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Which of the following conditions correlate with the following information: High pH High HCO3 High BE Neutral pCO2 A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Metabolic alkalosis 2. Which of the following conditions correlate with the following information: High pH Neutral HCO3 Neutral BE Low pCO2 A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Metabolic alkalosis 3. Which of the following conditions correlate with the following information: Low pH Low HCO3 Low BE Neutral pCO2 A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Metabolic alkalosis 4. Which of the following information corresponds with a negative TB test? A. 0-4 mm induration at 48 hours B. 0-5 mm induration at 48 hours C. 0-6 mm induration at 48 hours D. 0-7 mm induration at 48 hours 5. Which of the following is the most common type of lung cancer? A. Large cell B. Adenocarcinoma C. Oat cell D. Squamous cell 6. What cell type secrets surfactant? A. Plasma cell B. Type I alveolar cell C. Type II alveolar cell D. Type III alveolar cell 7. Which of the following pulmonary term correlates with the definition: noted obstruction of the trachea or larynx. A. Rhonchi B. Stridor C. Wheezes D. Vesicular 8. Normal values for pCO2 are considered:
A. 20-40 mm Hg B. 25-30 mm Hg C. 30-40 mm Hg D. 35-45 mm Hg 9. Normal values for HCO3 are considered: A. 15-30 mEq/L B. 20-35 mEq/L C. 22-26 mEq/L D. 24-29 mEq/L 10. Pneumoncystis carinii infections are commonly treated with which of the following medications? A. Pentamidine B. Allopurinol C. Iorazepam D. Chlorpropamide 11. Which of the following is not generally caused by COPD? A. Pneumonia B. Right sided heart failure C. Headaches D. Cor pulmonale 12. Which of the following is not considered a COPD related disease? A. Bronchiectasis B. Bronchial asthma C. Bronchitis D. Bronchial hypotension 13. Which of the following pulmonary term correlates with the definition: bronchospasm of the bronchial walls? A. Wheezes B. Rhonchi C. Stridor D. Pleural Rub 14. Which of the following is considered an expectorant? A. Acetylcysteine B. Guaifenesin C. Theophylline D. Epinephrine HCL 15. Which of the following is considered a bronchodilator? A. Acetylcysteine B. Guaifenesin C. Theophylline D. Epinephrine HCL 16. Which of the following is considered a xanthine? A. Acetylcysteine B. Guaifenesin C. Theophylline D. Epinephrine HCL 17. Which of the following is considered a mucolytic?
A. Acetylcysteine B. Guaifenesin C. Theophylline D. Epinephrine HCL 18. Which of the following matches the definition: The volume of air that can be inhaled following exhalation of tidal volume? A. Expiratory reserve volume B. Inspiratory capacity C. Inspiratory reserve volume D. Vital capacity 19. Which of the following matches the definition: The maximum volume of air that can be exhaled after taking the deepest breath possible? A. Expiratory reserve volume B. Inspiratory capacity C. Inspiratory reserve volume D. Vital capacity 20. The respiratory center is located in the ____ and ______. A. Midbrain and pons B. Pons and Medulla oblongata C. Midbrain and Medulla oblongata D. Pons and Hypothalamus Answer Key 1. D 2. A 3. C 4. A 5. D 6. C 7. B 8. D 9. C 10. A 11. C 12. D 13. A 14. B 15. D 16. C 17. A 18. B 19. D 20. B
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1. Which of the following syndromes corresponds to: A failure of neutrophils to generate an immune response and lab values indicate elevated IgE levels? A. Job's syndrome B. Wiskott-Aldrich syndrome C. Carcinoid syndrome D. Mallory-Weiss syndrome 2. Which of the following syndromes corresponds to: right sided valvular disease and diarrhea? A. Job's syndrome B. Wiskott-Aldrich syndrome C. Carcinoid syndrome D. Mallory-Weiss syndrome 3. Which of the following syndromes corresponds to: lab values indicate elevated IgA levels and presence of thrombocytopenia? A. Job's syndrome B. Wiskott-Aldrich syndrome C. Carcinoid syndrome D. Mallory-Weiss syndrome
Psychiatric Disorders Cardiac Disorders Diabetes Digestive Disorders Endocrine Disorders Neurological Disorders Nutrition Respiratory Disorders
4. Which of the following syndromes corresponds to: presence of arthritis and commonly found in males? A. Reiter's syndrome B. Sjogren's syndrome C. Kartagener's syndrome D. Ehlers-Danlos syndrome 5. Which of the following syndromes corresponds to: immotile sperm and presence of reoccurring sinusitis? A. Reiter's syndrome B. Sjogren's syndrome C. Kartagener's syndrome D. Ehlers-Danlos syndrome 6. Which of the following syndromes corresponds to: presence of arthritis, xerophthalmia and commonly found in females? A. Reiter's syndrome B. Sjogren's syndrome C. Kartagener's syndrome D. Ehlers-Danlos syndrome
