Chapter 59.

Metabolic Disorders

1. What Kind Of Control Mechanism Is Indicated When Increased Blood Glucose Levels Stimulate
Increased Secretion Of Insulin?

a. Control By Releasing Hormones

b. Control By Tropic Hormones

c. Negative Feedback Control ✓

d. Hypothalamus/Hypophysis Coordination

2. What Is The Most Common Cause Of Endocrine Disorders?

a. Malignant Neoplasm

b. Infection

c. Congenital Defect

d. Benign Tumor ✓

3. Choose The Statement That Applies To Type 1 Diabetes Mellitus.

a. Onset Often Occurs During Childhood. ✓

b. Relative Insufficiency Of Insulin Or Insulin Resistance Develops.

c. It Can Be Treated By Diet, Weight Control And Exercise, Or Oral Hypoglycemics.

d. Complications Rarely Occur.

a. Increased Thirst And Hypoglycemia

b. Ketoacidosis

c. Osmotic Pressure Due To Glucose ✓

d. Diabetic Nephropathy

5. What Is The Cause Of Diabetic Ketoacidosis?

a. Excess Insulin In The Body

b. Loss Of Glucose In The Urine

c. Failure Of The Kidney To Excrete Sufficient Acids

d. Increased Catabolism Of Fats And Proteins ✓

6. What Is A Precipitating Factor For Diabetic Ketoacidosis?

a. Skipping A Meal

b. Anorexia

c. Serious Infection ✓

d. Insulin Overdose

7. Which Of The Following May Cause Insulin Shock To Develop?

a. Strenuous Exercise ✓

b. Missing An Insulin Dose

c. Eating Excessively Large Meals

d. Sedentary Lifestyle
8. Which Of The Following Indicates Hypoglycemia In A Diabetic?

a. Deep, Rapid Respirations

b. Flushed Dry Skin And Mucosa

c. Thirst And Oliguria

d. Staggering Gait, Disorientation, And Confusion ✓

9. Which Of The Following Are Signs Of Diabetic Ketoacidosis In An Unconscious Person?

a. Pale Moist Skin

b. Thirst And Poor Skin Turgor

c. Deep Rapid Respirations And Fruity Breath Odor ✓

d. Tremors And Strong Rapid Pulse

10. Immediate Treatment For Insulin Shock May Include:

a. Administration Of Bicarbonates.

b. Consumption Of Fruit Juice Or Candy. ✓

c. Induced Vomiting.

d. Consumption Of Large Amounts Of Water.

11. What Causes Loss Of Consciousness In A Person With Diabetic Ketoacidosis?

A. Toxic Effects Of Excessive Insulin

B. Excessive Glucose In The Blood

C. Metabolic Acidosis ✓

D. Lack Of Glucose In Brain Cells

A. Osteoporosis ✓

B. Nephropathy

C. Impotence

D. Peripheral Neuropathy

13. How Do Many Oral Hypoglycemic Drugs Act?

A. To Replace Insulin In Patients With Insulin-Dependent Diabetes Mellitus (IDDM)

B. To Transport Glucose Into Body Cells

C. To Prevent Gluconeogenesis

D. To Stimulate The Pancreas To Produce More Insulin ✓

14. Diabetes May Cause Visual Impairment Through Damage To The Lens; This Is Referred To As:

a. Cataracts. ✓

b. Macular Degeneration.

c. Myopia.

d. Strabismus.
15. Which Of The Following Applies To Diabetic Macro-Angiography?

1. It Affects The Small Arteries And Arterioles.

2. It Is Related To Elevated Serum Lipids.

3. It Leads To Increased Risk Of Myocardial Infarction And Peripheral Vascular Disease.

4. It Frequently Causes Damage To The Kidneys.

A. 1, 3

B. 1, 4

C. 2, 3 ✓

D. 2, 4

16. Why Is Amputation Frequently A Necessity In Diabetics?

a. Necrosis And Gangrene In The Feet And Legs ✓

b. Lack Of Glucose To The Cells In The Feet And Legs

c. Severe Dehydration In The Tissues

d. Elevated Blood Glucose Increasing Blood Viscosity

17. A Type Of Diabetes That May Develop During Pregnancy And Disappear After Delivery Is Called:

a. Temporary Maternal Diabetes.

b. Fetal Diabetes.

c. Acute Developmental Diabetes.

