Question 1

An emergency department physician tells you that the hyperglycemic diabetic you brought in earlier has a pH of 7.40. What is the likeliest explanation of this statement?

Accepted Answer

A)   The patient is a type II diabetic who was no longer secreting enough insulin to prevent the use of fats for energy.
B)   The patient is a type II diabetic who was secreting enough insulin to prevent the use of fats for energy.
C)   The patient is a type I diabetic who did not take his insulin and is therefore unable to use glucose for energy.
D)   The patient is a type I diabetic who took his insulin and did not eat, resulting in the breakdown of proteins for energy.E) B) and C)
F) All of the above

Question 2

A 24-year-old male is supine on the floor and unconscious with snoring respirations. You note a weak, rapid pulse and cool, diaphoretic skin. HR = 124 and regular, BP = 136/88, RR = 12 and regular. Blood glucose is 24 mg/dL. After manually opening the airway and providing oxygen, which of the following should be performed next?

Accepted Answer

A)   Start an IV and administer 25 gm dextrose, IV.
B)   Start an IV and administer 0.3 mg glucagon, IV.
C)   Intubate the trachea, start an IV, and administer 25 gm dextrose.
D)   Administer glucagon, 1 mg IM.E) C) and D)
F) B) and D)

Question 3

If a patient being treated for hypoparathyroidism stopped taking the medications prescribed for his condition, which of the following would be most likely to occur?

Accepted Answer

A)   Hypercalcemia
B)   Hyperkalemia
C)   Hypocalcemia
D)   HypokalemiaE) C) and D)
F) None of the above

Question 4

A 34-year-old female, conscious, alert, and oriented, is complaining of a three-week history of increased appetite, weight loss, weakness, insomnia, and inability to tolerate heat. She has recently been frequently agitated and prone to mood swings. Based on these signs and symptoms, which of the following best describes the additional findings you could expect?

Accepted Answer

A)   Hyperpigmentation of the skin and hirsutism
B)   Heart block and hypotension
C)   Enlarged tongue and cool, puffy skin
D)   Exophthalmos and goiterE) A) and D)
F) C) and D)

Question 5

Your patient is a 39-year-old male with a history of alcoholism. He is unresponsive, with cool, clammy skin and a weak, rapid pulse of 108. BP = 128/92, RR = 12 and regular. Your partner manages the airway and assists ventilations, but you are unable to start an IV after three attempts. Which of the following is most appropriate at this point?

Accepted Answer

A)   Reattempt the IV while en route.
B)   Dextrose, 25 g, and thiamine, 100 mg, both IM
C)   Glucagon, 1.0 mg, and thiamine, 100 mg, both IM
D)   Glucagon 1.0 mg IME) A) and B)
F) B) and C)

Question 6

Which of the following explains the profound protein catabolism and gluconeogenesis associated with Cushing's syndrome?

Accepted Answer

A)   Cushing's syndrome affects normal fat deposition.
B)   Glucocorticoids cause sodium retention and increased blood volume.
C)   Cortisol is an antagonist to insulin.
D)   Increased epinephrine and norepinephrine release result in hypermetabolism.E) A) and D)
F) None of the above

Question 7

In response to an increase in blood sugar, the pancreas will release insulin to:

Accepted Answer

A)   produce more glucose.
B)   allow the glucose to permeate the cell membrane.
C)   allow glucose to be wasted in the urine.
D)   allow glucose to cross the blood-brain barrier.E) B) and C)
F) C) and D)

Question 8

The thyroid releases TSH to:

Accepted Answer

A)   promote shivering.
B)   protect the vascular system.
C)   increase metabolism.
D)   decrease insulin.E) A) and B)
F) A) and C)

Question 9

Which of the following is least likely to be a precipitating factor of thyrotoxic crisis?

Accepted Answer

A)   Trauma
B)   Cold environment
C)   Infection
D)   Overdose of thyroid hormoneE) None of the above
F) All of the above

Question 10

Which of the following statements about hyperglycemic hyperosmolar nonketotic coma (HHNK)  is TRUE?

