NURS 511 WEEK 6, DUNPHY ENDOCRINE AND
ISM:gkFinitegkM Chaptergk12:gkDifferencegkEquationsgkandgkMathematicalgkM
ath odels
METABOLIC PROBLEMS, ENDOCRINE Q AND A
Whichnjofnjthenjfollowingnjconditionsnjisnjanjcommonnjpathologicalnjcausenjofnjhirsutism?nj-njanswer--
Polycysticnjovarynjsyndrome.
Joannjhasnjseverenjasthmanjandnjhasnjbeennjonnjhighnjdosesnjofnjoralnjcorticosteroidsnjfornj2njyears.njShenjha
beennjreadingnjsomenjhomenjremedynjbooksnjandnjstopsnjallnjofnjhernjmedications.njWhatnjconditionnjmaynjs
njdevelop?nj-njanswer--Addisoniannjcrisis.
Mary,njagenj72,njhasnjbeennjtakingnjinsulinnjfornjseveralnjyears.njShenjjustnjcallednjyounjbecausenjshenjrealize
thatnjyesterdaynjshenjputnjhernjshort-actingnjinsulinnjinnjthenjlong-
actingnjinsulinnjboxnjandnjvicenjversa.njShenjjustnjtooknj22njunitsnjofnjregularnjinsulinnjwhennjshenjwasnjsuppos
dnjtonjtakenjonlynj5njunits.njShenjsaysnjthatnjshenjtriednjtonjdonjanjfingersticknjtonjtestnjhernjglucosenjlevelnjbutnjw
njunablenjtonjobtainnjanynjblood.njShenjstatesnjthatnjshenjfeelsnjfine.njWhatnjdonjyounjtellnjhernjtonjdonjfirst?nj-
njanswer--"Drinknjfournjouncesnjofnjfruitnjjuice."
Thenjmostnjcommonnjcausenjofnjhyperthyroidismnjis:nj-njanswer--Gravesnjdisease.
Marie,njagenj50,njhasnjtypenj1njdiabetesnjandnjchecksnjhernjbloodnjglucosenjlevelnjseveralnjtimesnjeverynjday.
ernjbloodnjglucosenjlevelnjrangesnjfromnj250njtonj280njmg/
dLnjinnjthenjmorningnjandnjisnjusuallynjaboutnj140njatnjlunch,njaboutnj120njatnjdinner,njandnjaboutnj100njatnjbed
me.njInnjthenjmorning,njshenjtakesnj30njunitsnjofnjneutralnjprotaminenjHagedornnj(NPH)njinsulinnjandnj4njunits
njregularnjinsulin,njandnjbeforenjdinnernjshenjtakesnj18njunitsnjofnjNPHnjinsulinnjandnj4njunitsnjofnjregularnjinsul
njAlthoughnjshenjhasnjhadnjhernjinsulinnjdosenjadjustednjseveralnjtimesnjinnjthenjpastnjmonth,njitnjhasnjhadnjnon
fectnjonnjhernjhighnjmorningnjbloodnjglucosenjlevel.njWhatnjisnjyournjnextnjcoursenjofnjaction?nj-njanswer--
Havenjhernjchecknjhernjbloodnjglucosenjlevelnjbetweennj2njamnjandnj4njamnjfornjthenjnextnjseveralnjdays.
Steve,njagenj42,njhasnjnevernjbeennjhypertensivenjbutnjappearsnjtodaynjinnjthenjofficenjwithnjanjbloodnjpressu
ofnj162/100njmmnjHg.njHenjalsonjcomplainsnjofnj"attacks"njofnjheadache,njperspiration,njandnjpalpitations,njw
njfrequentnjboutsnjofnjnausea,njpain,njweakness,njdyspnea,njandnjvisualnjdisturbances.njHenjhasnjlostnj10njlbn
ernjthenjpastnj2njmonthsnjandnjseemsnjverynjanxiousnjtoday.njYournjnextnjactionnjwouldnjbenjto:nj-njanswer--
Obtainnjanj24-hournjurinenjtestnjfornjcatecholamines.
Anjclientnjwithnjhyperthyroidismnjpresentsnjwithnjanjcomplaintnjofnjanj"gritty"njfeelingnjinnjhernjeyes.njOvernjthe
astnjweek,njhernjvisualnjacuitynjhasnjdiminished,njandnjhernjabilitynjtonjseenjcolorsnjhasnjchanged.njShenjalson
snjanjfeelingnjofnjpressurenjbehindnjhernjeyes.njThenjnextnjstepnjfornjthenjnursenjpractitionernjisnjto:nj-njanswer-
Refernjthenjclientnjfornjimmediatenjevaluationnjbynjannjophthalmologist.
Whatnjisnjthenjmedicationnjofnjchoicenjfornjannjinitialnjacutenjattacknjofnjgout?nj-njanswer--Anjnonnjsteroidalnjan
inflammatorynjdrugnj(NSAID)
Morrisnjhasnjhadnjtypenj1njdiabetesnjfornj10njyears.njSeveralnjrecentnjurinalysisnjreportsnjhavenjshownnjmicro
buminuria.njYournjnextnjstepnjwouldnjbenjto:nj-njanswer--Startnjhimnjonnjannjangiotensin-
convertingnjenzymenj(ACE)njinhibitor.
