A patient presents with excessive thirst, large volumes of dilute urine, and low urine osmolality. Laboratory tests reveal hypernatremia and elevated serum osmolality. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hyperthyroidism
- B. Hypothyroidism
- C. Diabetes mellitus
- D. Diabetes insipidus
Correct Answer: D
Rationale: The correct answer is D: Diabetes insipidus. This condition is characterized by excessive thirst, large volumes of dilute urine, low urine osmolality, hypernatremia, and elevated serum osmolality. The underlying cause is a deficiency in or insensitivity to antidiuretic hormone (ADH), leading to the inability of the kidneys to concentrate urine properly. Hyperthyroidism (choice A) and hypothyroidism (choice B) do not directly affect urine concentration. While diabetes mellitus (choice C) can also present with polyuria and polydipsia, it would typically have high urine osmolality due to the presence of glucose. Therefore, diabetes insipidus is the most likely endocrine disorder responsible for these specific symptoms.
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Sensitivity is the ability of a screening test to accurately identify what aspect of the screening?
- A. Persons with symptoms of the disease.
- B. Persons who have the disease.
- C. Persons who do not have the disease.
- D. Persons who now have a diagnosis of disease.
Correct Answer: B
Rationale: The correct answer is B: Persons who have the disease. Sensitivity measures how well a test correctly identifies individuals who have the disease (true positives). It is essential in determining the test's ability to detect the presence of the disease accurately. Choices A, C, and D are incorrect because sensitivity focuses on correctly identifying individuals who have the disease, not those with symptoms, those without the disease, or those with a diagnosis of the disease.
Which of the following structures is responsible for the initial mechanical breakdown of food during mastication?
- A. Tongue
- B. Pharynx
- C. Salivary glands
- D. Teeth
Correct Answer: D
Rationale: The correct answer is D: Teeth. Teeth are responsible for the initial mechanical breakdown of food during mastication. Step 1: Teeth use their hard surfaces to chew and grind food into smaller pieces. Step 2: This process increases the surface area of the food, making it easier for digestive enzymes to break down. Step 3: The tongue aids in moving the food around the mouth but does not break down the food mechanically. Pharynx is responsible for swallowing, not mastication. Salivary glands produce saliva that helps in the lubrication and digestion of food, but they do not directly participate in the mechanical breakdown of food.
A patient with a suspected autoimmune disorder exhibits antibodies directed against self-antigens, leading to tissue damage and inflammation. Which of the following mechanisms is primarily responsible for the development of autoimmune diseases?
- A. Loss of self-tolerance
- B. Failure of innate immunity
- C. Defective T cell activation
- D. Impaired phagocytosis
Correct Answer: A
Rationale: The correct answer is A: Loss of self-tolerance. This is because autoimmune diseases result from a breakdown in the immune system's ability to distinguish between self and non-self antigens, leading to the production of antibodies against self-antigens. When self-tolerance is lost, immune cells mistakenly target the body's own tissues, causing tissue damage and inflammation.
Choice B (Failure of innate immunity) is incorrect because autoimmune diseases are primarily driven by adaptive immunity rather than innate immunity. Choice C (Defective T cell activation) is incorrect as T cells play a critical role in the immune response to self-antigens in autoimmune diseases. Choice D (Impaired phagocytosis) is incorrect as phagocytosis is a mechanism primarily involved in the removal of pathogens, not in the development of autoimmune diseases.
Which of the following is the best predictor of adolescents attempting suicide?
- A. Depressed mood
- B. Feeling of euphoria
- C. Joyful mood
- D. Feeling of hopelessness
Correct Answer: D
Rationale: The correct answer is D: Feeling of hopelessness. Adolescents who feel hopeless are at a higher risk of attempting suicide due to a lack of belief in positive outcomes. This feeling can lead to a sense of being trapped and unable to see a way out. Depressed mood (A) can contribute to suicide risk, but specifically feeling hopeless is a more direct predictor. Feeling of euphoria (B) and joyful mood (C) are actually less likely to be associated with suicide attempts, as they may temporarily mask underlying issues or provide a sense of distraction. Hopelessness is a key psychological factor that can lead to suicidal thoughts and behaviors in adolescents.
Nurse Victor reviews the medical history of patient Mila. Which of the following conditions is the MOST common cause of cardiogenic shock?
- A. Decreased hemoglobin level
- B. Acute myocardial infarction (MI)
- C. Hypotension
- D. Coronary artery disease
Correct Answer: B
Rationale: The correct answer is B: Acute myocardial infarction (MI) is the most common cause of cardiogenic shock. During an MI, there is significant damage to the heart muscle, leading to a decrease in cardiac output and subsequent shock. This results in inadequate tissue perfusion and oxygen delivery. Choices A, C, and D are incorrect because decreased hemoglobin level (A) may lead to anemia but is not the most common cause of cardiogenic shock. Hypotension (C) is a symptom of shock, not the cause. Coronary artery disease (D) is a risk factor for MI but not the direct cause of cardiogenic shock.