Bioscience 2: Test 3
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Test 3 in bioscience covering the Endocrine lectures.
- 1.Which of the following is not one of the major regulating systems for homestasis?
- A.
Cardiovascular system
- B.
Nervous System
- C.
Endocrine System
- D.
All of these are important in regulating homeostasis
- 2.The endocrine system in important in regulating all of the following except…
- A.
Metabolism
- B.
Mobility
- C.
Fluid Status
- D.
Behavior
- 3.Which of the following is not an endocrine gland?
- A.
Placenta
- B.
Thyroid
- C.
Spleen
- D.
Pancreas
- 4.Endocrine function is mediated by ____
- A.
Neurotransmitters
- B.
Peptides
- C.
Cortisol
- D.
Hormones
- 5.Growth hormone is synthesized and secretd by the anterior pituitary but exerts its effects in tissues throughout the body, this is known as a _______ function.
- A.
Paracrine
- B.
Mesocrine
- C.
Autocrine
- D.
Somacrine
- 6.When a secreted hormone acts on the producer cell itself this is known as a ______ function.
- A.
Paracrine
- B.
Mesocrine
- C.
Autocrine
- D.
Somacrine
- 7.Which of the following is not one of the major categories of hormones?
- A.
Peptides
- B.
Esters
- C.
Amines
- D.
Steroids
- 8.Which of the following are not Peptide hormones? (multiple answers)
- A.
Oxytocin
- B.
Vasopressin
- C.
Thyroxine
- D.
Aldosterone
- E.
Estrogen
- 9.Which of the following are Amine hormones? (mult answer)
- A.
Thyroxine
- B.
Calcitonin
- C.
Testosterone
- D.
ACTH
- E.
Serotonin
- 10.Which of the following are steroid hormones? (mult answer)
- A.
Serotonin
- B.
Cortisol
- C.
Angiotensin
- D.
Estrogen
- E.
Prolactin
- 11.A person with Hypothyroidism most likely has a _________ number of receptors for that hormone.
- A.
Amount of circulating hormone has no effect on receptors.
- B.
Decreased
- C.
Increased
- 12.The “master gland” is also called the….
- A.
Pituitary
- B.
Adrenal
- C.
Pancreas
- D.
Thyroid
- 13.Secretion of pituitary hormones is regulated by what?
- A.
Adenohypophysis
- B.
Hypothalamus
- C.
Neurohypophysis
- D.
Pons
- 14.Which of the following are secreted by the Adenohypophysis? (mult Answers)
- A.
ADH
- B.
Prolactin
- C.
ACTH
- D.
Oxytocin
- E.
Growth Hormone
- 15.Hypothalamic hormones may inhibit release of anterior pituitary hormones.
- A.
True
- B.
False
- 16.Sheehan’s syndrome is a form of postpartum shock that results in a pituitary infract. Thus causing hypopituitarism. Knowing the hormones of the pituitary gland you would expect this pt to require which of the following treatments? (mult answer)
- A.
Synthroid, to maintain thyroid function
- B.
Demeclocycline, to antagonize effects of ADH on kidneys
- C.
Corticosteroid replacement, due to decreased cortisol levels
- D.
Smaller ETT due to subglottic narrowing caused by growth hormone
- 17.Which of the following is not a symptom of acromegaly?
- A.
Cardiomyopathy
- B.
Hepatomegaly
- C.
Hyperglycemia
- D.
Decreased Lung volumes
- 18.Hypersecretion of growth hormone is a 21 yr old male is most likely to result in which of the following?
- A.
Acromegaly
- B.
Dwarfism
- C.
Gigantism
- D.
Sheehans Syndrome
- 19.You are caring for Mr. Andrews today who has a PMH of Acromegaly. Your preceptor asks you what anesthetic considerations are most important when inducing the for anesthesia. To sound like a really smart SRNA you should say which of the following?
- A.
“My pt has decreased lung volumes due to the effects of growth hormone, so may desaturate easily. I need to intubate quickly”
- B.
“This pt may be a difficult intubation due to the effects of excessive growth hormone. Perhaps we should consider a fiberoptic intubation.”
- C.
“My pt will be hypotensive. Perhaps I should consider giving a small fluid bolus prior to inducing this pt.”
- D.
“I will put the tube in, YOU check a blood sugar. I need to focus most of all on the hyperglycemia.”
- 20.Aweeee! You’re having a Baby! (If you are a male consider it a divine miracle). It sounds nice but you are currently experiencing horrible uterine contractions while cursing God and the stupid &*#% man that put you here. In this moment of exquisite pain you think back to bioscience and realize what gland and hormone are responsible for your current predicament?
- A.
Anterior Pituitary and Prolactin
- B.
Anterior Pituitary and Oxytocin
- C.