Whatnjisnjthenjprimarynjpathologicalnjirregularitynjassociatednjwithnjdiabetesnjmellitusnjtypenj1?nj-njanswer--
Nonfunctioningnjbetanjcells.
, Chaptergk12:gkDifferencegkEquationsgkandgkMathematicalgkM ISM:gkFinitegkM
odels ath
Anjpatientnjpresentsnjtonjyournjprimarynjcarenjofficenjwithnjabnormalnjlabnjresults.njOnnjphysical njexam,njyounj
pnjthenjpatient'snjfacialnjnervenjaroundnjthenjzygomaticnjarch,njjustnjanteriornjtonjthenjearlobe.njThisnjdescribe
whichnjofnjthenjfollowingnjtestsnjandnjisnjassociatednjwithnjwhichnjofnjthenjfollowingnjlabnjabnormalities?nj-
njanswer--Chvosteknjsign,njhypocalcemia
Martin,njagenj62,njhasnjacutenjnontransientnjabdominalnjpainnjthatnjgrowsnjsteadilynjworsenjinnjthenjepigastric
areanjandnjradiatesnjstraightnjthroughnjtonjthenjback.njThenjpainnjhasnjlastednjfornjdays.njHenjisnjalsonjcomplai
gnjofnjnausea,njvomiting,njsweating,njweakness,njandnjpallor.njPhysicalnjexaminationnjrevealsnjabdominalnjt
dernessnjandnjdistentionnjandnjanjlow-gradenjfever.njWhatnjdonjyounjsuspect?nj-njanswer--Acutenjpancreatiti
Dan,njagenj45,njisnjobesenjandnjhasnjtypenj2njdiabetes.njHenjhasnjbeennjhavingnjtroublenjgettingnjhisnjglycohe
oglobinnjundernjcontrol.njHenjhasnjheardnjthatnjexenatidenj(Byetta)njcausesnjweightnjlossnjandnjwantsnjtonjtryn
njWhatnjdonjyounjtellnjhim?nj-
njanswer--"Let'snjtrynjit.njYournjglycohemoglobinnjwillnjbenjlowerednjandnjyounjmaynjlosenjweight."
Whichnjclassnjofnjantihypertensivenjagentsnjmaynjbenjproblematicnjfornjclientsnjwithnjdiabetes?nj-njanswer--
Betanjblockers.
Harriet,njagenj62,njhasnjtypenj1njdiabetesnjthatnjisnjwellnjcontrollednjbynjinsulin.njRecently,njshenjhasnjbeennjha
ngnjmaritalnjdifficultiesnjthatnjhavenjleftnjhernjemotionallynjupset.njAsnjanjresultnjofnjthisnjstress,njitnjisnjpossible
atnjshenjwill:nj-njanswer--Havenjannjincreasednjbloodnjsugarnjlevel.
Sadie,njagenj40,njhasnjjustnjbeennjgivennjanjdiagnosisnjofnjGravesnjdisease.njShenjhasnjrecentlynjlostnj25njlb,nj
snjpalpitations,njisnjverynjirritable,njfeelsnjverynjwarm,njandnjhasnjanjnoticeablenjbulgenjonnjhernjneck.njThenjmo
njlikelynjcausenjofnjhernjincreasednjthyroidnjfunctionnjis:nj-njanswer--Annjautoimmunenjresponse.
Mr.njReynoldsnjisnjonnjthenjantithyroidnjdrugnj(ATD)njmethimazolenj(Tapazole),njsonjyounjmakenjitnjanjpointnjto
hecknjhis:nj-njanswer--Completenjbloodnjcountnj(CBC)njandnjlivernjtransaminases.
Jeffrey,njagenj17,njhasnjgynecomastia.njYounjshouldnjalsonjassessnjhimnjfor:nj-njanswer--Testicularnjcancer
WhennjteachingnjMarcynjhownjtonjusenjhernjnewnjinsulinnjpump,njyounjtellnjhernjthatnjshenjneedsnjtonjmonitornj
rnjbloodnjglucosenjlevel:nj-njanswer--Atnjleastnj4njtimesnjanjday.
Anjclientnjwithnjdiabetesnjonnjanjsulfonylureanjandnjmetforminnjwithnjanjglycatednjhemoglobinnj(HbA1c)njofnj6.
%njisnjcomplainingnjofnjepisodesnjofnjlownjbloodnjsugar.njWhichnjofnjthenjfollowingnjchangesnjwouldnjbenjthenjm
stnjappropriate?nj-njanswer--Decreasingnjthenjdosagenjofnjthenjsulfonylurea.
Whennjyounjinspectnjthenjintegumentarynjsystemnjofnjclientsnjwithnjendocrinenjdisorders,njanjfindingnjofnjcoar
njhairnjmaynjbenjannjindicatornjof:nj-njanswer--Hypothyroidism.
Tonjreducenjthenjincidencenjofnjflares,njfoodsnjhighnjinnjwhatnjaminonjacidnjneednjtonjbenjlimitednjinnjthenjdietsn
jpatientsnjwithnjgout?nj-njanswer--Purine.
Thenjmajornjrisknjfactornjfornjthyroidnjcancernjis:nj-njanswer--Exposurenjtonjradiation.
