems.

Regulation of the release of T3 and T4 from the thyroid gland is controlled by: A) neural feedback. B) negative feedback. C) positive feedback. D) all of the above.

B) negative feedback. Thyroid hormone, like most other hormones, is regulated through negative feedback. An example of neural regulation is the release of epinephrine from the adrenal medulla. An example of positive feedback or feed-forward control is the release of oxytocin to stimulate labor during pregnancy. Thyroid hormone levels are regulated through negative feedback only.

Hypersecretion of androgens from an adrenal tumor in female children causes virilization, which is: A) the early development of female sex characteristics. B) the development of male sex characteristics. C) a form of hypercortisolism. D) sterility.

B) the development of male sex characteristics. Androgens are male sex hormones that stimulate the development of male sex characteristics in females.

Graves disease is an example of a: A) type I hypersensitivity. B) type II hypersensitivity. C) type III hypersensitivity. D) type IV hypersensitivity.

B) type II hypersensitivity. Type III hypersensitivities are immune complex-mediated reactions. Graves disease is an example of a tissue-specific (type II) hypersensitivity. Type IV hypersensitivities involve a delayed T-cytotoxic cell response. Type I hypersensitivities involve the production of histamine in response to an allergen.

Signs and symptoms common to both type 1 and type 2 diabetes mellitus (DM) include all of the following except: A) polyphagia. B) weight loss. C) polydipsia. D) polyuria.

B) weight loss. Weight loss is a symptom of type 1 DM. Typically, individuals with type 2 DM are overweight. Polyphagia, polydipsia, and polyuria are the classic signs of DM.

Which of the following statements about hormone regulation of the female reproductive cycle is false? A) LH and FSH are produced in the pituitary, and estradiol and progesterone are produced in the ovaries. B) Estradiol and progesterone secreted from the corpus luteum cause the endometrium to thicken. C) Both progesterone and estradiol are produced by the follicles. D) Secretion of GnRH by the hypothalamus is inhibited by low levels of estradiol but stimulated by high levels of estradiol.

C) Both progesterone and estradiol are produced by the follicles.

Prolactinomas (pituitary tumors that secrete prolactin) cause which of the following problems in women? A) Heavy menstrual periods B) Infertility C) Breast milk production without pregnancy D) Hair loss

C) Breast milk production without pregnancy Elevated prolactin in women causes galactorrhea, which is the discharge of milk from the breast. Elevated prolactin in women causes hirsutism, which is the presence of excess body hair. Elevated prolactin also causes galactorrhea, which is the discharge of milk from the breast. Elevated prolactin in women results in amenorrhea. Dysmenorrhea refers to painful menstruation.

Which of the following is a steroid hormone? A) Insulin B) Thyroxine (T4) C) Cortisol D) Growth hormone

C) Cortisol Cortisol is one example of a steroid hormone. Insulin and growth hormone are protein hormones. Although T4 is lipid soluble like steroid hormones, it is an amine hormone.

What term is used to describe the inner epithelial lining of the uterus? A) Myometrium B) Perimetrium C) Endometrium D) Epimetrium

C) Endometrium The inner lining of the uterus is called the endometrium and is composed of columnar epithelial cells. The myometrium is the muscular layer of the uterus. The perimetrium is the outer serous membrane that covers the uterus. Epimetium is not an actual lining but rather a term to identify the area above the existing uterine linings.

The development of an acute metabolic acidosis from insulin deficiency is due to which of the following processes? A) Protein catabolism with ammonia release B) Anaerobic metabolism of glucose C) Fatty acid metabolism with ketone production D) Renal failure

C) Fatty acid metabolism with ketone production An insulin deficiency will increase the release and utilization of fatty acids as fuel. Metabolizing fatty acids liberates acidic molecules called ketones. An insulin deficiency will increase the rate of protein breakdown and the liberation of ammonia; however, ammonia is not acidic. With insulin deficiency, glucose cannot be transported into the cell and metabolized. In addition, metabolic processes are generally aerobic, unless oxygen is not present. Although renal failure can be a long-term complication of DM, acute acidosis is usually due to fatty acid metabolism and the release of ketones.

Mental status changes in people with Addison disease are caused by: A) CNS ischemia. B) encephalopathy. C) hypoglycemia. D) insulin resistance

C) Hypoglycemia Mental status changes in people with Addison disease are caused by hypoglycemia from low cortisol levels.

