Question 1

Characteristic physical features of individuals with Cushing syndrome include:

Accepted Answer

A)  weight loss and muscle wasting. 
B)  truncal obesity and thin skin. 
C)  pallor and swollen tongue. 
D)  depigmented skin and eyelid lag.

Question 2

Mental status changes and muscle weakness in people with Addison disease are primarily caused by:

Accepted Answer

A)  hyperkalemia. 
B)  hypoglycemia. 
C)  severe metabolic acidosis. 
D)  glucose intolerance.

Question 3

A 13-year-old male who uses insulin to control his type 1 diabetes experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion during gym class. The most probable cause of these symptoms is:

Accepted Answer

A)  hyperglycemia resulting from incorrect insulin administration. 
B)  dawn phenomenon caused by eating a snack before gym class. 
C)  hypoglycemia caused by increased exercise. 
D)  Somogyi effect caused by insulin sensitivity.

Question 4

A 30-year-old female with Graves disease is admitted to your hospital unit for the surgical removal of her thyroid gland. During the postoperative period, you note that her serum calcium is low. She should be observed for which of the following signs/symptoms?

Accepted Answer

A)  Muscle weakness and constipation 
B)  Laryngeal spasms and hyperreflexia 
C)  Abdominal pain 
D)  Anorexia, nausea, and vomiting

Question 5

Visual disturbances are a common occurrence in patients with untreated Graves disease. The main cause of these complications is:

Accepted Answer

A)  decreased blood flow to the eye. 
B)  orbital edema and extraocular muscle paralysis. 
C)  TSH neurotoxicity to retinal cells. 
D)  local lactic acidosis.

Question 6

The basal metabolic rate is unusually _____ with hypothyroidism.

Accepted Answer

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

Question 7

What is the cause of the hyperpigmentation seen in people with Cushing syndrome and Addison disease?

Accepted Answer

A)  Abnormal levels of cortisol 
B)  Permissive effects of aldosterone when cortisol levels are altered 
C)  Elevated levels of ACTH 
D)  Hypersensitivity of melanocytes with sun exposure

Question 8

A severe consequence of syndrome of inappropriate ADH secretion (SIADH) is:

Accepted Answer

A)  stroke. 
B)  diabetes insipidus. 
C)  neurologic damage. 
D)  renal failure.

Question 9

A 50-year-old female presents with lightheadedness and overall abnormal feelings. CT scan reveals an adrenal cortical tumor. Lab tests reveal that the tumor is hormone secreting. Which of the following would be expected?

Accepted Answer

A)  Increased renin levels 
B)  Hypotension 
C)  Hypokalemia 
D)  Hyponatremia

Question 10

A 45-year-old female with Graves disease underwent surgical removal of her thyroid gland. During the postoperative period, her serum calcium was low. The most probable reason for her low serum calcium is:

Accepted Answer

A)  hyperparathyroidism secondary to Graves disease. 
B)  myxedema secondary to surgery. 
C)  hypoparathyroidism caused by surgical injury to the parathyroid glands. 
D)  hypothyroidism resulting from lack of thyroid replacement.

Question 11

A 30-year-old male presents to his physician complaining of visual disturbances. CT reveals a pituitary tumor and lab tests reveal elevated prolactin. Which of the following would also be expected?

Accepted Answer

A)  Increased dopamine 
B)  Increased libido 
C)  Increased luteinizing hormone (LH) and follicle-stimulating hormone (FSH) 
D)  Hypotension

Question 12

A 12-year-old male is newly diagnosed with type 1 diabetes mellitus. Which of the following is most beneficial in confirming the diagnosis?

Accepted Answer

A)  Fasting plasma glucose levels and glucose tolerance tests 
B)  Random serum glucose levels 
C)  Genetic testing 
D)  Glycosylated hemoglobin measurements

Question 13

A 25-year-old female with Graves disease is admitted to a medical-surgical unit. Palpation of her neck would most likely reveal:

Accepted Answer

A)  a normal-sized thyroid. 
B)  a small discrete thyroid nodule. 
C)  multiple discrete thyroid nodules. 
D)  diffuse thyroid enlargement.

Question 14

The most common cause of Addison disease is:

Accepted Answer

A)  an autoimmune reaction. 
B)  dietary deficiency of sodium and potassium. 
C)  cancer. 
D)  viral infection of the pituitary gland.

Question 15

A 54-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which of the following clinical manifestations would be expected in this patient?

Accepted Answer

A)  Peripheral edema 
B)  Tachycardia 
C)  Low blood pressure 
D)  Concentrated urine

Question 16

A 3-year-old male was diagnosed with congenital hypothyroidism. If left untreated, the child would have:

Accepted Answer

A)  mental retardation and stunted growth. 
B)  increased risk of childhood thyroid cancer. 
C)  hyperactivity and attention deficit disorder. 
D)  liver, kidney, and pancreas failure.

Question 17

The level of T3 in Graves disease is usually abnormally:

Accepted Answer

A)  low. 
B)  high. 
C)  variable. 
D)  absent.

Question 18

A 12-year-old female is newly diagnosed with type 1 diabetes mellitus (DM). Which of the following is the most likely cause of her disease?

Accepted Answer

A)  A familial, autosomal dominant gene defect 
B)  Obesity and lack of exercise 
C)  Immune destruction of the pancreas 
D)  Hyperglycemia from eating too many sweets

Question 19

The body's inability to conserve water and sodium when affected by Addison disease is explained by which of the following conditions?

Accepted Answer

A)  Low levels of cortisol 
B)  High levels of ACTH 
C)  Hypersecretion of ADH 
D)  Aldosterone deficiency

Question 20

A 25-year-old male presents to his physician complaining of changes in facial features. CT scan reveals a mass on the anterior pituitary, and lab tests reveal severely elevated growth hormone (GH). Which of the following would also be expected?

Accepted Answer

A)  Decreased IGF-1 
B)  Hypotension 
C)  Sexual dysfunction 
D)  Height increases

Exam 18: Alterations of Hormonal Regulation