WhatnjisnjthenjmostnjcommonnjcausenjofnjCushingnjdisease?nj-njanswer--Pituitarynjadenoma.
LynnenjhasnjCushingnjsyndrome.njYounjwouldnjexpectnjhernjtonjhavenjornjdevelop:nj-njanswer--
Onychomycosis.
,Sara, njage
ISM: nj40,
gkFinite Mhasnjdiabetesnjandnjisnjnownjexperiencing
gknj Chaptergk12:njgkanhidrosis njonnjthenjgk
DifferencegkEquations hands njandnjfeet,gk
andgkMathematical njincreased
M
ath odels
weatingnjonnjthenjfacenjandnjtrunk,njdysphagia,njanorexia,njandnjheartburn.njWhichnjcomplicationnjofnjdiabet
njdonjyounjsuspect?nj-njanswer--Autonomicnjneuropathies.
Thenjprocessnjofnjagingnjresultsnjin:nj-njanswer--Anjdecreasednjabsorptionnjofnjfat-solublenjvitamins.
Anj55-year-
oldnjAsiannjmalenjpresentsnjwithnjanjhistorynjofnjseverenjleftnjgreatnjtoenjpain.njHenjstatesnjhenjcannotnjevennjto
chnjthenjtoenjwithnjanjsheetnjwithoutnjitnjcausingnjpain.njHenjdeniesnjtraumanjbutnjstatesnjhenjcannotnjambulate
withoutnjpain.njHenjadmitsnjtonjdrinkingnjalcoholnjbutnjnotnjtonjexcess.njOnnjphysicalnjexam,njhenjhasnjnormaln
alnjsigns,njandnjyounjnotenjerythemanjofnjthenjgreatnjtoenjatnjthenjinterphalangealnj(IP)njjoint.njWhichnjofnjthenjf
owingnjisnjthenjgoldnjstandardnjfornjdiagnosisnjofnjthisnjproblem?nj-njanswer--
Jointnjaspirationnjwithnjcrystalnjanalysis.
Jason,njagenj14,njappearsnjwithnjtendernjdiscoidnjbreastnjtissuenjenlargementnj(2-
3njcmnjinnjdiameter)njbeneathnjthenjareolae.njYournjnextnjactionnjwouldnjbenjto:nj-njanswer--
Performnjwatchfulnjwaitingnjfornj1njyear.
Marsha,njagenj24,njisnjpreparingnjfornjradioactivenjiodinenjtherapynjfornjhernjGravesnjdisease.njWhichnjtestnjm
tnjshenjundergonjfirst?nj-njanswer--Beta-humannjchorionicnjgonadotropin.
Afternjannjoralnjcholecystogram,njSamnjcomplainsnjofnjburningnjonnjurination.njThisnjisnjbecausenjof:nj-
njanswer--Thenjpresencenjofnjdyenjinnjthenjurine.
Joynjhasnjgout.njInnjteachingnjhernjaboutnjhernjdisease,njwhichnjfoodnjdonjyounjtellnjhernjisnjallowednjinnjthenjdie
nj-njanswer--Broccoli.
Sandra,njagenj28,njhasnjsecondarynjobesity.njWhichnjofnjthenjfollowingnjmaynjhavenjcausednjthis?nj-njanswer-
Polycysticnjovarynjsyndrome.
Jennifernjhasnjdiabetesnjmellitusnj(DM)njandnjisnjinjectingnj30njunitsnjofnjNovolinnj70/30njwithnjbreakfastnjandn
8njunitsnjatnjbedtime.njShenjisnjcomplainingnjthatnjshenjwokenjupnjoncenjinnjthenjmiddlenjofnjthenjnightnjwithnjpa
tationsnjandnjsweating.njBasednjonnjthisnjinformation,njwhatnjdonjyounjrecommend?nj-njanswer--
Changingnjthenjtimenjofnjthenjnighttimenjinsulinnjinjection.
Whatnjisnjthenjmostnjcommonnjcausenjofnjgynecomastia?nj-njanswer--Puberty.
Whichnjofnjthenjfollowingnjbodynjmassnjindexnj(BMI)njvaluesnjdefinesnjclassnj1njobesity?nj-njanswer--30
Juanita,njagenj23,njcomplainsnjofnjpalpitationsnjthatnjstartednjanjfewnjweeksnjago;njtheynjoccurnj2njtonj4njtimes
jdaynjandnjlastnj5njtonj10njminutes.njShenjfeelsnjnervousnjandnjisnjhavingnjtroublenjsleeping.njHernjstoolsnjhave
eennjfrequentnj(1-
3njpernjday)njandnjloose.njShenjisnjtakingnjlevothyroxinenj150njµgnjdaily.njHernjlabsnjindicatenjfreenjthyroxinenj(
4)nj2.28njandnjthyroid-
stimulatingnjhormonenj(TSH)nj0.022.njShenjhasnjanjhistorynjofnjGravesnjdiseasenjandnjhadnjradioactivenjiodin
(RAI)njtreatmentnjanjfewnjmonthsnjago.njShenjhasnjbeennjonnjthyroidnjreplacementnjfornj2njmonths.njBasednjo
thesenjdata,njyounjdecidenjto:nj-njanswer--Decreasenjthenjlevothyroxinenjdosage.