7. Which of the following syndromes corresponds to: excessive movement occurring at joints and loose skin? A. Reiter's syndrome B. Sjogren's syndrome C. Kartagener's syndrome D. Ehlers-Danlos syndrome 8. Which of the following syndromes corresponds to: hematuria, glomerulonephritis and pulmonary dysfunction? A. Brown-Sequard syndrome B. Thoracic outlet syndrome C. Angelman's syndrome D. Goodpasture's syndrome 9. Which of the following syndromes corresponds to: presence of ipsilateral motor loss and contralateral spinothalmic tract damage? A. Brown-Sequard syndrome B. Thoracic outlet syndrome C. Angelman's syndrome D. Goodpasture's syndrome 10. Which of the following syndromes corresponds to: C8/T1 nerve involvement and weakness in hand muscles? A. Brown-Sequard syndrome B. Thoracic outlet syndrome C. Angelman's syndrome D. Goodpasture's syndrome 11. Which of the following syndromes corresponds to: maternal genetic phenotype syndrome? A. Brown-Sequard syndrome B. Thoracic outlet syndrome C. Angelman's syndrome D. Goodpasture's syndrome 12. Which of the following syndromes corresponds to: Abnormal development of the 3rd and 4th (Pharyngeal pouches)? A. Acute coronary syndrome B. ARDS C. Budd-Chiari syndrome D. DiGeorge's syndrome 13. Which of the following syndromes corresponds to: leads to an increased risk of stroke? A. Acute coronary syndrome B. ARDS C. Budd-Chiari syndrome D. DiGeorge's syndrome 14. Which of the following syndromes corresponds to: abdominal pain, ascites, and hepatic vein occulsions? A. Acute coronary syndrome B. ARDS C. Budd-Chiari syndrome D. DiGeorge's syndrome 15. Which of the following syndromes corresponds to: increased pulmonary permeability and fluid entering the lung space? A. Acute coronary syndrome B. ARDS C. Budd-Chiari syndrome D. DiGeorge's syndrome
16. Which of the following syndromes corresponds to: can be caused by high doses of Tetracyclines? A. Dubin-Johnson syndrome B. Fanconi's syndrome C. Edward's syndrome D. Cri-du-chat syndrome 17. Which of the following syndromes corresponds to: caused by poor liver excretion? A. Dubin-Johnson syndrome B. Fanconi's syndrome C. Edward's syndrome D. Cri-du-chat syndrome 18. Which of the following syndromes corresponds to: chromosomal deficit of #5? A. Dubin-Johnson syndrome B. Fanconi's syndrome C. Edward's syndrome D. Cri-du-chat syndrome 19. Which of the following syndromes corresponds to: chromosomal deficit of #18? A. Dubin-Johnson syndrome B. Fanconi's syndrome C. Edward's syndrome D. Cri-du-chat syndrome 20. Which of the following syndromes corresponds to: chromosomal deficit of #13? A. Dubin-Johnson syndrome B. Patau's syndrome C. Edward's syndrome D. Down syndrome
Answer Key
1. A 2. C 3. B 4. A 5. C 6. B 7. D 8. D 9. A 10. B 11. C 12. D 13. A 14. C 15. B 16. B 17. A 18. D 19. C 20. B
1. Antidepressant medication is an initial primary treatment modality for moderate to severe major depressive disorder unless: a. ECT is planned b. Patient is less than 18 years of age c. Patient is admitted to hospital d. Patient is age 65 and older 2. Dysthymia may be treated with all of the following except: a. Antidepressants b. Cognitive behavioral therapy c. ECT d. Interpersonal therapy 3. Symptoms of depression in children and adolescents include all of the following except: a. Persistent depressive or sad mood b. Irritability c. Gregariousness d. Anhedonia 4 Prior to initiating bright light therapy for seasonal affective disorder, it is important to: a. Try a course of antidepressant drugs b. Consider ophthalmological evaluation for persons with a history of eye disorders c. Initiate milieu therapy d. Complete a course of cognitive behavioral therapy 5. All of the following are associated with bipolar disorder except: a. Functional impairment b. Manic episodes c. Rapid cycling d. Frequent spontaneous resolution of all symptoms 6. Which of the following statement about children and adolescents with bipolar disorder is not true? a. Most require ongoing treatment to prevent relapse and some require lifelong treatment b. Many have co-occurring disorders such as substance abuse, suicidality, and psychosocial issues c. Treatment generally involves a combination of medication and behavioral/psychosocial interventions d. A significant proportion outgrows the disorder and requires no further follow-up 7. The goals of acute treatment for schizophrenia include all except: a. Encouraging introspection and reflection b. Eliminating or reducing symptoms such as disturbed behavior c. Reducing the severity of psychosis and associated symptoms d. Preventing harm 8. When may ECT be used to treat adults with schizophrenia or schizoaffective disorder? a. In both the acute phase and stable phase for psychotic symptoms that have not responded to pharmacological treatment b. Only during the acute phase c. Only during the stable phase d. Only in persons who have not been treated with antipsychotic agents 9. The most common behavioral health problem in adults, adolescents and children is:
