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Insulin is a:
A. Protein
B. Fat
C. Mineral
D. Carbohydrate

A

Which of the following types of diabetes is controlled primarily through diet, exercise, and oral medications?
A. Diabetes insipidus
B. Diabetic ketoacidosis
C. Type 1 diabetes mellitus
D. Type 2 diabetes mellitus

D

A client presenting with low levels of adrenocortical hormones in the blood or urine may have which of the following conditions?
A. Addison's Disease
B. Cushing's syndrome
C. Hyperthyroidism
D. Hypothyroidism

A

Secretion of thyroid-stimulating hormone (TSH) by which of the following glands controls the rate at which thyroid hormone is released?
A. Adrenal gland
B. Parathyroid gland
C. Pituitary gland
D. Thyroid gland

C

The hormones triiodothyronine (T3) and thyroxine (T4) affect which of the following body processes?
A. Blood glucose level & glyconeogenesis
B. Growth & development as well as metabolic rate
C. Growth of bones, muscles, & other organs
D. Bone resorption, calcium absorption, and blood calcium levels

B

What tests should be ordered if hypothyroidism is suspected?
A. Liver function tests
B. Hemoglobin A1C
C. T4 and thyroid-stimulating hormone (TSH)
D. 24-hour urine free cortisol level

C

Which of the following groups of hormones are released by the medulla of the adrenal gland?
A. Epinephrine & norepinephrine
B. Glucocorticoids, mineralocorticoids, & androgens
C. Triiodothyronine (T3), thyroxine (T4) , and calcitonin
D. Insulin , glucagon, and somatostatin

A

Diabetes Mellitus is a group of metabolic disorders in which the body's capacity to utilize glucose, fat, and protein are disturbed due to insulin deficiency or insulin resistance.
A. True
B. False

A

Which of the following conditions is caused excessive secretion of ADH (vasopressin)?
A. Thyrotoxic crisis (storm)
B. Diabetes insipidus
C. Primary Adrenocortical insufficiency
D. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

D

Insulin deficiency or resistance leads to elevated blood glucose concentration and glycosuria.
A. True
B. False

A

Diabetes insipidus is a disorder of which of the following glands?
A. Adrenal gland
B. Parathyroid gland
C. Pituitary gland
D. Thyroid gland

C

Which of the following disease processes releases enough insulin to prevent ketosis but not enough to prevent hyperglycemia?
A. Diabetes insipidous
B. Diabetic ketoacidosis
C. Type 2 diabetes mellitus
D. Hyperosmolar hyperglycemic nonketotic syndrome

D

Which of the following laboratory results results supports a diagnosis of primary hyperparathyroidism?
A. High parathyroid hormone & high calcium levels
B. High magnesium & high thyroid hormone levels
C. Low parathyroid hormone & low potassium levels
D. Low thyroid-stimulating hormone (TSH) & high phosphorus level

A

Which of the following symptoms is the chief sign of hypoparathyroidism?
A. Chest pain
B. Exophthalmos
C. Shortness of breath
D. Tetany

D

Supratentorial processes reduce arousal by:
a. destroying the RAS
b. displacement of the brain stem
c. destroying the brain stem
d. both a and c
e. none of above

B

An individual shows flexion in pper extremities and extension in lower extremities. This is:
a. decorticate posturing
b. decerebrate posturing
c. excitation posturing
d. caloric posturing

A

Cerebral death:
a. is death of the cerebellum
b. permits normal internal homeostasis
c. no longer maintains respiratory and cardiovascular functions
d. is death of the brain stem

B

Precipitating causes of seizure include all of the following except:
a. mengitis
b. stroke
c. hyperglycemia
d. hyperthermia
e. all of the above

A

Which epileptic seizure is characterized by temporal lobe spikes in the EEG?
a. autonomic
b. status epilepticus
c. absence
d. Jacksonian
e. psychomotor

D

Postictal sleeping can be seen in _________ seizures.
a. partial
b. unilateral
c. absence
d. grand mal
e. psychomotor