Anjclientnjwithnjnewlynjdiagnosednjdiabetesnjwhonjhasnjanjglycatednjhemoglobinnj(HbA1c)njofnj7.5njisnjstarted
nnjtherapeuticnjlifestylenjchangesnj(TLCs)njandnjmedicalnjnutritionnjtherapynj(MNT).njWhichnjoralnjantidiabet
agentnjisnjrecommendednjasnjmonotherapy?nj-njanswer--Metforminnj(Glucophage).
, Which njofnjgk
Chapter the following
12:njgk statements
Differencenjgk njabout
Equationsgkand njdiabetes
gkMathematical njmellitusnjisnjuntrue?nj-njanswer--
gkM ISM:gkFinitegkM
odels
Diabetesnjmellitusnjisnjcurable. ath
Mason,njagenj52,njhasnjdiabetesnjmellitusnj(DM)njandnjisnjoverweight.njYounjnownjfindnjthatnjhenjisnjhypertens
e.njHownjshouldnjyounjtreatnjhisnjhypertension?nj-njanswer--
Younjshouldnjtreatnjitnjverynjaggressively,njpreferablynjwithnjangiotensin-
convertingnjenzymenj(ACE)njinhibitors.
Marknjhasnjtypenj1njdiabetesnjandnjhasnjmildnjhyperglycemia.njWhatnjeffectnjdoesnjphysicalnjactivitynj(exercis
njhavenjonnjhisnjbloodnjglucosenjlevel?nj-njanswer--Itnjmaynjdecreasenjit.
Mindynjisnjschedulednjtonjhavenjannjoralnjglucosenjtolerancenjtestnj(OGTT).njShenjisnjinstructednjtonjdiscontin
njmanynjofnjhernjmedicationsnjfornj3njdaysnjbeforenjthenjtest.njWhichnjonenjisnjitnjsafenjtonjcontinuenjtaking?nj-
njanswer--Calcium.
Whichnjofnjthenjfollowingnjwouldnjnotnjconfirmnjanjdiagnosisnjofnjdiabetes?nj-njanswer--
Randomnjglucosenjofnj198.
Whichnjofnjthenjfollowingnjstatementsnjaboutnjmetforminnjisnjuntrue?nj-njanswer--
Metforminnjisnjtypicallynjusednjinnjconjunctionnjwithnjothernjdiabetesnjmedications.
Whichnjofnjthenjfollowingnjwouldnjnotnjbenjorderednjonnjanjregularnjbasisnjtonjevaluatenjdiabeticnjpatientsnjfornj
dnjorgannjdamagenjassociatednjwithnjdiabetes?nj-njanswer--Completenjbloodnjcountnj(CBC).
Eunice,njagenj32,njhasnjtypenj2njdiabetes.njShenjsaidnjshenjheardnjshenjshouldnjtakenjannjaspirinnjanjdaynjafter
henjreachesnjmenopausenjfornjitsnjcardioprotectivenjaction.njShenjdoesnjnotnjhavenjcoronarynjarterynjdisease
butnjhernjfathernjdoes.njHownjdonjyounjrespond?nj-
njanswer--"ThenjAmericannjDiabetesnjAssociationnjrecommendsnjthatnjyounjstartnjonnjlow-
dosenjaspirinnjtherapynjnow."
Jeremiah,njagenj72,njhasnjgoutnjandnjisnjobese.njWhennjteachingnjhimnjaboutnjdiet,njwhichnjofnjthenjfollowingn
njyounjtellnjhim?nj-
njanswer--"Fluidnjintakenjshouldnjexceednjthreenjthousandnjmillilitersnjdailynjtonjpreventnjformationnjofnjuricnja
dnjkidneynjstones."
ThenjAmericannjDiabetesnjAssociationnj(ADA)njrecommendsnjwhichnjofnjthenjfollowingnjquarterlynjbloodnjtes
njbenjperformednjonnjallnjclientsnjwithnjdiabetes?nj-njanswer--Glycatednjhemoglobin.
Annjelderlynjclientnjpresentsnjwithnjatrialnjfibrillation.njWhichnjofnjthenjfollowingnjlabnjtestsnjisnjimportantnjinnjfor
ngnjthenjdiagnosis?nj-njanswer--Thyroid-stimulatingnjhormonenj(TSH).
Leah,njagenj70,njhasnjhadnjdiabetesnjfornjmanynjyears.njWhennjteachingnjhernjaboutnjfootnjcare,njyounjwantnjt
stress:nj-njanswer--Thatnjpainlessnjulcerationsnjmightnjoccurnjandnjfeetnjshouldnjbenjexaminednjwithnjanjmirro
Sigrid,njagenj48,njappearsnjwithnjanj3-
monthnjhistorynjofnjheatnjintolerance,njincreasednjsweating,njpalpitations,njtachycardia,njnervousness,njirrita
lity,njfatigue,njandnjmusclenjweakness.njWhichnjtestnjwouldnjyounjordernjfirst?nj-njanswer--Thyroid-
stimulatingnjhormonenj(TSH)njlevel.
Yournjclientnjwithnjdiabetesnjasksnjyounjaboutnjinsulinnjglarginenj(Lantus).njYounjtellnjhernjthat:nj-njanswer--
Insulinnjglarginenj(Lantus)njstaysnjinnjyournjsystemnjfornj24njhours.