a. Depression b. Anxiety c. ADHD d. Thought disorders 10. An effective intervention for many anxiety disorders is: a. Antipsychotic agents alone b. Antidepressants alone c. Behavioral health treatment, especially cognitive behavioral therapy d. ECT and pharmacotherapy 11. The percentage of persons with generalized anxiety disorder with a comorbid condition is: a. 25% b. >50% c. <20% d. 15% 12. Symptoms of panic disorder may include all of the following except: a. Chest pain and tachycardia b. Feelings of impending doom c. Dizziness and shortness of breath d. Fever and shaking chills 13. All of the following are true about panic disorder except: a. Panic attacks do not occur during sleep b. It affects an estimated 6 million adults in the United States c. Twice as many women are affected d. The tendency to develop panic attacks appears to be heritable 14. Trichotillomania is an impulse control disorder that involves: a. Disordered eating b. An irresistible urge to pull out hair c. Compulsive gambling d. Harming pets and small animal 15. All of the following statements about oppositional defiant disorder are true except: a. It involves recurrent patterns of hostility and negative behaviors b. It arises from a combination of genetic, biological and environmental causes c. It is a developmentally appropriate behavior displayed by children d. Early onset is associated with poorer prognosis 16. Persons with intermittent explosive disorder generally display all of the following except: a. Aggressive outbursts and violence b. Destruction of property c. Remorse, regret and embarrassment about their actions d. Bulimia 17. All of the following are impulse disorders or disruptive behaviors except: a. Pathological gambling b. Kleptomania c. Mania d. Pyromania 18. Naltrexone may be used as pharmacotherapy for which of the following disorders:
a. Mood disorders b. Impulse and Disruptive Behaviors c. Schizoaffective disorder d. Substance use disorders 19. Outpatient detoxification may be contraindicated for all of the following groups except: a. Persons with a history of delirium tremens or withdrawal seizures b. Persons with unstable medical conditions such as diabetes, hypertension, or pregnancy c. Persons whose withdrawal signs and symptoms are sufficiently severe to require 24-hour inpatient care d. Adolescents 20. Nearly one-half of patients with schizophrenia have which type of comorbid disorders? a. Hypertension b. ADHD c. Trichotillomania d. Substance use disorders
11. B: More than half of persons diagnosed with generalized anxiety disorder have a comorbid condition such as panic disorder and major depressive disorder is the most common. Panic disorder is often comorbid with substance abuse. Because the anxiety disorders share many common signs and symptoms, it is imperative to conduct a thorough assessment to establish the primary diagnosis. 12. D: People who have panic disorder are often disabled by the condition; they avoid normal activities of daily living such as shopping and riding buses or trains. About one-third becomes housebound or able to confront a feared situation only when accompanied. Panic disorder is one of the most treatable of all the anxiety disorders; most people respond well to pharmacological and psychosocial interventions. 13. A: Panic attacks occur suddenly, often without warning, and can occur at any time, even during sleep. Panic attacks commonly begin in late adolescence or early adulthood, but not everyone who experiences panic attacks will develop panic disorder. Many people have a single attack and do not develop the persistent pattern that characterizes panic disorder. 14. B: A combination of pharmacological and psychotherapeutic treatment appears to be most effective. Selective serotonin reuptake inhibitors (SSRIs) are the drugs of choice and cognitive behavioral therapy is the psychotherapeutic modality of choice. 15. C: Oppositional defiant disorder (ODD) is not the oppositional behavior displayed by children in the course of normal development; ODD is an extreme and significant exaggeration of developmentally normal behaviors. Because ODD is frequently a co-morbid condition, it is vital that other conditions/disorders be identified and treated. 16. D: Intermittent explosive disorder is characterized by repeated outbursts of aggressive, violent behavior People with intermittent explosive disorder may attack and harm others and vandalize and destroy property. Following these outbursts they are often contrite, expressing remorse, regret and embarrassment about their actions. 17. C: Although persons with mania may behave impulsively, mania is a mood disorder characterized by abnormal affect, inflated feelings of self-worth, pressured speech, scattered ideas, increased interest in goal-directed activities and high-risk behaviors, unexplained euphoria, irritable mood, decreased need for sleep, and magical thinking. 18. D: Naltrexone, an opioid receptor antagonist, may be used as a pharmacotherapy for alcohol-dependent and opioid-dependent patients. It has demonstrated efficacy in helping alcohol-dependent patients adhere to treatment by reducing cravings, thereby, reducing the frequency and severity of relapse. Naltrexone has not demonstrated comparable efficacy for opioid dependency, largely because there is lower adherence to treatment in this population. 19. D: Persons with mild to moderate withdrawal symptoms may be effectively managed in intensive outpatient programs or partial hospitalization programs. Because many such programs are on medical center campuses or close to hospitals, immediate transfer to a higher level of care is feasible. 20. D: Many patients with schizophrenia self-medicate with alcohol, prescription drugs, and street drugs. It is vitally important to identify the presence of comorbid substance use and to develop a treatment plan that effectively addresses schizophrenia and substance use.
