Deck 38: Pancreatic Hormones and Antidiabetic Drugs

Question 1

As a healthcare professional,how would you explain to a diabetic patient the outcome of discontinuing thyroid treatment without notifying the physician?

A) Stopping thyroid therapy may bring about hyperglycemia unless the antidiabetic medication is readjusted.
B) Stopping thyroid therapy may bring about hypoglycemia unless the antidiabetic medication is readjusted.
C) Stopping thyroid therapy may bring about exophthalmos.
D) None of these are correct.

Answer 1

Stopping thyroid therapy may bring about hypoglycemia unless the antidiabetic medication is readjusted.

Question 2

Which of the following instructions should a healthcare professional give a patient who is undergoing hormonal replacement therapy?

A) One need not inform the physician if he or she chooses to discontinue thyroid hormone replacement therapy.
B) If one is receiving radioactive iodide, he or she should not expectorate.
C) Drugs like cholestyramine should be taken only an hour after taking the thyroid hormones.
D) Thyroid hormones should preferably be taken at night.

Answer 2

If one is receiving radioactive iodide, he or she should not expectorate.

Question 3

The thyroid hormones triiodothyronine (T₃)and thyroxine (T₄):

A) increase glucose absorption from the intestines.
B) decrease protein synthesis.
C) increase the serum cholesterol level.
D) decrease the basal metabolic rate.

Answer 3

increase glucose absorption from the intestines.

Question 4

Thyroid hormone is contraindicated in patients with _____.

A) thyroid nodules
B) thyroid cancer
C) acute myocardial infarction
D) goiter

Question 5

Martha,a patient suffering from hypothyroidism,has just found out that she is pregnant.She contacts Dr.Hudson to find out whether she should continue her thyroid hormone replacement therapy during her pregnancy.Which of the following instructions is Dr.Hudson most likely to give Martha?

A) Discontinue treatment until the third trimester, when there is no longer a risk of the drug affecting fetal development.
B) Discontinue treatment because the thyroid hormones administered to pregnant women readily cross the placental barrier and affect fetal development.
C) Continue treatment as usual because the thyroid hormones administered to pregnant women do not readily cross the placental barrier to affect fetal development.
D) Continue the treatment at half the dosage as the growing fetus may be very sensitive to the effects of the drug.

Question 6

To avoid interference with the intestinal absorption of the thyroid hormones:

A) a patient should take cholestyramine and the thyroid hormones on alternating days.
B) a patient should take cholestyramine and the thyroid hormones 2 or 3 hours apart.
C) a patient should not take cholestyramine within 4 to 5 hours of taking the thyroid hormones.
D) a patient should take the thyroid hormones along with cholestyramine.

Question 7

What are the physical ramifications of hypothyroidism in infants and children?

A) Mental and physical retardation
B) Exophthalmos
C) Toxic nodular goiter
D) None of the above

Question 8

_____ is an acute condition in which there is a reduction in the number of white blood cells (WBCs),specifically polymorphonuclear cells (granulocytes).

A) Hypercalcemia
B) Agranulocytosis
C) Osteoporosis
D) Cretinism

Question 9

David is suffering from hypothyroidism.He has been using liotrix to treat his condition for many months now.When he accidently consumes a very large amount of the medication,he begins to experience reactions to the drug and is rushed to the doctor.Which of the following adverse reactions is he most likely to experience?

A) Constipation
B) Decreased heart rate
C) Increased blood pressure
D) Decreased blood pressure

Question 10

Which of the following drugs do not affect the thyroid gland but are administered to inhibit the increased sympathetic responses that accompany hyperthyroidism?

A) Beta-adrenergic blocking drugs
B) Leukotriene inhibitors
C) Calcium channel blockers
D) None of the above

Question 11

Which of the following provides the most accurate description of the formation of the thyroid hormones triiodothyronine (T₃)and thyroxine (T₄)?

A) The hypothalamus secretes TSH (thyroid-stimulating hormone), which travels in the portal vein to the anterior pituitary to stimulate the secretion of TRH (thyrotropin-releasing hormone) into the bloodstream, which, in turn, stimulates the production of T₃ and T₄ by the thyroid gland.
B) The hypothalamus secretes TRH (thyrotropin-releasing hormone), which travels in the portal vein to the posterior pituitary to stimulate the secretion of TSH (thyroid-stimulating hormone) into the bloodstream, which, in turn, stimulates the production of T₃ and T₄ by the thyroid gland.
C) The hypothalamus secretes TRH (thyrotropin-releasing hormone), which travels in the portal vein to the anterior pituitary to stimulate the secretion of TSH (thyroid-stimulating hormone) into the bloodstream, which, in turn, stimulates the production of T₃ and T₄ by the thyroid gland.
D) None of these are correct.

Question 12

Ella develops a large swelling in the front of her neck,which makes it difficult for her to swallow.Ella visits Dr.Stein for a checkup who decides to run some tests.After receiving the test results,Dr.Stein explains to Ella that she has iodine deficiency and that the protrusion in the front of her neck is,in fact,her enlarged thyroid gland.Based on the information provided in this scenario,from which of the following conditions is Ella most likely suffering?

