P25(A)

1. 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

2. Choose the statement that applies to Type I 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.

3. 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

4. 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

5. How do the different types of available insulin vary? 1. time until onset of action 2. time until peak effect 3. duration of effect 4. source of insulin

A. 1, 2

B. 3, 4

C. 1, 2, 4

D. 1, 2, 3, 4

6. 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

7. 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

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 applies to acromegaly?

A. It occurs in infants and children.

B. It causes excessive longitudinal bone growth.

C. It results from excessive secretion of GH.

D. It does not change soft tissue growth.

10. Which of the following hormonal imbalances causes myxedema?

A. increased glucocorticoids

B. decreased glucocorticoids

C. deficit of ADH

D. deficit of T3 and T4

11. Which signs are typical of Graves' disease?

A. facial puffiness, bradycardia, and lethargy

B. exophthalmos, heat intolerance, and restlessness

C. delayed physical and intellectual development

12. Which of the following does NOT usually develop as a complication of diabetes?

A. osteoporosis

B. nephropathy

C. impotence

D. peripheral neuropathy

13. 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

14. Which of the following may cause insulin shock to develop?

A. recurrent vomiting

B. missing an insulin dose

C. eating excessively large meals

D. sedentary lifestyle

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. Which one of the following develops hypoglycemia more frequently?

A. Type I diabetics

B. Type II diabetics

C. patients with a poor stress response

D. those with a regular exercise and meal plan

17. 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.

18. What is the most common cause of endocrine abnormalities?

A. malignant neoplasm

B. infection

C. congenital defect

D. benign tumor

19. How do many oral hypoglycemic drugs act?

A. to replace insulin in patients with IDDM

B. to transport glucose into body cells

C. to prevent gluconeogenesis

D. to stimulate the pancreas to produce more insulin

20. What is caused by hypocalcemia due to hypoparathyroidism? 1. skeletal muscle twitching or spasm 2. weak cardiac contraction 3. increased secretion of PTH 4. decreased serum phosphate level

A. 1, 2

B. 1, 3

C. 2, 3

D. 3, 4

21. Why does polyuria develop with diabetes mellitus?

A. increased thirst

B. ketoacidosis

C. glucosuria develops

D. diabetic nephropathy

22. Which of the following may cause goiter? 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

23. What causes loss of consciousness in a person with diabetic ketoacidosis?

A. toxic effects of excessive insulin

B. excessive glucose in the blood

C. acidosis and hypovolemia

D. lack of glucose in brain cells

24. What is a precipitating factor for diabetic ketoacidosis?

A. skipping a meal

B. strenuous exercise

C. serious infection

D. insulin overdose

25. Characteristics of Cushing's 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

26. Which of the following is an effect of long-term glucocorticoid therapy?

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

27. What is caused by hyperparathyroidism?

A. hypocalcemia

B. tetany

C. bone demineralization

D. deficit of vitamin D

28. Which of the following is an effect of Addison's disease?

A. elevated blood glucose levels

B. high blood pressure

C. low serum potassium levels

D. poor stress response

29. Which of the following hormonal imbalances causes Addison's disease?

A. increased glucocorticoids

B. decreased glucocorticoids

C. deficit of ADH

D. deficit of T3 and T4

30. Why does diabetes insipidus cause polyuria?

A. There is increased osmotic pressure of the filtrate.

B. Damaged tubules cannot reabsorb sufficient fluid.

C. Excessive ADH secretion is present.

D. There is a deficit of ADH.

E. Excessive aldosterone is secreted.

31. Visual impairment may develop in diabetics, primarily because of:

A. abnormal metabolism in the lens

B. macroangiopathy

C. neuropathy affecting cranial nerves

D. development of exophthalmos

32. Which of the following indicates compensated acidosis in the diabetic?

A. increased serum bicarbonate

B. serum pH of 7.35

C. increased serum carbonic acid

D. urine pH 8.0

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. Which of the following are common early signs of a pituitary adenoma? 1. persistent headaches 2. hemianopia 3. hypertension 4. papilledema

A. 1, 4

B. 2, 3

C. 1, 2

D. 1, 3, 4