Endocrine System

1. A 35-year-old patient arrives at the emergency room. She says she’s been feeling very agitated and irritable, in addition to being unable to sleep and having a very quick heartbeat. Since she is experiencing a lot of stress at work, she is afraid of suffering an infarction. Her appearance reveals a bulge in her neck, bulging eyes, and a lower than average BMI. The physician requests a blood test and an ECG. The patient suffers from a TSH imbalance (hyperthyroidism). Which of the following clinical manifestation relates to the patient’s condition? *
2. A 22-year-old university student arrives at the campus clinic complaining of constant fatigue and difficulty concentrating during classes. He reports that over the past few weeks, he has been eating much more than usual because he feels “hungry all the time,” even shortly after meals. Despite this increased appetite, he has unintentionally lost weight. He also mentions feeling very thirsty throughout the day and waking up at night to urinate. His mother has type 1 diabetes, and he is worried he may have it too. On assessment, his BMI is slightly below normal, his skin appears dry, and his capillary blood glucose reads 18.2 mmol/L. The physician orders further blood work, including fasting glucose and HbA1c. The patient is suspected of having type 1 diabetes. Which of the following clinical manifestations is most strongly associated with this patient’s condition? *
3. Mr. Cloutier, a 23-year-old university student with Type 1 diabetes, arrives feeling extremely weak and nauseated. He reports missing his insulin doses during exams and has been drinking large amounts of water. The LPN notes deep, rapid respirations and the smell of fruit on his breath. His glucose in triage reads 28.9 mmol/L, and he appears dehydrated with dry mucous membranes. Which clinical manifestation is most associated with DKA? *
4. Ms. FIorent, 41, with untreated hyperthyroidism, reports heart palpitations, heat intolerance, and unintentional weight loss. Today she feels extremely anxious and sweaty. Her heart rate is 138 bpm, and she has tremors in both hands. She states she “can’t calm down” and feels like her heart is racing out of her chest. Which manifestation supports hyperthyroidism? *
5. Mrs. Poirier, 67, has been feeling increasingly fatigued, depressed, and intolerant to cold. Her daughter states she has slowed down in her movements and speech. On assessment, the LPN notices dry skin, and coarse hair. Her heart rate is 52 bpm. Which finding is characteristic of hypothyroidism? *
6. Mr. Landau, 55, with Addison’s disease, reports severe fatigue and dizziness after a recent flu. He feels weak when standing and has noted darkening of his skin. The LPN records a blood pressure of 86/52 mmHg and mild confusion. Which manifestation indicates adrenal insufficiency? *
7. Ms. Fortin, 46, presents with new-onset weight gain mostly in her abdomen and face. She reports easy bruising, mood changes, and purple stretch marks. On assessment, she has a rounded “moon face” and a fatty hump between her shoulders. Her blood pressure is elevated. Which manifestation aligns with Cushing syndrome? *
8. Mr. Masson, 70, hospitalized for lung cancer, becomes increasingly confused and drowsy. His wife reports he has been drinking very little, yet he is not urinating much. The LPN notes crackles in his lungs and mild edema. His sodium returns at 122 mmol/L (Normal: 135 to 145). Which manifestation reflects SIADH? *
9. Ms. Grenier, 33, presents with intense thirst and frequent urination, reporting she drinks up to 6 liters per day. Despite this, her mouth remains dry. Her urine is clear, almost water-like. Her history includes a recent head injury. Which clinical manifestation supports DI? *
10. A 58-year-old man with Type 2 diabetes becomes suddenly pale and shaky while waiting for his appointment. The LPN notes he is sweating and confused, unable to recall what he ate this morning. His glucometer reading shows 2.4 mmol/L. Which finding indicates hypoglycemia? *
