Med-surg: neuro, endocrine & renal worksheet with answers

What is acromegaly?

1. AToo much growth hormone in an adult
2. BToo much cortisol from the adrenal glands
3. CToo little growth hormone in a child
4. DToo little thyroid hormone in an adult

Which symptoms are typical of uraemia in advanced kidney disease?

1. ASevere flank pain with visible blood in the urine
2. BExcess thirst with a very high glucose
3. CItching, nausea, tiredness and poor appetite
4. DHeat intolerance, tremor and weight loss

Which statement about metformin is correct?

1. AIt works by making the pancreas release a lot more insulin
2. BUsed on its own, it rarely causes hypoglycaemia
3. CIt is the usual first treatment for type 1 diabetes in adults
4. DIt is given by injection into the abdomen once a week

Why should long-term steroid treatment not be stopped suddenly?

1. AThe steroids build up and become toxic after they are stopped
2. BThe suppressed adrenal glands cannot make enough cortisol at once
3. CStopping causes the blood glucose to fall sharply
4. DStopping suddenly makes the bones grow too quickly and then fracture

A patient with type 1 diabetes has gastroenteritis and cannot eat. Which sick-day advice is correct?

1. AKeep taking basal insulin and check glucose and ketones more often
2. BCheck glucose once a day only and rest in bed until better
3. CStop all insulin until normal eating restarts
4. DAvoid drinking fluids to reduce the vomiting

Which headache feature most suggests raised intracranial pressure from a brain tumour?

1. AWorse on waking and on coughing, with vomiting
2. BA tight band across the forehead that eases with rest
3. CBetter in the morning and worse with stress
4. DOnly present after reading for a long time

A patient with AKI has a low urine sodium and concentrated urine. What does this suggest?

1. ADiabetes insipidus, with too little ADH
2. BA post-renal blockage, with urine backed up
3. CA pre-renal cause, with kidneys holding salt and water
4. DAcute tubular necrosis, with damaged and leaking tubules

A patient with a brain tumour on high-dose dexamethasone has a capillary glucose of 16 mmol/L (288 mg/dL). They have no history of diabetes. What is the best explanation?

1. AA sign that the brain tumour has now spread to the pancreas
2. BNormal for this patient, so no action is needed
3. CSteroid-induced hyperglycaemia, which needs monitoring and treatment
4. DA lab error, because steroids lower blood glucose