1. The risk of dying as a result of cardiovascular disease increases with advancing age. Approximately what percent of persons who die of coronary heart disease are older adults - age 65 or older? a. >80% b. 55% c. 66% d. 75% 2. Modifiable risk factors that increase the risk of acute myocardial infarction (MI) include all of the following except: a. Hypertension b. Smoking c. Food allergies d. Lack of physical activity 3. The overwhelming majority of strokes are ischemic. The percentage of strokes attributable to intracerebral hemorrhage is: a. 25% b. 18% c. 10% d. <6% 4. More than 60% of stroke deaths occur in: a. Native Americans b. Women c. Mexican Americans d. Persons age 45-64 5. Risk of ischemic stroke is reduced among women with all of the following characteristics except: a. Low BMI b. Regular exercise c. Healthy diet d. Menopause before age 42 6. Transient ischemic attacks (TIA) are associated with all of the following except: a. Increased risk of stroke in the first 30 days following the TIA b. Increased risk of stroke in the first 90 days following the TIA c. Increased risk of death within one year of the TIA d. Increased risk of congenital heart disease 7. High blood pressure is less common among women who: a. Are age 45 and younger b. Are obese c. Use oral contraceptives d. Are African American 8. By definition, prehypertension is untreated systolic or diastolic pressure ranging from: a. Systolic pressure of 120-139 mm Hg or diastolic pressure of 80-89 mm Hg b. Systolic pressure of 110-129 mm Hg or diastolic pressure of 70-79 mm Hg c. Systolic pressure of 130-149 mm Hg or diastolic pressure of 90-99 mm Hg d. Systolic pressure of 130-149 mm Hg and diastolic pressure of 90-99 mm Hg 9. The most commonly occurring congenital cardiovascular defect is:
a. Tetralogy of Fallot b. Ventricular septal defects c. Coarctation of the aorta d. Hypoplastic left heart syndrome 10. Among postmenopausal women with coronary heart disease the strongest risk factor for heart failure is: a. First child after age 30 b. No children c. Diet low in fruit and vegetables d. Diabetes 11. Heart disease is the leading cause of death among men and women of all races and ethnic groups, however mortality varies by ethnicity. The group with the lowest mortality is: a. African Americans b Native Americans or Alaska Natives c. Hispanics/Latinos d. Asian or Pacific Islanders 12. Reducing cholesterol and blood pressure may reduce all of the following except: a. Heart disease mortality b. Incidence of nonfatal myocardial infarction c. Risk of developing heart disease d. Risk of congenital heart disease 13. The most commonly occurring arrhythmia is: a. Atrial fibrillation b. Ventricular tachycardia c. Bradycardia d. Ventricular fibrillation 14. Symptoms such as shortness of breath, fatigue, weakness, difficulty breathing when recumbent, weight gain, and swelling in the lower extremities may indicate: a. Atrial fibrillation b. Heart failure c. Cardiac arrest d. Stroke 15. To reduce the risk of heart disease total cholesterol levels should be less than: a. 100 mg/dL b. 60 mg/dL c. 200 mg/dL d. 150 mg/dL 16. Which condition has a 95% risk of death? a. Myocardial infarction b. Atrial fibrillation c. Heart failure d. Sudden cardiac arrest 17. Atrial septal defect is: a. A congenital heart defect in which there is a hole between the heart's two lower chambers b. A congenital heart defect in which there is a hole between the heart's two upper chambers c. A nonfatal cardiac arrhythmia d. Enlargement of the atria 18. Which of the following groups is not at increased risk of developing endocarditis?
a. Patients with artificial heart valve or implanted medical devices in the heart or blood vessels b. Patients with congenital heart defects c. Persons with poor dental hygiene and gum disease d. Persons with elevated cholesterol levels 19. Which of the following statement about mitral valve prolapse is false? a. It is generally asymptomatic and requires no treatment b. It affects less than 3% of the population c. It is more common in persons with connective tissue disorders such as Marfan syndrome d. All people with mitral valve prolapse require immediate medical or surgical treatment 20. The risks associated with stents include all of the following except: a. Blood clot at the stent site b. Rupture of an aneurysm c. Blocked blood flow to the lower body d. Elevated cholesterol or triglyceride levels
15. C: For persons at risk for heart disease, LDL cholesterol should be <100 mg/dL and triglycerides should be < 150 mg/dL. HDL cholesterol, which is considered protective against heart disease, should be 60 mg/dL or higher. 16. D: Although immediate defibrillation to restore normal rhythm may be lifesaving, 95% of persons with sudden cardiac arrest die within minutes. 17. B: Atrial septal defect is a congenital heart defect; a hole between the atria that allows blood to pass from the left side of the heart to the right side. As a result, oxygen-rich blood may be pumped to the lungs rather than throughout the body. Some atrial septal defects close spontaneously; however, many require surgical repair. 18. D: Endocarditis is an infection of the lining of the heart's chambers and valves. It is more common in men than women, and in addition to the groups identified above, injection drug users are also at increased risk of developing endocarditis. 19. D: Even people with symptoms attributable to mitral valve prolapse such as palpitations, shortness of breath, cough, dizziness and fatigue may not have significant backflow through the mitral valve. Mitral valve backflow may be more significant among persons with high blood pressure and persons with backflow sufficient to provoke serious symptoms such as arrhythmias or endocarditis may require surgery to repair the valve. 20. D: An estimated 1-2% of people who have stents place.