Which of the following are functions of progesterone? A) Development of secondary sex characteristics B) Stimulating uterine smooth muscle contraction C) Maintaining the endometrium during pregnancy D) All of the above

C) Maintaining the endometrium during pregnancy

Ovulation occurs immediately after which of the following uterine phases in the endometrial cycle? A) Ischemic B) Secretory C) Proliferative D) Menstrual

C) Proliferative Ovulation occurs immediately after the proliferative phase. The ischemic phase occurs at the end of the cycle, whereas the secretory phase occurs after ovulation. Menstruation is a phase associated with the menstrual, not endometrial, cycle.

Which structure is situated just below the urinary bladder in the male? A) Seminal vesicle B) Cowper gland C) Prostate gland D) Montgomery gland

C) Prostate gland The prostate gland is situated just below the urinary bladder and surrounds the first part of the urethra. Glands of Montgomery are located in the breast. Cowper (bulbourethral) glands are located below the prostate gland. The seminal vesicles are paired glands that lie posterior to the bladder.

What is the most common cause of urethritis of the male urethra? A) Mechanical trauma B) Poor Hygiene C) Sexually transmitted infections (STIs) D) Urethral scarring

C) Sexually transmitted infections (STIs) Mechanical trauma is a less common cause of urethritis than bacterial infection and generally only occurs with urethral catheterization or instrumentation. Urethritis is most often caused by sexually transmitted infections from microorganisms such as Neisseria gonorrhoeae and Chlamydia trachomatis. It is less commonly caused by mechanical trauma, scarring, or poor hygiene.

Which of the following statements concerning benign breast disease is true? A) Most benign breast lesions are solid tumors B) Benign breast lumps can be differentiated from malignant tumor by palpation alone C) Some benign fibrocysts are associated with the development of breast cancer D)Risk factors for benign breast disease include exposure to carcinogens

C) Some benign fibrocysts are associated with the development of breast cancer Most benign breast tumors are fluid-filled fibrocysts. It is true that some benign fibrocysts are associated with the development of breast cancer.

Which of the following thyroid disorders can be caused by exposure of the thyroid gland to ionizing radiation? A) Graves disease B) Hashimoto thyroiditis C) Thyroid cancer D) Subacute thyroiditis

C) Thyroid cancer Ionizing radiation, often from treatment of a prior cancer, is a risk factor for thyroid cancer.

Which of the following alterations would you expect to find in a patient with untreated Cushing disease or syndrome? A) Weight loss B) Pale skin C) Truncal obesity D) Peripheral edema

C) Truncal obesity Truncal obesity secondary to central fat deposition is a common physical manifestation of hypercortisolism. Elevated cortisol generally leads to weight gain. If ACTH levels are elevated, the hyperpigmentation of the skin will be observed. Otherwise, no changes in skin pigmentation occur. Peripheral edema is not a sign of hypercortisolism.

In adults, the most serious consequence of panhypopituitarism is the loss of: A) growth hormone. B) luteinizing hormone (LH). C) adrenocorticotropic hormone (ACTH). D) thyroid-stimulating hormone (TSH).

C) adrenocorticotropic hormone (ACTH). Loss of ACTH secretion leads to decreased cortisol production, resulting in life-threatening hypoglycemia. Although growth hormone plays a role in the division and growth of cells, loss of ACTH secretion leads to decreased cortisol production, resulting in life-threatening hypoglycemia.

Adrenocorticotropic hormone (ACTH) is synthesized and released in the: A) adrenal cortex. B) adrenal medulla. C) anterior pituitary. D) posterior pituitary.

C) anterior pituitary. ACTH is synthesized and released by the anterior pituitary gland in response to stimulation from the hypothalamus.

Gestational diabetes can occur: A) during fetal development. B) in early childhood. C) during pregnancy. D) in older adults

C) during pregnancy. Gestational diabetes is the development of glucose intolerance in women during pregnancy.

Hyperglycemia and lipid abnormalities in type 2 diabetes mellitus (DM) are a result of: A) production of inactive insulin. B) glucagon deficiency. C) insulin resistance. D) glycogen excess.

C) insulin resistance. Type 2 DM is caused by cellular resistance to the physiologic effects of insulin. Increased secretion of glucagons is also observed.

