Deck 17: Diseases of the Endocrine System

Question 1

Current recommendations for the use of sucrose and other refined sugars in diabetics are that they are

A)never allowed.
B)acceptable for all patients.
C)more restricted than in the general population.
D)not part of individualized carbohydrate goals.

Answer 1

B

Question 2

Glucagon promotes the degradation of _____ to _____

A)glycogen, glucose
B)glucose, glycogen
C)glycogen, glycerol
D)glycerol, glucose

Answer 2

A

Question 3

Which of the following situations would not make blood glucose higher in a diabetic patient?

A)stress
B)flu
C)taking too much insulin
D)eating excessive amounts of food

Answer 3

C

Question 4

When is the peak time for insulin glargine?

A)2 hours after the injection
B)there is no peak
C)before the third meal of the day (dinner)
D)at bedtime

Question 5

Which of the following is dependent on insulin for transportation of glucose?

A)brain
B)liver
C)working muscles
D)adipose tissues

Question 6

Which of the following is not a parameter used to diagnose DM?

A)casual plasma glucose concentration
B)fasting plasma glucose
C)oral glucose tolerance test
D)hemoglobin A1c

Question 7

All of the following hormones are responsible for stimulating lipolysis except:

A)glucagon.
B)insulin.
C)growth hormone.
D)cortisol.

Question 8

Self-monitoring of blood glucose should be performed _____ in type 1 diabetics

A)twice a day (every morning and night)
B)only when symptoms of hypoglycemia are experienced
C)at least three times each day
D)only when the client feels badly

Question 9

Insulin promotes the conversion of _____ into _____ in the liver

A)glucose, glycogen
B)glycogen, glucose
C)glucose, glycerol
D)glycerol, glycogen

Question 10

Most cases of hyporesponsiveness in endocrine disorders are caused by:

A)lack or deficiency of hormone receptors on the target cells.
B)lack or deficiency of hormones.
C)lack or deficiency of cofactors or coenzymes.
D)excess production of hormones.

Question 11

The diabetic patient should be told that the use of alcohol is

A)acceptable if body weight is normal.
B)acceptable if consumed only once per day.
C)acceptable if diabetes is well controlled and if food is consumed at the same time.
D)never acceptable.

Question 12

What situation might cause hypoglycemia in a diabetic client?

A)avoiding alcohol
B)skipping a meal
C)taking too little insulin
D)decreased amounts of physical activity

Question 13

The adrenal medulla secretes all of the following except:

A)epinephrine.
B)catecholamines.
C)norepinephrine.
D)thyroxine.

Question 14

People with type 1 diabetes mellitus need insulin because they:

A)have become insulin resistant.
B)have developed hyperinsulinemia.
C)no longer synthesize insulin.
D)digest insulin with GI enzymes.

Question 15

Which of the following statements is true?

A)Insulin is an anabolic hormone.
B)Insulin stimulates lipolysis.
C)Insulin is not necessary for protein metabolism.
D)Insulin stimulates gluconeogenesis.

Question 16

Insulin promotes the conversion of _____ into _____ in the liver

A)glucose, glycogen
B)glycogen, glucose
C)glucose, glycerol
D)glycerol, glycogen

Question 17

Glucagon promotes the degradation of _____ to _____

A)glycogen, glucose
B)glucose, glycogen
C)glycogen, glycerol
D)glycerol, glucose

Question 18

Which of the following levels of blood glucose indicates a positive test for IGT in an individual who has been given an oral glucose tolerance test?

A)140-199 mg/dL
B)100-125 mg/dL
C)70-110 mg/dL
D)115-140 mg/dL

Question 19

Which of the following is a valid test to measure the degree of hyperglycemia for the period beginning more than 1 month prior to the test?

A)fructosamine test
B)hemoglobin A1c test
C)urine test
D)ketone test

Question 20

All of the following are basic types of insulin administration regimens except:

A)conventional/standard insulin therapy.
B)flexible/intensive insulin therapy.
C)continuous subcutaneous insulin infusion .
D)scheduled intermittent insulin therapy.

Question 21

Which of the following statements is false in regards to HHS?

A)It is characterized by BG levels > 600 mg/dL.
B)Infection and dehydration are most likely the precipitating factors.
C)Symptoms include polyuria, polydipsia, and weight loss.
D)This does not require hospitalization.

Question 22

Prolonged hyperglycemia from uncontrolled diabetes can lead to one of two acute metabolic crises They are:

A)diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome.
B)diabetic neuritis and hyperosmolar hypertension.
C)cerebral vascular accident and severe dehydration.
D)diabetic nephrosis and acute dehydration.

Question 23

You have a T1DM patient who is non-compliant and does not regularly inject her prescribed insulin Your main concern is:

A)assessing the level of glucose in the blood.
B)assessing the patient's dietary intake.
C)reducing the risk of DKA.
D)reducing long-term complications such as retinal damage.

Question 24

One way that oral hypoglycemic agents help to lower blood glucose levels is by

A)augmenting beta-cell secretion of insulin.
B)decreasing the insulin sensitivity of the receptor cell.
C)increasing glucose formation from liver glycogen.
D)decreasing the deamination of protein.

