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Pharm Final Quiz 3 (Endocrine: DI/Thyroid/Adrenal)

Total questions: 100

Worksheet time: 50mins

Name
Class
Date
1.

What hormone is dysfunctional in Diabetes Insipidus (DI)?

a)

ADH

b)

Insulin

c)

Cortisol

d)

Thyroxine

2.

Diabetes Insipidus is characterized by a partial or complete deficiency of which hormone?

a)

ADH

b)

Insulin

c)

Thyroxine

d)

Cortisol

3.

In Diabetes Insipidus, up to how many liters of urine can be excreted per day?

a)

20L

b)

2L

c)

5L

d)

10L

4.

Which of the following is NOT a symptom of Diabetes Insipidus?

a)

Low specific gravity and osmolarity

b)

Severe hypovolemia

c)

Decreased thirst and HR

d)

Severe drop in BP

5.

Diabetes Insipidus can be neurogenic or nephrogenic in nature.

a)

True

b)

False

6.

One possible cause of Diabetes Insipidus mentioned in the overview is:

a)

Damage to the pituitary gland

b)

Excess insulin production

c)

High blood glucose levels

d)

Overactive thyroid gland

7.

What can untreated Diabetes Insipidus lead to?

a)

Death

b)

Improved kidney function

c)

Rapid weight gain

d)

Increased blood clotting

8.

ADH is also known as:

a)

Oxypressin

b)

Vasopressin

c)

Jesupressin

d)

Aldosterone

e)

Desmopressin

9.

Where is ADH secreted from?

a)

Posterior pituitary

b)

Anterior pituitary

c)

Adrenal cortex

d)

Thyroid gland

10.

ADH promotes water reabsorption from kidney tubules.

a)

True

b)

False

11.

Which of the following is released from the posterior pituitary in response to an increase in plasma osmolarity, decrease in blood volume, or hypotension, nausea/vomiting, diarrhea, or hypovolemia of any kind?

a)

ADH

b)

Aldosterone

c)

Natriuretic peptide

d)

Renin

12.

Which agent is the drug of choice for the pharmacological management of Diabetes Insipidus (DI)?

a)

Vasopressin

b)

Desmopressin

c)

Both are equally preferred

d)

None of the above

13.

Vasopressin is identical in structure to natural _______.

a)

ADH

b)

Insulin

c)

Glucagon

d)

Oxytocin

14.

What is the duration of action for vasopressin?

a)

1-2 hrs

b)

2-4 hrs

c)

8-20 hrs

d)

24 hrs

15.

Desmopressin acetate/DDAVP is used for which of the following conditions?

a)

A) Central diabetes insipidus

b)

B) Excessive bed wetting

c)

C) Both A and B

d)

D) None of the above

16.

Which of the following does NOT have intense vasoconstrictor effect?

a)

Vasopressin

b)

Desmopressin

c)

Both

d)

Neither

17.

What is a major adverse effect of both vasopressin and DDAVP?

a)

Water intoxication

b)

Hypertension

c)

Hyperkalemia

d)

Bradycardia

18.

Kidney function must be monitored when using vasopressin or DDAVP.

a)

True

b)

False

19.

What is excessive vasoconstriction specifically caused by?

a)

Vasopressin

b)

Desmopressin

c)

DDVAP

d)

Pizzapressin

20.

Vasopressin is contraindicated in patients with which condition?

a)

Coronary artery disease

b)

Asthma

c)

Diabetes mellitus

d)

Hypothyroidism

21.

The thyroid gland affects nearly every tissue and organ by controlling which two aspects?

a)

Metabolic rate and activity

b)

Blood pressure and heart rate

c)

Calcium absorption and bone density

d)

Immune response and antibody production

22.

Which of the following is NOT affected by the HPT axis?

a)

Cardiac output

b)

Oxygen consumption

c)

Bone density

d)

Body heat regulation

23.

Dysfunction of the HPT axis can result in which two conditions?

a)

Hyperthyroidism and Hypothyroidism

b)

Diabetes and Hypertension

c)

Cretinism and Myxedema

d)

Angina and Gangrene

24.

A decrease in thyroid hormone secretion is called ________.

a)

Hypothyroidism

b)

Hyperthyroidism

c)

Diabetes mellitus

d)

Cushing's syndrome

25.

In hypothyroidism, T3 or T4 levels are ______ and TSH levels are ______.

a)

Low; High

b)

High; Low

c)

High; High

d)

Low; Low

26.

