ATI LPN
ATI Medical Surgical Endocrine Questions
Question 1 of 5
The nurse recognizes which disorder as the most common cause of hyperthyroidism?
Correct Answer: D
Rationale: Graves's disease is the most common cause of hyperthyroidism and is an autoimmune disorder involving antibodies (thyroid-stimulating immunoglobulins) that bind to the thyroid gland, resulting in the enlargement of the thyroid gland and subsequent hypersecretion of thyroid hormone.
Question 2 of 5
Patients with diabetes can develop various foot problems, including ulcers and foot infections. Foot complications in diabetics are primarily caused by
Correct Answer: D
Rationale: All factors "neuropathy (loss of sensation), PAD (poor circulation), and impaired immunity "contribute to diabetic foot complications.
Question 3 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 4 of 5
An autopsy study is performed involving persons with gross pathologic findings of bilaterally small kidneys (<100 g) that have a coarsely granular surface appearance. Microscopic examination shows sclerotic glomeruli, a fibrotic interstitium, tubular atrophy, arterial thickening, and scattered lymphocytic infiltrates. Which of the following clinical findings was most likely reported in these patients' medical histories?
Correct Answer: B
Rationale: These findings describe end-stage renal disease, the appearance of which can be similar regardless of the cause (e.g. vascular disease or glomerular disease). The characteristics of progressive renal damage include glomerulosclerosis (starting with focal segmental glomerulosclerosis) and tubulointerstitial fibrosis. With advanced renal destruction, hypertension almost always supervenes, even if it was absent at the onset of renal disease. Many such cases are referred to as chronic glomerulonephritis (GN), for want of a better term. Hemoptysis occurs in Goodpasture syndrome that involves lungs as well as kidneys. Lens dislocation is a feature of Alport syndrome, from thinning of the anterior lens capsule. Pharyngitis with group A streptococcal infection may precede postinfectious GN. A skin rash might have preceded the postinfectious GN.
Question 5 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.