Question 1

Hypoparathyroidism is most commonly caused by:

Accepted Answer

A)   pituitary hyposecretion.
B)   parathyroid adenoma.
C)   parathyroid gland injury.
D)   hypothalamic inactivity. C

Question 2

A 22-year-old female has a low level of thyroid-stimulating hormone (TSH). This condition would cause _____ hypothyroidism.

Accepted Answer

A)   primary
B)   secondary
C)   autoimmune
D)   atypical B

Question 3

A 19-year-old female with type 1 diabetes mellitus was admitted to the hospital with the following lab values: serum glucose 500 mg/dl (high); serum K+ 2 (low); serum Na+ 130 (low). Her parents state that she has been sick with the "flu" for a week. What relationship do these values have with her insulin deficiency?

Accepted Answer

A)   Increased glucose utilization causes the shift of fluid from the intravascular to the intracellular space.
B)   Decreased insulin causes hyperglycemia and osmotic diuresis.
C)   Increased glucose and fatty acid metabolism stimulates renal diuresis and electrolyte loss.
D)   Increased insulin use results in protein catabolism, tissue wasting, and electrolyte loss. B

Question 4

Diabetes insipidus, diabetes mellitus, and SIADH share which of the following clinical manifestations?

Accepted Answer

A)   Polyuria
B)   Edema
C)   Vomiting and abdominal cramping
D)   Thirst

Question 5

An 11-year-old male is newly diagnosed with type 1 diabetes mellitus. Before treatment he most likely experienced:

Accepted Answer

A)   recurrent infections, visual changes, fatigue, and paresthesias.
B)   polydipsia, polyuria, polyphagia, and weight loss.
C)   vomiting; abdominal pain; sweet, fruity breath; dehydration; and Kussmaul breathing.
D)   weakness, vomiting, hypotension, and mental confusion.

Question 6

A 30-year-old male was diagnosed with thyroid carcinoma. Lab tests would most likely indicate _____ T3 and T4 levels.

Accepted Answer

A)   high
B)   low
C)   normal
D)   variable

Question 7

A side effect of some general anesthetic agents is _____ diabetes insipidus.

Accepted Answer

A)   neurogenic
B)   nephrogenic
C)   psychogenic
D)   allogenic

Question 8

General causes of abnormal target cell responses include:

Accepted Answer

A)   abnormal receptor activity.
B)   abnormal hormone levels.
C)   increased synthesis of second messengers.
D)   extracellular electrolyte alterations.

Question 9

Which of the following alterations would you expect to find in a patient with untreated Cushing disease or syndrome?

Accepted Answer

A)   Bradycardia
B)   Tachypnea
C)   Hyperkalemia
D)   Hypertension

Question 10

Management of diabetes mellitus involves measuring glycosylated hemoglobin (hemoglobin A1c) levels. The purpose of this test is to:

Accepted Answer

A)   measure fasting glucose levels.
B)   monitor long-term serum glucose control.
C)   detect acute complications of diabetes.
D)   check for hyperlipidemia.

Question 11

The most common cause of elevated levels of antidiuretic hormone (ADH) secretion is:

Accepted Answer

A)   autoimmune disease.
B)   cancer.
C)   pregnancy.
D)   heart failure.

Question 12

A 25-year-old male presents with fatigue, constipation, and sexual dysfunction. Tests reveal all pituitary hormones are normal and no masses are appreciated. The most likely cause of his symptoms is a dysfunction in the:

Accepted Answer

A)   anterior pituitary.
B)   posterior pituitary.
C)   pars intermedia.
D)   hypothalamus.

Question 13

Both Cushing syndrome and Addison disease can manifest with elevated levels of:

Accepted Answer

A)   ADH.
B)   cortisol.
C)   adrenocorticotropic hormone (ACTH) .
D)   aldosterone.

Question 14

A 55-year-old female is admitted to the medical unit for complications of long-term, poorly controlled type 2 diabetes mellitus. Which of the following would be expected in addition to elevated glucose?

Accepted Answer

A)   Elevated serum lipids
B)   Metabolic alkalosis
C)   Elevated liver enzymes
D)   Low red blood cell count

Question 15

A 30-year-old female presents with hypertension, headache, tachycardia, impaired glucose tolerance, and weight loss. Which of the following is the most likely diagnosis?

Accepted Answer

A)   Addison disease
B)   Conn disease
C)   Cushing disease
D)   Pheochromocytoma

Question 16

A 50-year-old male patient presents with polyuria and extreme thirst. He was given exogenous ADH. For which of the following would this treatment be effective?

Accepted Answer

A)   Neurogenic diabetes insipidus
B)   Psychogenic diabetes insipidus
C)   Nephrogenic diabetes insipidus
D)   SIADH

Question 17

Hyperglycemia in type 2 diabetes mellitus is a result of:

Accepted Answer

A)   insulin deficiency.
B)   hyperinsulinemia and insulin resistance.
C)   glucagon deficiency.
D)   liver dysfunction.

Question 18

A 19-year-old female with type 1 diabetes mellitus was admitted to the hospital with the following lab values: serum glucose 500 mg/dl (high); urine glucose and ketones 4+ (high); arterial pH 7.20 (low). Her parents state that she has been sick with the "flu" for a week. Which of the following statements best explains her acidotic state?

Accepted Answer

A)   Increased insulin levels promote protein breakdown and ketone formation.
B)   Her uncontrolled diabetes has led to renal failure.
C)   Low serum insulin promotes lipid storage and a corresponding release of ketones.
D)   Insulin deficiency promotes lipid metabolism and ketone formation.

Question 19

A 35-year-old female with Graves disease is admitted to a medical-surgical unit. Lab tests would most likely reveal:

Accepted Answer

A)   high levels of circulating thyroid-stimulating antibodies.
B)   ectopic secretion of thyroid-stimulating hormone (TSH) .
C)   low circulating levels of thyroid hormones.
D)   stimulation of thyroid-binding globulin.

Question 20

A 35-year-old female took corticosteroid therapy for several months. Which of the following would be expected?

Accepted Answer

A)   Renal toxicity
B)   Episodes of hypoglycemia
C)   Hirsutism
D)   Type 2 diabetes mellitus

Exam 18: Alterations of Hormonal Regulation