Order Endocrine and Metabolic Systems

Order Endocrine and Metabolic Systems
Order 5980210
Order Endocrine and Metabolic Systems
1. While performing a preoperative assessment on a patient with acromegaly, you
note that his home medication list includes octreotide. Which of the following is
the mechanism of action of octreotide?
A. Competitive inhibition at the growth hormone (GH) receptor
B. Inhibition of GH and IGF-1 secretion
C. Stimulation of insulin secretion
D. Agonism at the dopamine receptor
2. Which of the following hormones is released from the posterior pituitary gland?
A. Thyroid-stimulating hormone (TSH)
B. Vasopressin (antidiuretic hormone [ADH])
C. Corticotropin (adrenocorticotropic hormone [ACTH])
D. Growth hormone
3. Which of the following statements is true of the syndrome of inappropriate
antidiuretic hormone (SIADH)?
A. Chronic hyponatremia from SIADH should be corrected with hypertonic saline.
B. Peripheral edema is a common physical exam finding.
C. Most cases of SIADH are due to an intrinsic pituitary disorder.
D. Demeclocycline may be used to treat SIADH.
4. Which of the following statements is true with regard to diabetes insipidus
(DI)?
A. Desmopressin administration can distinguish central versus nephrogenic DI.
B. Patients with nephrogenic DI will increase urine osmolality in response to
desmopressin.
C. Thiazide diuretics may be used to treat central DI.
D. Patients with central DI will fail to respond to exogenous desmopressin
administration.
5. Which of the following features is more consistent with a diagnosis of a
pituitary macroadenoma than that of a pituitary microadenoma?
A. Galactorrhea
B. Visual field deficit
C. Thyrotoxicosis
D. Cushing disease
Order Endocrine and Metabolic Systems
6. 6. Which of the following sets of laboratory values is consistent with a diagnosis
of subclinical hypothyroidism?
TSH Free T4
A. Decreased Increased
B. Increased Decreased
C. Decreased Decreased
D. Increased Normal
7. Which of the following statements pertaining to thyroid storm is true?
A. Atrial fibrillation is required for diagnosis.
B. Mortality rate may exceed 20%.
C. TSH levels are elevated.
D. Hyperthermia is rare.
8. Which of the following is likely to be seen when a patient with hypothyroidism
is under general anesthesia?
A. Hypotension
B. Prolongation of nondepolarizing neuromuscular blockers
C. Bradycardia
D. Hyperglycemia
9. Which of the following statements is true with regard to potential complications
associated with thyroid surgery?
A. Unilateral recurrent laryngeal nerve damage will cause aphonia.
B. Unanticipated difficult airway is present in 5%-8% of thyroid cases.
C. Retrosternal thyroid may cause airway obstruction with prone positioning.
D. Postoperative hypocalcemia typically manifests immediately in the
postanesthesia care unit.
10. Which of the following diagnostic results is consistent with a diagnosis of Grave
disease?
A. Elevated TSH
B. Normal free T4
C. Diffusely increased radioactive iodine uptake
D. Decreased free T3
11. Which statement correctly describes one of the actions of parathyroid hormone
(PTH)?
A. PTH increases Ca
2
resorption in the ascending loop of Henle, distal tubule, and
collecting tubule of the kidney.
B. PTH inhibits 1α-hydroxylase gene in renal cells.
C. PTH promotes uptake of calcium by osteocytes.
D. PTH increases the reabsorption of phosphate and bicarbonate in the nephron.
12. Which of the following is the primary mechanism by which calcitonin reduces
serum Ca
2
levels?
A. Increasing the renal excretion of phosphate
B. Decreasing the intestinal absorption of calcium
C. Promotion of osteoblastic activity to increase bone formation
D. Inhibition of osteoclast activity to decrease bone resorption
Order Endocrine and Metabolic Systems
13. 13. What is the initial step in the management of a patient with symptomatic
hypercalcemia?
A. Calcitonin
B. Furosemide
C. Normal saline
D. Pamidronate
14. What is the adjusted plasma calcium for a patient with end-stage liver disease
who is hypoalbuminemic with the following laboratory values?
Plasma calcium 7.6 mg/dL
Plasma albumin 1.6 g/dL
A. 5.7 mg/dL
B. 7.6 mg/dL
C. 9.5 mg/dL
D. 10 mg/dL
15. Which of the following causes an increase in the ionized calcium concentration?
A. Increased serum albumin
B. Alkalosis
C. Transfusion of fresh frozen plasma
D. Acidosis
16. Which of the following sets of values would you expect to observe in a patient
with primary adrenal insufficiency?
CRH ACTH CORTISOL ALDOSTERONE
A. Elevated Elevated Decreased Decreased
B. Elevated Elevated Decreased Normal
C. Elevated Decreased Decreased Decreased
D. Decreased Elevated Decreased Normal
17. Which of the following statements is true regarding the preoperative
preparation for a patient with pheochromocytoma?
A. Selective α1
-blockers have a longer duration of action compared with
phenoxybenzamine.
B. β-Blockade should be initiated before α-blockade.
C. Calcium channel blockers are contraindicated in patients with
pheochromocytoma.
D. The primary side effect of phenoxybenzamine is orthostatic hypotension.
18. Which of the following steroids lacks mineralocorticoid activity?
A. Hydrocortisone
B. Dexamethasone
C. Methylprednisolone
D. Prednisone
19. 19. In which of the following patients is stress dose steroid administration
indicated?
A. A 67-year-old man on prednisone 10 mg daily for 5 days for chronic obstructive
pulmonary disease exacerbation presenting for laparoscopic cholecystectomy
B. A 40-year-old woman on prednisone 2.5 mg daily for 6 years for systemic lupus
erythematosus presenting for total knee arthroplasty
C. A 23-year-old man on prednisone 20 mg daily for ulcerative colitis presenting
for subtotal colectomy
D. A 56-year-old woman on prednisone 40 mg daily for rheumatoid arthritis
presenting for superficial lymph node biopsy
20. Which of the following correctly describes a physiologic effect of
glucocorticoids?
A. Increase in eosinophils and basophils
B. Decreased protein catabolism
C. Sensitization to insulin
D. Promotion of gluconeogenesis
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