Mild deficiency of thyroid hormone is called ________, while severe deficiency is called ________.

a)

Hypothyroidism; Myxedema

b)

Hyperthyroidism; Cretinism

c)

Goiter; Graves' disease

d)

Thyrotoxicosis; Hashimoto's disease

27.

Hypothyroidism in infants is called ________.

a)

Cretinism

b)

Myxedema

c)

Goiter

d)

Acromegaly

28.

Which of the following is a sign or symptom (S/S) of hypothyroidism?

a)

Insomnia

b)

Fatigue

c)

Weight loss

d)

Increased appetite

29.

Which of the following is a symptom of hypothyroidism?

a)

Heat intolerance

b)

Lethargy, slowed speech

c)

Bulging eyes (exophthalmos)

d)

Facial flushing

30.

What is the treatment for hypothyroidism?

a)

Lifelong medication

b)

Short-term glucocorticoids

c)

Surgical removal of thyroid

d)

High-protein diet

31.

Levothyroxine increases metabolic rate, oxygen consumption and demand.

a)

True

b)

False

32.

Patients with cardiac issues and/or hypertension should be careful when taking which medication for hypothyroidism?

a)

Levothyroxine

b)

Metformin

c)

Atorvastatin

d)

Omeprazole

33.

How long does it take for levothyroxine to reach therapeutic plasma levels?

a)

About one month

b)

About one week

c)

About six months

d)

About one day

34.

Which of the following is NOT a symptom of hypothyroidism?

a)

A) Decreased cardiac contractility

b)

B) Weight gain

c)

C) Hair loss

d)

D) Bulging eyes (exophthalmos)

35.

An increase in circulating T3 and T4 levels is characteristic of which condition?

a)

Hyperthyroidism

b)

Hypothyroidism

c)

Cushing's syndrome

d)

Addison's disease

36.

What are possible causes of hyperthyroidism?

a)

A) Overactive thyroid gland

b)

B) Excessive dosage of hypothyroidism medications (levo)

c)

D) Both A and B

d)

C) Adrenal insufficiency

e)

E) A, B, and C

37.

Which of the following is a symptom of hyperthyroidism?

a)

Cold intolerance

b)

Fine, straight hair

c)

Decreased GI motility

d)

Weight gain

38.

Bulging eyes (exophthalmos) is a sign of which thyroid disorder?

a)

Hyperthyroidism

b)

Hypothyroidism

c)

Thyroid cancer

d)

Thyroiditis

39.

Tachycardia and increased systolic BP are symptoms of hyperthyroidism.

a)

True

b)

False

40.

Which of the following is a symptom of thyroid disorder? (Select all that apply)

a)

Menstrual changes (amenorrhea)

b)

Increase in diarrhea

c)

Wt LOSS

d)

Breast enlargement, finger clubbing

e)

Tremors, muscle wasting

41.

ANY of the treatments for Grave's disease can lead to _________.

a)

hypothyroidism

b)

hypertension

c)

diabetes mellitus

d)

asthma

42.

Which of the following is NOT a treatment for thyroid disorders?

a)

Surgical removal of thyroid gland

b)

Radioactive iodine therapy

c)

Antithyroid Drugs

d)

Insulin therapy

43.

What is the goal of radioactive iodine therapy in thyroid treatment?

a)

Remission without causing complete destruction of the thyroid gland

b)

Completely destroy all thyroid tissue

c)

Increase the size of the thyroid gland

d)

Prevent the absorption of iodine in the body

44.

Antithyroid drugs inhibit the synthesis/release of which hormones?

a)

T3+T4

b)

Insulin

c)

Cortisol

d)

Adrenaline

45.

Which of the following is a thioamide used as an antithyroid medication?

a)

A) Propylthiouracil

b)

B) Methamphetamine

c)

C) Both A and B

d)

D) None of the above

46.

True or False: Thioamides destroy existing stores of thyroid hormone.

a)

True

b)

False

47.

How long may it take for thioamides to stabilize thyroid level?

a)

3-12 weeks

b)

1-2 days

c)

6-8 months

d)

24 hours

e)

2-4 years

48.

What is agranulocytosis?

a)

A sharp, dangerous drop in WBCs

b)

A rise in red blood cells

c)

A decrease in platelets

d)

An increase in thyroid hormones

49.

What are the earliest indicators of agranulocytosis?

a)

Rash and itching

b)

Sore throat and fever

c)

Weight gain and fatigue

d)

Hair loss and dry skin

50.

Fill in the blank: When a patient is at risk for agranulocytosis, you must monitor ______ counts closely.

a)

WBC

b)

RBC

c)

Platelet

d)

Hemoglobin

51.

