Question

Which of the following are the pathophysiologic changes in acute type 1 diabetes :

a- calcification of the islets of langerhams b- decreased number of insulin receptors on target organs c- fatty pancreatic and liver changes d- 90% + destruction of the beta cells in the pancreas.

Julia, 22 yo is admitted to the intensive care unit with a closed head injury secondary to a motocycle accident. Within 24 hours, the patient's urine is 6-8 liters per day and electrolytes are within normal limits.The practitioner draws a serum ADH level and conducts a water deprivation test. with no intake for 4 hours, there is no change in the patient's polyuria. the serum ADH level is low. Ths is an indication of : A- Neurogenic diabetes insipidus B- SIADH C- Diabetes mellitus D- Osmotically induced diuresis.

You have the following lab valus : Low T4, low T3,low serum calcium, increased parathyroi hormone(PTH), which of the following are possible causes of these values ?

a- low dietary intake of iodine and calcium b- surgical removal of the thyroid gland c- pituitary gland tumor d- medications that block uptake of iodine e- all the above

The major problems in evaluating the endocrine system include :

a- complexity of clinical presentation b- nonspecific signs and symptoms c- problems with laboratory test interpretation d- all the above

Which of the following is not secreted by the adrenal cortex : a- cortisol b- catechoamines c-androgens d- estrogens

Answer 1

1 (d) 90% destruction of the beta cells in the pancreas (autoimmune destruction of the beta cells occurs and thus pancreas is unable to secrete insulin)

2 (A) Neurogenic diabetes insipidus (occurs because of damage or injury to the hypothalamus or pituitary gland)

3 (B) surgical removal of thyroid gland ( if thyroid is removed the parathyroid glands can also be affected and calcium level can fall below normal, T3 and T4 will not be produced )

4 (d) all of the above ( major problems are: i) complexity of the clinical presentation because of multiple organ system involvement (ii) non specific nature of complaints frequently associated with endocrine dysfunction and (iii) inappropriate use of lab test interpretations)

5 (b) catecholamines (these are secreted by chromaffin cells of adrenal medulla)