Test Bank for Applied Pathophysiology: A Conceptual
Approach 4th Edition by Nath Braun | 9781975179199 | All
Chapters with Answers and Rationals
Which of the following is caused by the release of insulin?
a. decreased blood glucose level
b. increased blood glucose level
c. increased lipid breakdown
d. increased protein breakdown - ANSWER: decreased blood glucose level
Which of the following is not true of type 1 diabetes?
a. can be treated with oral glycemic agents
b. pancreas is completely unable to produce insulin
c. acute onset
d. definite genetic link - ANSWER: can be treated with oral glycemic agents
Which of the following is not true about type 2 diabetes?
a. accounts for up to 95% of diabetics
b. gradual onset
c. significant weight loss occurs as a symptom
d. risk factors are hypertension, family history, and obesity - ANSWER: significant weight loss occurs as
a symptom
Which of the following is not a sign of DKA?
a. Kussmaul's respirations
b. dehydration
c. ketonuria
d. low blood glucose level - ANSWER: low blood glucose level
Which laboratory test is the best predictor of previous blood glucose control?
a. HbA1c
b. Fasting blood glucose
c. Urinalysis
d. Feasting (postprandial) blood glucose - ANSWER: HbA1c
Neuropathies are a potential complication of diabetes. Why do these occur?
a. Infection in the nerves
b. Thickening and ischemia of the vessels that supply the nerve fibers
c. Inability to provide continuous glucose to the brain and spinal cord
d. Excessive glucose exposure to the brain and spinal cord - ANSWER: Thickening and ischemia of the
vessels that supply the nerve fibers
What is the major difference between the Somoygi effect and the dawn phenomenon?
a. One is caused by the release of certain hormones
b. One occurs between 4am and 9am
c. One triggers insulin resistance and the release of glucose from the liver
d. One is characterized by hyperglycemia that is not triggered by overnight hypoglycemia - ANSWER:
One is characterized by hyperglycemia that is not triggered by overnight hypoglycemia
What would happen if your patient did not have alpha cells of the pancreas?
a. They would not be able to secrete insulin
b. They would not be able to secrete somatostatin and gastrin
c. They would not be able to secrete glucagon d. They would not be able to secrete pancreatic
polypeptides - ANSWER: They would not be able to secrete glucagon
,What would be an unusual sign in a child that may alert the parent to the presence of diabetes?
a. Bedwetting in a child that was previously dry through the night
b. Irritability
c. Asking for water to drink in the middle of the night
d. All of these - ANSWER: All of these
What is your explanation to the parents who do not want to give their child insulin injections to treat
type 1 diabetes because they have heard that pills can be used to treat this condition?
a. Insulin is destroyed in the gastrointestinal tract if taken orally, so it must be injected
subcutaneously
b. The child can go ahead and take the oral medication because he does have type 1 diabetes
c. The child cannot take the pills because we can't be sure that he would take the entire dose
d. The pills are reserved for those over the age of 12 - ANSWER: Insulin is destroyed in the
gastrointestinal tract if taken orally, so it must be injected subcutaneously
When increased blood glucose levels stimulate increased secretion of insulin, this is an example of
control by:
a. Releasing hormones
b. Ectopic hormones
c. Negative feedback
d. Positive feedback - ANSWER: Negative feedback
A major difference between Bobby (type 1 diabetes) and his father (type 2 diabetes) is:
a. How the condition is diagnosed between type 1 and type 2
b. How the condition is treated between type 1 and type 2
c. The potential long term complications
d. The overall goal of treatment between type 1 and type 2 - ANSWER: How the condition is treated
between type 1 and type 2
Bobby's father (with type 2 diabetes) has been encouraged to increase his exercise level. Exercise is
encouraged in type 2 diabetes because:
a. Exercise decreases stress
b. Skeletal muscles can use glucose without a proportionate insulin amount
c. Exercise decreases cardiovascular effects of excessive glucose
d. All of these - ANSWER: All of these
Bobby's father has been prescribed an oral hypoglycemic drug. Such drugs act:
a. As an insulin replacement
b. To decrease the body's need for glucose in body cells
c. To prevent the formation of glucose
d. To reduce insulin resistance - ANSWER: To reduce insulin resistance
. Bobby comes in to the clinic after 6 months for a follow up visit. He indicates that his blood sugars
have been around 100-120 mg/dl and he has been fully participating in the other aspects of his
diabetes management plan. Which would lead you to believe that he has not been in tight control of
his diabetes?