A) Hyperthyroidism
B) Goiter
C) Toxic nodular goiter
D) Cretinism

Question 13

Which of the following tissues does the hormone calcitonin primarily affect?

A) Fat tissue
B) Bone tissue
C) Muscle tissue
D) Nerve tissue

Question 14

Which of the following diseases is associated with the long-term use of thyroxine in postmenopausal women?

A) Osteosclerosis
B) Agranulocytosis
C) Cretinism
D) Osteoporosis

Question 15

Which of the following statements is true of the thyroid gland?

A) The cells of the thyroid gland absorb iodide and combine it with the amino acid tyrosine to make T₃ and T₄.
B) The thyroid gland synthesizes and secretes five hormones that are essential for tissue growth and development.
C) The hormones of the thyroid gland directly influence the activity of only one peripheral tissue, bone tissue.
D) The thyrotropin-releasing hormone directly stimulates the thyroid gland to produce triiodothyronine (T₃) and thyroxine (T₄).

Question 16

Allison has lost a lot of weight and has an abnormally rapid heartbeat.She often suffers from anxiety and muscle weakness.When she visits Dr.Ford's clinic for a checkup,Dr.Ford immediately observes that Allison has bulging eyeballs.After running a few tests,Dr.Ford confirms his suspicions and tells Allison that she is suffering from an autoimmune disease that affects the thyroid gland.He tells her that,according to the test results,she has very high levels of thyroid hormones circulating in her bloodstream and that the excess hormones are responsible for producing these symptoms.Based on the information provided in this scenario,from which of the following conditions is Allison most likely suffering?

A) Cretinism
B) Nontoxic goiter
C) Graves' disease
D) Myxedema

Question 17

Bella suffers from hypotension and bradycardia.She cannot endure cold temperatures,and her skin is very dry.She visits Dr.Solomon for a checkup.Upon examination,Dr.Solomon observes that Bella's face is round and puffy.After running a few tests,he discovers that there is a total absence of the thyroid hormones T₃ and T₄ in Bella's bloodstream.Based on the information provided in this scenario,with which of the following conditions is Dr.Solomon most likely to diagnose Bella?

A) Cretinism
B) Toxic nodular goiter
C) Myxedema
D) Agranulocytosis

Question 18

Which of the following statements is true of thyroid hormone?

A) Thyroid hormone inhibits protein synthesis.
B) Thyroid hormone decreases the rate of carbohydrate breakdown.
C) Thyroid hormone decreases the insulin-dependent entry of glucose into cells.
D) Thyroid hormone decreases the level of serum cholesterol.

Question 19

Which of the following is true of the physiological effects of the thyroid hormones T₃ and T₄?

A) The thyroid hormones stimulate protein synthesis.
B) The thyroid hormones increase carbohydrate breakdown as well as the blood glucose and insulin-dependent entry of glucose into cells.
C) The thyroid hormones decrease serum cholesterol levels.
D) All of these are correct.

Question 20

Which of the following statements is true of antithyroid drugs such as propylthiouracil and methimazole?

A) Antithyroid drugs inhibit the incorporation of iodide into tyrosine and the condensation of monoiodotyrosine and diiodotyrosine.
B) Antithyroid drugs cannot be easily absorbed into the thyroid gland after oral use.
C) Antithyroid drugs stimulate the thyroid to secrete more T₃ and T₄.
D) Antithyroid drugs inhibit the anterior pituitary from secreting TSH (thyroid-stimulating hormone) into the bloodstream.

Question 21

Ally,a 50-year-old woman,has been experiencing severe bone pain in her pelvic region.She visits Dr.Carl for a consultation,and he instructs her to undergo a few diagnostic tests.When Dr.Carl examines an X-ray of Ally's pelvic region,he observes microfractures along her bones and notices that her bones are thick and calcified.After examining the other medical reports,Dr.Carl confirms his diagnosis and tells Ally that she is suffering from a bone disorder that is characterized by hyperactive bone metabolism.Based on the information provided in this scenario,from which of the following conditions is Ally suffering?

A) Osteoporosis
B) Paget's disease
C) Hypocalcemia
D) Graves' disease

Question 22

Using your knowledge of the mechanism of action of the bisphosphonates,select the true statement related to their use in the treatment of osteoporosis.

A) It is advisable not to take the bisphosphonates within 2 hours of taking calcium supplements, caffeine, or antacids because absorption will be increased.
B) It is advisable not to take the bisphosphonates within 1 hour of taking calcium supplements, caffeine, or antacids because absorption will be decreased.
C) It is advisable not to take the bisphosphonates within 1 hour of taking calcium supplements, caffeine, or antacids because absorption will be increased.
D) It is advisable not to take the bisphosphonates within 2 hours of taking calcium supplements, caffeine, or antacids because absorption will be decreased.

Question 23

Which of the following conditions is characterized by a significant reduction in bone mass?

