Nokea
A patient with mild iatrogenic Cushing syndrome is on an alternate-day regimen of corticosteroid therapy. What does the nurse explain to the patient about this regimen?
- A. It maintains normal adrenal hormone balance.
- B. It prevents ACTH release from the pituitary gland.
- C. It minimizes hypothalamic-pituitary-adrenal suppression.
- D. It provides a more effective therapeutic effect of the drug.
Correct Answer: C
Rationale: Alternate-day corticosteroid therapy minimizes hypothalamic-pituitary-adrenal axis suppression, which helps prevent long-term adrenal insufficiency.
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Which of the following is not a function of the stomach?
- A. To digest proteins
- B. To digest carbohydrates
- C. Temporary store of food
- D. To neutralize alkali from the mouth
Correct Answer: B
Rationale: The correct answer is B: To digest carbohydrates. The stomach primarily digests proteins through the action of pepsin and hydrochloric acid. Carbohydrates are primarily broken down in the mouth by salivary amylase, not in the stomach. Choices A, C, and D are incorrect because the stomach does play a role in digesting proteins, temporarily storing food, and neutralizing alkali from the mouth, respectively.
Cellular responses to hormones that initiate second-messenger systems include ________.
- A. possible activation of several different second-messenger systems
- B. cyclic AMP phosphodiesterase formation of an active second messenger
- C. formation of a specific protein kinase that acts on a series of extracellular intermediates
- D. hormone binding to intracellular receptors
Correct Answer: A
Rationale: The correct answer is A because cellular responses to hormones initiating second-messenger systems can activate various pathways. Different hormones can utilize different second messengers such as cAMP, cGMP, IP3, and DAG. This diversity allows for a wide range of responses in target cells.
Choice B is incorrect because cyclic AMP phosphodiesterase degrades cAMP, not forms an active second messenger.
Choice C is incorrect as it describes the mechanism of a specific protein kinase, which is not a characteristic of second-messenger systems.
Choice D is incorrect since hormone binding to intracellular receptors typically leads to gene transcription regulation, not direct activation of second-messenger systems.
A patient presents with weight loss, sweating, palpitations, tachycardia, tremors, lid lag, exopthalmosis, and a goiter. Upon taking a thyroid scan, there appears to be an increased amount of iodine. What is the pathogenesis of his disease?
- A. Autoimmune Mediated
- B. Immune Complex Mediated
- C. Unknown
- D. Infection
Correct Answer: A
Rationale: The correct answer is A: Autoimmune Mediated. In this case, the patient is presenting with symptoms of hyperthyroidism along with a goiter, which is indicative of Graves' disease, an autoimmune disorder where antibodies stimulate the thyroid gland to produce excess thyroid hormones. The presence of increased iodine uptake in the thyroid scan supports this diagnosis. On the other hand, immune complex mediated diseases typically involve tissue damage caused by immune complexes, not thyroid hormone excess. The cause being unknown or infection-related are not consistent with the symptoms and thyroid scan findings in this case.
Diabetes mellitus occurs due to deficiency of:
- A. Glucagon
- B. Thyroxin
- C. Insulin
- D. Melatonin
Correct Answer: C
Rationale: Step-by-step rationale for why choice C (Insulin) is correct:
1. Insulin is a hormone produced by the pancreas that regulates blood sugar levels.
2. Diabetes mellitus is a condition characterized by high blood sugar levels due to inadequate insulin production or ineffective use of insulin.
3. The deficiency of insulin leads to the inability to properly regulate blood sugar levels, resulting in diabetes mellitus.
4. Glucagon (choice A) is a hormone that increases blood sugar levels, so its deficiency would not cause diabetes.
5. Thyroxin (choice B) is a hormone produced by the thyroid gland and is not directly related to diabetes.
6. Melatonin (choice D) is a hormone that regulates sleep-wake cycles and is not involved in blood sugar regulation.
Summary:
Insulin is the correct choice because its deficiency directly leads to diabetes mellitus, while the other choices do not play a significant role in the development of this condition.
What is a potential adverse effect of palpation of an enlarged thyroid gland?
- A. Carotid artery obstruction
- B. Damage to the cricoid cartilage
- C. Release of excessive thyroid hormone into circulation
- D. Hoarseness from pressure on the recurrent laryngeal nerve
Correct Answer: C
Rationale: Palpation of an enlarged thyroid gland may trigger the release of excessive thyroid hormone, especially if the thyroid is overactive, such as in Graves' disease.