a. A reduced glycosylated hemoglobin level
b. An elevated glycosylated hemoglobin level
c. A random blood sugar of 150 mg/dl performed in the clinic
d. There is no method to determine whether or not he is in tight control - ANSWER: A reduced
glycosylated hemoglobin level
Bobby, a 12-year-old male, is admitted with type 1 diabetes mellitus. In order for this diagnosis to
have been made, Bobby had all of the following pathophysiologic characteristics except:
a. Enlarged pancreas
b. Peak occurrence between ages 7 and 15 years
, c. A combination of environmental and genetic factors as the cause
d. Hyperglycemia and hyperketonuria - ANSWER: Enlarged pancreas
The pathophysiology of type I diabetes can best be described as:
a. Destruction of the pancreatic islet cells, which produce insulin
b. Resistance of insulin sensitive tissues to insulin
c. Decreased production of releasing hormones by the hypothalamus
d. Stimulation by food intake of glucose production resulting in increased insulin production -
ANSWER: Destruction of the pancreatic islet cells, which produce insulin
The origin of the pathophysiology in type 1 diabetes is related to:
a. IgE-mediated hypersensitivity, which destroys the endocrine pancreas and impairs release of insulin
b. IgA-mediated hypersensitivity, which affects the sensitivity of tissues to insulin
c. B-lymphocyte autoimmunity against the endocrine pancreas beta cells
d. T-lymphocyte autoimmunity against the endocrine pancreas beta cells - ANSWER: T-lymphocyte
autoimmunity against the endocrine pancreas beta cells
Early signs and symptoms you would expect a person with type 1 diabetes to exhibit include:
a. Recurrent infections, visual changes, paresthesias
b. Polydipsia, polyuria, polyphagia, weight loss, fatigue
c. Vomiting, abdominal pain, sweet, fruity breath, dehydration, Kussmaul breathing
d. Weakness, vomiting, hypotension, mental confusion - ANSWER: Polydipsia, polyuria, polyphagia,
weight loss, fatigue
What would you expect to find in the individual with type 1 diabetes?
a. An elevated blood glucose level
b. An elevated insulin level
c. An elevated white blood cell count
d. All of the above - ANSWER: An elevated blood glucose level
A child asks you if he will out grow his diabetes and eventually be cured. You tell him:
a. "There is no cure at this time; you will need to take medication every day to manage the diabetes"
b. "There is no cure at this time but if you lose some weight it may correct itself"
c. "As you get older the disease will decrease in severity; you will be able to control it by diet only"
d. "By the time you have completed puberty it will be gone" - ANSWER: "There is no cure at this time;
you will need to take medication every day to manage the diabetes"
After Bobby, age 12, was diagnosed with type 1 diabetes his father, John went for a physical and was
diagnosed with type 2 diabetes. What led the practitioner to believe that John had type 2 diabetes?
a. John's blood glucose was high
b. John was producing no insulin
c. John was over weight
d. All of the above are signs of type 2 diabetes - ANSWER: John's blood glucose was high
Obesity is a major risk factor for the development of type 2 diabetes. What is the mechanism for this?
a. Obesity is a result of high sugar intake, which leads to hyperglycemia
b. Obesity releases fatty acids and cytokines, which interfere with insulin receptors
c. Obesity is associated with hypercholesterolemia, which impairs the circulation of insulin
d. Obesity is associated with a mutation of the MiR-21 gene, which is the same gene implicated in the
development of insulin resistance - ANSWER: Obesity releases fatty acids and cytokines, which
interfere with insulin receptors
Bobby (from previous questions), now age 14, is admitted with the following lab values: arterial pH
7.2; serum glucose 500 mg/dl; urine glucose and ketones 4+/strong. His parents state that he has
been sick with the "flu" for a week. What relationship do these values have to his insulin deficiency?