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1. The risk factors for type 1 diabetes include all of the following except: a. Diet b. Genetic c. Autoimmune d. Environmental 2. Type 2 diabetes accounts for approximately what percentage of all cases of diabetes in adults? a. 55%-60% b. 35%-40% c. 90-95% d. 25-30% 3. Risk factors for type 2 diabetes include all of the following except: a. Advanced age b. Obesity c. Smoking d. Physical inactivity 4. What percentage of women with gestational diabetes is diagnosed with type 2 diabetes following pregnancy? a. 25%-30% b. 5%-10% c. <5% d. 20%-25% 5. Untreated diabetes may result in all of the following except: a. Blindness b. Cardiovascular disease c. Kidney disease d. Tinnitus
6. Prediabetes is associated with all of the following except: a. Increased risk of developing type 2 diabetes b. Impaired glucose tolerance c. Increased risk of heart disease and stroke d. Increased risk of developing type 1 diabetes 7. Diabetics are at increased risk of heart disease if they also: a. Smoke b. Have high HDL cholesterol levels c. Take aspirin d. Consume a high-fiber diet 8. Blood sugar is well controlled when Hemoglobin A1C is: a. Below 7% b. Between 12%-15% c. Less than 180 mg/dL d. Between 90 and 130 mg/dL 9. Excessive thirst and volume of very dilute urine may be symptoms of: a. Urinary tract infection b. Diabetes insipidus c. Viral gastroenteritis d. Hypoglycemia 10. Among female children and adolescents, the first sign of type 1 diabetes may be: a. Rapid weight gain b. Constipation c. Genital candidiasis d. Insomnia 11. Untreated hyperglycemia may lead to all of the following complications except: a. Hyperosmolar syndrome b Vitiligo c. Diabetic ketoacidosis d. Coma 12. Hyperinsulinemia may be caused by all of the following except: a. An insulinoma b. Nesidioblastosis c. Insulin resistance d. Type 1 diabetes 13. Which statement about diabetes is false? a. The U.S. prevalence of diabetes is decreasing b. Diabetes is the seventh leading cause of death in the United States c. Diabetes is the leading cause of blindness among persons age 20 to 74 d. Diabetes is the leading cause of kidney failure 14. The lifetime risk of developing diabetes for a male born in 2000 is: a. 1 in 5 b. 1 in 3 c. 2 in 5 d. 1 in 2
15. Which of the following measures does not help to prevent diabetes complications? a. Controlling blood glucose b. Controlling blood pressure and blood lipids c. Eliminating all carbohydrates from the diet d. Prompt detection of diabetic eye and kidney disease 16. Proliferative retinopathy is often treated using: a. Tonometry b. Fluorescein angiogram c. Antibiotics d. Laser surgery 17. Which of the following diabetes drugs acts by decreasing the amount of glucose produced by the liver? a. Sulfonylureas b. Meglitinides c. Biguanides d. Alpha-glucosidase inhibitors 18. The benefits of using an insulin pump include all of the following except: a. By continuously providing insulin they eliminate the need for injections of insulin b. They simplify management of blood sugar and often improve A1C c. They enable exercise without compensatory carbohydrate consumption d. They help with weight loss 19. Which of the following regimens offers the best blood glucose control for persons with type 1 diabetes? a. A single anti-diabetes drugs b. Once daily insulin injections c. A combination of oral anti-diabetic medications d. Three or four injections per day of different types of insulin. 20. Diabetic neuropathies are diagnosed using all of the following except: a. Nerve conduction studies or electromyography b. Ultrasound c. Foot examinations d. Minnesota Mutiphasic Personality inventory (MMPI)
7. A: Diabetics who smoke are at greater risk of developing heart disease because both diabetes and smoking act to narrow blood vessels. Smoking also is associated with increased risk of eye problems and may compromise circulation to the legs. 8. A: A1c measures the percentage of hemoglobin that is glycated and determines average blood glucose during the two to three months prior to testing. Used as a diagnostic tool, A1C levels of 6.5% or higher on two tests indicate diabetes. A1C of 6% to 6.5% is considered prediabetes. 9. B: Diabetes insipidus is a condition in which the kidneys are unable to conserve water, often because there is insufficient antidiuretic hormone (ADH) or the kidneys are unable to respond to ADH. Although diabetes mellitus may present with similar symptoms, the disorders are different. Diabetes insipidus does not involve hyperglycemia. 10. C: The signs and symptoms that suggest type 1 diabetes include excessive thirst, hunger, urination, weight loss, fatigue, irritability, blurred vision, and infection with candida albicans (also known as yeast infections). 