Question 1

Insulin is a hormone secreted by cells located in which organ?&#10;A) The adrenal glands&#10;B) The hypothalamus&#10;C) The pancreas&#10;D) The thyroid gland

Accepted Answer

Insulin is secreted by the beta cells of the pancreas.

Question 2

Insulin is a:&#10;A) Carbohydrate&#10;B) Polypeptide&#10;C) Triglyceride&#10;D) Catabolic hormone

Accepted Answer

Insulin is a peptide hormone composed of 51 linked amino acids. It is an anabolic hormone (a hormone that contributes to body growth and development). It influences both carbohydrate and fat metabolism.

Question 3

Hypoglycemia differs from hyperglycemia in which of the following ways?&#10;A) Only hypoglycemia can cause confusion or coma&#10;B) Hyperglycemia is caused by excessive doses of insulin; hypoglycemia is caused by eating too much&#10;C) Of the two, only hypoglycemia can be caused by excessive exercise&#10;D) Of the two, only hyperglycemia is hazardous to health

Accepted Answer

Hypoglycemia (low blood glucose levels) and hyperglycemia (elevated blood glucose levels) differ in several fundamental ways. Hypoglycemia can be caused by starvation, excessive exercise, or excessive doses of insulin or oral hypoglycemic agents. Hyperglycemia can result from a variety of causes, including insulin resistance, excessive eating, a sedentary lifestyle, drugs (such as prednisone), glucose infusions (intravenous dextrose, for example), among other causes. Both hypo- and hyperglycemia can result in confusion or coma (hypoglycemia does this by depriving neurons of their primary energy source, glucose; severe hyperglycemia does this by increasing serum osmolarity). Both hypoglycemia and hyperglycemia are hazardous to health.

Question 4

Lipolysis is:&#10;A) Fatty acid synthesis&#10;B) The metabolic breakdown of fats&#10;C) The conversion of hepatic glycogen to glucose&#10;D) The storage of glucose as glycogen in the liver

Accepted Answer

Lipolysis is the metabolic breakdown of stored fats into circulating fatty acids which can then be used as a source of energy. Lipolysis is inhibited by high circulating insulin levels and promoted by low levels of circulating insulin. The conversion of stored glycogen to glucose is a process called gluconeogenesis; it occurs when circulating insulin levels are low-that is, when an animal has not been recently fed. The uptake of glucose by the liver and its storage as the polysaccharide glycogen in the liver is stimulated by insulin.

Question 5

Microalbuminuria results from glycosylation of:&#10;A) The coronary arteries&#10;B) The kidneys&#10;C) The peripheral nerves&#10;D) The retina

Accepted Answer

Microalbuminuria is the loss of small amounts of albumin in the urine, a feature of diabetes mellitus (and some other renal diseases), which causes the renal glomeruli to become more permeable to glucose. In diabetes mellitus, glycosylation ("sugar-coating") of the glomeruli is partly responsible for this condition, which is often a harbinger of future renal failure.

Question 6

The blood test that indicates how well controlled a diabetic has been for the last few months is the:&#10;A) C-reactive protein level&#10;B) Erythrocyte sedimentation rate&#10;C) Hemoglobin A1c level&#10;D) Troponin I

Accepted Answer

Glucose that circulates in the blood binds chemically to red blood cells (and other cells and tissues)-a process known as "glycosylation." The hemoglobin A1c test, sometimes called the glycosylated hemoglobin test, is the best long-term measure of diabetic control. A1c levels of about 7.0 or less are considered optimal, because they decrease the likelihood of many of the complications of diabetes (except for hypoglycemia, of course). Strict control of diabetes lowers blood glucose levels, and when blood glucose levels are too low, symptomatic hypoglycemia may occur. The C-reactive protein level and erythrocyte sedimentation rate are both markers of systemic inflammation. Troponin I is a cardiac muscle enzyme that is released into the circulation when the heart is damaged.

Question 7

Profound dehydration is a characteristic of which of the following?&#10;A) Hypoglycemia&#10;B) Diabetic ketoacidosis&#10;C) Gestational diabetes mellitus&#10;D) Type 2 diabetes mellitus

Accepted Answer

In diabetic ketoacidosis, a lack of insulin contributes to lipolysis (evidenced by the presence of ketones in blood and urine) and hyperglycemia. High blood sugars cause massive osmotic diuresis, dehydration, and severe metabolic acidosis.

Question 8

The term &#34;brittle&#34; diabetes is used to signify:&#10;A) Diabetes mellitus that is difficult to control&#10;B) Diabetes mellitus that develops without warning&#10;C) Diabetes mellitus that requires insulin&#10;D) Diabetes mellitus associated with osteoporosis and an increased risk of fractures.