a. Increased glucose utilization causes the shift of fluid from the intravascular to intracellular space
b. Decreased insulin causes fatty acid use, ketone formation, metabolic acidosis, and solute diuresis
Approach 4th Edition by Nath Braun | 9781975179199 | All
Chapters with Answers and Rationals
Which of the following is caused by the release of insulin?
a. decreased blood glucose level
b. increased blood glucose level
c. increased lipid breakdown
d. increased protein breakdown - ANSWER: decreased blood glucose level
Which of the following is not true of type 1 diabetes?
a. can be treated with oral glycemic agents
b. pancreas is completely unable to produce insulin
c. acute onset
d. definite genetic link - ANSWER: can be treated with oral glycemic agents
Which of the following is not true about type 2 diabetes?
a. accounts for up to 95% of diabetics
b. gradual onset
c. significant weight loss occurs as a symptom
d. risk factors are hypertension, family history, and obesity - ANSWER: significant weight loss occurs as
a symptom
Which of the following is not a sign of DKA?
a. Kussmaul's respirations
b. dehydration
c. ketonuria
d. low blood glucose level - ANSWER: low blood glucose level
Which laboratory test is the best predictor of previous blood glucose control?
a. HbA1c
b. Fasting blood glucose
c. Urinalysis
d. Feasting (postprandial) blood glucose - ANSWER: HbA1c
Neuropathies are a potential complication of diabetes. Why do these occur?
a. Infection in the nerves
b. Thickening and ischemia of the vessels that supply the nerve fibers
c. Inability to provide continuous glucose to the brain and spinal cord
d. Excessive glucose exposure to the brain and spinal cord - ANSWER: Thickening and ischemia of the
vessels that supply the nerve fibers
What is the major difference between the Somoygi effect and the dawn phenomenon?
a. One is caused by the release of certain hormones
b. One occurs between 4am and 9am
c. One triggers insulin resistance and the release of glucose from the liver
d. One is characterized by hyperglycemia that is not triggered by overnight hypoglycemia - ANSWER:
One is characterized by hyperglycemia that is not triggered by overnight hypoglycemia
What would happen if your patient did not have alpha cells of the pancreas?
a. They would not be able to secrete insulin
b. They would not be able to secrete somatostatin and gastrin
c. They would not be able to secrete glucagon d. They would not be able to secrete pancreatic
polypeptides - ANSWER: They would not be able to secrete glucagon
,What would be an unusual sign in a child that may alert the parent to the presence of diabetes?
a. Bedwetting in a child that was previously dry through the night
b. Irritability
c. Asking for water to drink in the middle of the night
d. All of these - ANSWER: All of these
What is your explanation to the parents who do not want to give their child insulin injections to treat
type 1 diabetes because they have heard that pills can be used to treat this condition?
a. Insulin is destroyed in the gastrointestinal tract if taken orally, so it must be injected
subcutaneously
b. The child can go ahead and take the oral medication because he does have type 1 diabetes
c. The child cannot take the pills because we can't be sure that he would take the entire dose
d. The pills are reserved for those over the age of 12 - ANSWER: Insulin is destroyed in the
gastrointestinal tract if taken orally, so it must be injected subcutaneously
When increased blood glucose levels stimulate increased secretion of insulin, this is an example of
control by:
a. Releasing hormones
b. Ectopic hormones
c. Negative feedback
d. Positive feedback - ANSWER: Negative feedback
A major difference between Bobby (type 1 diabetes) and his father (type 2 diabetes) is:
a. How the condition is diagnosed between type 1 and type 2
b. How the condition is treated between type 1 and type 2
c. The potential long term complications
d. The overall goal of treatment between type 1 and type 2 - ANSWER: How the condition is treated
between type 1 and type 2
Bobby's father (with type 2 diabetes) has been encouraged to increase his exercise level. Exercise is
encouraged in type 2 diabetes because:
a. Exercise decreases stress
b. Skeletal muscles can use glucose without a proportionate insulin amount
c. Exercise decreases cardiovascular effects of excessive glucose
d. All of these - ANSWER: All of these
Bobby's father has been prescribed an oral hypoglycemic drug. Such drugs act:
a. As an insulin replacement
b. To decrease the body's need for glucose in body cells
c. To prevent the formation of glucose
d. To reduce insulin resistance - ANSWER: To reduce insulin resistance
. Bobby comes in to the clinic after 6 months for a follow up visit. He indicates that his blood sugars
have been around 100-120 mg/dl and he has been fully participating in the other aspects of his
diabetes management plan. Which would lead you to believe that he has not been in tight control of
his diabetes?