Which medication is a non-selective beta blocker used to control symptoms of hyperthyroidism?

a)

Metoprolol

b)

Propranolol

c)

Atenolol

d)

Labetalol

52.

Propranolol specifically slowly decreases serum T3 concentrations up to what percentage over several days?

a)

10%

b)

20%

c)

30%

d)

50%

53.

What is the most common form of hyperthyroidism?

a)

Hashimoto's disease

b)

Grave's Disease

c)

Thyroid cancer

d)

Goiter

54.

Grave's Disease is an autoimmune disease of ______ etiology.

a)

unknown

b)

bacterial

c)

viral

d)

genetic

55.

In Grave's Disease, antibodies attach to receptors to stimulate the thyroid gland to release more ______ and ______.

a)

T3 and T4

b)

Insulin and Glucagon

c)

Cortisol and Aldosterone

d)

ADH and Oxytocin

56.

Thyrotoxic Crisis is also known as ______.

a)

Thyroid Storm

b)

Myxedema Coma

c)

Addisonian Crisis

d)

Cushing's Syndrome

57.

Which of the following can cause a Thyrotoxic Crisis?

a)

Stress

b)

Infection

c)

Surgery

d)

Trauma

e)

All of the above

58.

Which of the following is considered a priority clinical manifestation?

a)

Hyperthermia

b)

Severe tachycardia

c)

Restlessness

d)

Seizures

59.

Severe tachycardia may lead to _________

a)

heart failure

b)

depleted T3 and T4

c)

acromegaly

d)

Addison's

60.

The adrenal gland is divided into how many sections?

a)

1

b)

2

c)

3

d)

4

61.

The medulla of the adrenal gland secretes ______ and ______.

a)

Epinephrine and norepinephrine

b)

Aldosterone and cortisol

c)

Insulin and glucagon

d)

Thyroxine and calcitonin

62.

Corticosteroids are released from the adrenal cortex after the release of ______ from the pituitary gland.

a)

ACTH

b)

TSH

c)

FSH

d)

GH

63.

Which of the following is a function of cortisol/cortisone?

a)

Suppresses the immune system

b)

Increases pain sensitivity

c)

Decreases blood glucose

d)

Decreases attention

64.

Corticosteroids regulate blood glucose concentration by increasing BG via ______ and decreasing peripheral glucose use in fasting state.

a)

hepatic gluconeogenesis

b)

renal filtration

c)

pancreatic lipolysis

d)

muscle glycogenolysis

65.

Which of the following is an anti-inflammatory action of corticosteroids?

a)

Increases capillary permeability

b)

Inhibits prostaglandins and leukotrienes

c)

Increases serotonin

d)

Decreases CNS stimulation

66.

Corticosteroids affect mood by ______ serotonin and heightening attention (CNS stimulation).

a)

decreasing

b)

increasing

c)

stabilizing

d)

eliminating

67.

What is the primary cause of Cushing Syndrome?

a)

Excess secretion of adrenocorticotropic hormone (ACTH)

b)

Deficiency of insulin

c)

Excess secretion of thyroid hormone (TSH)

d)

Deficiency of cortisol (Cortisone)

68.

Which of the following is NOT a symptom (S/S) of Cushing Syndrome?

a)

Emotional liability/euphoria

b)

Buffalo hump

c)

Cataracts

d)

Bradycardia

69.

Fill in the blank: A characteristic physical sign of Cushing Syndrome is ________ face with red (plethoric) cheeks.

a)

moon

b)

square

c)

oval

d)

triangular

70.

Which of the following is a treatment option for Cushing Syndrome?

a)

Removal or radiation of tumors

b)

Insulin therapy

c)

Beta-blockers

d)

Thyroid hormone replacement

71.

Adrenalectomy is considered the ideal treatment for Cushing Syndrome.

a)

True

b)

False

72.

What can happen if exogenous prescribed corticosteroids are abruptly stopped in a patient with Cushing Syndrome?

a)

Acute adrenal insufficiency (cardiovascular collapse due to decrease in NE)

b)

Hyperglycemia (cardiovascular collapse due to increase in BG)

c)

Increased digoxin levels (cardiovascular collapse due to increase in NE)

d)

Cataracts

73.

Fill in the blank: Increased ________ fat is a symptom of Cushing Syndrome.

a)

abdominal

b)

subcutaneous

c)

thigh

d)

scalp

74.

Which of the following is NOT a primary treatment for Cushing Syndrome?

a)

Drugs that suppress cortisol production

b)

Removal or radiation of tumors

c)

Adrenalectomy

d)

Decrease dose of exogenous corticosteroids

75.