ISM:gkFinitegkM Chaptergk12:gkDifferencegkEquationsgkandgkMathematicalgkM
ath odels
METABOLIC PROBLEMS, ENDOCRINE Q AND A
Whichnjofnjthenjfollowingnjconditionsnjisnjanjcommonnjpathologicalnjcausenjofnjhirsutism?nj-njanswer--
Polycysticnjovarynjsyndrome.
Joannjhasnjseverenjasthmanjandnjhasnjbeennjonnjhighnjdosesnjofnjoralnjcorticosteroidsnjfornj2njyears.njShenjha
beennjreadingnjsomenjhomenjremedynjbooksnjandnjstopsnjallnjofnjhernjmedications.njWhatnjconditionnjmaynjs
njdevelop?nj-njanswer--Addisoniannjcrisis.
Mary,njagenj72,njhasnjbeennjtakingnjinsulinnjfornjseveralnjyears.njShenjjustnjcallednjyounjbecausenjshenjrealize
thatnjyesterdaynjshenjputnjhernjshort-actingnjinsulinnjinnjthenjlong-
actingnjinsulinnjboxnjandnjvicenjversa.njShenjjustnjtooknj22njunitsnjofnjregularnjinsulinnjwhennjshenjwasnjsuppos
dnjtonjtakenjonlynj5njunits.njShenjsaysnjthatnjshenjtriednjtonjdonjanjfingersticknjtonjtestnjhernjglucosenjlevelnjbutnjw
njunablenjtonjobtainnjanynjblood.njShenjstatesnjthatnjshenjfeelsnjfine.njWhatnjdonjyounjtellnjhernjtonjdonjfirst?nj-
njanswer--"Drinknjfournjouncesnjofnjfruitnjjuice."
Thenjmostnjcommonnjcausenjofnjhyperthyroidismnjis:nj-njanswer--Gravesnjdisease.
Marie,njagenj50,njhasnjtypenj1njdiabetesnjandnjchecksnjhernjbloodnjglucosenjlevelnjseveralnjtimesnjeverynjday.
ernjbloodnjglucosenjlevelnjrangesnjfromnj250njtonj280njmg/
dLnjinnjthenjmorningnjandnjisnjusuallynjaboutnj140njatnjlunch,njaboutnj120njatnjdinner,njandnjaboutnj100njatnjbed
me.njInnjthenjmorning,njshenjtakesnj30njunitsnjofnjneutralnjprotaminenjHagedornnj(NPH)njinsulinnjandnj4njunits
njregularnjinsulin,njandnjbeforenjdinnernjshenjtakesnj18njunitsnjofnjNPHnjinsulinnjandnj4njunitsnjofnjregularnjinsul
njAlthoughnjshenjhasnjhadnjhernjinsulinnjdosenjadjustednjseveralnjtimesnjinnjthenjpastnjmonth,njitnjhasnjhadnjnon
fectnjonnjhernjhighnjmorningnjbloodnjglucosenjlevel.njWhatnjisnjyournjnextnjcoursenjofnjaction?nj-njanswer--
Havenjhernjchecknjhernjbloodnjglucosenjlevelnjbetweennj2njamnjandnj4njamnjfornjthenjnextnjseveralnjdays.
Steve,njagenj42,njhasnjnevernjbeennjhypertensivenjbutnjappearsnjtodaynjinnjthenjofficenjwithnjanjbloodnjpressu
ofnj162/100njmmnjHg.njHenjalsonjcomplainsnjofnj"attacks"njofnjheadache,njperspiration,njandnjpalpitations,njw
njfrequentnjboutsnjofnjnausea,njpain,njweakness,njdyspnea,njandnjvisualnjdisturbances.njHenjhasnjlostnj10njlbn
ernjthenjpastnj2njmonthsnjandnjseemsnjverynjanxiousnjtoday.njYournjnextnjactionnjwouldnjbenjto:nj-njanswer--
Obtainnjanj24-hournjurinenjtestnjfornjcatecholamines.
Anjclientnjwithnjhyperthyroidismnjpresentsnjwithnjanjcomplaintnjofnjanj"gritty"njfeelingnjinnjhernjeyes.njOvernjthe
astnjweek,njhernjvisualnjacuitynjhasnjdiminished,njandnjhernjabilitynjtonjseenjcolorsnjhasnjchanged.njShenjalson
snjanjfeelingnjofnjpressurenjbehindnjhernjeyes.njThenjnextnjstepnjfornjthenjnursenjpractitionernjisnjto:nj-njanswer-
Refernjthenjclientnjfornjimmediatenjevaluationnjbynjannjophthalmologist.
Whatnjisnjthenjmedicationnjofnjchoicenjfornjannjinitialnjacutenjattacknjofnjgout?nj-njanswer--Anjnonnjsteroidalnjan
inflammatorynjdrugnj(NSAID)
Morrisnjhasnjhadnjtypenj1njdiabetesnjfornj10njyears.njSeveralnjrecentnjurinalysisnjreportsnjhavenjshownnjmicro
buminuria.njYournjnextnjstepnjwouldnjbenjto:nj-njanswer--Startnjhimnjonnjannjangiotensin-
convertingnjenzymenj(ACE)njinhibitor.
