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level: Endocrine, continued

Questions and Answers List

level questions: Endocrine, continued

QuestionAnswer
What are the early signs of hypothyroidism?Weight gain, difficulty concentrating, constipation, fluid/weight gain
Mood swings, depression, infertility, and acute fatigue syndrome are late signs of ______Hypothyroidism
What would assessment of the hair and skin of a patient with hypothyroidism reveal?Hair that is thin and falling out Thickened skin
Hormone replacement therapy using dissected animal thyroid, T4, and levothyroxine therapy are used to treat _________Hypothyroidism
What kind of agents are preferred over biologic agents to treat hypothyroidism?Synthetic agents
What time of the day are drugs used to treat hypothyroidism administered?In the morning
How should levothyroxine be taken?On an empty stomach
What temperature should the room be set to for a patient with hypothyroidism?70-74 F
A patient with hypothyroidism needs an adequate intake of iodine found in foods such as:Salt water fish Eggs Milk
A simple goiter develops when the thyroid gland enlarges in response to:Low iodine levels in the bloodstream
In a patient with a simple goiter, what accumulates in the thyroid follicles, causing them to enlarge?Thyroglobulin (colloid)
How is a simple goiter diagnosed?By physical appearance
______ solution is an antihyperthyroid agent, used in conjunction with other medications to decrease or shrink the thyroid glandLugol's solution
What is the medical treatment of a simple goiter?Oral administration of potassium iodine and foods high in iodine
How many people in the US are affected by cancer of the thyroid each year?25 per 1 million
What is the principal clinical manifestation of thyroid cancer?Firm, fixed, small, rounded, painless mass
What is suspected when a thyroid scan shows a "cold" nodule?Papillary thyroid cancer
When a patient has thyroid cancer, thyroid function tests usually yield ______ resultsNormal
What is the treatment of thyroid cancer?Total thyroidectomy with lifelong hormone replacement
Hyperparathyroidism usually occurs in adults between which ages?30 - 70
What is the primary clinical manifestation of hyperparathyroidism?Hypercalcemia
Hypercalcemia occurs as calcium _____ the bones, and accumulates in the _______Leaves the bones and accumulates in the bloodstream
A fractured bone, unrelated to trauma may be the first presentation of which illness?Hyperparathyroidism
Which blood levels are increased in a patient with hyperparathyroidism?PTH Alkaline phosphate
What will a radiographic examination reveal in a person with hyperparathyroidism?Skeletal decalcification
In hyperparathyroidism, serum ______ levels are elevated whereas _______ levels are decreased.Calcium levels are elevated, serum phosphorus levels are decreased
What is the diuretic of choice in treating a patient with hyperparathyroidism?Furosemide
Why are thiazide diuretics contraindicated in a patient with hyperparathyroidism?They decrease renal excretion of calcium- increased hypercalcemic state
Some diuretics, and lithium can _____ the serum calcium level.Elevate
Hypoparathyroidism occurs when there is decreased _____, resulting in decreased levels of serum calciumPTH
Decreased PTH in the bloodstream causes increased _______, and decreased ________Increased serum phosphorus, decreased calcium
A patient with hypoparathyroidism will have signs and symptoms of ________, do to lack of serum calciumHypocalcemia
Why should calcium gluconate and calcium chloride be given slowly?These drugs irritate the vessel wall
At what rate should calcium gluconate be given?1mL/min
Which drug interferes with normal parathyroid functioning?Cimetidine (Tagamet)
What is the preferred vitamin D supplement prescribed for a patient with hypoparathyroidism experiencing chronic and resistant hypocalcemia?Calcitroil (Rocaltrol)
How much calcium should a patient with hypoparathyroidism consume daily?1200mg/day
A patient with hypoparathyroidism should consume a diet low in ________Phosphorus
Cushing's syndrome is caused by excess _______Corticosteroids; particularly glucocorticoids
Moon face and buffalo hump are signs and symptoms associated with which syndrome?Cushing's syndrome
What is the most common feature of Cushing's syndrome?Weight gain
Hypokalemia is usually present in a patient with _____________.Cushing's syndrome
Why does hyperglycemia occur in a patient with Cushing's syndrome?Glucose intolerance and increased glucose release by the liver
If the patient cannot undergo surgery, what kind of therapy may be used to treat Cushing's syndrome?Mitotane (Lysodren) therapy
Tuberculosis causes _______ worldwide.Addison's disease
What is the most common cause of Addison's disease?Autoimmune response
Adrenal hypofunction is also called _______.Addison's disease
Adrenal insufficiency occurs most often in which ages?Younger than 60
Clinical manifestations of Addison's disease are not evident until __% of the adrenal cortex is destroyed90%
