ATI LPN
ATI The Medical Surgical Endocrine Test Questions
Question 1 of 5
End-stage Kidney failure is characterised by
Correct Answer: C
Rationale: End-stage renal failure is defined by eGFR <15, often requiring dialysis, indicating severe filtration loss.
Question 2 of 5
A 32-year-old man developed a fever and rash over 3 days. Five days later, he has increasing malaise. On physical examination, the maculopapular erythematous rash on his trunk has nearly faded away. His temperature is 37.1°C, and blood pressure is 135/85 mm Hg. Laboratory studies show a serum creatinine level of 2.8 mg/dL and blood urea nitrogen level of 29 mg/dL. Urinalysis shows 2+ proteinuria; 1+ hematuria; and no glucose, ketones, or nitrite. The leukocyte esterase result is positive. What is the most likely cause of these findings?
Correct Answer: D
Rationale: The truncated question implies a continuation related to hypercalcemia, as seen in subsequent options. The clinical picture of fever, rash, and renal impairment followed by hypercalcemia (assumed from context) suggests a parathyroid adenoma (D), causing primary hyperparathyroidism. This leads to elevated serum calcium, renal dysfunction, and systemic symptoms. Chronic renal failure (A) typically shows hypocalcemia, not hypercalcemia. Hypervitaminosis D (B) increases calcium but suppresses PTH, unlike adenoma. Medullary thyroid carcinoma (C) affects calcitonin, not typically causing hypercalcemia. Parathyroid hyperplasia (E) is less common and involves all glands, not a single adenoma.
Question 3 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 4 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 5 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.