If left untreated, congenital hypothyroidism results in: A) hyperactivity and attention deficit disorder. B) increased risk of childhood thyroid cancer. C) mental retardation and stunted growth. D) liver, kidney, and pancreas failure.

C) mental retardation and stunted growth. Thyroid hormone is necessary for nervous system development and skeletal growth in fetuses and children.

The purpose of monitoring glycosylated hemoglobin levels in persons with diabetes is to: A) check for hyperlipidemia. B) detect acute complications of diabetes. C) monitor long-term serum glucose control. D) measure fasting glucose levels.

C) monitor long-term serum glucose control. Hemoglobin A1c does not measure fasting glucose levels but can provide a measure of long-term glucose control. Lipid panels must be drawn to screen for hyperlipidemia.

Syndrome of inappropriate diuretic hormone (SIADH) results in excessive: A) renal retention of sodium and water. B) renal retention of sodium without water retention. C) renal retention of water without sodium retention. D) renal excretion of water without sodium retention.

C) renal retention of water without sodium retention. Elevated ADH secretion in SIADH stimulates increased water reabsorption in the distal and collecting tubules which dilutes serum electrolyte levels.

Chronic hyperparathyroidism will lead to all of the following conditions except: A) osteopenia. B) renal calculi (stones). C) weight loss. D) pathologic bone fractures.

C) weight loss. Weight loss is not associated with hyperparathyroidism. Elevated parathyroid hormone stimulates bone resorption, which can lead to increased bone fragility and pathologic fractures. Elevated parathyroid hormone stimulates bone resorption, which can lead to osteopenia Hypercalcemia can lead to the formation of calculi in the kidneys.

Alterations in lipid and protein metabolism lead to chronic complications of DM through which of the following processes? A) Activation of protein kinase C B) Induction of the polyol pathway C) Glycosylation D) All of the above

D) All of the above Hyperglycemia activates protein kinase C, induction of the polyol pathway, and glycosylation.

Chronic complications of DM include which of the following? A) Peripheral neuropathies B) End-stage renal disease C) Coronary artery disease D) All of the above

D) All of the above Microvascular and macrovascular disease can lead to peripheral neuropathies, end-stage renal disease (nephropathy), and coronary artery disease.

Which of the following sexually transmitted infections are associated with cervicitis and can result in pelvic pain, vaginal bleeding, and the presence of purulent cervical discharge? A) Chlamydia B) Trichomoniasis C) Gonorrhea D) All of the above

D) All of the above Chlamydia, trichomoniasis, and gonorrhea are all sexually transmitted infections that can lead to cervicitis.

Male sex hormones are collectively known by what term? A) Gonadotropins B) Catabolic steroids C) Estrogens D) Androgens

D) Androgens Male sex hormones are known as androgens. Estrogens are primarily produced by females. Testosterone is the primary male androgen. Gonadotropins regulate the release of male and female sex hormones. Male androgens are anabolic steroids.

Angela is 51 years old and has stopped having a menstrual cycle and is beginning to experience hot flashes and other negative symptoms like night sweats. What is the reason for these symptoms? Responses A) Angela's body has run out of eggs B) Angela's uterus has entered the luteal phase C) Angela has had too many children D) Angela's ovaries have lost their sensitivity to FSH and LH which control the ovarian and menstrual cycles

D) Angela's ovaries have lost their sensitivity to FSH and LH which control the ovarian and menstrual cycles FSH and LH are both hormones which play a part in the regulation of the menstrual and ovarian cycles. When a woman hits a certain age then her body will stop being as sensitive to these hormones which will cause her ovaries to fail to produce and expel a viable egg from the ovaries for ovulation. This leads to her body going through menopause where her menstrual cycle and ovulation cease to continue.

What is the name of the duct that carries the ovum to the uterus? A) Ductus deferens B) Fundus C) Endocervical canal D) Fallopian tube

D) Fallopian tube An ovum travels from the ovary to the uterus via the fallopian (uterine) tube. The fundus is the top of the uterus. The passageway between the cervix's upper opening (the internal os) and its lower opening (the external os) is called the endocervical canal. The vas deferens (ductus deferens) is a duct with muscular layers capable of powerful peristalsis that transports sperm toward the urethra.