A

Alzheimer disease:
a. can be caused by an increased cerebral levels of acetylcholine
b. is most prevalent as a late onset dementia
c. manifests as nerve tangles
d. manifests as neural senile plaques
e. All of the above

B

Dystonia is:
a. abnormal posture maintained by muscular contractions
b. flexed posture
c. stooped, hyperflexed posture
d. a spastic gait

B

An individual with increased intracranial pressure from a head injury shows small and reactive pupils, widened pulse pressure, and slowed breathing. Which stage of ICP exists?
a. stage 1
b. stage 2
c. stage 3
d. stage 4

B

Infratentorial herniation occurs with:
a. shifting of the mesencephalon
b. shifting of the diencephalon
c. shifting of the cerebellum
d. both a and c are correct
e. none of the above

C

In cerebral vasogenic edema:
a. active transport fails
b. there is autodigestion
c. plasma proteins leak into extracellular spaces
d. cerebrospinal fluid leaves the ventricles

B

Which statement is not true regarding increasing intracranial pressure?
a. accumulating CO2 causes vasoconstriction
b the brain volume increases
c. the blood volume in the vessels increases
d. brain tissue shifts from the compartment of greater pressure to one of lesser pressure
e. both b and c

C

Intellectual function is impaired in the dementing process. Which intellectual function is not impaired?
a. anterograde memory
b. retrograde memory
c. abstraction
d. language deficits
e. all of the above are impaired

A

In blunt head trauma:
a. brain tissues are exposed
b. only focal injury occurs
c. the dura is severed
d. the dura remains intact

D

In an automobile accident, an individual's forehead struck the windshield. The coup/ contrecoup injury would be in the:
a. frontal/ parietal region
b. frontal/ occipital region
c. parietal/ occipital region
d. occipital/ frontal region

B

In moderate diffuse axonal injury:
a. coma lasts more than 24 hours
b. coma lasts less than 24 hours
c. disruption of axons occurs in cerebral hemispheres and those extending into the diencephalon and brain stem
d. tearing of axons in the cerebral hemisphere
e. both a and d

E

Most spinal cord injuries occur in the:
a. cervical and thoracic region
b. cervical and lumber region
c. thoracic and lumber region
d. lumbar and sacral region

B

Injury of the cervical cord may be life threatening because of:
a. increased intracranial pressure
b. disrupted reflexes
c. spinal shock
d. loss of bladder and rectal control
e. diaphragmatic impairment

E

Autonomic hyperreflexia is characterized by all of the following except:
a. hypotension
b. slower heart rate
c. stimulation of sensory receptors below the level of cord lesion
d. precipitation because of a distended bladder or rectum

A

Intervertebral disk herniation:
a. usually occurs at the thoracic level
b. in the lumbosacral area causes pain over the gluteal region and into the calf or ankle
c. in infrequent in the lumbosacral disks
d. both d and c
e. a, b, and c are correct

B

Transient ischemic attacks are:
a. unilateral neurologic deficits that slowly resolve
b. generalized neurologic deficits that occur a few seconds an hour
c. focal neurologic deficits that develop suddenly, last for several minutes, and clear in 24 hours
d. neurologic deficits that slowly evolve or develop

C

Which is a risk factor for the development of CVAs?
a. polycythemia vera
b. hypertension
c. diabetes mellitus
d. hyperhomocysteinemia
e. all of the above

E

Which most typically characterizes the victims of a cerebral embolic stroke?
a. individuals older than 65 with a history of hypertension
b. individuals with a long history of TIAs
c. middle aged individuals with a history of heart disease
d. individuals with gradually occurring symptoms that then rapidly disappear

C

Ruptured aneurysms are most likely in _________ cerebrovascular accidents.
a. TIA
b. thrombotic
c. embolic
d. hemorrhagic

D

Which is not a primary intracerebral neoplasm?
a. astrocytoma
b. miningioma
c. oligodendroglioma
d. ependymoma

B

In bacterial meningitis, the CSF has:
a. normal glucose levels
b. an elevated number of lymphocytes
c. neutrophilic infiltration
d. none of above
e. a, b, c are correct

