NR 507 FINAL EXAM QUESTIONS WITH
COMPLETE ANSWERS
Cushing's disease - Answer-- Excess endogenous secretion of ACTH (Corticotropin).
-from a pituitary adenoma or by an ectopic secreting non pituitary tumor such as small
cell carcinoma of the lung.or adrenal tumor (rare)
- HYPERnatremia, HYPERtension, INCREASED blood volume, HYPOkalemia,
HYPERglycemia, weight gain, thin hair, moon face, easy bruising, buffalo hump, protein
wasting
Cause of hypoparathyroidism - Answer--decreased PTH
-Damage to or removal of the parathyroid gland during thyroid surgery.
- genetic syndromes, familial hypoparathyroidism, diGeorge syndrome, and idiopathic,
or autoimmune
Primary hypothyroidism labs - Answer-*Increased levels of TSH and decreased levels of
TH (Total T3 and total and free T4*
Autoimmune- Presence of thyroperoxidase and thyroglobulin antibodies
Thyroid Storm - Answer--occurs in people who have severe hyperthyroidism and are
subject to extreme stress (infection, trauma, burns, surgery, emotional).
-Sudden release and increased action of thyroxine (T4) and triiodothyronine (T3)
exceeding metabolic demands.
-Hyperthermia, tachycardia, atrial tachydysrhythmias, high-output heart failure,
agitation, n/v, diarrhea
-Tx- beta blockers, block TH synthesis, corticosteroids, iodine, plasma exchange
Thyrotoxicosis (hyperthyroidism) - Answer-Increased metabolic rate, heat intolerance,
thin hair, bulgy eyes, enlarged thyroid, heart failure, tachycardia, weight loss, diarrhea,
warm skin, sweaty palms, pretibial myxedema.
Muscle contraction ions - Answer-Calcium is combined with troponin
Long bone growth - Answer-cartilage cells at the epiphyseal side of the physeal plate
multiply and enlarge. Cartilage cells at the metaphyseal side of the plate are destroyed
and replaced by bone.
appendicular skeleton - Answer-126 bones that make up upper and lower extremities,
shoulder girdle, pelvic girdle
valve problem in women - Answer--Mitral valve prolapse
-genetic or environmental disruption of valvular development during the fifth or sixth
week of gestation
, Reversible myocardial ischemia - Answer-Chronic coronary obstruction results in
recurrent predictable chest pain called stable angina. Abnormal vasospasm of coronary
vessels results in unpredictable chest pain called Prinzmetal angina OR unstable
angina (impending infarction)
Stable angina - Answer-transient substernal chest discomfort, ranging from a sensation
of heaviness or pressure to moderately severe pain
-Feels like indigestion
-May radiate to neck, lower jaw, left arm and left shoulder or back or down right arm
-Pallor diaphoresis and dyspnea
-relieved by rest and nitrates
-Women (atypical chest pain, palpitations, sense of unease and severe fatigue)
orthostatic hypotension - Answer-decrease in SBP of at least 20, or decrease in DBP of
at least 10 within 3 minutes of standing.
-neurogenic, caused by ANS dysfunction
-dizziness, blurring of vision, syncope, fainting
-Tx: inc. salt intake, raise HOB, thigh-high stockings, erythropoietin, vomune,
vasoconstrictors (midodrine)
Isolated systolic hypertension - Answer-High SBP, normal DBP
-Associated with cardiovascular and cerebrovascular events, all age groups
Insulin resistance in HTN - Answer--associated with endothelial injury and affects renal
function, causing renal salt and water retention
-Insulin resistance is associated with overactivity of the SNS and the RAAS.
-BP will decrease when people are given meds to increase insulin sensitivity
SNS and HTN - Answer-Overactivity of the SNS leads to increased production of
catecholamines (epi/norepi) or from increased receptor reactivity.
- Increase SNS = inc HR, systemic vasoconstriction (inc BP), renin release, inc tubular
sodium reabsorption, dec renal blood flow.
-vascular remodeling, insulin resistance, inc renin and angiotensin levels, procoagulant
effect.
- Tx: beta blockers
Sustained HTN effects - Answer-- Inc. workload of myocardium, dec blood flow through
coronaries (LV hypertrophy, heart failure)
- Accelerated atherosclerosis (CAD) (ischemia, infarction, death)
- RAAS/SNS stimulation, inflammation (Glomerulosclerosis, dec GFR, ESRD)
- dec. brain blood flow/o2, weak vessel walls (TIAs, CVA, thrombosis, aneurysm,
hemorrhage)
- hypertensive retinopathy, retinal exudates, hemorrhage
-dissecting aortic aneurysm
- intermittent claudication, gangrene
COMPLETE ANSWERS
Cushing's disease - Answer-- Excess endogenous secretion of ACTH (Corticotropin).
