ATI LPN
ATI The Medical Surgical Endocrine Test Questions
Question 1 of 5
A 38-year-old woman has been feeling lethargic for 4 months. On physical examination, she is afebrile, and her blood pressure is 140/90 mm Hg. Laboratory findings show the serum creatinine level is 5.8 mg/dL. C3 nephritic factor is present in serum, resulting in hypocomplementemia, and the ANA test result is negative. Urinalysis shows 2+ blood and 1+ protein. A renal biopsy is done; microscopic examination shows hypercellular glomeruli and prominent ribbonlike deposits along the lamina densa of the glomerular basement membrane. Which of the following forms of glomerulonephritis is most likely to be present in this patient?
Correct Answer: B
Rationale: Dense deposit disease (formerly membranoproliferative glomerulonephritis type II) usually leads to hematuria, and half of cases end in chronic renal failure. The term chronic glomerulonephritis (GN) often is used when sclerosis of many glomeruli is present with no clear cause. Membranous nephropathy is often accompanied by proteinuria but less likely hematuria, and is characterized by thickening of only the basement membrane and small electron-dense deposits. Postinfectious GN is often characterized by a hypercellular glomerulus with infiltration of polymorphonuclear leukocytes, but no basement membrane thickening. A rapidly progressive GN is marked by crescents forming in the Bowman space.
Question 2 of 5
A 52-year-old man has been concerned about a gradual weight gain over the past 30 years. He is 174 cm (5 feet 7 inches) tall and weighs 91 kg (body mass index 30). He is taking no medications. On physical examination, he has decreased sensation to pinprick and light touch over the lower extremities. Patellar reflexes are reduced. Motor strength seems to be normal in all extremities. Laboratory studies show blood glucose of 169 mg/dL, creatinine of 1.9 mg/dL, total cholesterol of 220 mg/dL, HDL cholesterol of 27 mg/dL, and triglycerides of 261 mg/dL. A chest radiograph shows mild cardiomegaly. Five years later, he has claudication in the lower extremities when he exercises. Based on these findings, which of the following complications is most likely to occur in this man?
Correct Answer: A
Rationale: Severe peripheral atherosclerotic disease is a common complication of long-standing diabetes mellitus. Atherosclerotic narrowing of the arteries to the lower legs can cause ischemia and gangrene. The foot is often involved with gangrene, which may necessitate amputation. Diabetic neuropathy with decreased sensation increases the risk of repeated trauma, which enhances the risk of ulcerations that cause infection and inflammation that promotes gangrene.
Question 3 of 5
A 27-year-old man has headaches that have occurred frequently for the past 3 months. On physical examination, he is afebrile, and his blood pressure is 140/85 mm Hg. There are no neurologic abnormalities and no visual defects; however, he has an enlarged thyroid. Laboratory studies show that his serum calcitonin level is elevated. A total thyroidectomy is performed, and on sectioning, the thyroid has multiple tumor nodules in both lobes. Microscopically, the thyroid nodules are composed of nests of neoplastic cells separated by amyloid-rich stroma. The endocrinologist says that the patient's family members could be at risk for development of similar tumors and advises that they undergo genetic screening. Which of the following morphologic findings in the adrenal glands is most likely to be present in this patient?
Correct Answer: A
Rationale: These findings suggest multiple endocrine neoplasia (MEN) type 2A (Sipple syndrome) or possibly MEN type 2B (Williams syndrome). These patients have medullary carcinomas of the thyroid, pheochromocytomas, and parathyroid adenomas. This patient's headaches could be caused by hypertension from a pheochromocytoma arising in the adrenal medulla.
Question 4 of 5
During muscle contraction:
Correct Answer: D
Rationale: All occur: overlap increases, I band shrinks, Z-lines approach, H band narrows as actin/myosin slide.
Question 5 of 5
The role of slow calcium channels in the cardiac contractile cell action potential is:
Correct Answer: D
Rationale: Slow Ca2+ channels prolong depolarization (plateau), enhancing contraction time.