Accepted Answer

A)   Unlike diabetic ketoacidosis, HHNK is not life-threatening.
B)   Prehospital treatment of HHNK includes correcting metabolic acidosis.
C)   Aside from managing the ABCs, prehospital management is primarily aimed at correcting dehydration.
D)   Paradoxically, the definitive management of HHNK includes the administration of 50 percent dextrose.E) A) and D)
F) C) and D)

Question 11

Which of the following hormones has the greatest effect on blood pressure homeostasis?

Accepted Answer

A)   Calcitonin
B)   Cortisol
C)   Parathyroid hormone
D)   AldosteroneE) B) and C)
F) None of the above

Question 12

A type I diabetic presents with deep, rapid respirations and a fruity odor on her breath. Which of the following would best help correct the underlying physiologic disturbance?

Accepted Answer

A)   Oxygen
B)   Dextrose
C)   Insulin
D)   GlucagonE) All of the above
F) A) and B)

Question 13

Your patient is a 68-year-old female who has been in a rehabilitation hospital for one week following hip replacement surgery. According to the staff, the patient is a type II diabetic and is being treated for a postoperative infection. The patient was lethargic yesterday and was found unresponsive this morning, just before your arrival. Physical exam reveals an accumulation of secretions in her airway, lung sounds clear and equal bilaterally, and skin and mucous membranes warm and dry. HR = 119, BP = 86/58, RR = 16, blood glucose = 864 mg/dL. In addition to initiating basic airway management measures and gaining IV access, which of the following is the best treatment for this patient?

Accepted Answer

A)   Intubate, 1 to 2 L NS bolus, 25 g dextrose IV
B)   Oxygen by nonrebreather mask, NS at a KVO rate, 50 mEq sodium bicarbonate IV
C)   BVM ventilations with supplemental oxygen, NS at a KVO rate
D)   Intubate, 1 to 2 L NS bolusE) A) and B)
F) B) and D)

Question 14

You respond to an ill patient. Upon your arrival, the patient states that she has had an increase in urination, thirst, and general malaise. The patient's finger stick blood glucose reading is 550 mg/dL; her blood pressure is 110/80 mmHg; pulse, 100; respiratory rate 26; ETCO2 29; and you note an acetone odor. You suspect:

Accepted Answer

A)   HHNK.
B)   DKA.
C)   DNK.
D)   TNK.E) A) and B)
F) A) and D)

Question 15

You respond to an ill type 2 diabetic patient. Upon your arrival, the patient complains of not feeling well for a few days, and increasing blood glucose levels. You suspect:

Accepted Answer

A)   DKA.
B)   HHNK.
C)   TNK.
D)   TPA.E) A) and B)
F) All of the above

Question 16

A 36-year-old female is conscious and alert and complaining of palpitations. She denies chest pain, difficulty breathing, or loss of consciousness but becomes "dizzy" with exertion. She states that she has been experiencing agitation, insomnia, intolerance to heat, and weight loss. Physical exam reveals exophthalmos and an enlarged thyroid gland. HR = 142 and regular, BP = 110/70, RR = 14 and regular. Which of the following would be most effective in treating this patient?

Accepted Answer

A)   250 cc fluid challenge
B)   50 percent dextrose IV
C)   Synchronized cardioversion
D)   PropranololE) All of the above
F) B) and D)

Question 17

Which of the following statements would be most typical of an undiagnosed diabetic?

Accepted Answer

A)   "I am so thirsty I have to keep a glass of water by my bed at night."
B)   "I have gained ten pounds over the past two weeks."
C)   "It seems like I am dehydrated because I hardly urinate at all."
D)   "I haven't had much of an appetite. I am not hungry at all."E) B) and C)
F) None of the above

Question 18

Which of the following pathologies would necessitate the use of increased care in the preparation of an IV site because of skin fragility and increased risk of infection?

Accepted Answer

A)   Addison's disease
B)   Graves' disease
C)   Cushing's syndrome
D)   MyxedemaE) All of the above
F) A) and C)

Question 19

Which of the following most accurately represents the pathophysiological sequence of untreated type I diabetes?

