HONDROS 212 EXAM 3 QUESTIONS WITH ACCURATE
ANSWERS
A1C (glycosylated hemoglobin) correct answer provides a measurement of blood
glucose levels over the previous 2 to 3 months
Diseases affecting RBCs (anemia) can influence the AIC
acute thyrotoxicosis (thyroid storm) correct answer is an acute, severe and rare
condition that occurs when excess amounts of thyroid hormones are released
into the circulation. Results from stressors- infection, trauma, surgery, pts having
a thyroidectomy
Addison's disease correct answer adrenocortical insufficiency or secondary cause
(lack of pituitary ACTH secretions)
Addisonian crisis correct answer N/V confusion, abdominal pain, extreme
weakness, hypoglycemia, dehydration, decreased BP, tachycardia, hyponatremia,
hyperkalemia, fever, weakness- at risk for shock!!!CIRCULATORY COLLAPSE
adrenal insufficiency correct answer vomiting, increased weakness, dehydration
and hypotension
Alcohol induced hypoglycemia correct answer alcohol inhibits gluconeogenesis
(breakdown of glycogen into glucose) by the liver. This can cause severe
hypoglycemia in patients on insulin or OAs that increase insulin secretion.
Moderate alcohol consumption is fine. 1 drink for women, 2 drinks for men.
Teach pts to consume carbohydrates while drinking alcohol
,Anastomosis leak correct answer tachycardia, fever, tachypnea, chest and
abdominal pain
C peptide in serum and urine correct answer useful clinical indicator of pancreatic
b cell function and insulin levels
Care for retinopathy correct answer dilated eye examination at the time of
diagnosis and annually afterwards. T1DM- q 5 years. Prevent by maintaining
healthy glucose levels and managing HTN, laser photocoagulation therapy can
reduce the risk for vision loss. A pt who develops vitreous hemorrhage and retinal
detachment may undergo vitrectomy is he aspiration of blood, membraine and
fibers from inside the side. A flucinolone acetonide intraviteal implant (iluvien) is
used to treat retinopathy
Care of DKA correct answer First goal of therapy is to establish IV access and begin
fluid and electrolyte replacement. Give 0.9 to raise BP and restore urine output to
30 to 60 ml/hr. When blood glucose levels reach 250 5 or 10% dextrose is added.
Obtain serum potassium level before starting insulin. Monitor fluid balance and
potassium balance!!
Causes of Addisonian Crisis correct answer 1. stress (infection, surgery,
psychologic distress 2. sudden withdraw of corticosteroids, 3. adrenal surgery 4.
sudden pituitary gland destruction
Causes of HHS correct answer UTIs, pneumonia, sepsis, any acute illness and
newly diagnosed T2DM, impaired thirst sensation
Causes of hypothyroidism correct answer Primary- destruction of the thyroid
tissue or defective hormone synthesis, secondary- is caused by pituitary disease
, with decreased TSH secretion or hypothalamic dysfunction with decreased TRH
secretion. Iodine deficiency is the most common cause
Complications of hypothyroidism correct answer decreased cardiac contractility,
decreased cardiac output, high serum cholesterol and triglyceride levels,
myxedema coma is a medical emergency- can be caused by infection, drugs
(especially opiates, barbituates and tranquillizers, exposure to cold and trauma-
characterized by subnormal temperature, hypotension and hypoventilation-
cardiovascular collapse can result
counterregulatory hormones- increase blood glucose levels correct answer
glucagon, epinephrine, GH, cortisol
Criteria for metabolic syndrome correct answer Need any 3 of the 5- waist
circumference- >40in in men and >35 in women, Triglycerides- >150 or on drug
treatment for high triglycerides, HDL cholesterol- <40 in men <50 in women or
drug treatment for high cholesterol, BP- >130 sys >85 diastolic or on drug
treatment for HTN, fasting blood glucose >100 or on drug treatment for elevated
blood glucose
Criteria guidelines for bariatric surgery correct answer BMI of 40 or more or a BMI
of 35 or more with other significant co-morbidities (HTN, T2DM, HF, sleep apnea)
Cushing's syndrome correct answer a condition caused by prolonged exposure to
high levels of cortisol
Dawn phenomenon correct answer Hyperglycemia present on awakening (GH and
cortisol are increased in the morning. Treatment is an increase in insulin or an
adjustment in administration time.
