N4 test Adrenal Insufficiency

Price: Pathophysiology, 6th Edition
Study Questions Chapter 62: Adrenal Insufficiency

1. In Addison's disease:
A. Levels of aldosterone increase.
B. Both glucocorticoid and mineralocorticoid deficiencies develop simultaneously.
C. Serum potassium levels decrease.
D. Sodium reabsorption by the kidney increases.

2. Autoimmune destruction of the adrenal gland is caused by:
A. Tuberculosis or other granulomatous diseases
B. Malignant neoplasm of the lung that metastasizes to the adrenal gland
C. Adrenal tissues becoming antigenic, causing the production of antibodies

3. Which of the following sequences best explains the postural hypotension and tachycardia associated with Addison's disease?
A. Aldosterone deficiency → increased sodium and water excretion → hypovolemia → fall in systolic and diastolic blood pressure on standing → compensatory increase in heart rate to maintain cardiac output
B. Cortisol deficiency → decreased protein synthesis → hypoproteinemia → decreased osmotic pressure → edema → decreased intravascular plasma volume → fall in systolic and diastolic blood pressure on standing → compensatory increase in heart rate to maintain cardiac output
C. Antidiuretic hormone deficiency → inability of kidney to conserve water → hypovolemia → fall in systolic and diastolic blood pressure on standing → compensatory increase in heart rate to maintain cardiac output

4. The hyperpigmentation observed in patients with Addison's disease is a result of:
A. Decreased production of adrenocorticotropic hormone (ACTH) by the pituitary gland and associated increased production of melanocyte-stimulating hormone (MSH)
B. Decreased production of cortisol, causing an increase in ACTH and MSH secretion
C. Increased production of cortisol by the adrenal cortex, causing increased production of MSH

5. The diagnosis of primary adrenocortical insufficiency can be made with certainty when:
A. Serum cortisol levels are low.
B. Serum aldosterone is low.
C. Hyperkalemia, hyponatremia, and hypotension are present.
D. Serum cortisol fails to rise after ACTH infusion.

6. In more than 50% of patients with Addison's disease, the destruction of the adrenal cortex results from:
A. Tuberculosis
B. Chronic use of anticoagulants
C. Autoimmunity
D. Granulomatous diseases

7. Factors contributing to hypoglycemia in Addison's disease are: (More than one answer may be correct.)
A. Decreased gluconeogenesis in the liver
B. Increased glycogen storage in the liver
C. Increased sensitivity of the peripheral tissues to insulin
D. Increased insulin secretion by the pancreas

8. Adrenocortical insufficiency is associated with: (More than one answer may be correct.)
A. Increased plasma renin activity and decreased plasma aldosterone
B. Decreased plasma renin activity and increased plasma aldosterone
C. Hyperkalemia and hyponatremia
D. Hypokalemia and hypernatremia

9. Treatment of Addison's disease usually includes the administration of: (More than one answer may be correct.)
A. ACTH
B. Cortisol
C. Pitressin
D. 9Alpha-fluorocortisol
E. Pituitary extract

10. Loss of pubic and axillary hair: (More than one answer may be correct.)
A. May be a manifestation of adrenal androgen insufficiency in women but not in men
B. Typically occurs in men with Addison's disease
C. Occurs infrequently in men with Addison's disease, since serum testosterone levels are generally normal