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In the emergency department, during initial assessment of a new admission with diabetes, you discover all of the following. Which information should you immediately report to the physician?
- A. Hammertoe of the left second metatarsophalangeal joint
- B. Rapid respiratory rate with deep inspirations
- C. Numbness and tingling bilaterally in feet and hands
- D. Decreased sensitivity and swelling of the abdomen
Correct Answer: B
Rationale: Rapid respiratory rate with deep inspirations may indicate diabetic ketoacidosis (DKA) or another metabolic disturbance and requires immediate intervention.
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Which stimulates parietal cell secretion?
- A. prostaglandins
- B. aspirin
- C. vinegar
- D. acetylcholine
Correct Answer: D
Rationale: The correct answer is D: acetylcholine. Parietal cells in the stomach are primarily stimulated by acetylcholine to secrete hydrochloric acid. Acetylcholine binds to muscarinic receptors on parietal cells, leading to an increase in intracellular calcium levels and subsequent acid secretion. Prostaglandins (choice A) actually inhibit acid secretion, making it an incorrect choice. Aspirin (choice B) is known to damage the gastric mucosa and does not directly stimulate parietal cells. Vinegar (choice C) is acidic but does not specifically target parietal cells for acid secretion. Therefore, the correct choice is acetylcholine as it directly stimulates parietal cell secretion through muscarinic receptors.
Calcium level in the blood is regulated by the:
- A. Parathyroid and thyroid
- B. Adrenal medulla and pancreas
- C. Testes
- D. Parathyroid and thymus
Correct Answer: A
Rationale: The correct answer is A: Parathyroid and thyroid. The parathyroid glands secrete parathyroid hormone, which increases blood calcium levels by promoting calcium release from bones and increasing calcium absorption in the intestines. The thyroid gland produces calcitonin, which lowers blood calcium levels by inhibiting bone breakdown and increasing calcium excretion by the kidneys. The adrenal medulla and pancreas do not play a direct role in regulating calcium levels. Testes are not involved in calcium regulation. The thymus is responsible for developing T-cells and does not have a role in calcium regulation.
A 33-year-old woman becomes poisoned after receiving an injection of concentrated botulinum toxin. Which of the following is the main neurochemical mechanism by which this Clostridium toxin causes its effects?
- A. Directly activates all muscarinic and nicotinic receptors
- B. Inhibits ACh release from all cholinergic nerves
- C. Prevents neuronal norepinephrine reuptake
- D. Releases norepinephrine via a nonexocytotic process
Correct Answer: B
Rationale: The correct answer is B: Inhibits ACh release from all cholinergic nerves. Botulinum toxin blocks the release of acetylcholine (ACh) from cholinergic nerve terminals, leading to muscle paralysis. This occurs through the cleavage of SNARE proteins, preventing vesicle fusion and neurotransmitter release. Choice A is incorrect because botulinum toxin does not directly activate receptors. Choice C is incorrect as botulinum toxin does not affect neuronal norepinephrine reuptake. Choice D is incorrect because botulinum toxin does not release norepinephrine via a nonexocytotic process.
Which term describes the maintenance of a stable internal environment?
- A. negative feedback
- B. positive feedback
- C. homeostasis
- D. metabolism
Correct Answer: C
Rationale: Homeostasis is the maintenance of a stable internal environment to support optimal physiological functioning. It involves mechanisms that regulate variables within a narrow range. Negative feedback is a key mechanism in maintaining homeostasis by counteracting deviations from set points. Positive feedback amplifies changes and is not involved in maintaining stability. Metabolism refers to the chemical processes in the body and is not specifically related to the maintenance of internal stability. Therefore, the correct answer is C (homeostasis) because it directly relates to the concept of maintaining a stable internal environment through regulatory mechanisms.
One of the least complicated of the endocrine control systems directly responds to changing blood levels of ions and nutrients. Which of the following describes this mechanism?
- A. the rapid oxidation of carbohydrates
- B. catabolic inhibition
- C. protein synthesis
- D. humoral stimulation
Correct Answer: D
Rationale: The correct answer is D: humoral stimulation. This mechanism directly responds to changing blood levels of ions and nutrients. Humoral stimulation refers to the regulation of hormone secretion in response to changes in blood levels of various substances like ions and nutrients. It is a feedback mechanism that helps maintain homeostasis by adjusting hormone levels based on the body's needs.
A: Rapid oxidation of carbohydrates is not related to endocrine control systems responding to changing blood levels of ions and nutrients.
B: Catabolic inhibition does not directly respond to changing blood levels of ions and nutrients.
C: Protein synthesis is not a mechanism that directly responds to changing blood levels of ions and nutrients.