A) Hypothyroidism
B) Agranulocytosis
C) Osteoporosis
D) Cretinism

Question 24

Which of the following is true of osteoporosis?

A) Osteoporosis is a condition associated with increased bone mass.
B) Osteoporosis typically affects people aged between 15 and 30 years.
C) Tall and fat women are more likely to develop osteoporosis than women who are lean and have short statures.
D) Women are more likely to be affected by osteoporosis than men are.

Question 25

Which of the following is true of calcitonin?

A) Calcitonin is secreted in response to abnormally low levels of plasma calcium.
B) Calcitonin does not affect intestinal and renal calcium absorption.
C) Calcitonin is secreted by the parathyroid gland.
D) Calcitonin directly stimulates bone resorption. Calcitonin does not affect intestinal and renal calcium absorption, and its action does not require vitamin

Question 26

For bisphosphonates to be optimally effective,these medications must be taken with an adequate amount of:

A)oral calcium and vitamin D
B)vitamin C
C)iron.
D)folic acid.

Question 27

Why is iodide suppression not useful for the long-term treatment of hyperthyroidism?

A) Because iodide reduces the vascularity of the thyroid gland
B) Because the effects of iodide suppression are not permanent
C) Because iodide destroys overactive thyroid tissue
D) Because iodide enhances the size of the thyroid gland over time

Question 28

How does the body respond to calcium levels greater than 10.5 mg/dL?

A) When the plasma calcium level reaches 10.5 mg/dL, calcitonin is secreted, which lowers the level of circulating calcium by antagonizing the effect of parathormone (PTH) on bone.
B) When the plasma calcium level reaches 10.5 mg/dL, calcitonin is secreted, which raises the level of circulating calcium by potentiating the effect of PTH on bone.
C) When the plasma calcium level reaches 10.5 mg/dL, PTH is secreted, which lowers the level of circulating calcium by antagonizing the effect of calcitonin on bone.
D) None of these are correct. When the plasma calcium level becomes too high (hypercalcemia, more than 10.5 mg/dL), calcitonin is secreted. It lowers the circulating calcium level by antagonizing the effect of PTH on bone. Calcitonin directly inhibits bone resorption so that calcium ions are retained in the bone. This is particularly important in children during bone development. It does not affect intestinal and renal calcium absorption, and its action does not require vitamin

Question 29

Select a true statement about the calcium balance mechanism in the body.

A) Osteoclasts secrete enzymes that break down bone and release calcium ions.
B) Osteoblasts secrete a protein matrix that facilitates the deposition of calcium ions.
C) Osteoblasts and osteoclasts balance plasma calcium concentration through bone remodeling.
D) All of these are correct.

Question 30

In the context of the drugs used to treat bone disorders,which of the following is true of bisphosphonates?

A) Bisphosphonates are used to stimulate bone resorption in men and women.
B) Bisphosphonates are analogs of endogenous pyrophosphates that have a special attraction to calcium in bones.
C) The nitrogen-bisphosphonates have lesser resorption inhibition potency than non-nitrogen bisphosphonates.
D) Bisphosphonates are well absorbed by the gastrointestinal tract.

Question 31

Which of the following statements is true of calcium homeostasis?

A)Calcitriol is a form of vitamin D that facilitates calcium absorption from the GI tract,thus increasing the level of circulating calcium.
B)Hypercalcemia stimulates calcitonin secretion,while hypocalcemia stimulates the secretion of parathormone (PTH).
C)All of these are correct.
D)Plasma calcium is maintained at 9.0 to 10.4 mg/dL for men and 8.9 to 10.2 mg/dL for women.

Question 32

Select the statement that best explains the results of the excessive use of calcium and vitamin D in the treatment of hypocalcemia.

A) The excessive use of calcium and vitamin D may lead to convulsions and paresthesia.
B) The excessive use of calcium and vitamin D may lead to hypercalcemia and kidney stone formation.
C) The excessive use of calcium and vitamin D may lead to carpopedal spasms.
D) All of these are correct.

Question 33

Which of the following is true of the hormone parathormone?

A) Parathormone is secreted in response to hypercalcemia.
B) Parathormone is secreted by the thyroid gland.
C) Parathormone is the primary regulator of calcium balance.
D) Parathormone decreases the intestinal absorption and renal reabsorption of calcium ions.

Question 34

Which of the following is the primary treatment for the calcium disorder hypoparathyroidism?

A)Administration of bisphosphonates
B)Administration of the parathyroid hormone teriparatide (Forteo)
C)Administration of intravenous calcium followed by oral calcium salts and vitamin D
D)All of these

Question 35

Identify a difference between the antithyroid drugs methimazole and propylthiouracil.

A) Methimazole reduces hyperthyroidism less quickly than propylthiouracil does.
B) Methimazole produces fewer adverse effects than propylthiouracil does.
C) Unlike propylthiouracil, methimazole does not cross the placental barrier during pregnancy.
D) Propylthiouracil does not have anticoagulant activity, whereas methimazole does.