Posterior Pituitary and Oxytocin
- D.
Posterior Pituitary and Prolactin
- E.
Wait... If I'm a guy where the heck is that thing going to come out of?!?!?!?!
- 21.ADH is synthesized and secreted by the posterior pituitary gland.
- A.
True
- B.
False
- 22.A decrease in ADH secretion will result in a ______ in urine osmolarity and a _____ decrease in serum osmolarity.
- A.
Decrease, Decrease
- B.
Increase, Increase
- C.
Increase, Decrease
- D.
Decrease, Increase
- 23.Which of the following will not trigger release of ADH from the posterior pituitary?
- A.
Decrease in plasma sodium ion concentration
- B.
Increase in plasma osmolarity
- C.
Decrease in blood volume
- D.
Decrease in BP
- 24.Diabetes Insipidus is caused by excessive secretion of ADH from the posterior pituitary lobe.
- A.
True
- B.
False
- 25.You are caring for Ms. Mourtain who is in the hospital due to AMS related to a brain tumor. She was recently diagnosed with Diabetes Insipidus, and needs to be treated. Which of the following would be the best choice to treat this pt?
- A.
Democlocycline 150 mg PO every 6 hours
- B.
Administer D5NS IV first to correct hypovolemic shock and hyponatremia
- C.
Give Desmopressin 2mcg SC every 6 hours as needed
- D.
Fluid restriction is sufficient to treat mild cases
- 26.You are evaluating Mr. Massadure who was admitted to the hospital one week ago with a subarachnoid hemorrhage. In the past few days this pt has become hypertensive and edematous. His labs reveal hyponatremia, low BUN, low creatinine, and hypoalbuminemia. The nurse reports the output from his foley has also been low. What is wrong with Mr. Massadure?
- A.
Hypopituitarism
- B.
Diabetes Insipidus
- C.
Renal insufficiency related to hypertension
- D.
SIADH
- 27.Democlocycline is an effective treatment for moderate to severe SIADH.
- A.
True
- B.
False
- 28.All of the following are important in regulating the plasma concentration of calcium except:
- A.
Parathyroid Hormone
- B.
Serotonin
- C.
Calcitonin
- D.
Vit D
- 29.The most important regulator of plasma calcium is…
- A.
Serotonin
- B.
Vit D
- C.
Parathyroid Hormone
- D.
Calcitonin
- 30.Which hormone is secreted by the thyroid gland in response to hypercalcemia?
- A.
Serotonin
- B.
Vit D
- C.
Parathyroid Hormone
- D.
Calcitonin
- 31.Parathyroid hormone secretion is inhibited by which of the following chronic electrolyte imbalances?
- A.
Hypomagnesemia
- B.
Hypocalcemia
- C.
Hyperphosphatemia
- D.
Hyperkalemia
- 32.Which of the following is not a clinical manifestation of hypocalcemia?
- A.
Confusion
- B.
Polyuria
- C.
Laryngeal Stridor
- D.
Masseter spasm
- 33.The average adult secretes approximately ____ units of insulin per day.
- A.
100
- B.
85
- C.
60
- D.
35
- 34.Due to the first pass effect, approximately ___ units of insulin is delivered to tissues daily.
- A.
40
- B.
85
- C.
60
- D.
30
- 35.Thanksgiving dinner was very good, and very big. After feasting with friends and family you beach yourself on a sofa and commence an immediate fat nap. While dreaming you can’t help but think about all of the wonderous things the anesthesia program has taught you. You know that right after eating a large meal you have stimulated the _____ cells of pancreas to release insulin, and inhibited the _____ cells from releasing glucagon.
- A.
Alpha, Beta
- B.
Beta, Acinar
- C.
Acinar, Alpha
- D.
Beta, Alpha
- 36.Approximately 10% of diabetics have type 2, or IDDM characterized by an absolute deficiency of insulin.
- A.
True
- B.
False
- 37.What is the most common endocrine disorder encountered in surgical patients?
- A.
Diabetes Mellitus
- B.
Hypothyroidism
- C.
SIADH
- D.
Addison’s Disease
- 38.Which of the following is not true regarding diabetic patients in the OR?
- A.
Patients with diabetes should be scheduled for early in the morning when possible.
- B.
Patients under anesthesia should be maintained with mild hypoglycemia.
- C.
No specific anesthetic technique has been proven superior for diabetics.
- D.
Blood glucose should be checked frequently during surgery and post-op.
- 39.You are caring for Ms. Flajorm today and have been asked by your preceptor to look at her labs and determine her diagnosis. You notice an elevated BUN, Severe hyperglycemia, ketonemia, hyponatremia, hyperosmolarity, and metabolic acidosis. What does this pt have?
- A.
