ATI LPN
ATI Medical Surgical Endocrine Questions
Question 1 of 5
A 45-year-old man has experienced increasing malaise, nausea, and reduced urine output for the past 3 days. On physical examination, he is afebrile and normotensive. Laboratory findings show a serum creatinine level of 7.5 mg/dL. Urinalysis shows hematuria, but no pyuria or glucosuria. A renal biopsy is done; the light microscopic picture is shown in the figure. Which of the following additional studies is most useful for classification and treatment of this disease?
Correct Answer: B
Rationale: The figure shows glomeruli with epithelial crescents indicative of a rapidly progressive glomerulonephritis. Crescentic GN is divided into three groups on the basis of immunofluorescence: type I (anti-glomerular basement membrane [GBM] disease); type II (immune complex disease); and type III (characterized by the absence of anti-GBM antibodies or immune complexes). Anti-GBM antibody testing (B) is critical to diagnose Goodpasture syndrome (type I), requiring plasmapheresis, distinguishing it from other causes like SLE (A) or ANCA vasculitis (type III). HIV (C), immunoglobulins (D), and rheumatoid factor (E) are less specific for crescentic GN classification.
Question 2 of 5
A 23-year-old woman has a routine health status examination. Her body mass index is 22. Laboratory studies show fasting plasma glucose is 130 mg/dL. Urinalysis shows mild glucosuria, but no ketonuria or proteinuria. She has no detectable insulin autoantibodies. Her father was similarly affected at age 20 years. She is most likely to have a mutation in a gene encoding for which of the following?
Correct Answer: B
Rationale: This patient has maturity-onset diabetes of the young (MODY), which accounts for less than 5% of cases of diabetes mellitus and is linked to specific genetic defects involving islet cells and inherited in an autosomal dominant fashion. In this patient with MODY2, there is an inactivating mutation in glucokinase that increases the beta cell threshold for insulin release, and the hyperglycemia is mild.
Question 3 of 5
A 73-year-old woman has experienced malaise and a 10-kg weight loss over the past 4 months. She also has developed a chronic cough during this time. She has a 100 pack-year history of smoking cigarettes. Physical examination shows muscle wasting and 4/5 motor strength in all extremities. Abdominal CT scan shows bilaterally enlarged adrenal glands. A chest radiograph shows a 6-cm perihilar mass on the right and prominent hilar lymphadenopathy. Laboratory studies show Na+, 118 mmol/L; K+, 6 mmol/L; Cl-, 95 mmol/L; CO2, 21 mmol/L; and glucose, 49 mg/dL. Her 8:00 am serum cortisol level is 9 ng/mL. What is the most likely diagnosis?
Correct Answer: D
Rationale: The lung mass is likely a primary lung carcinoma, and the bilaterally enlarged adrenal glands can be explained by metastases to the adrenal glands. Destruction of over 90% of the adrenal cortices is responsible for adrenal failure manifested by malaise and the low serum cortisol concentration and the electrolyte disturbances.
Question 4 of 5
Which of the following hormones come from anterior lobe of the pituitary gland?
Correct Answer: B
Rationale: ACTH is from anterior pituitary; inhibin (gonads), T3 (thyroid), oxytocin and ADH (posterior pituitary) are not.
Question 5 of 5
Which is true of dark (red) muscle?
Correct Answer: A
Rationale: Dark (red) muscle is slow-twitch, rich in mitochondria, suited for endurance.