The release of a matured ovum from the follicle is a process referred to by what term? A) Reproduction B) Ejaculation C) Menarche D) Ovulation

D) Ovulation Ovulation is marked by the release of a matured ovum from the ovarian follicle. Reproduction is the process of producing new offspring, which in the female starts with ovulation, the release of a matured ovum. Ejaculation is generally a process that occurs in males and involves the release of sperm. Menarche is the first menstruation in a female's life.

An abnormal dilation of veins within the spermatic cord is known by what term? A) Cystocyle B) Spermatocele C) Hydrocele D) Varicocele

D) Varicocele An abnormal dilation of veins within the spermatic cord is known as a varicocele. A cystocele involves the bladder. A spermatocele is a diverticulum of the epididymis. A hydrocele is the accumulation of fluid in the tunica vaginalis.

In Graves disease, accumulation of edema in the orbit can lead to: A) optic nerve damage. B) eye muscle palsies. C) exophthalmos. D) all of the above.

D) all of the above. Accumulation of edema behind the eyeball can lead to compression of the optic nerve, strain on the extraocular eye muscles resulting in palsies, and eyeball protrusion that is known as exophthalmos.

The pathophysiology of type 1 diabetes mellitus (DM) involves: A) autoimmune destruction of pancreatic beta cells. B) production of antibodies against insulin. C) type IV hypersensitivity against pancreatic islet cells. D) all of the above.

D) all of the above. The insulin deficiency that results in type 1 DM is caused by three factors: (1) the production of antibodies that destroy the beta cells in the pancreatic islets of Langerhans, (2) the production of antibodies against insulin, and (3) cell-mediated destruction of the islet cells.

The most common cause of primary hypothyroidism in adults is: A) bacterial infection of the thyroid gland. B) viral infection of the thyroid gland. C) congenital hypothyroidism. D) autoimmune thyroiditis.

D) autoimmune thyroiditis. Autoimmune thyroiditis (Hashimoto) is the most common cause of primary hypothyroidism in adults.

To adapt to high hormone concentrations, many target cells have the capacity for: A) negative feedback. B) positive feedback. C) up-regulation. D) down-regulation.

D) down-regulation. To adapt to high levels of hormones, some cells have the capacity to decrease the number of receptors for that hormone through the process of down-regulation.

The physiologic stress of illness or surgery can induce a severe response in individuals who have unrecognized and untreated thyrotoxicosis. The pathophysiology of thyroid storm, also known as thyrotoxic crisis, involves: A) hypotension and bradycardia leading to shock. B) pulmonary edema and bronchoconstriction leading to respiratory arrest. C) hypercoagulability and formation of deep vein thromboses leading to pulmonary emboli. D) fever and tachycardia leading to high-output heart failure.

D) fever and tachycardia leading to high-output heart failure. High levels of thyroid hormone in conjunction with high levels of stress hormones lead to fever, tachycardia, and eventually high-output heart failure if the condition is not treated. igh levels of thyroid hormone in conjunction with high levels of stress hormones lead to fever, tachycardia, and eventually high-output heart failure if the condition is not treated.

Metabolic abnormalities in Addison disease include all of the following except: A) hyperkalemia. B) hyponatremia. C) hypoglycemia. D) hypercalcemia.

D) hypercalcemia. Serum calcium levels are not directly affected by cortisol. A primary effect of cortisol is to raise blood glucose levels; therefore, low cortisol levels lead to hypoglycemia. Loss of aldosterone in Addison disease leads to decreased sodium reabsorption and hyponatremia. Loss of aldosterone in Addison disease leads to decreased potassium secretion and hyperkalemia.

The symptom of polyuria in diabetes mellitus (DM) is caused by: A) a reduced AHD response caused by insulin deficiency. B) the loss of protein across the glomerular membrane. C) the production of ketones. D) increased glucose in the urine.

D) increased glucose in the urine. When glucose levels in the blood are greater than 300 mg/dL, glucose is excreted in the urine. The presence of glucose in the urine filtrate draws water into the tubules, causing an "osmotic diuresis."

Target cells for aldosterone are located in the: A) adrenal cortex. B) adrenal medulla. C) liver. D) kidneys.

D) kidneys. Aldosterone stimulates sodium reabsorption by the kidneys.

The main function of thyroid hormone (T3 and T4) is control of: A) gastric secretions. B) synaptic activity. C) insulin secretion. D) metabolic rate.

D) metabolic rate. Increased secretion of thyroid hormone results in increased metabolic rate of all cells. Synaptic activity is not under the direct control of the endocrine system. Increased secretion of thyroid hormone results in increased metabolic rate of all cells.

