ATI LPN
ATI Targeted Medical Surgical Endocrine Questions
Question 1 of 5
A 7-year-old boy is recovering from impetigo. Physical examination shows five honey-colored crusts on his face. The crusts are removed, and a culture of the lesions grows Streptococcus pyogenes. He is treated with antibiotics. One week later, he develops malaise with nausea and a slight fever and passes dark brown urine. Laboratory studies show a serum anti-streptolysin O titer of 1:1024. Which of the following is the most likely outcome of his renal disease?
Correct Answer: B
Rationale: The strains of group A streptococci that cause poststreptococcal glomerulonephritis (GN) differ from the strains that cause rheumatic fever, and most elicit an immune response via streptococcal pyogenic exotoxin B (SpeB). Most children with poststreptococcal GN recover, although 1% develop a rapidly progressive GN characterized by crescent formation. Progression to chronic renal failure occurs in 40% of affected adults. A urinary tract infection is not likely to accompany poststreptococcal GN because the organisms that caused the immunologic reaction are no longer present when symptoms of GN appear.
Question 2 of 5
Blood relatives of individuals diagnosed with type 1 or type 2 diabetes mellitus are studied for 10 years. Laboratory testing for glucose and insulin levels and autoantibody formation is performed on a periodic basis. The HLA types of the subjects are determined. A cohort of the subjects who are 8 to 22 years old has no overt clinical illnesses and no hyperglycemia; however, autoantibodies to glutamic acid decarboxylase are present. Many subjects in this cohort have the HLA-DR3 and HLA-DR4 alleles. Which of the following pancreatic abnormalities is most likely to be found in this cohort of study subjects?
Correct Answer: D
Rationale: The presence of HLA-DR3 and HLA-DR4 alleles of the MHC class II region has the strongest linkage to type 1 diabetes mellitus. Autoantibodies to islet cell antigens such as glutamic acid decarboxylase are present years before overt clinical diabetes develops. An insulitis caused by T cell infiltration occurs before the onset of symptoms or very early in the course of type 1 diabetes mellitus.
Question 3 of 5
A 43-year-old woman has had absent menstrual cycles along with increasing weakness and weight gain over the past 5 months. She notes low back pain for the past week. On physical examination, vital signs include blood pressure of 155/95 mm Hg. She has a prominent fat pad in the posterior neck and back. Facial plethora, hirsutism, and abdominal cutaneous striae are present. Laboratory findings include Na+, 139 mmol/L; K+, 4.1 mmol/L; Cl-, 96 mmol/L; CO2, 23 mmol/L; glucose, 163 mg/dL; creatinine, 1.3 mg/dL; calcium, 8.9 mg/dL; and phosphorus, 4.1 mg/dL. Her serum ACTH level is low. A radiograph of the spine shows decreased bone density with a compression fracture at T9. Which of the following radiographic findings is most likely to be present in this patient?
Correct Answer: A
Rationale: The clinical findings of Cushing syndrome with masculinization suggest an adrenal cortical carcinoma, which is more likely to have endocrine function in women. A low ACTH level helps to rule out the possibility of an ACTH-secreting pituitary adenoma in the sella turcica, or ectopic ACTH from a neoplasm such as lung carcinoma.
Question 4 of 5
Which of the following statements is false regarding the hypothalamus?
Correct Answer: C
Rationale: Hypothalamus produces ADH and oxytocin (stored in posterior pituitary), but ADH increases BP by reducing urine output; oxytocin aids labor.
Question 5 of 5
Since Adonis was unable lift the dumbbell, he decided to use the exercise bike for a cardiovascular workout. During maximum exertion on the exercise bike, Adonis began to breathe heavily and felt 'the burn' in his legs. The skeletal muscles of his legs were using primarily which form of respiration at maximum exertion?
Correct Answer: D
Rationale: At max exertion, glycolysis produces lactate (burn) due to limited O2, shifting from aerobic respiration.