ATI LPN
Medical Surgical Endocrine ATI Quizlet Questions
Question 1 of 5
A 7-year-old boy has become less active over the past 10 days. On physical examination, the boy has facial puffiness. Urinalysis shows no blood, glucose, or ketones, and microscopic examination shows no casts or crystals. The serum creatinine level is normal. A 24-hour urine collection yields 3.8 g of protein. He improves after corticosteroid therapy. He has two more episodes of proteinuria over the next 4 years, both of which respond to corticosteroid therapy. What is the most likely mechanism causing his disease?
Correct Answer: A
Rationale: Steroid-responsive proteinuria in a child is typical of minimal change disease, in which the kidney looks normal by light microscopy, but fusion of foot processes is visible with electron microscopy. The most likely cause of foot process fusion is a primary injury to visceral epithelial cells caused by T cell-derived cytokines. Acute cellular renal transplant rejection is mediated by T cell injury with tubulitis. IgA nephropathy with mesangial IgA deposition and consequent glomerular injury causes recurrent gross or microscopic hematuria and, far less commonly, nephrotic syndrome. Immune complex deposition in membranous nephropathy can cause nephrotic syndrome, but is less common in children than in adults and is not steroid responsive. Certain verocytotoxin-producing Escherichia coli strains can cause hemolytic uremic syndrome by injury to capillary endothelium.
Question 2 of 5
An infant is born following premature delivery. Multiple external congenital anomalies are noted. The infant exhibits a seizure soon after birth. The blood glucose is 19 mg/dL. Which of the following maternal diseases is the most likely cause for the observed findings in this infant?
Correct Answer: B
Rationale: The findings are complications of diabetes with pregnancy, and the malformations suggest that hyperglycemia preceded the pregnancy, and type 2 diabetes is quite common, even now in women of childbearing age. The neonatal hypoglycemia is a consequence of excessive islet beta-cell function from having been in a hyperglycemic environment.
Question 3 of 5
A 29-year-old woman with systemic lupus erythematosus has been treated with corticosteroid therapy for several years because of recurrent lupus nephritis. She undergoes an emergency appendectomy for acute appendicitis. On postoperative day 2, she becomes somnolent and develops severe nausea and vomiting. She then becomes hypotensive. Blood cultures are negative, and laboratory studies now show Na+ of 128 mmol/L, K+ of 4.9 mmol/L, Cl- of 89 mmol/L, CO2 of 19 mmol/L, glucose of 52 mg/dL, and creatinine of 1.3 mg/dL. Which of the following morphologic findings in the adrenal gland cortex is most likely to be present in this patient?
Correct Answer: B
Rationale: This woman has findings of acute adrenocortical insufficiency (acute addisonian crisis). Long-term corticosteroid therapy shuts off corticotropin stimulation to the adrenal glands, leading to adrenal atrophy. When this history is not elicited, and the patient is not continued on the corticosteroid therapy, a crisis ensues, in this case made worse by the stress of surgery.
Question 4 of 5
Diabetes mellitus is a deficiency or limited activity of which hormone?
Correct Answer: D
Rationale: Diabetes mellitus results from insulin deficiency (T1DM) or resistance (T2DM), impairing glucose uptake.
Question 5 of 5
Which of the following is responsible for closing the left AV valve?
Correct Answer: C
Rationale: Ventricular systole closes mitral valve as ventricular pressure exceeds atrial.