Diabetes Mellitus
- B.
Hyperglycemic hyperosmolar nonketotic syndrome
- C.
Diabetic Ketoacidosis
- D.
Hyperparathyroidism
- 40.Hyperglycemic Hyperosmolar nonketotic syndrome is more likely to occur in type 2 diabetics.
- A.
True
- B.
False
- 41.Which of the following does the Thyroid gland secrete the most of?
- A.
TSH
- B.
Triiodothyronine
- C.
Calcitonin
- D.
Thyroxine
- 42.You are caring for Ms. Rodern today who has a PMH of: HTN, DM, Graves disease, Bronchitis, GERD, and arthritis. She is coming in today for a total thyroidectomy. About 30 minutes after inducing the pt you notice the pt is becoming tachycardic. You look around and also notice hypotension, and a high fever. What is most likely happening?
- A.
Thyroid Storm
- B.
Diabetic Ketoacidosis
- C.
Hypoparathyroidism
- D.
Malignant Hyperthermia
- 43.Post-op for a thryoidectomy it is most important to measure what electrolyte?
- A.
Potassium
- B.
Calcium
- C.
Magnesium
- D.
Iodine
- 44.Weight gain, lethargy, and cold intolerance are most commonly associated with which of the following disorders?
- A.
Grave’s Disease
- B.
Cushing’s Disease
- C.
Hypothyroidism
- D.
Diabetes Mellitus
- 45.Exocrine glands secrete their hormones…
- A.
Directly onto neighboring cells
- B.
Into extracellular fluid
- C.
Into the synaptic junction
- D.
Through ducts
- 46.Hormones are degraded and eliminated through the _____ and _______. (Mult Answer)
- A.
Liver
- B.
Plasma Cholinesterases
- C.
Lungs
- D.
Kidneys
- 47.Hormones with receptors on the outside of the cell generally have an immediate response.
- A.
True
- B.
False
- 48.How long does it take for a hormone to exert its effect on the target cells?
- A.
Depends upon the hormone, every hormone has different onset.
- B.
Several seconds
- C.
Several Hours
- D.
Several days
- 49.Hurray! You have finally hit puberty! You can finally develop some *real* teen angst (along with some other things….). Hormones surge through your body giving you acne and a bad attitude. As you fondly recall your awkward moments in life you realize the hormones were secreted in response to what form hormone regulation?
- A.
Neural Control
- B.
Biorhythms
- C.
Positive Feedback
- D.
Negative Feedback
- 50.The most common form of feedback is what?
- A.
Positive feedback
- B.
Biocircadian feedback
- C.
Negative Feedback
- D.
Psychothalamic feedback
- 51.Protein and Carbohydrate metabolism is regulated by which of the following?
- A.
Insulin
- B.
Luteinizing hormone
- C.
ACTH
- D.
Growth Hormone
- 52.ACTH does which of the following?
- A.
Stimulate adrenal gland to release cortisol
- B.
Stimulates body to absorb water and decreases plasma osmolarity
- C.
Regulates protein and carbohydrate metabolism
- D.
Stimulates testes to produce testosterone
- 53.Today you will be the SRNA for a transphenoidal removal of pituitary tumor. What position would you expect the pt to be in for this surgery?
- A.
Supine, slight trendelenburg
- B.
Sitting position
- C.
Prone position
- D.
Left lateral decubitus
- 54.Where is oxytocin synthesized?
- A.
Posterior Pituitary
- B.
Supraoptic Nucleus
- C.
Paraventricular Nucleus
- D.
Parathyroid Gland
- 55.Which of the following ECG effects would you likely see on a pt with hypercalcemia?
- A.
Shortened PR interval
- B.
Frequent PAC’s
- C.
Peaked T waves
- D.
Shortened QT interval
- 56.Which of the following is true regarding a pt with hypercalcemia?
- A.
The pt should be hydrated with isotonic saline and given lasix 40 mg
- B.
The pt is likely to display Chvosteks and Trousseaus signs
- C.
The pt is likely to have a prolonged QT interval
- D.
All the above are true
- 57.The most important role of glucagon is to…
- A.
Increase insulin secretion from beta cells of pancreas
- B.
Enhance hepatic glucose output and increase plasma glucose
- C.
Increase glucose uptake by cells in the peripheral tissues
- D.
Act as negative feedback mechanism to prevent hyperglycemia
- 58.Why would a septic pt be likely to have hyperglycemia?
- A.
Insulin secretion decreases in response to infection
- B.
Anyone who gets that sick was likely a diabetic to start with
- C.
Glucagon secretion increases in response to infection
- D.
Cells become resistant to insulin during times of stress
- 59.Which of the following blood glucose values represents optimal glucose control periopteratively?
- A.
87
- B.