d. Gestational Diabetes. ✓
18. Which One Of The Following Develops Hypoglycemia More Frequently?

a. Type 1 Diabetic Patients ✓

b. Type 2 Diabetic Patients

c. Patients With A Poor Stress Response

d. Patients With A Regular Exercise And Meal Plan

19. Which Of The Following Hormonal Imbalances Causes Addisons Disease?

a. Increased Glucocorticoids

b. Decreased Glucocorticoids ✓

c. Deficit Of Antidiuretic Hormone (ADH)

D. Deficit Of T3 And T4

20. Which Of The Following Hormonal Imbalances Causes Myxedema?

a. Increased Glucocorticoids

b. Decreased Glucocorticoids

c. Deficit Of ADH

D. Deficit Of T3 And T4 ✓

21. Which Of The Following Hormonal Imbalances Causes Diabetes Insipidus?

a. Increased Insulin

b. Decreased Glucocorticoids

c. Deficit Of ADH ✓

D. Deficit Of T3 And T4
22. What Is Caused By Hyperparathyroidism?

a. Hypocalcemia

b. Tetany

c. Bone Demineralization ✓

d. Deficit Of Vitamin D

23. What Is Caused By Hypocalcemia Due To Hypoparathyroidism?

1. Skeletal Muscle Twitching Or Spasm

2. Weak Cardiac Contraction

3. Increased Secretion Of Parathyroid Hormone (PTH)

4. Decreased Serum Phosphate Level

A. 1, 2 ✓

B. 1, 3

C. 2, 3

D. 3, 4

24. Which Of The Following Applies To Acromegaly?

a. It Occurs In Infants And Children.

b. It Causes Excessive Longitudinal Bone Growth.

c. It Results From Excessive Secretion Of Growth Hormone (GH). ✓

d. It Does Not Change Soft Tissue Growth.

1. Hyperthyroidism

2. Hypothyroidism

3. Lack Of Iodine In The Diet

4. Pheochromocytoma

A. 1, 4

B. 2, 3

C. 1, 2, 3 ✓

D. 1, 2, 3, 4

26. Which Signs Are Typical Of Graves Disease?

a. Facial Puffiness, Bradycardia, And Lethargy

b. Exophthalmos And Tachycardia ✓

c. Delayed Physical And Intellectual Development

d. Goiter And Decreased Basal Metabolic Rate (BMR)

27. Characteristics Of Cushings Syndrome Include All Of The Following EXCEPT:

a. Heavy Body And Round Face

b. Atrophied Skeletal Muscle In The Limbs

c. Staring Eyes With Infrequent Blinking ✓

d. Atrophy Of The Lymph Nodes

a. Decreased Secretion From The Adrenal Cortex Gland ✓

b. An Increased Inflammatory Response To Irritants

c. Hypotension And Poor Circulation

d. Increased Number Of Hypersensitivity Reactions

29. Which Of The Following Is An Effect Of Addisons Disease?

a. Elevated Blood Glucose Levels

b. High Blood Pressure

c. Low Serum Potassium Levels

d. Poor Stress Response ✓

30. What Is The Most Common Cause Of Type 1 Diabetes Mellitus?

a. Increased Glucose Production In The Liver

b. Destruction Of Pancreatic Cells By An Autoimmune Reaction ✓

c. Increased Resistance Of Body Cells To Insulin Action

d. Chronic Obesity

31. Why Does Glucosuria Occur In Diabetics?

a. Excess Ketoacids Displace Glucose Into The Filtrate.

b. Excess Water In The Filtrate Draws More Glucose Into The Urine.

c. The Amount Of Glucose In The Filtrate Exceeds The Renal Tubule Transport Limit. ✓

d. Sufficient Insulin Is Not Available For Glucose Reabsorption.

1. Persistent Headaches

2. Hemianopia

3. Hypertension

4. Papilledema

A. 1, 4

B. 2, 3

C. 1, 2 ✓

D. 1, 3, 4

33. Which Of The Following Does NOT Apply To Inappropriate ADH Syndrome?

a. The Cause Is Excess ADH Secretion.

b. Severe Hyponatremia Results.

c. Excessive Sodium Is Retained. ✓

d. Fluid Retention Increases.