-from a pituitary adenoma or by an ectopic secreting non pituitary tumor such as small
cell carcinoma of the lung.or adrenal tumor (rare)
- HYPERnatremia, HYPERtension, INCREASED blood volume, HYPOkalemia,
HYPERglycemia, weight gain, thin hair, moon face, easy bruising, buffalo hump, protein
wasting
Cause of hypoparathyroidism - Answer--decreased PTH
-Damage to or removal of the parathyroid gland during thyroid surgery.
- genetic syndromes, familial hypoparathyroidism, diGeorge syndrome, and idiopathic,
or autoimmune
Primary hypothyroidism labs - Answer-*Increased levels of TSH and decreased levels of
TH (Total T3 and total and free T4*
Autoimmune- Presence of thyroperoxidase and thyroglobulin antibodies
Thyroid Storm - Answer--occurs in people who have severe hyperthyroidism and are
subject to extreme stress (infection, trauma, burns, surgery, emotional).
-Sudden release and increased action of thyroxine (T4) and triiodothyronine (T3)
exceeding metabolic demands.
-Hyperthermia, tachycardia, atrial tachydysrhythmias, high-output heart failure,
agitation, n/v, diarrhea
-Tx- beta blockers, block TH synthesis, corticosteroids, iodine, plasma exchange
Thyrotoxicosis (hyperthyroidism) - Answer-Increased metabolic rate, heat intolerance,
thin hair, bulgy eyes, enlarged thyroid, heart failure, tachycardia, weight loss, diarrhea,
warm skin, sweaty palms, pretibial myxedema.
Muscle contraction ions - Answer-Calcium is combined with troponin
Long bone growth - Answer-cartilage cells at the epiphyseal side of the physeal plate
multiply and enlarge. Cartilage cells at the metaphyseal side of the plate are destroyed
and replaced by bone.
appendicular skeleton - Answer-126 bones that make up upper and lower extremities,
shoulder girdle, pelvic girdle
valve problem in women - Answer--Mitral valve prolapse
-genetic or environmental disruption of valvular development during the fifth or sixth
week of gestation
, Reversible myocardial ischemia - Answer-Chronic coronary obstruction results in
recurrent predictable chest pain called stable angina. Abnormal vasospasm of coronary
vessels results in unpredictable chest pain called Prinzmetal angina OR unstable
angina (impending infarction)
Stable angina - Answer-transient substernal chest discomfort, ranging from a sensation
of heaviness or pressure to moderately severe pain
-Feels like indigestion
-May radiate to neck, lower jaw, left arm and left shoulder or back or down right arm
-Pallor diaphoresis and dyspnea
-relieved by rest and nitrates
-Women (atypical chest pain, palpitations, sense of unease and severe fatigue)
orthostatic hypotension - Answer-decrease in SBP of at least 20, or decrease in DBP of
at least 10 within 3 minutes of standing.
-neurogenic, caused by ANS dysfunction
-dizziness, blurring of vision, syncope, fainting
-Tx: inc. salt intake, raise HOB, thigh-high stockings, erythropoietin, vomune,
vasoconstrictors (midodrine)
Isolated systolic hypertension - Answer-High SBP, normal DBP
-Associated with cardiovascular and cerebrovascular events, all age groups
Insulin resistance in HTN - Answer--associated with endothelial injury and affects renal
function, causing renal salt and water retention
-Insulin resistance is associated with overactivity of the SNS and the RAAS.
-BP will decrease when people are given meds to increase insulin sensitivity
SNS and HTN - Answer-Overactivity of the SNS leads to increased production of
catecholamines (epi/norepi) or from increased receptor reactivity.
- Increase SNS = inc HR, systemic vasoconstriction (inc BP), renin release, inc tubular
sodium reabsorption, dec renal blood flow.
-vascular remodeling, insulin resistance, inc renin and angiotensin levels, procoagulant
effect.
- Tx: beta blockers
Sustained HTN effects - Answer-- Inc. workload of myocardium, dec blood flow through
coronaries (LV hypertrophy, heart failure)
- Accelerated atherosclerosis (CAD) (ischemia, infarction, death)
- RAAS/SNS stimulation, inflammation (Glomerulosclerosis, dec GFR, ESRD)
- dec. brain blood flow/o2, weak vessel walls (TIAs, CVA, thrombosis, aneurysm,
hemorrhage)
- hypertensive retinopathy, retinal exudates, hemorrhage
-dissecting aortic aneurysm
- intermittent claudication, gangrene