ANSWERS
A1C (glycosylated hemoglobin) correct answer provides a measurement of blood
glucose levels over the previous 2 to 3 months
Diseases affecting RBCs (anemia) can influence the AIC
acute thyrotoxicosis (thyroid storm) correct answer is an acute, severe and rare
condition that occurs when excess amounts of thyroid hormones are released
into the circulation. Results from stressors- infection, trauma, surgery, pts having
a thyroidectomy
Addison's disease correct answer adrenocortical insufficiency or secondary cause
(lack of pituitary ACTH secretions)
Addisonian crisis correct answer N/V confusion, abdominal pain, extreme
weakness, hypoglycemia, dehydration, decreased BP, tachycardia, hyponatremia,
hyperkalemia, fever, weakness- at risk for shock!!!CIRCULATORY COLLAPSE
adrenal insufficiency correct answer vomiting, increased weakness, dehydration
and hypotension
Alcohol induced hypoglycemia correct answer alcohol inhibits gluconeogenesis
(breakdown of glycogen into glucose) by the liver. This can cause severe
hypoglycemia in patients on insulin or OAs that increase insulin secretion.
Moderate alcohol consumption is fine. 1 drink for women, 2 drinks for men.
Teach pts to consume carbohydrates while drinking alcohol
,Anastomosis leak correct answer tachycardia, fever, tachypnea, chest and
abdominal pain
C peptide in serum and urine correct answer useful clinical indicator of pancreatic
b cell function and insulin levels
Care for retinopathy correct answer dilated eye examination at the time of
diagnosis and annually afterwards. T1DM- q 5 years. Prevent by maintaining
healthy glucose levels and managing HTN, laser photocoagulation therapy can
reduce the risk for vision loss. A pt who develops vitreous hemorrhage and retinal
detachment may undergo vitrectomy is he aspiration of blood, membraine and
fibers from inside the side. A flucinolone acetonide intraviteal implant (iluvien) is
used to treat retinopathy
Care of DKA correct answer First goal of therapy is to establish IV access and begin
fluid and electrolyte replacement. Give 0.9 to raise BP and restore urine output to
30 to 60 ml/hr. When blood glucose levels reach 250 5 or 10% dextrose is added.
Obtain serum potassium level before starting insulin. Monitor fluid balance and
potassium balance!!
Causes of Addisonian Crisis correct answer 1. stress (infection, surgery,
psychologic distress 2. sudden withdraw of corticosteroids, 3. adrenal surgery 4.
sudden pituitary gland destruction
Causes of HHS correct answer UTIs, pneumonia, sepsis, any acute illness and
newly diagnosed T2DM, impaired thirst sensation
Causes of hypothyroidism correct answer Primary- destruction of the thyroid
tissue or defective hormone synthesis, secondary- is caused by pituitary disease
, with decreased TSH secretion or hypothalamic dysfunction with decreased TRH
secretion. Iodine deficiency is the most common cause
Complications of hypothyroidism correct answer decreased cardiac contractility,
decreased cardiac output, high serum cholesterol and triglyceride levels,
myxedema coma is a medical emergency- can be caused by infection, drugs
(especially opiates, barbituates and tranquillizers, exposure to cold and trauma-
characterized by subnormal temperature, hypotension and hypoventilation-
cardiovascular collapse can result
counterregulatory hormones- increase blood glucose levels correct answer
glucagon, epinephrine, GH, cortisol
Criteria for metabolic syndrome correct answer Need any 3 of the 5- waist
circumference- >40in in men and >35 in women, Triglycerides- >150 or on drug
treatment for high triglycerides, HDL cholesterol- <40 in men <50 in women or
drug treatment for high cholesterol, BP- >130 sys >85 diastolic or on drug
treatment for HTN, fasting blood glucose >100 or on drug treatment for elevated
blood glucose
Criteria guidelines for bariatric surgery correct answer BMI of 40 or more or a BMI
of 35 or more with other significant co-morbidities (HTN, T2DM, HF, sleep apnea)
Cushing's syndrome correct answer a condition caused by prolonged exposure to
high levels of cortisol
Dawn phenomenon correct answer Hyperglycemia present on awakening (GH and
cortisol are increased in the morning. Treatment is an increase in insulin or an
adjustment in administration time.