Accepted Answer

Diabetes mellitus in which a patient swings rapidly from very high to very low sugars is called "brittle diabetes."

Question 9

A medication that is commonly used to treat exacerbations of chronic obstructive pulmonary disease that can elevate blood glucose is:&#10;A) Albuterol&#10;B) Atrovent&#10;C) Prednisone&#10;D) Tiotropium

Accepted Answer

Corticosteroids like prednisone elevate blood glucose levels.

Question 10

Which of the following statements about the hypothalamus and the pituitary gland is correct? Cells in the hypothalamus _____________; cells in the pituitary gland ________.&#10;A) Directly control the adrenals, gonads, and thyroid gland; act on these organs indirectly, through their control of the hypothalamus&#10;B) Release corticotrophin-releasing hormone (CRH); release adrenocorticotropin (ACTH)&#10;C) Activate the parasympathetic nervous system; activate the sympathetic nervous system&#10;D) Secrete insulin; secrete glucose

Accepted Answer

The hypothalamus is a portion of the diencephalon of the brain. It produces releasing hormones, like corticotrophin-releasing hormone which stimulate the pituitary gland to release hormones like adrenocorticotropin (ACTH). The pituitary gland has a more immediate action on effector glands like the adrenals, the gonads, and the thyroid gland than the hypothalamus.

Question 11

Which of the following is the best device to use for multiple daily injections of insulin?&#10;A) A 30-gauge, 5/8-in. needle&#10;B) A 22-gauge, 1-in. needle&#10;C) An 18-gauge, 2 1/2-in. needle&#10;D) An 18-French urethral catheter

Accepted Answer

The answer of Which of the following is the best...

Question 12

Methods or techniques that prolong life and good health with aging are known as:&#10;A) Aging in place strategies&#10;B) Life extension, or age retardation techniques&#10;C) Anabolic steroids&#10;D) Avoidable decline therapies

Accepted Answer

The answer of Methods or techniques that prolong life and...

Question 13

Which of the following patients is most likely to be found to be hypothyroid?&#10;A) An adolescent female who reports fatigue and a hematocrit of 28&#10;B) A depressed woman, aged 65 with a resting heart rate of 50&#10;C) An athletic male with high blood pressure, aged 65, with a resting heart rate of 50&#10;D) An obese sedentary male, aged 35, who reports excessive sweating with exertion

Accepted Answer

The answer of Which of the following patients is most...

Question 14

A viral infection that attacks salivary glands and the testes is:&#10;A) Chickenpox&#10;B) Measles&#10;C) Mumps&#10;D) Rubella

Accepted Answer

The answer of A viral infection that attacks salivary glands...

Question 15

A normal fasting blood glucose level is:&#10;A) Less than 100 mg/dl&#10;B) 100 to 125 mg/dl&#10;C) 126 to 199 mg/dl&#10;D) Greater than 200 mg/dl

Accepted Answer

The answer of A normal fasting blood glucose level is:&#10;A)...

Question 16

A disease known for producing weight loss, an increased metabolic rate, tachycardia, and fevers is:&#10;A) Hypothyroidism&#10;B) Hypoparathyroidism&#10;C) Renal failure&#10;D) Hyperthyroidism

Accepted Answer

The answer of A disease known for producing weight loss,...

Question 17

When glands fail, hormone levels may drop, and health can be restored with hormone replacement therapy. For example, ovarian failure (menopause) can be treated with estrogens; adrenal failure (Addison's disease) with gluco- and mineralocorticoids. Hashimoto's disease (failure of the thyroid gland after Grave's disease) is treated with:

A) Atorvastatin
B) Amlodipine
C) Atenolol
D) Levothyroxine

Accepted Answer

The answer of When glands fail, hormone levels may drop,...

Question 18

Excess glucose is stored in the liver in the form of ___________________, a ____________.&#10;A) Insulin; hormone&#10;B) Glycogen; starch&#10;C) Hemoglobin; protein&#10;D) Plasma; colloid

Accepted Answer

The answer of Excess glucose is stored in the liver...

Question 19

Which of the following agents counteract the effects of insulin and oral hypoglycemic agents?&#10;A) Adrenaline (epinephrine)&#10;B) Angiotensin-converting enzyme inhibitors&#10;C) Sulfonylureas&#10;D) Limiting caloric intake

Accepted Answer

The answer of Which of the following agents counteract the...