What is Addison's Disease?

a)

Opposite of Cushing's, decrease in glucocorticoids

b)

Increase in glucocorticoids

c)

Excessive adrenal function

d)

None of the above

76.

Addison's Disease is also known as _________.

a)

Adrenal Insufficiency

b)

Cushing's Syndrome

c)

Graves' Disease

d)

Hashimoto's Thyroiditis

77.

Signs and symptoms of Addison's Disease are evident as soon as the adrenal cortex starts to malfunction.

a)

True

b)

False

78.

Patients with Addison's Disease require lifelong therapy.

a)

True

b)

False

79.

Which of the following is NOT a symptom of Addison's Disease?

a)

Hypoglycemia

b)

Hypertension

c)

Weakness

d)

Hyperpigmentation of skin

80.

Fill in the blank: Hyponatremia and hyperkalemia in Addison's Disease are due to ________ deficiency.

a)

mineralocorticoid

b)

glucocorticoid

c)

thyroid hormone

d)

parathyroid hormone

81.

Which mineralocorticoid is specifically mentioned as deficient in Addison's Disease?

a)

Cortisol

b)

Aldosterone

c)

Epinephrine

d)

Norepinephrine

82.

Acute Adrenal Insufficiency (Lethal) in Addison's Disease can present with which of the following symptoms?

a)

All of the above

b)

Nausea/vomiting

c)

Lethargy

d)

Confusion

e)

Hypotension

83.

SATA: Which drugs are 1st line agents used for treatment of Addison's Disease?

a)

Prednisone

b)

Hydrocortisone

c)

Fludrocortisone

d)

Dexamethasone

e)

Anabolic Steroids

84.

Hydrocortisone contains both a ________ and a ________.

a)

mineralocorticoid, glucocorticoid

b)

catecholamine, peptide

c)

androgen, estrogen

d)

prostaglandin, leukotriene

85.

Which medication is administered IV for ACUTE adrenal insufficiency (critical situation)?

a)

Fludrocortisone

b)

Hydrocortisone

c)

Dexamethasone

d)

Prednisone

86.

Why should BP and weight be assessed frequently when administering high doses of hydrocortisone?

a)

To prevent dehydration

b)

To monitor for Cushing's syndrome

c)

To check for infection

d)

To assess for hypoglycemia

87.

Dosage of glucocorticoids may need to be increased during periods of stress.

a)

True

b)

False

88.

Fill in the blank: You should _______ stop glucocorticoids abruptly.

a)

never

b)

always

c)

sometimes

d)

rarely

89.

What is added to hydrocortisone therapy if more mineralocorticoid is needed?

a)

Hippacortisone

b)

Fludrocortisone

c)

Dexamethasone

d)

Prednisone

90.

Adverse effects for both hydrocortisone and fludrocortisone in excessive dosages include _______.

a)

sodium retention and edema

b)

hypoglycemia and hypovolemia

c)

weight loss and lethargy

d)

hyperkalemia and excessive fatigue

91.

Which glucocorticoid agent is used to treat inflammation from cerebral edema after neurosurgery?

a)

Dexamethasone/Decadron

b)

Methylprednisolone/Solu-Medrol

c)

Prednisone/Deltasone

d)

Fludrocortisone

92.

Methylprednisolone/Solu-Medrol is basically the IV version of which drug?

a)

Dexamethasone

b)

Prednisone

c)

Fludrocortisone

d)

Hydrocortisone

93.

Prednisone/Deltasone is inexpensive and frequently prescribed.

a)

True

b)

False

94.

In regards to replacement therapy for adrenal insufficiency/Addison’s, adverse effects are minimal as the dose is _______.

a)

small

b)

large

c)

irregular

d)

toxic

95.

Corticosteroids are used for allergies, asthma, inflammation, and _________.

a)

immunosuppression

b)

hypertension

c)

diabetes

d)

infection

96.

What is a possible adverse effect (AE) of corticosteroids that should be monitored for?

a)

Diabetes

b)

Cushing's syndrome

c)

Hypertension

d)

Anemia

97.

Avascular necrosis of the femoral head is a symptom of which endocrine condition?

a)

Addison's Disease

b)

Cushing's Syndrome

c)

Hyperthyroidism

d)

Hypothyroidism

98.

Thyroid Storm can manifest as seizures, delirium, and coma.

a)

True

b)

False

99.

Hypothyroidism and Hyperthyroidism are examples of a _______ feedback loop.

a)

positive

b)

negative

100.

Diabetes insipidus can lead to ______ shock.

a)

septic

b)

neurogenic

c)

cardiovascular

d)

hypovolemic

e)

hypervolemia

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