11. B: Excessively high blood sugar or prolonged hyperglycemia can cause diabetic ketoacidosis, the condition in which the body breaks down fat for energy and ketones spill into the urine. Diabetic hyperosmolar syndrome occurs when blood sugar is excessively high and available insulin is ineffective. In this case, the body cannot use glucose or fat for energy and glucose is excreted in the urine. Without immediate medical attention, both conditions may result in coma or death. 12. D: Hyperinsulinemia indicates a difficulty in blood sugar regulation; the pancreas is working to produce enough insulin to regulate blood sugar. Hyperinsulinemia may be cause by a tumor of insulin-producing cells (an insulinoma), excessive numbers of insulin producing cells (nesidioblastosis), or insulin resistance. 13. A: The prevalence of diabetes is increasing dramatically. The CDC reports an increase of more than three million cases in the two years from 2006 to 2008. By 2008, an estimated 8% of the U.S. population had diabetes. 14. B: The CDC reports that adults in the U.S. are at high risk of developing diabetes. Females are at higher risk than males and Hispanics/Latinos are at the greatest risk. 15. C: There is no evidence that eliminating all sugar from the diet benefits people with diabetes. It is more important for diabetics to manage and control total carbohydrate intake so that their blood glucose levels remain on target. Controlling blood glucose, blood pressure, and blood lipid levels can aid in the prevention of complications associated with diabetes. 16. D: Scatter laser treatment is used to shrink abnormal blood vessels in an effort to preserve vision. When there is significant bleeding in the eye, it is removed in a procedure known as vitrectomy. Tonometry is a diagnostic test that measures pressure inside the eye. A fluorescein angiogram is a diagnostic test that traces the flow of dye through the blood vessels in the retina; it is used to detect macular edema. 17. C: Biguanides, such as metformin, lower blood glucose by reducing the amount of glucose produced by the liver. Sulfonylureas and Meglitinides stimulate the beta cells of the pancreas to produce more insulin. Alpha-glucosidase inhibitors block the breakdown of starches and some sugars, which helps to reduce blood glucose levels 18. D: Using an insulin pump has many advantages, including fewer dramatic swings in blood glucose levels, increased flexibility about diet, and improved accuracy of insulin doses and delivery; however, the use of an insulin pump has been associated with weight gain. 19. D: Because persons with type 1 diabetes do not produce insulin, they require insulin and cannot be treated with oral anti-diabetic drugs. Several injections of insulin per day, calibrated to respond to measured blood glucose levels, offer the best blood glucose control and may prevent or postpone the retinal, renal, and neurological complications of diabetes. 20. D: Nerve conduction studies assess transmission of electrical signals through nerves and electromyography evaluates nerve transmission to muscles. Ultrasound can assess the responsivity and function of internal organs that may be compromised by neurological damage. Foot exams help to assess peripheral neuropathy and to ensure the integrity of skin. The MMPI is a psychological test and is not used to assess diabetic neuropathy. ed develop a blood clot at the insertion site. The risk of blood clots is greatest in the months following stent placement. Most patients are prescribed aspirin or other anticlotting agents to prevent clot formation.
1. Persons with celiac disease cannot tolerate: a. Gluten b. Lactose c. Peanuts d. Eggs 2. GERD is a risk factor for the development of: a. Celiac disease b. Biliary Atresia c. Barrett's Esophagus d. Inguinal Hernia 3. Risk factors for hepatitis A include all of the following except: a. Men who have sex with men b. Illegal drug users c. Overweight d. Persons who visit developing countries 4. Interferon is prescribed for the treatment of: a. Hepatitis A b. Chronic Hepatitis B c. GERD d. Diverticulitis 5. Persons of Jewish heritage are disproportionately affected by: a. Barrett's Esophagus b. Diverticulosis c. Appendicitis d. Crohn's disease 6. Which of the following conditions usually is asymptomatic? a. Diverticulitis b. Crohn's disease c. Inflammatory bowel disease d. Diverticulosis 7. Bowel diversion surgery may be indicated for all of the following conditions except: a. Gastroparesis b. Cancer c. Inflammatory bowel disease d. Bowel obstruction 8. The most frequent cause of abdominal adhesions is: a. Abdominal surgery b. Gastroenteritis c. Hepatitis A d. Hepatitis B 9. The most frequent cause of emergency abdominal surgery is:
