MS Midterm Reviewer - Answers with
Rationales
1. Answer: a
Rationale: Normal bowel sounds occur 5–30 times per minute, indicating regular peristalsis.
2. Answer: c
Rationale: Peripheral neuropathy is a common complication of diabetes that impairs
sensation, particularly in the extremities.
3. Answer: c
Rationale: Supine position with knees flexed relaxes the abdominal muscles, ideal for
abdominal assessment.
4. Answer: a
Rationale: SIADH causes water retention; fluid restriction prevents further dilutional
hyponatremia.
5. Answer: b
Rationale: Tetanic contractions are due to hyponatremia-related low calcium levels in
SIADH.
6. Answer: a
Rationale: Diabetes insipidus results from ADH deficiency, causing excessive urination and
thirst.
7. Answer: a
Rationale: Mitotane is an adrenolytic agent used to treat adrenal carcinoma in Cushing’s
syndrome.
8. Answer: d
Rationale: Hypothyroidism reduces GFR, leading to water retention and possible dilutional
hyponatremia.
9. Answer: c
Rationale: Desmopressin (DDAVP) replaces ADH in diabetes insipidus, reducing urine
output.
10. Answer: c
Rationale: Heredity is a known contributing factor to the development of Crohn's disease.
11. Answer: c
Rationale: Crohn's can affect any part of the GIT, most commonly the terminal ileum and
colon, across all bowel wall layers.
12. Answer: c
Rationale: DKA occurs due to lack of insulin, causing hyperglycemia and ketone production.
13. Answer: a
Rationale: Immunosuppression in Cushing's syndrome increases infection risk.
14. Answer: b
Rationale: Adrenalectomy may cause temporary adrenal insufficiency due to hormone
withdrawal.
15. Answer: c
Rationale: The fluid deprivation test confirms DI by showing inability to concentrate urine.
16. Answer: b
Rationale: Therapy for DI focuses on replacing fluid losses and administering vasopressin.
17. Answer: d
Rationale: Without fluids, DI leads to dehydration and high sodium due to excess water loss.
18. Answer: b
Rationale: Billroth II involves partial gastrectomy with anastomosis to the jejunum.
19. Answer: d
Rationale: Addison’s requires high sodium and low potassium diet; this statement needs
correction.
20. Answer: c
Rationale: Thyroid storm is a life-threatening state of hyperthyroidism with fever,
tachycardia, and restlessness.
21. Answer: b
Rationale: Myxedema coma is a severe hypothyroid emergency with hypothermia,
bradycardia, and respiratory depression.
22. Answer: b
Rationale: Thyroid storm causes hypermetabolism: high temperature, pulse, and BP.
23. Answer: a
Rationale: Unexplained weight loss is a classic symptom of type 1 diabetes onset.
24. Answer: b
Rationale: Kussmaul respirations are deep, rapid breaths that compensate for metabolic
acidosis in DKA.
25. Answer: a
Rationale: Polyuria from hyperglycemia indicates poor glucose control and long-term
complications.
26. Answer: c
Rationale: Alendronate can irritate the esophagus; sitting up prevents reflux or esophageal
injury.
29. Answer: a
Rationale: Limiting fluids in hyperparathyroidism is incorrect; patients need hydration to
prevent kidney stones.
30. Answer: b
Rationale: Effective SIADH treatment leads to increased urine, corrected sodium, and dilute
urine.
31. Answer: a
Rationale: Polyuria is a common sign of hyperparathyroidism due to hypercalcemia-
induced diuresis.
32. Answer: c
Rationale: Thyrotoxic crisis presents with high fever and cardiovascular compromise.
33. Answer: a
Rationale: Addisonian crisis is life-threatening adrenal insufficiency with acute hypotension.
34. Answer: d
Rationale: Adrenalectomy in pheochromocytoma can cause unstable BP due to hormone
shifts.
35. Answer: c
Rationale: Aspirin and beta-blockers interfere with test accuracy and must be discontinued.
36. Answer: a
Rationale: Acute pancreatitis presents with steatorrhea, abdominal pain, and fever.
37. Answer: c
Rationale: Metformin should be taken with meals to minimize GI side effects.
38. Answer: c
Rationale: Bleeding after thyroidectomy may track to the back of the neck and compromise
the airway.
39. Answer: b
Rationale: Exophthalmos in Graves' disease is caused by fluid and tissue buildup behind the
eyes.