C

Multiple sclerosis involves:
a. degeneration of dopaminergic receptors
b. activation of the syncytin gene
c. depletion of GABA
d. lower motor neuron muscle wasting

B

Manifestation of a subarachnoid hemorrhage include (more than one):
a. explosive headache
b. muscle flaccidity
c. neurologic deficits
d. a delayed age of onset

A C

Organs that respond to a particular hormone are called:
a. target organs
b. integrated organs
c. responder organs
d. hormone attack organs
e. none of above

A

A major feature of the "plasma membrane receptor" mechanism of hormonal action is:
a. action of cyclic AMP
b. increased lysosomal activity
c. requirement of a second messenger
d. all of above
e. both A and C

E

A major feature of the "activation of genes" mechanism of hormonal action is:
a. a second messenger is used
b. a hormone- Golgi complex is used
c. the hormone enters the cell
d. lysosomal activity increases
e. All of above

C

A hormone having an antidieuretic effect similar to that of ADH is:
a. insulin
b. oxytocin
c. hGH
d. aldosterone
e. ACTH

B

The hypothalamus controls the adenohypophysis by direct involvement of:
a. nerve impulses
b. prostaglandins
c. cerebrocortical controlling factors
d. regulating hormones
e. none of above

D

Hormones convey regulatory info by:
a. endocrine signaling
b. paracring signaling
c. autocrine signaling
d. synaptic signaling
e. all of above

E

If calcium levels in the blood were too high, (calcitonin) concentrations in the blood should:
a. increase, thereby inhibiting osteoclasts
b. increase, thereby stimulating osteoclasts
c. increase, but this wouldn't affect osteoclasts
d. decrease, thereby inhibiting osteoclasts
e. decrease, thereby stimulating osteoclasts

A

In the negative feedback mechanism controlling thyroid hormone secretion, which his the non-regulatory hormone?
a. TRH
b. TSH
c. thyroxine
d. all of above are regulatory

C

The control of parathyroid hormone is most accurately described as:
a. negative feedback controlled by the hypothalamus
b. positive feedback controlled by the pituitary
c. negative feedback involving the pituitary
d. negative feedback not involving the pituitary
e. both a and c

D

The renin- angiotensin- aldosterone system begins to function when renin is secreted by the:
a. adrenal cortex
b. adrenal medulla
c. pancreas
d. kidneys
e. none of above

D

The effects of adrenal medullary hormones and the effects of sympathetic stimulation can be described as:
a. opposites in all respects
b. overlapping in some respects
c. opposites in some respects
d. variable depending on the sex involved
e. overlapping in most respects

E

Which best describes the respective effects of insulin and glucagon on blood sugar?
a. insulin raises blood sugar; glucagon lowers it
b. both raise blood sugar
c. insulin lowers blood sugar; glucagon raises it
d. both lower blood sugar
e. none of above

C

The releasing hormones produces in the hypothalamus travel to the anterior pituitary via the:
a. stem neurons
b. infundibular stem
c. hypophyseal stalk
d. hypophysial portal system

D

Which anabolic hormone increases muscle protein synthesis?
a. T4
b. aldosterone
c. FSH
d. insulin

D

Aldosterone maintains electrolyte balance by:
a. retention of potassium
b. elimination of sodium
c. retention of both Na and K
d. both a and b
e. none of above

E

Which lab value would be expected in an individual with SIADH?
a. serum Na= 150mEq/L and urine hypoosmolality
b. serum K= 5mEq/L and serum hypoosmolality
c. serum Na= 120 mEq/L and urine hypoosmolality
d. serum K= 3 mEq/L and serum hypoosmolality

C

Hypopituitarism in an adult male likely includes all of the following except:
a. dwarfism
b. impotence
c. muscular mass decrease
d. skin pallor

A

Excessive secretion of GH in an adult may cause:
a. acromegaly
b. giantism
c. hypoglycemia
d. decreased metabolic rate

