30 Questions
What is the association between increased urine bilirubin and indirect serum bilirubin?
They are associated with hepatitis
What is hepatic encephalopathy associated with?
Increased blood ammonia levels
What is hyperbilirubinemia associated with, but not with hepatic encephalopathy?
Hypokalemia
In a patient with suspected lactose intolerance, what would fecal leukocyte screening indicate?
Enterocolitis
What causes an increase in urinary urobilinogen seen with liver dysfunction and hepatitis?
Decrease in hepatic fraction of bilirubin
What does an increase in indirect serum bilirubin indicate?
Hepatitis
What are hepatic encephalopathy symptoms characterized by?
Both a and b
What are unexpected findings in more severe pancreatitis?
Hypotension, rigid abdomen, and absent bowel sounds
What is a severe condition associated with hypothyroidism?
Myxedema coma
What is the primary treatment for cerebral edema?
Intravenous infusion of mannitol
What is the likely outcome for patients after radioactive iodine treatment for Graves disease?
Lifelong thyroid replacement therapy
What laboratory result elevation suggests a biliary cause of acute pancreatitis?
Alkaline phosphatase
What is a characteristic symptom of myxedema coma?
Altered mental state
What is the management option for varices?
Octreotide acetate
What should be expected following radioactive iodine therapy for Graves disease?
Hypothyroidism
What is evidenced by elevated serum amylase and lipase levels?
Acute pancreatitis
What is a characteristic symptom of primary Cushing syndrome?
Hyperglycemia
What is the suspected cause of diabetic neuropathy?
Decreased myoinositol transport and glucose competition
What should patients undergoing high-dose oral glucocorticoid treatment be routinely evaluated for?
Peptic ulcer disease
What does an increased urine bilirubin indicate?
Hepatitis and liver dysfunction
What is a common manifestation of myxedema coma?
Altered mental state and edematous skin
What is a characteristic symptom of hepatic encephalopathy?
Increased blood ammonia levels
What is indicated in patients with suspected enterocolitis?
Fecal leukocyte screening
Which of the following is not associated with diabetic neuropathy?
Elevated HbA1c
What is the effect of high-dose oral glucocorticoid treatment on peptic ulcer disease risk?
Increases the risk
What is associated with primary Cushing syndrome?
Hyperglycemia
What does no change in serum glucocorticoid level after an ACTH injection indicate?
Primary adrenal insufficiency
What is myxedema coma associated with?
Hypothyroidism
What is the result of surgical removal of a gland?
Hyposecretion
What is increased urine bilirubin associated with?
Hepatitis
Study Notes
Clinical Medicine Key Points
- Deficient neuronal insulin receptors and demyelination may play a role in diabetic neuropathy.
- Glucose competes with myoinositol for transport into cells, and the polyol pathway degrades glucose to sorbitol and fructose in nerves during hyperglycemia and insulinopenia.
- Elevated HbA1c is not associated with diabetic neuropathy, and deficient neuronal insulin receptors are not responsible for it.
- Focal ischemic lesions of the nerves may contribute to diabetic neuropathy.
- High-dose oral glucocorticoid treatment increases the risk of peptic ulcer disease due to the role of glucocorticoids in excess acid production and destruction of gastric mucosal defenses.
- Primary Cushing syndrome is associated with hyperglycemia, not hyperkalemia.
- No change in serum glucocorticoid level after an ACTH injection indicates primary adrenal insufficiency.
- Myxedema coma is a severe condition associated with hypothyroidism, characterized by altered mental state and edematous skin.
- Surgical removal of a gland results in hyposecretion, not hypersecretion, hyporesponsiveness, or tissue resistance.
- Increased urine bilirubin is associated with hepatitis, not hemolytic reactions or Gilbert syndrome.
- Hematemesis and profound anemia in a patient with a history of alcoholism indicate gastroesophageal varices, not ascites, cerebral edema, or hepatic encephalopathy.
- Hepatic encephalopathy is associated with increased blood ammonia levels and is positively correlated with elevated arterial ammonia levels. Hypotension, rigid abdomen, and absent bowel sounds in pancreatitis indicate peritonitis with a substantial risk for sepsis and shock.
Test your knowledge of clinical medicine with these key points covering diabetic neuropathy, glucocorticoid treatment, endocrine disorders, gastrointestinal conditions, and hepatic encephalopathy.
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