a. Inflammatory bowel disease b. Appendicitis c. Viral gastroenteritis d. Barrett's Esophagus 10. Abdominal pain associated with appendicitis is generally described as: a. Near the diaphragm b. Relieved by eating c. Near or around the umbilicus and in the right lower quadrant of the abdomen d. Worse in the morning 11. Physical examination of a patient with acute appendicitis may reveal all of the following except: a. Guarding b Rectal bleeding c. Rebound tenderness d. Rovsing's sign 12. Symptoms of ulcerative colitis may include abdominal pain, rectal bleeding, diarrhea, and all of the following except: a. Anemia b. Weight loss c. Joint pain d. Bradycardia 13. Peptic ulcers may be caused by all of the following except: a. Emotional stress and eating spicy foods b. Bacterial infection with Helicobacter pylori c. Long-term use of nonsteroidal anti-inflammatory agents (NSAIDS) d. Malignant tumors in the stomach or pancreas 14. All of the following are symptoms of peptic ulcer except: a. Pain is relieved by eating b. Pain is unrelenting and quickly worsens c. Pain is relieved by antacids d. Pain occurs at night when the stomach is empty 15. Which of the following symptoms is not associated with dyspepsia? a. Feeling overly full after a normal meal b. Mild to severe epigastric pain c. Black tarry stools d. Epigastric burning sensations 16. In the United States the most common causes of hepatitis C are: a. Wilson disease, cystic fibrosis, and glycogen storage diseases b. Alpha-1 antitrypsin deficiency and hemochromatosis c. Chronic hepatitis B and D d. Excessive alcohol consumption, hepatitis C, and obesity 17. Food borne illness associated with eating raw and undercooked eggs is generally attributable to: a. Campylobacter jejuni b. L. monocytogenes c. Salmonella enteriditis d. C. botulinum 18. About 80% of gallstones are composed of:
a. Calcium b. Bile c. Bilirubin d. Hardened cholesterol 19. Persons at risk for gallstones include all of the following except: a. Adults age 60 and older b. Pregnant women or women using hormone replacement therapy or oral contraceptives c. Native Americans and Mexican Americans d. People with rheumatoid or osteoarthritis 20. Disorders that increase risk for chronic pancreatitis include all of the following except: a. Cystic fibrosis b. Hypercalcemia c. Excessive alcohol consumption d. Hyperthyroidism
13. A: H. pylori is responsible for most peptic ulcers. The bacteria weaken the mucosal lining of the stomach, rendering it acid permeable. The combination of the bacteria and acid erode the lining and produce the ulcer. Although stress and a diet of spicy food do not cause peptic ulcers, both may exacerbate symptoms. 14. B: Peptic ulcer pain is described as dull and gnawing and is often intermittent - arising and subsiding over the course of several days. It generally occurs within a couple of hours of eating and may be accompanied by bloating, nausea, and vomiting. 15. C: Mild dyspepsia, or indigestion, may be treated by diet (several small, low-fat meals rather than three large meals, eliminating alcohol, coffee and carbonated beverages from the diet, stopping smoking, and eliminating use of drugs that are known to irritate the gastric mucosa such as aspirin and anti-inflammatory agents) and managing stress. Nonprescription antacids, H2 receptor antagonists, proton pump inhibitors, and prokinetics also may relieve symptoms. 16. D: All of the conditions listed above may cause cirrhosis, the condition in which healthy liver is replaced by scar tissue. Cirrhosis is the 12th leading cause of death and many people have more than one causal factor. Rising rates of obesity have resulted in increasing number of cases of nonalcoholic fatty liver disease, which causes cirrhosis. 17. C: Food borne illnesses that result from consuming raw and undercooked meat and poultry are generally attributable to Campylobacter jejuni, E. coli O157:H7, L. monocytogenes, and Salmonella. Food borne illnesses that result from consuming raw foods and unpasteurized milk and dairy products are generally attributable to L. monocytogenes, Salmonella, Shigella, Staphylococcus aureus, and C. jejuni. Improperly canned goods and smoked or salted fish may harbor C. botulinum. 18. D: An estimated 10% of the population has gallstones but most people are asymptomatic and as such, require no treatment. In instances where gallstones injure or lodge in bile ducts or impede the flow of bile or digestive enzymes, oral dissolution therapy, contact dissolution therapy or surgery - laparoscopic cholecystectomy or in about 5% of cases open procedures - may be indicated. 19. D: Populations at risk for gallstones include the above-mentioned groups as well as persons who are overweight or obese, persons who experience rapid weight loss such as bariatric surgery patients, diabetics, persons with a family history of gallstones, and persons who take statin drugs. 20. D: Chronic pancreatitis is often presents in adults ages 30 to 40 and in addition to chronic, excessive alcohol use, cystic fibrosis, and hypercalcemia may be caused or precipitated by hyperlipidemia, hypertriglyceridemia, or autoimmune disorders. Untreated, chronic pancreatitis results in calcification, which is permanent damage, and may require surgical excision.