Whatnjisnjthenjprimarynjpathologicalnjirregularitynjassociatednjwithnjdiabetesnjmellitusnjtypenj1?nj-njanswer--
Nonfunctioningnjbetanjcells.
, Chaptergk12:gkDifferencegkEquationsgkandgkMathematicalgkM ISM:gkFinitegkM
odels ath
Anjpatientnjpresentsnjtonjyournjprimarynjcarenjofficenjwithnjabnormalnjlabnjresults.njOnnjphysical njexam,njyounj
pnjthenjpatient'snjfacialnjnervenjaroundnjthenjzygomaticnjarch,njjustnjanteriornjtonjthenjearlobe.njThisnjdescribe
whichnjofnjthenjfollowingnjtestsnjandnjisnjassociatednjwithnjwhichnjofnjthenjfollowingnjlabnjabnormalities?nj-
njanswer--Chvosteknjsign,njhypocalcemia
Martin,njagenj62,njhasnjacutenjnontransientnjabdominalnjpainnjthatnjgrowsnjsteadilynjworsenjinnjthenjepigastric
areanjandnjradiatesnjstraightnjthroughnjtonjthenjback.njThenjpainnjhasnjlastednjfornjdays.njHenjisnjalsonjcomplai
gnjofnjnausea,njvomiting,njsweating,njweakness,njandnjpallor.njPhysicalnjexaminationnjrevealsnjabdominalnjt
dernessnjandnjdistentionnjandnjanjlow-gradenjfever.njWhatnjdonjyounjsuspect?nj-njanswer--Acutenjpancreatiti
Dan,njagenj45,njisnjobesenjandnjhasnjtypenj2njdiabetes.njHenjhasnjbeennjhavingnjtroublenjgettingnjhisnjglycohe
oglobinnjundernjcontrol.njHenjhasnjheardnjthatnjexenatidenj(Byetta)njcausesnjweightnjlossnjandnjwantsnjtonjtryn
njWhatnjdonjyounjtellnjhim?nj-
njanswer--"Let'snjtrynjit.njYournjglycohemoglobinnjwillnjbenjlowerednjandnjyounjmaynjlosenjweight."
Whichnjclassnjofnjantihypertensivenjagentsnjmaynjbenjproblematicnjfornjclientsnjwithnjdiabetes?nj-njanswer--
Betanjblockers.
Harriet,njagenj62,njhasnjtypenj1njdiabetesnjthatnjisnjwellnjcontrollednjbynjinsulin.njRecently,njshenjhasnjbeennjha
ngnjmaritalnjdifficultiesnjthatnjhavenjleftnjhernjemotionallynjupset.njAsnjanjresultnjofnjthisnjstress,njitnjisnjpossible
atnjshenjwill:nj-njanswer--Havenjannjincreasednjbloodnjsugarnjlevel.
Sadie,njagenj40,njhasnjjustnjbeennjgivennjanjdiagnosisnjofnjGravesnjdisease.njShenjhasnjrecentlynjlostnj25njlb,nj
snjpalpitations,njisnjverynjirritable,njfeelsnjverynjwarm,njandnjhasnjanjnoticeablenjbulgenjonnjhernjneck.njThenjmo
njlikelynjcausenjofnjhernjincreasednjthyroidnjfunctionnjis:nj-njanswer--Annjautoimmunenjresponse.
Mr.njReynoldsnjisnjonnjthenjantithyroidnjdrugnj(ATD)njmethimazolenj(Tapazole),njsonjyounjmakenjitnjanjpointnjto
hecknjhis:nj-njanswer--Completenjbloodnjcountnj(CBC)njandnjlivernjtransaminases.
Jeffrey,njagenj17,njhasnjgynecomastia.njYounjshouldnjalsonjassessnjhimnjfor:nj-njanswer--Testicularnjcancer
WhennjteachingnjMarcynjhownjtonjusenjhernjnewnjinsulinnjpump,njyounjtellnjhernjthatnjshenjneedsnjtonjmonitornj
rnjbloodnjglucosenjlevel:nj-njanswer--Atnjleastnj4njtimesnjanjday.
Anjclientnjwithnjdiabetesnjonnjanjsulfonylureanjandnjmetforminnjwithnjanjglycatednjhemoglobinnj(HbA1c)njofnj6.
%njisnjcomplainingnjofnjepisodesnjofnjlownjbloodnjsugar.njWhichnjofnjthenjfollowingnjchangesnjwouldnjbenjthenjm
stnjappropriate?nj-njanswer--Decreasingnjthenjdosagenjofnjthenjsulfonylurea.
Whennjyounjinspectnjthenjintegumentarynjsystemnjofnjclientsnjwithnjendocrinenjdisorders,njanjfindingnjofnjcoar
njhairnjmaynjbenjannjindicatornjof:nj-njanswer--Hypothyroidism.
Tonjreducenjthenjincidencenjofnjflares,njfoodsnjhighnjinnjwhatnjaminonjacidnjneednjtonjbenjlimitednjinnjthenjdietsn
jpatientsnjwithnjgout?nj-njanswer--Purine.
Thenjmajornjrisknjfactornjfornjthyroidnjcancernjis:nj-njanswer--Exposurenjtonjradiation.