Question 25

Which of the following would lead to protein in the urine?

A)retinopathy
B)neuropathy
C)peripheral vascular disease
D)nephropathy

Question 26

Which of these would lead to blurred vision?

A)retinopathy
B)neuropathy
C)peripheral vascular disease
D)nephropathy

Question 27

Microvascular complications of diabetes mellitus include which of the following?

A)retinopathy
B)heart failure
C)peripheral vascular disease
D)premature birth

Question 28

People with type 2 DM are prone to

A)ketosis.
B)weight loss.
C)acidosis.
D)hyperglycemic hyperosmolar syndrome.

Question 29

During an acute episode of the flu with nausea and vomiting, clients with type 1 DM should:

A)drink only sugar-free fluids.
B)not take their insulin.
C)monitor their urine for ketones.
D)not eat.

Question 30

T2DM is an often undiagnosed symptom of:

A)PCOS.
B)uterine fibroids.
C)HTN.
D)atherosclerosis.

Question 31

Individuals with diabetes should monitor their protein intake, which should not exceed _____ for those who have developed nephropathy

A)1.2 g/kg
B)1.5 g/kg
C)0.8 g/kg
D)1.0 g/kg

Question 32

You have a patient experiencing symptoms of gastroparesis Which of the following is an appropriate recommendation for treatment of this condition?

A)discontinue insulin until symptoms subside
B)maintain inactivity for at least 1 hour after eating
C)continue with a liberal diet
D)eat small, frequent meals

Question 33

A target preprandial serum glucose for a non-pregnant diabetic should be _____

A)<180 mg/dL
B)70-130 mg/dL
C)<7%
D)100-140 mg/dL

Question 34

Urine testing glucose was used routinely in the past The greatest limitation for this test is that glucose is not in the urine until the serum glucose is greater than _____ mg/dL

A)85
B)100
C)250
D)300

Question 35

Which of the following is a macrovascular complication of diabetes?

A)retinophathy
B)nephropathy
C)neuropathy
D)cardiovascular disease

Question 36

Macrovascular complications include which of the following?

A)gastroparesis
B)sexual dysfunction
C)ischemic heart disease
D)nephropathy

Question 37

The patient who can be a candidate for oral hypoglycemic agents is one with

A)functioning alpha cells in the pancreas.
B)functioning beta cells in the pancreas.
C)functioning chromaffin tissue in the liver.
D)resistance to insulin in all tissue.

Question 38

In order for T2DM to develop both _____ must be evident

A)cell receptor defects and insulin secretory defects
B)central body adiposity and insulin secretory defects
C)identifiable gene defects and cell receptor defects
D)identifiable gene defects and insulin secretory defects

Question 39

Mr M is a 45-year-old man He has type 2 DM that is controlled by diet alone He is 5'9" and weighs 210 lbs Which of the following will help to improve insulin resistance?

A)weight reduction
B)hard candy for hypoglycemic attack
C)antioxidants
D)3 meals with a bedtime snack

Question 40

Oral glucose-lowering medications are frequently prescribed for type 2 DM Which of the following groups of medications causes the pancreas to secrete additional insulin?

A)biguanides, such as Glucophage
B)sulfonylureas, such as DiaBeta
C)alpha-glucosidase inhibitors, such as acarbose

Question 41

FG is a 30 yo F who has just been diagnosed with T2DM.Her doctor told her she had IFG a year ago, but she did not make any lifestyle changes.She is now very concerned with her new diagnosis and has decided to see a registered dietitian.
HT: 5'2" WT: 206# Hemoglobin A1C 10%
Which of the following is a good long-term measurement of how well FG is doing with her blood sugars?

A)fasting plasma glucose
B)oral glucose tolerance test
C)hemoglobin A1C
D)weight

Question 42

The most common cause of hyperthyroidism is:

A)Graves' disease.
B)multiple sclerosis.
C)Addison's disease.
D)Cushing's disease.

Question 43

Case Study Multiple Choice
JK is a 19 yo M college student with T1DM.He is away from home and is reportedly drinking and eating poorly.His school schedule is erratic so he eats at all different times of the day.He currently takes an extended long-acting analogue insulin once per day.Around 8 pm, his blood sugars are falling very low.
HT: 5'10" WT: 178 Hemoglobin A1c 9%
If JK's MD adopts the above option, JK will have to work with the dietitian to learn:

A)carbohydrate counting.
B)how to inject insulin for maximum benefits.
C)changing his schedule.
D)changing his diet to all sugar-free foods.

Question 44

FG is a 30 yo F who has just been diagnosed with T2DM.Her doctor told her she had IFG a year ago, but she did not make any lifestyle changes.She is now very concerned with her new diagnosis and has decided to see a registered dietitian.
HT: 5'2" WT: 206# Hemoglobin A1C 10%
What is the likely cause of her condition?

A)weight
B)family history
C)her hemoglobin A1C
D)high intake of carbohydrates

Question 45

FG is a 30 yo F who has just been diagnosed with T2DM.Her doctor told her she had IFG a year ago, but she did not make any lifestyle changes.She is now very concerned with her new diagnosis and has decided to see a registered dietitian.
HT: 5'2" WT: 206# Hemoglobin A1C 10%
The registered dietitian meets with FG and teaches her the exchange system for meal planning FG reports that she eats a turkey sandwich for lunch every day and two bananas How many starch exchanges does this amount to?

