ATI LPN
Medical Surgical Endocrine Quizlet Questions
Question 1 of 5
A 12-year-old girl has experienced increasing malaise for the past 2 weeks. On physical examination, she has periorbital edema. The child is afebrile. Laboratory findings show proteinuria on dipstick urinalysis, but no hematuria or glucosuria. Microscopic examination of the urine shows numerous oval fat bodies. The serum creatinine level is 2.3 mg/dL. She receives a course of corticosteroid therapy, but does not improve. A renal biopsy is performed and microscopic examination shows that approximately 50% of the glomeruli in the specimen are affected by the lesion shown in the figure. What is the most likely diagnosis?
Correct Answer: B
Rationale: Focal segmental glomerulosclerosis (FSGS) shows sclerosis of only a segment of the glomerulus (segmental lesion), and because only 50% of the glomeruli are affected, this is focal disease. FSGS manifests clinically with nephrotic syndrome that does not respond to corticosteroid therapy. FSGS can result from many forms of glomerular injury; some may be linked to NPHS gene mutations. In contrast, corticosteroid-responsive nephrotic syndrome in children is typically caused by minimal change disease (lipoid nephrosis) that is not associated with any glomerular change seen under the light microscope. Membranoproliferative glomerulonephritis (GN) and dense deposit disease are more likely to produce a nephritic syndrome in adults. A diabetic patient with nephrotic syndrome is likely to have nodular glomerulosclerosis or diffuse thickening of the basement membrane. An acute proliferative postinfectious GN has hypercellular glomeruli with neutrophils. A rapidly progressive GN is associated with hematuria, and glomerular crescents are present.
Question 2 of 5
A 50-year-old man with fasting blood glucose >140 mg/dL on two occasions is put on a restricted caloric diet and started on a glucagon-like peptide-1 (GLP-1) receptor agonist. Which of the following laboratory studies is most likely to afford the best method of monitoring disease control in this man?
Correct Answer: C
Rationale: Nonenzymatic glycosylation refers to the chemical process whereby glucose attaches to proteins without the aid of enzymes. The degree of glycosylation is proportionate to the level of blood glucose. Many proteins, including hemoglobin, undergo nonenzymatic glycosylation. Because RBCs have a life span of about 120 days, the amount of glycosylated hemoglobin is a function of the blood glucose level over the previous 120-day period.
Question 3 of 5
A 44-year-old woman has become increasingly listless and weak and has had chronic diarrhea and a 5-kg weight loss over the past 7 months. She also notices that her skin seems darker, although she rarely goes outside because she is too tired for outdoor activities. On physical examination, she is afebrile, and her blood pressure is 85/50 mm Hg. A chest radiograph shows no abnormal findings. Laboratory findings include serum Na+, 120 mmol/L; K+, 5.1 mmol/L; glucose, 58 mg/dL; urea nitrogen, 18 mg/dL; and creatinine, 0.8 mg/dL. The serum corticotropin level is 82 pg/mL. Which of the following is most likely to account for these findings?
Correct Answer: B
Rationale: Chronic adrenal insufficiency (Addison disease) results in decreased cortisol production and decreased mineralocorticoid activity. The skin hyperpigmentation results from increased corticotropin precursor hormone production, which also stimulates melanocytes. The most common cause of Addison disease, in areas where tuberculosis is not endemic, is autoimmune adrenalitis.
Question 4 of 5
Which connective tissue layer surrounds the biceps femoris muscle belly, separating it from the rest of the body?
Correct Answer: A
Rationale: Epimysium (not epimyseum) surrounds entire muscle; perimysium bundles fascicles, endomysium covers fibers.
Question 5 of 5
Which of the following statements is false regarding the cardiac conducting system?
Correct Answer: D
Rationale: SA node, not AV node, is the pacemaker (60-100 bpm); AV node delays signal.