Nokea
The term catecholamine best describes drugs that are:
- A. Adrenergic receptor blockers
- B. Atropine-like in terms of their mechanisms and sites of action
- C. Classified like neostigmine and physostigmine
- D. Similar to adrenaline and noradrenaline in terms of structure and major pharmacologic properties
Correct Answer: D
Rationale: The correct answer is D because catecholamines are structurally similar to adrenaline and noradrenaline, sharing a catechol nucleus and amine group. This similarity allows them to exert similar pharmacologic effects such as increasing heart rate and blood pressure. Adrenergic receptor blockers (A) inhibit the action of catecholamines, atropine-like drugs (B) block muscarinic receptors, and neostigmine and physostigmine (C) are cholinesterase inhibitors, not catecholamines.
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A 32-year-old woman presents with a blood pressure of 155/96 mm Hg. In response to questioning, she admits that she loves licorice and eats some at least three times a week. She probably has a low level of
- A. type 2 11β-hydroxysteroid dehydrogenase activity
- B. ACTH
- C. 11β-hydroxylase activity
- D. glucocorticoid transferase
Correct Answer: A
Rationale: The correct answer is A: type 2 11β-hydroxysteroid dehydrogenase activity. Licorice contains glycyrrhizin, which inhibits this enzyme, leading to increased levels of cortisol and mineralocorticoids. This explains the elevated blood pressure in the patient. Choice B, ACTH, is incorrect because licorice consumption does not directly affect ACTH levels. Choice C, 11β-hydroxylase activity, is incorrect as licorice does not impact this enzyme directly. Choice D, glucocorticoid transferase, is also incorrect as licorice does not affect this enzyme's activity.
Regulating hormones from the hypothalamus ________.
- A. enter venous circulation and travel to the heart, which pumps the hormone-containing blood to the pituitary
- B. enter the hepatic portal system, which feeds the pituitary
- C. travel by arteries to the pituitary
- D. first enter into the hypophyseal portal system
Correct Answer: D
Rationale: The correct answer is D because hormones from the hypothalamus first enter the hypophyseal portal system before reaching the pituitary gland. This system allows direct communication between the hypothalamus and the pituitary gland, enabling precise control over hormone release. Choices A, B, and C are incorrect because they do not accurately describe the normal pathway of hormone regulation from the hypothalamus to the pituitary gland. Option A is incorrect as hormones do not travel to the heart before reaching the pituitary. Option B is incorrect because hormones do not enter the hepatic portal system to reach the pituitary. Option C is incorrect as hormones do not travel to the pituitary through arteries.
A patient presents with a bump on his neck. Upon taking a tissue sample, there appears to be parafollicular cells. The tumor is also associated with MEN II, although most of the time it is sporadic. What is the best way to moniter treatment?
- A. Measure Thyroid Hormone Levels
- B. Measure Iodine Levels
- C. Measure Tsh Levels
- D. Measure Calcitonin Levels
Correct Answer: D
Rationale: Rationale: The parafollicular cells in the tissue sample indicate a tumor of the thyroid gland, likely medullary thyroid carcinoma (MTC) associated with Multiple Endocrine Neoplasia Type II (MEN II). MTC primarily secretes calcitonin. Monitoring Calcitonin levels is crucial for assessing disease progression and treatment response in MTC. Measuring Thyroid Hormone Levels (A) would not be specific for MTC. Iodine Levels (B) are not relevant in this context. TSH Levels (C) reflect pituitary feedback and are not specific to MTC. Therefore, the best way to monitor treatment in this case is to measure Calcitonin Levels (D).
Steatorrhoea occurs with all of the following EXCEPT:
- A. gastrinoma
- B. congenital defect in gastric lipase
- C. ileal disease with failure to reabsorb bile salts
- D. exocrine pancreatic disease
Correct Answer: B
Rationale: The correct answer is B because a congenital defect in gastric lipase would not lead to steatorrhoea. Gastrinoma, ileal disease with failure to reabsorb bile salts, and exocrine pancreatic disease can all cause steatorrhoea due to impaired fat digestion or absorption. Gastrinoma can lead to excessive acid production, which can interfere with fat digestion. Ileal disease can affect the reabsorption of bile salts necessary for fat digestion. Exocrine pancreatic disease can result in insufficient pancreatic enzymes needed for fat digestion. Therefore, choice B is the exception as it does not directly impact fat digestion or absorption.
Which change in vital signs would you instruct a nursing assistant to report immediately for a patient with hyperthyroidism?
- A. Increased and rapid heart rate
- B. Decreased systolic blood pressure
- C. Increased respiratory rate
- D. Decreased oral temperature
Correct Answer: A
Rationale: Increased and rapid heart rate is a critical sign of hyperthyroidism and requires immediate reporting, as it could indicate an exacerbation of the condition or potential complications.