Question 20

A person awaiting minor surgery begins to behave strangely in the preanesthesia care unit of a hospital, is noticed to be diaphoretic and tachycardic, and then loses consciousness. She is wearing a Medic-Alert bracelet that states she is a diabetic on insulin. Which of the following actions should be undertaken immediately?

A) The patient should be given intravenous insulin
B) The patient should be given intravenous dextrose

Accepted Answer

The answer of A person awaiting minor surgery begins to...

Question 21

It is reasonable to assume that a diabetic patient found comatose in the ICU:&#10;A) Is severely hyperglycemic and needs insulin&#10;B) Is severely hypoglycemic and needs concentrated dextrose&#10;C) Is severely hyperglycemic and needs glucagon&#10;D) Is severely hypoglycemic and needs intravenous hydration

Accepted Answer

The answer of It is reasonable to assume that a...

Question 22

You are called to the home of an unconscious patient. He is a 16-year-old athlete who played soccer during the afternoon and seemed to be healthy and vigorous all day. His parents are away on business, and his aunt is looking after the family home in their absence. You arrive at the boy's home at 4:30 P.M.; dinner is cooking on the stove. The boy is slumped on the couch. He has no signs of trauma. A Medic-Alert bracelet on his wrist says he is a type 1 diabetic He takes insulin, aspirin, and lisinopril. After protecting his airway and cervical spine, and making certain he has a pulse, you should:

A) Administer insulin
B) Administer dextrose
C) Administer glucagon
D) Administer epinephrine

Accepted Answer

The answer of You are called to the home of...

Question 23

Which of the following statements about insulin are accurate?&#10;A) It causes muscle cells to take up glucose from the circulation&#10;B) It causes liver cells to take up glucose from the circulation&#10;C) It causes fat cells to take up fats from circulation to form triglycerides&#10;D) It is synthesized by the islets of Langerhans

Accepted Answer

The answer of Which of the following statements about insulin...

Question 24

Insulin secreted by the body differs from insulin administered by injection in which of the following ways?&#10;A) It is synthesized as a prohormone, which is cleaved before it is released from cells&#10;B) It is incapable of regulating blood glucose levels&#10;C) It contains C peptide, an accessory chain of amino acids.&#10;D) It has no effect on skeletal muscle cells.

Accepted Answer

The answer of Insulin secreted by the body differs from...

Question 25

An 18-year-old male with type 1 diabetes mellitus comes to the Emergency Department complaining of thirst, dizziness, and frequent urination. He has not taken his insulin in 3 days. He looks emaciated and ill. On physical assessment of the patient and laboratory study which of the following are you most likely to find?

A) Rapid respirations
B) Fruity breath
C) A bicarbonate level of 16
D) A pH of 7.5

Accepted Answer

The answer of An 18-year-old male with type 1 diabetes...

Question 26

Diseases associated with gestational diabetes mellitus include:&#10;A) Fetal macrosomia&#10;B) Eclampsia&#10;C) The development of type 2 diabetes mellitus later in life&#10;D) The need for cesarean delivery.

Accepted Answer

The answer of Diseases associated with gestational diabetes mellitus include:&#10;A)...

Question 27

Diabetic patients should:&#10;A) Avoid vaccination against influenza&#10;B) Always show their feet to their health care providers because of the risk of foot ulceration and peripheral vascular disease&#10;C) Maintain above-normal blood pressures, to avoid hypotension&#10;D) Have regular ophthalmologic examinations

Accepted Answer

The answer of Diabetic patients should:&#10;A) Avoid vaccination against influenza&#10;B)...

Question 28

Insulins or insulin analogs with a very short half-life are typically used:&#10;A) Before meals&#10;B) At bedtime&#10;C) As part of a sliding scale&#10;D) In weight loss programs

Accepted Answer

The answer of Insulins or insulin analogs with a very...

Question 29

Adrenal insufficiency:&#10;A) Is characterized by low levels of cortisol circulating in the blood&#10;B) Is called &#34;primary adrenal insufficiency&#34; when the adrenal cortex produces insufficient quantities of adrenal hormones&#10;C) Can cause life-threatening hypotension during critical illness&#10;D) Can occur as a result of insufficient production of adrenocorticotropic hormone (ACTH) by the pituitary gland

Accepted Answer

The answer of Adrenal insufficiency:&#10;A) Is characterized by low levels...

Question 30

Matching&#10; Match the type of diabetes mellitus to the characteristics:&#10;&#10;-Onset before age 10&#10;A) Type 1 diabetes mellitus&#10;B) Type 2 diabetes mellitus&#10;C) Both type 1 and type 2 diabetes mellitus&#10;D) Neither type 1 nor type 2 diabetes mellitus

Accepted Answer