WhatnjisnjthenjmostnjcommonnjcausenjofnjCushingnjdisease?nj-njanswer--Pituitarynjadenoma.
LynnenjhasnjCushingnjsyndrome.njYounjwouldnjexpectnjhernjtonjhavenjornjdevelop:nj-njanswer--
Onychomycosis.
,Sara, njage
ISM: nj40,
gkFinite Mhasnjdiabetesnjandnjisnjnownjexperiencing
gknj Chaptergk12:njgkanhidrosis njonnjthenjgk
DifferencegkEquations hands njandnjfeet,gk
andgkMathematical njincreased
M
ath odels
weatingnjonnjthenjfacenjandnjtrunk,njdysphagia,njanorexia,njandnjheartburn.njWhichnjcomplicationnjofnjdiabet
njdonjyounjsuspect?nj-njanswer--Autonomicnjneuropathies.
Thenjprocessnjofnjagingnjresultsnjin:nj-njanswer--Anjdecreasednjabsorptionnjofnjfat-solublenjvitamins.
Anj55-year-
oldnjAsiannjmalenjpresentsnjwithnjanjhistorynjofnjseverenjleftnjgreatnjtoenjpain.njHenjstatesnjhenjcannotnjevennjto
chnjthenjtoenjwithnjanjsheetnjwithoutnjitnjcausingnjpain.njHenjdeniesnjtraumanjbutnjstatesnjhenjcannotnjambulate
withoutnjpain.njHenjadmitsnjtonjdrinkingnjalcoholnjbutnjnotnjtonjexcess.njOnnjphysicalnjexam,njhenjhasnjnormaln
alnjsigns,njandnjyounjnotenjerythemanjofnjthenjgreatnjtoenjatnjthenjinterphalangealnj(IP)njjoint.njWhichnjofnjthenjf
owingnjisnjthenjgoldnjstandardnjfornjdiagnosisnjofnjthisnjproblem?nj-njanswer--
Jointnjaspirationnjwithnjcrystalnjanalysis.
Jason,njagenj14,njappearsnjwithnjtendernjdiscoidnjbreastnjtissuenjenlargementnj(2-
3njcmnjinnjdiameter)njbeneathnjthenjareolae.njYournjnextnjactionnjwouldnjbenjto:nj-njanswer--
Performnjwatchfulnjwaitingnjfornj1njyear.
Marsha,njagenj24,njisnjpreparingnjfornjradioactivenjiodinenjtherapynjfornjhernjGravesnjdisease.njWhichnjtestnjm
tnjshenjundergonjfirst?nj-njanswer--Beta-humannjchorionicnjgonadotropin.
Afternjannjoralnjcholecystogram,njSamnjcomplainsnjofnjburningnjonnjurination.njThisnjisnjbecausenjof:nj-
njanswer--Thenjpresencenjofnjdyenjinnjthenjurine.
Joynjhasnjgout.njInnjteachingnjhernjaboutnjhernjdisease,njwhichnjfoodnjdonjyounjtellnjhernjisnjallowednjinnjthenjdie
nj-njanswer--Broccoli.
Sandra,njagenj28,njhasnjsecondarynjobesity.njWhichnjofnjthenjfollowingnjmaynjhavenjcausednjthis?nj-njanswer-
Polycysticnjovarynjsyndrome.
Jennifernjhasnjdiabetesnjmellitusnj(DM)njandnjisnjinjectingnj30njunitsnjofnjNovolinnj70/30njwithnjbreakfastnjandn
8njunitsnjatnjbedtime.njShenjisnjcomplainingnjthatnjshenjwokenjupnjoncenjinnjthenjmiddlenjofnjthenjnightnjwithnjpa
tationsnjandnjsweating.njBasednjonnjthisnjinformation,njwhatnjdonjyounjrecommend?nj-njanswer--
Changingnjthenjtimenjofnjthenjnighttimenjinsulinnjinjection.
Whatnjisnjthenjmostnjcommonnjcausenjofnjgynecomastia?nj-njanswer--Puberty.
Whichnjofnjthenjfollowingnjbodynjmassnjindexnj(BMI)njvaluesnjdefinesnjclassnj1njobesity?nj-njanswer--30
Juanita,njagenj23,njcomplainsnjofnjpalpitationsnjthatnjstartednjanjfewnjweeksnjago;njtheynjoccurnj2njtonj4njtimes
jdaynjandnjlastnj5njtonj10njminutes.njShenjfeelsnjnervousnjandnjisnjhavingnjtroublenjsleeping.njHernjstoolsnjhave
eennjfrequentnj(1-
3njpernjday)njandnjloose.njShenjisnjtakingnjlevothyroxinenj150njµgnjdaily.njHernjlabsnjindicatenjfreenjthyroxinenj(
4)nj2.28njandnjthyroid-
stimulatingnjhormonenj(TSH)nj0.022.njShenjhasnjanjhistorynjofnjGravesnjdiseasenjandnjhadnjradioactivenjiodin
(RAI)njtreatmentnjanjfewnjmonthsnjago.njShenjhasnjbeennjonnjthyroidnjreplacementnjfornj2njmonths.njBasednjo
thesenjdata,njyounjdecidenjto:nj-njanswer--Decreasenjthenjlevothyroxinenjdosage.