One problem associated with untreated hypoparathyroidism is: A) osteoporosis. B) metabolic acidosis. C) insulin resistance. D) muscle spasms.

D) muscle spasms. Hypocalcemia in untreated hypoparathyroidism can cause muscle spasms, including laryngeal spasms that can cause airway obstruction. Untreated hyperparathyroidism can cause osteoporosis, metabolic acidosis, and insulin resistance.

Damage to the posterior pituitary caused by a cerebrovascular accident (stroke) results in _____ diabetes insipidus (DI). A) vascular B) nephrogenic C) psychogenic D) neurogenic

D) neurogenic When DI develops from injury to the CNS, it is called "neurogenic" DI. Nephrogenic DI occurs when the renal tubules are unable to adequately respond to ADH. Psychogenic DI is caused by excessive thirst and fluid intake, which has manifestations similar to neurogenic or nephrogenic DI.

The most common cause of hypoparathyroidism is: A) hypothalamic inactivity. B) pituitary hyposecretion. C) parathyroid adenoma. D) parathyroid gland injury or removal.

D) parathyroid gland injury or removal. The parathyroid glands are not under the control of the hypothalamus; therefore tumors of the hypothalamus do not affect parathyroid hormone function. Parathyroid adenomas are a cause of hyperparathyroidism. The parathyroid glands are not under the control of the pituitary gland; therefore pituitary tumors do not affect parathyroid hormone function. Pituitary adenomas can lead to hyperthyroidism.

The primary physiologic effect of insulin is to: A) stimulate nutrient absorption from the digestive tract. B) raise blood glucose levels. C) decrease basal metabolic rate. D) promote glucose uptake into cells.

D) promote glucose uptake into cells. Insulin does not affect nutrient absorption from the digestive tract; rather, it stimulates glucose uptake into cells. Insulin lowers blood sugar levels by stimulating glucose uptake into cells. In addition to stimulating glucose uptake into cells, insulin also increases the metabolic rate of cells. promote glucose uptake into cells. The presence of insulin stimulates the transport of glucose into cells to be stored or used as a substrate for metabolism.

Pain in the abdomen or pelvis occurring with dysmenorrhea, dyschezia, dyspareunia, vaginal bleeding, infertility, adhesions, and scarring anywhere in the abdomen and pelvis is generally associated with what condition?

Endometriosis Endometriosis is the presence of ectopic endometrial glands that can be found throughout the body, especially in the abdominal and pelvic cavities, and are associated with the suggested symptomology. Leiomyomas are benign growths that arise from the myometrial smooth muscle and are commonly called "fibroids." Most leiomyomas are asymptomatic. Endometrial polyps consist of an accumulation of endometrial glands, stroma, and blood vessels that arise from the uterine fundus or upper endocervix. Most are asymptomatic but can cause dysfunctional uterine bleeding. Adenomyosis is a condition in which endometrial glands are found within the uterine myometrium. This condition may cause dysmenorrhea or dysfunctional uterine bleeding.

Which complication is associated with polycystic ovarian syndrome?

Infertility Polycystic ovarian syndrome results in stimulation of follicle growth without ovulation and generally leads to infertility. This condition is not associated with dysmenorrhea, ovarian cancer, or heavy periods.

What can dermoid cysts eventually develop into?

Ovarian cancer Dermoid cysts are ovarian tumors that are generally asymptomatic but must be removed to prevent the development of ovarian cancer. They are not generally associated with uterine fibroids, benign breast tumors, or follicular cysts.

What is a possible outcome of benign prostatic hyperplasia (BPH)? A) Infertility B) Urethral obstruction C) Testicular cancer D) Prolapsed bladder

Urethral obstruction Hyperplasia and hypertrophy of prostatic tissue in BPH lead to the formation of nodules that compress the urethra and cause urethral obstruction. BPH does not generally lead to fertility problems, prolapsed bladder, or testicular cancer.

The protrusion of the uterus into the vaginal canal and possibly outside of the vagina is a condition known as uterine ______________

prolapse Uterine prolapse is the protrusion of the uterus into the vaginal canal and is a pelvic relaxation disorder. A rectocele is bulging of the rectum into the posterior vaginal wall, whereas a cystocele involves the bladder. Vulvitis involves inflammation of the skin of the perineum.


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