A

A manifestation shared by both diabetes mellitus and diabetes insipidus is:
a. elevated blood and urine glocose levels
b. inability to produce ADH
c. inability to produce insulin
d. polyuria
e. elevated blood urine and ketone body levels

D

The manifestations of hyperthyroidism include all of the following except:
a. diarrhea
b. constipation
c. heat intolerance
d. weight loss
e. wakefulness

B

Hypothyroidism crisis is:
a. myxedema coma
b. Addison disease
c. Cushing disease
d. Graves disease
e. cretenism

A

Graves disease is:
a. hyperthyroidism
b. associated with autoimmunity
c. manifested as ophthalmopathy
d. all of above

D

Inadequate levels of thyroid hormones at birth may cause:
a. mental retardation
b. immediate death
c. thyroid crisis
d. myxedema
e. dwarfism

A

Hyperparathyroidism causes:
a. increased osteoclastic activity
b. decreased plasma calcium
c. increased phosphorus absorption from GI tract
d. hyopcalcemia

A

A manifestation of hypocalcemia is:
a. myopathy
b. lethargy
c. hypertension
d. tetany
e. bone cysts

D

What is the most common cause of acromegaly?
a. anterior pituitary adenoma
b. overproduction of ACTH
c. overproduction of TSH
d. pituitary atrophy

A

If a 19 year old woman were suffering from shortness of breath, weight loss, excessive sweating, exophthalmos, and irritability, which hormone would you expect to find elevated in her serum?
a. cortisol
b. thyroxine
c. ACTH
d. 17- ketosteroid

B

A 24 year old female with a history of "juvenile onset" diabetes is found in a stuporous state. She is hypotensive and has cold, clammy skin. What is the likely etiology of her condition?
a. hyperglycemia
b. insulin shock
c. renal failure
d. peripheral neuropathy

B

A 10 year old male was brought into the emergency room comatose, suffering from metabolic acidosis with a blood glucose level of 800 mg/dl. The most probable disease causing his condition is:
a. cretenism
b. type 1 diabetes mellitus
c. type 2 diabetes mellitus
d. IGT
e. GDM

B

Your neighbor, not previously diagnosed as a diabetic, has gained 80 lobs in the past year and is able to produce some insulin. Her fasting blood sugar is always elevated. She is being treated with oral insulin stimulating drugs. Your neighbor is most likely suffering from:
a. diabetes insipidus
b. type 1 diabetes mellitus
c. type 2 diabetes mellitus
d. IGT
e. GDM

C

Common symptoms and signs of diabetes mellitus include all of the following except:
a. hyperglycemia
b. blurred vision
c. increased muscle anabolism
d. persistent infection
e. polyuria

C

Which lab finding is inconsistent with a diagnosis of absolute insulin deficiency?
a. FBS (fasting blood sugar) of 90 mg/dl
b. ketonuria
c. blood glucose of 210 mg/dl after 1 hour following ingestion of 100 g glucose
d. decreased serum insulin levels
e. all of the above are good

A

Common complications of diabetes mellitus include all of the following except:
a. retinopathy
b. peripheral neuropathy
c. nephropathy (kidney disease)
d. none of above
e. all of above

E

An individual with type 1 diabetes mellitus experiences hunger, lightheadedness, headache, confusion, and tachycardia while cross- country running. The likely cause of these manifestations is:
a. hyperglycemia
b. eating a snack before running
c. hypoglycemia because of running
d. both a and b
e. none of above

C

Which is/are expected during hyperinsulinism?
a. excess insulin
b. high serum glucose
c. epinephrine release
d. all of above
e. both a and c

E

Long-term corticosteroid therapy may cause: (more than one)
a. delayed wound healing
b. osteoporosis
c. peptic ulcers
d. hyperkalemia

A B C

Which electrolyte alteration occurs in Addison disease?
a. hypokalemia
b. hypernatremis
c. hyponatremia
d. hypocalcemia

C

A benign tumor of adrenal glands that causes hypersecretion of aldosterone is:
a. Addison disease
b. a phenochromocytoma
c. Gushing disease
d. Cushing syndrome
e. Conn disease

E

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