112
- C.
151
- D.
134
- 60.You are in the middle of an RFA ablation of the liver on a diabetic patient. You draw a blood glucose and it comes back with a glucose level of 58. What do you do?
- A.
Give ½ amp of D50
- B.
This is optimal glucose control, leave the pt alone
- C.
Assess pt for other sings of hypoglycemia and only treat if pt is symptomatic
- D.
Start pt on D5NS and hydrate with at 150 ml/hr
- 61.Which hormone released from the thyroid gland is most potent?
- A.
TSH
- B.
T3
- C.
T4
- D.
T2
- 62.Which of the following is not true regarding hyperthyroidism?
- A.
Pts are more likely to present to you with A-fib or ST
- B.
Pts are likely hypovolemic and may have exaggerated response to induction
- C.
MAC levels will be increased due to increased metabolism
- D.
Ketamine and Pavulon should be avoided in these pts.
- 63.You are the SRNA for Mr. Jones who just had a thyroidectomy. You took him to PACU about 30 minutes ago and he was just fine, but now the nurses there are calling you. You walk into PACU to see Mr. Jones is very SOB. He complains that his chest hurts quite a bit and he feels like he can’t breathe. His O2 sat has dropped from his previous 99% to 91%. You peak under his dressing and everything still looks clean. What is wrong with Mr. Jones?
- A.
Hematoma around incision in his neck causing airway obstruction and SOB
- B.
Acute Hypocalcemia from Hypoparathyroidism
- C.
Bilateral recurrent laryngeal nerve palsy, causing stridor and SOB
- D.
Pneumothorax, causing SOB
- 64.You are watching over Mr.Phrates today. His PMH history includes hypothyroidism, DM, HTN, and GERD. He has come to ER with Altered mental status, right now he is pretty slowly but will wake if you so a sternal rub. His temperature is 95.8 on admission. Glucose check shows glucose of 86. You draw an ABG and find this: pH 7.20, pCO2 64, pO2 62, and oxygen saturation 91%. What do you think is the most likely diagnosis?
- A.
Myxedema
- B.
Hypoglycemia
- C.
CVA
- D.
Addisons Disease
- 65.Which of the following is not true regarding pts with Hypothyroidism?
- A.
These pts are more prone to respiratory depression
- B.
These pts will have faster wake-up from general anesthesia
- C.
These pts have diminished baroreceptor reflexes
- D.
Pts are more likely to be hypothermic
- 66.Catecholamines are secreted from which gland?
- A.
Anterior Pituitary
- B.
Posterior Pituitary
- C.
Adrenal Medulla
- D.
Adrenal Cortex
- 67.Which of the following hormones aids in fluid and electrolyte balance by causing sodium to be absorbed in the distal renal tubule?
- A.
ADH
- B.
Cortisol
- C.
ACTH
- D.
Aldosterone
- 68.Which of the following is not a stimulus for secretion of Aldosterone?
- A.
ACTH Insufficency
- B.
Hyperkalemia
- C.
Activation of Renin Angiotensin System
- D.
All the above result in secretion of Aldosterone
- 69.Approximately how much cortisol is secreted by the adrenal cortex daily?
- A.
50 mg
- B.
20 mg
- C.
30 mg
- D.
Cortisol is secreted by the adrenal medulla, not the cortex
- 70.80% of catecholamine secretion from the adrenal medulla is in the form of what?
- A.
Norepinephrine
- B.
Acetycholine
- C.
Epinephrine
- D.
Cortisol
- 71.Which of the following is not true regarding pheochromocytoma?
- A.
Pheochromocytoma is a catecholamine secreting tumor
- B.
Intra-op HTN should be treated either with sodium nitroprusside or a cardene drip
- C.
Pts are prone to hypotension post adrenallectomy
- D.
Pts should be adequately beta blocked before they are alpha-blocked.
- 72.Comic Relief: Happy Holidays! Ok, The video apparently isn't loading for everyone. Here is the link! (open in seperate window)http://media.mtvnservices.com/player/loader/?CONFIG_URL=http%3A%2F%2Fmedia.mtvnservices.com%2Fplayer%2Fconfig.jhtml%3Furi%3Dmgid%253Acms%253Aitem%253Asouthparkstudios.com%253A151728%26group%3Dentertainment%26type%3Dnormal%26ref%3dwebmail.aol.com&uri=mgid%3Acms%3Aitem%3Asouthparkstudios.com%3A151728&group=entertainment&type=normal&ref=webmail.aol.com&geo=US
- A.
The cultural insensitivity in that video is absolutely horrid! You are sooooo failing culture class next summer.
- B.
Ha ha ha! Damn Skippy.
- C.
Blaspemous and Funny. Awesome.
- D.
All The Above
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