34. What Is/Are The Effect(S) Of Thyrotoxic Crisis?

a. Hyperthermia And Heart Failure ✓

b. Hypotension And Hypoglycemia

c. Toxic Goiter And Hypometabolism

d. Decreased Stress Response

a. Hypothyroidism

b. Cushings Disease ✓

c. Addisons Disease

d. Growth Hormone Deficit

36. Which Of The Following Conditions May Cause Immunosuppression?

a. Graves Disease

b. Acromegaly

c. Cushings Disease ✓

d. Diabetes Insipidus

37. Hyperosmolar Hyperglycemic Nonketotic Coma (HHNC) More Frequently Develops In Patients
With:

a. Type 1 Diabetes.

b. Type 2 Diabetes. ✓

c. Graves Disease.

d. Hyperparathyroidism.
Question 38

38. Which Of The Following Is Recommended For Immediate Treatment Of Hypoglycemic Shock?

1. If Conscious, Immediately Give Sweet Fruit Juice, Honey, Candy, Or Sugar.

2. If Unconscious, Give Nothing By Mouth (Require Intravenous Glucose 50%).

3. Treat Immediately With Insulin.

4. Give Large Quantity Of Clear Fluids For Shock.

A. 1, 2 ✓

B. 1, 3

C. 2, 3

D. 1, 3, 4

39. All These Tissues Use Glucose Without The Aid Of Insulin EXCEPT:

a. Liver. ✓

b. Digestive System.

c. Exercising Skeletal Muscle.

d. Brain.

40. Differences Between Type 1 And Type 2 Diabetes Include Which Of The Following?

a. Type 1 Diabetes Weight Gain Is Common, And Type 2 Weight Loss Often Occurs.

b. Type 1 Diabetes Leads To Fewer Complications Than Does Type 2 Diabetes.

c. Type 1 Diabetes May Be Controlled By Adjusting Dietary Intake And Exercise, But Type 2 Diabetes
Requires Insulin Replacement.

d. Type 1 Diabetes Occurs More Frequently In Children And Adolescents, And Type 2 Diabetes
Occurs More Often In Adults. ✓
41. Complications Of Diabetes Mellitus Include:

a. Peripheral Neuropathy.

b. Frequent Infections.

c. Cataracts.

d. A, B, And C. ✓

42. Which Of The Following Often Causes Hyperparathyroidism?

a. A Malignant Tumor In The Parathyroid Glands

b. End-Stage Renal Failure

c. Osteoporosis

d. Radiation Involving The Thyroid Gland And Neck Area ✓

43. Dwarfism Is Caused By:

a. Excessive Levels Of Somatotropin (GH).

b. A Deficit Of Somatotropin (GH). ✓

c. Excessive Levels Of Insulin.

d. Excessive Levels Of Parathyroid Hormone.

44. Which Of The Following Results From A Deficit Of Antidiuretic Hormone (ADH)?

a. Inappropriate ADH Syndrome

b. Gigantism

c. Diabetes Insipidus ✓

d. Myxedema
45. Goiters Occur More Frequently In Persons Living In The:

a. Great Lakes Or Mountainous Regions. ✓

b. Southwest United States.

c. Temperate Regions.

d. Areas Bordering The Oceans.

46. Which Of The Following Is Caused By Graves Disease?

a. Hypermetabolism ✓

b. Decreased Size Of Thyroid Gland

c. Bradycardia And Hypothermia

D. Decreased Blood Levels Of T3, T4, And TSH

47. Goiters May Be Caused By:

a. Hypothyroid Conditions Only.

b. Either Hypothyroid Or Hyperthyroid Conditions. ✓

c. Hyperthyroid Conditions Only.

d. Fungal Infections Such As Candidiasis.

48. Severe Impairment Of All Aspects Of Growth And Development, Including Difficulty Feeding,
Mental Retardation, And Stunted Skeletal Growth, Are Associated With:

a. Myxedema.

b. Cushings Syndrome.

c. Diabetes Insipidus.

d. Cretinism. ✓

e. Graves Disease.
49. A Benign Tumor Of The Adrenal Medulla That Secretes Epinephrine And Norepinephrine Is
Called:

a. Pheochromocytoma. ✓

b. Cushings Syndrome.

c. Graves Disease.

d. Addisons Disease.

50. The Anterior Pituitary Gland Secretes All Of The Following Hormones EXCEPT:

a. Prolactin (PRL).

b. Glucagon. ✓

c. Adrenocorticotropic Hormone (ACTH).

d. Growth Hormone (GH).