11. Mrs. Dupéré, 69, reports chronic fatigue, nausea, and bone pain. She has had several kidney stones over the last year. Blood tests show elevated calcium levels. She denies recent trauma or vitamin supplements. Which manifestation is consistent with hyperparathyroidism? *
12. Mr. Choi, 62, with long-standing Type 2 diabetes, reports burning sensations in both feet, especially at night. He notes he sometimes doesn’t feel when he steps on small objects. Assessment reveals decreased sensation and weakened pedal pulses. Which manifestation reflects diabetic neuropathy? *
13. Julie Martel, 23, with type 1 diabetes, is brought to the ER after 2 days of nausea, vomiting, and abdominal pain. She reports missing insulin doses due to feeling ill. Assessment shows dry mucous membranes, Kussmaul respirations, fruity breath, and confusion. Labs: glucose 29.6 mmol/L, pH 7.18, HCO₃ 12 mEq/L, K⁺ 5.8, ketones +++. After starting IV insulin and fluids, she suddenly becomes lethargic, with unequal pupils and bradycardia. These new findings suggest which complication? *
14. Lianne Nguyen, 34, has untreated Graves’ disease. She arrives with severe anxiety, palpitations, weight loss, and tremors. HR 142/min, BP 158/84, temp 38.6°C. After being stressed by an infection, she suddenly becomes delirious, with profuse sweating and a temperature rising to 40.5°C. These acute changes are most consistent with: *
15. Paul Girard, 68, with chronic hypothyroidism and poor medication adherence, is found very drowsy at home. VS: temp 34°C, BP 88/58, HR 48/min, RR 8/min, SpO₂ 86%. Skin is cold and dry; periorbital puffiness noted. He becomes increasingly unresponsive. What complication is most likely developing? *
16. Carmen Oliveira, 45, has Addison disease and reports nausea, fatigue, and dizziness after a gastroenteritis episode. She stopped taking her corticosteroids because she was vomiting. VS: BP 78/52, HR 128/min, confusion, and severe abdominal pain. These findings most likely indicate: *
17. Romain Lefebvre, 76, with type 2 diabetes, presents with extreme dehydration after a week of poor intake during influenza. Glucose is 41 mmol/L, but no ketones. VS: BP 92/56, HR 118/min, dry oral mucosa, lethargy. He becomes disoriented and has seizures. What complication is he most likely experiencing? *
18. Madeleine Cho, 70, hospitalized for lung cancer, is receiving IV fluids. She develops confusion, headache, and nausea. Labs: Na⁺ 119 mmol/L (Normal: 135-145), serum osmolality low, urine osmolality high. A few hours later she has a seizure. The seizure is most likely caused by: *
19. Eric Dulac, 55, postsurgical pituitary case, reports intense thirst and voids >8 L/day. VS: HR 122/min, BP 90/54. Labs show high serum sodium and high osmolality. His skin becomes very dry and he collapses. The collapse is most likely due to which complication? *
20. Simone Roussel, 63, with primary hyperparathyroidism, complains of constant bone pain, fatigue, and recurrent kidney stones. Labs show calcium 3.1 mmol/L. While reaching for an item, she feels a sudden sharp pain in her femur and cannot bear weight. What complication has most likely occurred? *
21. Martin Côté, 59, diabetic on insulin, skipped breakfast and took his usual dose. Now he is diaphoretic, pale, irritable, and has slurred speech. BG: 2.6 mmol/L. He becomes unresponsive. What complication has developed? *
22. Ariel Benhamou, 41, known pheochromocytoma, presents with sudden pounding headache, palpitations, sweating, and anxiety. VS: BP 238/132, HR 148/min. After standing, she develops chest pain and blurred vision. What life-threatening complication is developing? *
23. A 35-year-old patient arrives at the emergency room. She says she’s been feeling very agitated and irritable, in addition to being unable to sleep and having a very quick heartbeat. Since she is experiencing a lot of stress at work, she is afraid of suffering an infarction. Her appearance reveals a bulge in her neck, bulging eyes, and a lower than average BMI. The physician requests a blood test and an ECG. The patient suffers from a TSH imbalance (hyerpthyroidism). Which of the following clinical manifestation relates to the patient’s condition? *