REVIEW TEST 2

🔹 1. A patient presents with an enlarged jaw, hands, and forehead. What is the most likely diagnosis? 

• Gigantism

• Acromegaly 

• Cushing's syndrome 

• Hyperthyroidism 

Answer explanation

Answer: B. Acromegaly 

Rationale: Acromegaly is caused by excessive growth hormone in adulthood, leading to enlarged facial bones, hands, and feet. Gigantism happens before growth plates close (in children). The key differentiator is timing of hormone excess. 

🔹 2. Which of the following is a serious complication of hypoparathyroidism? 

• Weight gain 

• Hyperglycemia 

• Tetany 

• Increased heart rate 

Answer explanation

Answer: C. Tetany 

Rationale: Hypoparathyroidism leads to low calcium levels, causing neuromuscular irritability and tetany, which includes muscle spasms and convulsions. It can progress to cardiac dysrhythmias and laryngeal spasms. 

🔹 3. A patient is suspected to have diabetes insipidus. Which of the following findings would support this diagnosis? 

• Bradycardia and low urine output 

• Polyuria and polydipsia 

• High blood sugar and ketonuria 

• Weight gain and dry skin

Answer explanation

Answer: B. Polyuria and polydipsia 

Rationale: Diabetes insipidus is due to a deficiency of ADH, leading to massive urine output (3–20 L/day) and excessive thirst. It is not related to blood glucose levels. 

🔹 4. A patient with Type 1 diabetes is losing weight. What is the reason for this weight loss? 

• Increased insulin production

• Excessive protein in the diet 

• Loss of fluid and fat metabolism 

• Overactive thyroid 

Answer explanation

Answer: C. Loss of fluid and fat metabolism 

Rationale: Without insulin, Type 1 diabetics cannot use glucose, so the body breaks down fat and protein, leading to weight loss. Additionally, polyuria causes fluid loss. 

🔹 5. What lab value would you expect to be elevated in a patient with diabetic ketoacidosis (DKA)? 

• TSH

• BUN

• T4

• Sodium

Answer explanation

Answer: B. BUN 

Rationale: DKA causes dehydration, which raises BUN (Blood Urea Nitrogen). Elevated BUN indicates impaired renal perfusion due to fluid loss. 

🔹 6. Which of the following is true about levothyroxine therapy? 

• It is taken with food to prevent nausea. 

• It can be stopped once symptoms improve.

• It may take several weeks to show effects. 

• It works best when taken with calcium supplements. 

Answer explanation

Answer: C. It may take several weeks to show effects. 

Rationale: Levothyroxine requires 6–8 weeks for symptom improvement. It must be taken on an empty stomach and should not be stopped abruptly. 

🔹 7. Which sign indicates a positive Chvostek sign? 

• Spasm of the hand after BP cuff inflation

• Facial muscle twitching when tapped 

• Numbness in the fingers 

• Hyperactive reflexes in the knees 

Answer explanation

Answer: B. Facial muscle twitching when tapped 

Rationale: Chvostek sign is a classic sign of hypocalcemia and neuromuscular irritability, seen in hypoparathyroidism. 

🔹 8. Which hormone is directly responsible for ovulation in females? 

• FSH

• Estrogen 

• LH 

• Progesterone 

Answer explanation

Answer: C. LH 

Rationale: Luteinizing hormone (LH) triggers ovulation. FSH stimulates follicle growth; estrogen is produced by growing follicles, but LH causes the egg to be released. 

🔹 9. What dietary teaching is appropriate for a patient prescribed iodine solution for a goiter? 

• Take with milk to prevent GI upset 

• Use a straw to avoid teeth staining 

• Avoid high protein foods 

• Avoid liquids 1 hour after taking the drug

Answer explanation

Answer: B. Use a straw to avoid teeth staining 

Rationale: Iodine preparations can stain teeth, so using a straw is advised to minimize contact. 

🔹 10. A patient with Graves’ disease is taking Tapazole. What is important to teach? 

• Skip doses when symptoms improve 

• Take on an empty stomach only every other day 

• Take at the same time each day for effectiveness 

• It is safe to take for several years 

Answer explanation

Answer: C. Take at the same time each day for effectiveness 

Rationale: Tapazole must be taken on a strict schedule. It's typically not used beyond 1 year due to risk of liver damage