A)3
B)4
C)2
D)5

Question 46

FG is a 30 yo F who has just been diagnosed with T2DM.Her doctor told her she had IFG a year ago, but she did not make any lifestyle changes.She is now very concerned with her new diagnosis and has decided to see a registered dietitian.
HT: 5'2" WT: 206# Hemoglobin A1C 10%
What would be an optimal hemoglobin A1C for FG once she begins her new meal plan?

A)7%
B)8%
C)6%
D)9%

Question 47

Complications associated with gestational diabetes mellitus (GDM) include:

A)preeclampsia.
B)excessive sweating.
C)chronic fatigue.
D)fever.

Question 48

Risk factors for gestational DM include all of the following except:

A)family history.
B)high sugar intake.
C)maternal obesity.
D)delivery of an infant weighing >9 lb.

Question 49

FG is a 30 yo F who has just been diagnosed with T2DM.Her doctor told her she had IFG a year ago, but she did not make any lifestyle changes.She is now very concerned with her new diagnosis and has decided to see a registered dietitian.
HT: 5'2" WT: 206# Hemoglobin A1C 10%
If FG does not keep her blood glucose under control, she may develop which macrovascular disorder?

A)retinopathy
B)cardiovascular disease
C)nephropathy
D)DKA

Question 50

The typical nutrition prescription for a type 2 DM patient who needs approximately 2000 kcal/day would be:

A)50% carbohydrate, 20% protein, and 30% fat.
B)50% fat, 20% protein, and 30% carbohydrate.
C)50% protein, 20% fat, and 30% carbohydrate.
D)50% carbohydrate, 20% fat, and 30% protein.
E)50% fat, 20% carbohydrate, and 30% protein.

Question 51

You have a patient who reports loss of hair, weight gain, lack of energy, and intolerance to cold In addition, the patient's labs show low levels of T4 This patient is most likely exhibiting symptoms of which of the following?

A)anemia
B)poor circulation
C)insulin resistance
D)hypothyroidism

Question 52

Case Study Multiple Choice
JK is a 19 yo M college student with T1DM.He is away from home and is reportedly drinking and eating poorly.His school schedule is erratic so he eats at all different times of the day.He currently takes an extended long-acting analogue insulin once per day.Around 8 pm, his blood sugars are falling very low.
HT: 5'10" WT: 178 Hemoglobin A1c 9%
If JK does not take his insulin because he no longer wants to inject himself, what acute illness is he at risk for developing?

A)hypoglycemia
B)cardiovascular disease
C)renal failure
D)DKA

Question 53

All of the following foods have a profound positive effect on serum glucose except:

A)resistant starch.
B)pectin.
C)gums.
D)corn starch.

Question 54

When working with T2DM patients, the aim of nutrition intervention should be to:

A)support and facilitate lifestyle and behavior modification.
B)always obtain HbA1c periodically.
C)focus on increasing fiber intake because it has positive effects on BG levels.
D)encourage patients to use the exchange system.

Question 55

Treatment for reactive hypoglycemia includes all of the following except:

A)drug therapy using anticholinergic agents.
B)increasing simple carbohydrates in the diet.
C)limiting caffeine intake.
D)eating small, frequent meals.

Question 56

Case Study Multiple Choice
JK is a 19 yo M college student with T1DM.He is away from home and is reportedly drinking and eating poorly.His school schedule is erratic so he eats at all different times of the day.He currently takes an extended long-acting analogue insulin once per day.Around 8 pm, his blood sugars are falling very low.
HT: 5'10" WT: 178 Hemoglobin A1c 9%
What range did the MD likely use to calculate JK's initial insulin regimen?

A)0.3-0.5 units/kg
B)0.5-0.8 units/kg
C)0.8-1.1 units/kg
D)1.1-1.4 units/kg

Question 57

Case Study Multiple Choice
JK is a 19 yo M college student with T1DM.He is away from home and is reportedly drinking and eating poorly.His school schedule is erratic so he eats at all different times of the day.He currently takes an extended long-acting analogue insulin once per day.Around 8 pm, his blood sugars are falling very low.
HT: 5'10" WT: 178 Hemoglobin A1c 9%
What is likely the cause of JK's low blood sugar at 8 pm?

A)his insulin dosage is to high
B)he is eating too much
C)the timing and peak of his insulin are not matching his intake
D)low blood sugar is desirable for someone with T1DM

Question 58

Case Study Multiple Choice
JK is a 19 yo M college student with T1DM.He is away from home and is reportedly drinking and eating poorly.His school schedule is erratic so he eats at all different times of the day.He currently takes an extended long-acting analogue insulin once per day.Around 8 pm, his blood sugars are falling very low.
HT: 5'10" WT: 178 Hemoglobin A1c 9%
Given his schedule, what may work better for JK?

A)conventional therapy
B)multiple daily injections
C)split-dose insulin
D)single-dose insulin