Accepted Answer

A)   Oversecretion of insulin results in hypoglycemia; cells convert to the use of fats for energy resulting in the production of ketone bodies.
B)   Glucose is not absorbed through the gastrointestinal tract, resulting in hyposecretion of insulin and hypoglycemia. Lack of glucose results in anaerobic metabolism and acidosis.
C)   Hyposecretion of insulin prevents glucose from being broken down in the gastrointestinal tract; too much glucose is absorbed from the gastrointestinal tract resulting in hyperglycemia and ketoacidosis.
D)   Hyposecretion of insulin results in inability of glucose to enter cells; blood glucose levels rise, and cells convert to the use of fats for energy, resulting in the production of ketone bodies.E) All of the above
F) A) and D)

Question 20

The posterior pituitary produces which two hormones?

Accepted Answer

A)   Insulin and glucagon
B)   Epinephrine and norepinephrine
C)   Growth hormone and gonadotropin
D)   ADH and oxytocinE) B) and C)
F) A) and D)

Exam 4: Endocrinology

Which of the following is least likely to be a precipitating factor of thyrotoxic crisis?

Correct Answer
verified

Which of the following statements would be most typical of an undiagnosed diabetic?

Correct Answer
verified

Which of the following pathologies would necessitate the use of increased care in the preparation of an IV site because of skin fragility and increased risk of infection?

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

In response to an increase in blood sugar, the pancreas will release insulin to:

Correct Answer
verified

Which of the following statements about hyperglycemic hyperosmolar nonketotic coma (HHNK) is TRUE?

Correct Answer
verified

Which of the following hormones has the greatest effect on blood pressure homeostasis?

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

The thyroid releases TSH to:

Correct Answer
verified

The posterior pituitary produces which two hormones?

Correct Answer
verified

Which of the following explains the profound protein catabolism and gluconeogenesis associated with Cushing's syndrome?

Correct Answer
verified

Correct Answer
verified

If a patient being treated for hypoparathyroidism stopped taking the medications prescribed for his condition, which of the following would be most likely to occur?

Correct Answer
verified

Which of the following most accurately represents the pathophysiological sequence of untreated type I diabetes?

Correct Answer
verified

You respond to an ill type 2 diabetic patient. Upon your arrival, the patient complains of not feeling well for a few days, and increasing blood glucose levels. You suspect:

Correct Answer
verified

A type I diabetic presents with deep, rapid respirations and a fruity odor on her breath. Which of the following would best help correct the underlying physiologic disturbance?

Correct Answer
verified

Correct Answer
verified

An emergency department physician tells you that the hyperglycemic diabetic you brought in earlier has a pH of 7.40. What is the likeliest explanation of this statement?

Correct Answer
verified

Exam 4: Endocrinology

Which of the following is least likely to be a precipitating factor of thyrotoxic crisis?

Correct AnswerverifiedShow Answer

Which of the following statements would be most typical of an undiagnosed diabetic?

Correct AnswerverifiedShow Answer

Which of the following pathologies would necessitate the use of increased care in the preparation of an IV site because of skin fragility and increased risk of infection?

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

In response to an increase in blood sugar, the pancreas will release insulin to:

Correct AnswerverifiedShow Answer

Which of the following statements about hyperglycemic hyperosmolar nonketotic coma (HHNK) is TRUE?

Correct AnswerverifiedShow Answer

Which of the following hormones has the greatest effect on blood pressure homeostasis?

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

The thyroid releases TSH to:

Correct AnswerverifiedShow Answer

The posterior pituitary produces which two hormones?

Correct AnswerverifiedShow Answer

Which of the following explains the profound protein catabolism and gluconeogenesis associated with Cushing's syndrome?

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

If a patient being treated for hypoparathyroidism stopped taking the medications prescribed for his condition, which of the following would be most likely to occur?

Correct AnswerverifiedShow Answer

Which of the following most accurately represents the pathophysiological sequence of untreated type I diabetes?

Correct AnswerverifiedShow Answer

You respond to an ill type 2 diabetic patient. Upon your arrival, the patient complains of not feeling well for a few days, and increasing blood glucose levels. You suspect:

Correct AnswerverifiedShow Answer

A type I diabetic presents with deep, rapid respirations and a fruity odor on her breath. Which of the following would best help correct the underlying physiologic disturbance?

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

An emergency department physician tells you that the hyperglycemic diabetic you brought in earlier has a pH of 7.40. What is the likeliest explanation of this statement?

Correct AnswerverifiedShow Answer

Correct Answer
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