A life-threatening emergency caused by insufficient adrenocortical hormones is called ______Addisonian crisis
Decreased serum sodium, increased serum potassium, and decreased serum glucose are lab values associated with ____________.Addison's disease
What is the most common form of hormone replacement therapy for a patient with Addison's disease?Hydrocortisone
Management of an addisonian crisis includes hydrocortisone therapy, and 0.9% _____ and 5% _____.0.9% saline, 5% Dextrose
What occurs when the adrenal glands do not secrete adequate amounts of glucocorticoids, mineralocorticoids, and androgens?Adrenocortical insufficiency- Addison's disease
The patient with Addison's disease should carry an emergency kit with ___mg of _______.100 mg of hydrocortisone
A rare tumor of the adrenal medulla that causes excessive secretion of catecholamine is called a _________.Pheochromocytoma
Secretion of excessive catecholamine results in severe __________.Hypertension
During hypertensive crisis. the blood pressure may fluctuate as high as _____.300/175 mm Hg
What is the simplest and most reliable test for pheochromocytoma?24 hour urine collection
Which drug is used for patients with pheochromocytoma to help inhibit catecholamine production and must be continued if the tumor is inoperable?Metyrosine (Demser)
If pheochromocytoma is left untreated, it may lead to which 3 conditions?Diabetes mellitus Cardiomyopathy Death
Insulin is a _____ that allows the body's cells to absorb glucose from the bloodstreamProtein
What is the average about of insulin secreted in an adult?40 to 50 unites every 24 hrs
What is the value for a normal blood glucose level?Between 70 and 100 mg/dl
Within ____ years of the diagnosis of Type 1 Diabetes, all of the beta cells have been destroyed and no insulin is produced5 years
What is the main problem in Type 2 diabetes?Abnormal resistance to insulin action
What are the two reasons a patient with diabetes (elevated blood glucose) is at risk for infection?1. Increased amount of glucose is a food source for pathogens 2. Circulatory and nervous system complications
Signs and symptoms of type 1 diabetes often occur under the age of ___30
What are the three poly's of type 1 diabetes?Polydipsia Polyuria Polyphagia
What causes the patient with type 1 diabetes to lose weight?The body burns fat and protein instead of glucose for energy
During exercise, the muscles use glucose even if _______ is not availableInsulin
Glucose is stored in the form of glycogen in the _____Liver
Abnormal amounts of glucose are excreted in the ______Urine
HbA1C can determine the patient's average blood glucose levels over the past _____ days120 (3 months)
When should a diabetic patient test their blood glucose levels if receiving two or more injections of insulin per day?Before meals and at bedtime
A diabetic patient should maintain near normal blood glucose levels of:60 - 99 mg/dl
HbA1C levels should be ______4% - 6%
Exercise _____ the absorption rate of glucoseIncreases
What is necessary before exercise if the patients blood glucose level is less than 100 mg/dl?Carbohydrate snack
When should a type 2 diabetes patient discontinue oral antidiabetic medication before surgery?48 hours before surgery
When is Glargine (Lantus) taken?Once a day at bedtime
What kind of insulin is "peakless" and works around the clock for 24 hours?Glargine (Lantus)
What is the only kind of insulin that can be administered intravenously?Regular insulin
What kind of insulin is Lispro (Humalog)?Rapid-acting
When do rapid-acting insulins peak?10-30 min
100 U syringes are marked in ____ increments2-unit increments
Insulin needles are very fine, ___ to ___ gauge25 - 32 gauge
Insulin should be administered at what temperature?Room temperature
List the best sites for insulin injection in order, starting with the most preferred site:Abdomen, arms, thighs, buttocks
What is the closest substitute to a healthy, working pancreas?Insulin pump
What does glucagon do?Stimulates the liver to change stored glycogen into glucose
What is the usual adult dose of glucagon?0.5mg -1mg
Which drug acts adjunct to insulin therapy, and decreases gastric emptying, glucagon secretion, and glucose output?Pramlintide (Symlin)
Some patients with type 1 diabetes have the option of a pancreas transplant. When is a pancreas transplant usually performed?If the patient has end stage renal disease, and has already had a kidney transplant or will need one
What are the chronic complications of diabetes mellitus? List three.1. Blindness 2. Cardiovascular problems 3. Renal failure
What is the principal mineralocorticoid?Aldosterone
Aldosterone regulates sodium and potassium, causing _______ to increase and _______ to decrease?Sodium increases, potassium decreases
Epinephrine and norepinephrine are released by the _____ ______.Renal medulla
Mineralocorticoids are involved primarily in ______ and _______ balance; indirectly manages blood pressure.Water and electrolyte balance
Glucocorticoids exhibit _______ properties.Anti inflammatory properties