Anjclientnjwithnjnewlynjdiagnosednjdiabetesnjwhonjhasnjanjglycatednjhemoglobinnj(HbA1c)njofnj7.5njisnjstarted
nnjtherapeuticnjlifestylenjchangesnj(TLCs)njandnjmedicalnjnutritionnjtherapynj(MNT).njWhichnjoralnjantidiabet
agentnjisnjrecommendednjasnjmonotherapy?nj-njanswer--Metforminnj(Glucophage).
, Which njofnjgk
Chapter the following
12:njgk statements
Differencenjgk njabout
Equationsgkand njdiabetes
gkMathematical njmellitusnjisnjuntrue?nj-njanswer--
gkM ISM:gkFinitegkM
odels
Diabetesnjmellitusnjisnjcurable. ath
Mason,njagenj52,njhasnjdiabetesnjmellitusnj(DM)njandnjisnjoverweight.njYounjnownjfindnjthatnjhenjisnjhypertens
e.njHownjshouldnjyounjtreatnjhisnjhypertension?nj-njanswer--
Younjshouldnjtreatnjitnjverynjaggressively,njpreferablynjwithnjangiotensin-
convertingnjenzymenj(ACE)njinhibitors.
Marknjhasnjtypenj1njdiabetesnjandnjhasnjmildnjhyperglycemia.njWhatnjeffectnjdoesnjphysicalnjactivitynj(exercis
njhavenjonnjhisnjbloodnjglucosenjlevel?nj-njanswer--Itnjmaynjdecreasenjit.
Mindynjisnjschedulednjtonjhavenjannjoralnjglucosenjtolerancenjtestnj(OGTT).njShenjisnjinstructednjtonjdiscontin
njmanynjofnjhernjmedicationsnjfornj3njdaysnjbeforenjthenjtest.njWhichnjonenjisnjitnjsafenjtonjcontinuenjtaking?nj-
njanswer--Calcium.
Whichnjofnjthenjfollowingnjwouldnjnotnjconfirmnjanjdiagnosisnjofnjdiabetes?nj-njanswer--
Randomnjglucosenjofnj198.
Whichnjofnjthenjfollowingnjstatementsnjaboutnjmetforminnjisnjuntrue?nj-njanswer--
Metforminnjisnjtypicallynjusednjinnjconjunctionnjwithnjothernjdiabetesnjmedications.
Whichnjofnjthenjfollowingnjwouldnjnotnjbenjorderednjonnjanjregularnjbasisnjtonjevaluatenjdiabeticnjpatientsnjfornj
dnjorgannjdamagenjassociatednjwithnjdiabetes?nj-njanswer--Completenjbloodnjcountnj(CBC).
Eunice,njagenj32,njhasnjtypenj2njdiabetes.njShenjsaidnjshenjheardnjshenjshouldnjtakenjannjaspirinnjanjdaynjafter
henjreachesnjmenopausenjfornjitsnjcardioprotectivenjaction.njShenjdoesnjnotnjhavenjcoronarynjarterynjdisease
butnjhernjfathernjdoes.njHownjdonjyounjrespond?nj-
njanswer--"ThenjAmericannjDiabetesnjAssociationnjrecommendsnjthatnjyounjstartnjonnjlow-
dosenjaspirinnjtherapynjnow."
Jeremiah,njagenj72,njhasnjgoutnjandnjisnjobese.njWhennjteachingnjhimnjaboutnjdiet,njwhichnjofnjthenjfollowingn
njyounjtellnjhim?nj-
njanswer--"Fluidnjintakenjshouldnjexceednjthreenjthousandnjmillilitersnjdailynjtonjpreventnjformationnjofnjuricnja
dnjkidneynjstones."
ThenjAmericannjDiabetesnjAssociationnj(ADA)njrecommendsnjwhichnjofnjthenjfollowingnjquarterlynjbloodnjtes
njbenjperformednjonnjallnjclientsnjwithnjdiabetes?nj-njanswer--Glycatednjhemoglobin.
Annjelderlynjclientnjpresentsnjwithnjatrialnjfibrillation.njWhichnjofnjthenjfollowingnjlabnjtestsnjisnjimportantnjinnjfor
ngnjthenjdiagnosis?nj-njanswer--Thyroid-stimulatingnjhormonenj(TSH).
Leah,njagenj70,njhasnjhadnjdiabetesnjfornjmanynjyears.njWhennjteachingnjhernjaboutnjfootnjcare,njyounjwantnjt
stress:nj-njanswer--Thatnjpainlessnjulcerationsnjmightnjoccurnjandnjfeetnjshouldnjbenjexaminednjwithnjanjmirro
Sigrid,njagenj48,njappearsnjwithnjanj3-
monthnjhistorynjofnjheatnjintolerance,njincreasednjsweating,njpalpitations,njtachycardia,njnervousness,njirrita
lity,njfatigue,njandnjmusclenjweakness.njWhichnjtestnjwouldnjyounjordernjfirst?nj-njanswer--Thyroid-
stimulatingnjhormonenj(TSH)njlevel.
Yournjclientnjwithnjdiabetesnjasksnjyounjaboutnjinsulinnjglarginenj(Lantus).njYounjtellnjhernjthat:nj-njanswer--
Insulinnjglarginenj(Lantus)njstaysnjinnjyournjsystemnjfornj24njhours.