a. A reduced glycosylated hemoglobin level
b. An elevated glycosylated hemoglobin level
c. A random blood sugar of 150 mg/dl performed in the clinic
d. There is no method to determine whether or not he is in tight control - ANSWER: A reduced
glycosylated hemoglobin level
Bobby, a 12-year-old male, is admitted with type 1 diabetes mellitus. In order for this diagnosis to
have been made, Bobby had all of the following pathophysiologic characteristics except:
a. Enlarged pancreas
b. Peak occurrence between ages 7 and 15 years
, c. A combination of environmental and genetic factors as the cause
d. Hyperglycemia and hyperketonuria - ANSWER: Enlarged pancreas
The pathophysiology of type I diabetes can best be described as:
a. Destruction of the pancreatic islet cells, which produce insulin
b. Resistance of insulin sensitive tissues to insulin
c. Decreased production of releasing hormones by the hypothalamus
d. Stimulation by food intake of glucose production resulting in increased insulin production -
ANSWER: Destruction of the pancreatic islet cells, which produce insulin
The origin of the pathophysiology in type 1 diabetes is related to:
a. IgE-mediated hypersensitivity, which destroys the endocrine pancreas and impairs release of insulin
b. IgA-mediated hypersensitivity, which affects the sensitivity of tissues to insulin
c. B-lymphocyte autoimmunity against the endocrine pancreas beta cells
d. T-lymphocyte autoimmunity against the endocrine pancreas beta cells - ANSWER: T-lymphocyte
autoimmunity against the endocrine pancreas beta cells
Early signs and symptoms you would expect a person with type 1 diabetes to exhibit include:
a. Recurrent infections, visual changes, paresthesias
b. Polydipsia, polyuria, polyphagia, weight loss, fatigue
c. Vomiting, abdominal pain, sweet, fruity breath, dehydration, Kussmaul breathing
d. Weakness, vomiting, hypotension, mental confusion - ANSWER: Polydipsia, polyuria, polyphagia,
weight loss, fatigue
What would you expect to find in the individual with type 1 diabetes?
a. An elevated blood glucose level
b. An elevated insulin level
c. An elevated white blood cell count
d. All of the above - ANSWER: An elevated blood glucose level
A child asks you if he will out grow his diabetes and eventually be cured. You tell him:
a. "There is no cure at this time; you will need to take medication every day to manage the diabetes"
b. "There is no cure at this time but if you lose some weight it may correct itself"
c. "As you get older the disease will decrease in severity; you will be able to control it by diet only"
d. "By the time you have completed puberty it will be gone" - ANSWER: "There is no cure at this time;
you will need to take medication every day to manage the diabetes"
After Bobby, age 12, was diagnosed with type 1 diabetes his father, John went for a physical and was
diagnosed with type 2 diabetes. What led the practitioner to believe that John had type 2 diabetes?
a. John's blood glucose was high
b. John was producing no insulin
c. John was over weight
d. All of the above are signs of type 2 diabetes - ANSWER: John's blood glucose was high
Obesity is a major risk factor for the development of type 2 diabetes. What is the mechanism for this?
a. Obesity is a result of high sugar intake, which leads to hyperglycemia
b. Obesity releases fatty acids and cytokines, which interfere with insulin receptors
c. Obesity is associated with hypercholesterolemia, which impairs the circulation of insulin
d. Obesity is associated with a mutation of the MiR-21 gene, which is the same gene implicated in the
development of insulin resistance - ANSWER: Obesity releases fatty acids and cytokines, which
interfere with insulin receptors
Bobby (from previous questions), now age 14, is admitted with the following lab values: arterial pH
7.2; serum glucose 500 mg/dl; urine glucose and ketones 4+/strong. His parents state that he has
been sick with the "flu" for a week. What relationship do these values have to his insulin deficiency?
a. Increased glucose utilization causes the shift of fluid from the intravascular to intracellular space
b. Decreased insulin causes fatty acid use, ketone formation, metabolic acidosis, and solute diuresis