1. Acromegaly is most frequently diagnosed in: a. Middle-aged adults b. Newborns c. Children ages 2 to 5 d. Adults age 65 and older 2. Grave's disease is: a. The most common cause of hypothyroidism b. The most common cause of hyperparathyroidism c. The most common cause of hyperthyroidism d. The most common cause of adrenal insufficiency 3. Symptoms of Grave's ophthalmopathy include all of the following except: a. Bulging eyeballs b. Dry, irritated eyes and puffy eyelids c. Cataracts d. Light sensitivity 4. An ACTH stimulation test is commonly used to diagnose:
a. Grave's disease b. Adrenal insufficiency and Addison's disease c. Cystic fibrosis d. Hashimoto's disease 5. All of the following are symptoms of Cushing's syndrome except: a. Severe fatigue and weakness b. Hypertension and elevated blood glucose c. A protruding hump between the shoulders d. Hair loss 6. Which of the following conditions is caused by long-term exposure to high levels of cortisol? a. Addison's disease b. Crohn's disease c. Adrenal insufficiency d. Cushing's syndrome 7. A "sweat test" or newborn screening may be used to detect: a. Cystic fibrosis b. Adrenal insufficiency c. Grave's disease d. Hypothyroidism 8. Hashimoto's disease is: a. Chronic inflammation of the thyroid gland b. Diagnosed most frequently in Asian-Americans and Pacific Islanders c. A form of hyperthyroidism d. A rare form of hypothyroidism 9. Persons at increased risk of developing Hashimoto's disease include all of the following except: a. Persons with vitiligo b. Asian-Americans c. Persons with rheumatoid arthritis d. Persons with Addison's disease 10. All of the following statements about Hashimoto's disease are true except: a. Many patients are entirely asymptomatic b. Not all patients become hypothyroid c. Most cases of obesity are attributable to Hashimoto's disease d. Hypothyroidism may be subclinical 11. The most common benign tumor of the pituitary gland is a: a. Glioma b Prolactinoma c. Carcinoid tumor d. Islet cell tumor 12. Symptoms of polycystic ovarian syndrome (PCOS) may include all of the following except: a. Pelvic pain b. Acne, oily skin, and dandruff c. Infertility d. Weight Loss 13. Women with PCOS are at increased risk for all of the following except:
a. Pregnancy b. Diabetes c. Cardiovascular disease d. Metabolic syndrome 14. All of the following organs may be affected by multiple endocrine neoplasia type 1 except: a. Parathyroid glands b. Kidneys c. Pancreas and Duodenum d. Pituitary gland 15. What is the treatment for hyperparathyroidism? a. Synthetic thyroid hormone b. Desiccated thyroid hormone c. Surgical removal of the glands d. Calcium and phosphate 16. The most common causes of death in people with cystic fibrosis is: a. Dehydration b. Opportunistic infection c. Lung cancer d. Respiratory failure 17. Untreated hyperthyroidism during pregnancy may result in all of the following except: a. Premature birth and miscarriage b. Low birthweight c. Autism d. Preeclampsia 18. Short stature and undeveloped ovaries suggest which of the following disorders: a. Polycystic ovarian syndrome b. Prolactinoma c. Grave's disease d. Turner syndrome 19. Endocrine disorders may be triggered by all of the following except: a. Stress b. Infection c. Chemicals in the food chain and environment d. Cell phone use 20. An analysis of data from the Women's Health Initiative questioned the use of which therapy to prevent heart disease? a. Synthetic thyroid hormone b. Oral contraceptives c. Weight-loss drugs d. Postmenopausal hormone replacement therapy
3. C: Grave's ophthalmopathy is an inflammation of tissue behind the eye causing the eyeballs to bulge. In addition to the above-mentioned symptoms, Grave's ophthalmopathy may cause pressure or pain in the eyes, double vision, and trouble moving the eyes. About one-quarter of persons with Grave's disease develop Grave's ophthalmopathy. The condition is frequently self-limiting, resolving without treatment over the course of a year or two. 4. B: The ACTH stimulation test measures blood and urine cortisol before and after injection of ACTH. Persons with chronic adrenal insufficiency or Addison's disease generally do not respond with the expected increase in cortisol levels. An abnormal ACTH stimulation test may be followed with a CRH stimulation test to pinpoint the cause of adrenal insufficiency. 5. D: Cushing's syndrome also may cause fragile, thin skin prone to bruises and stretch marks on the abdomen and thighs as well as excessive thirst and urination and mood changes such as depression and anxiety. Women who suffer from high levels of cortisol often have irregular menstrual cycles or amenorrhea and present with hair on their faces, necks, chests, abdomens, and thighs. 6. D: Cushing's syndrome is a form of hypercortisolism. Risk factors for Cushing's syndrome are obesity, diabetes, and hypertension. Cushing's syndrome is most frequently diagnosed in persons ages 20 to 50 who have characteristic round faces, upper body obesity, large necks, and relatively thin limbs. 7. A: Cystic fibrosis is the most common inherited fatal disease of children and young adults in the United States. Cystic fibrosis is usually diagnosed by the time an affected child is three years old. Often, the only signs are a persistent cough, a large appetite but poor weight gain, an extremely salty taste to the skin, and large, foul-smelling bowel movements. A simple sweat test is currently the standard diagnostic test. The test measures the amount of salt in the sweat; abnormally high levels are the hallmark of the disorder. 8. A: Hashimoto's disease is the most common cause of hypothyroidism. It is an autoimmune disease that produces chronic inflammation of the thyroid gland. More women are affected than men and it is generally diagnosed in persons ages 40 to 60. When treatment is indicated, synthetic T4 is administered. 9. B: Along with the above-mentioned groups, persons with type 1 diabetes and persons suffering from pernicious anemia (insufficient vitamin b12) are at increased risk of developing Hashimoto's disease. Because it tends to run in families, there is likely a genetic susceptibility as well. Environmental factors such as excessive iodine consumption and selected drugs also have been implicated as potential risk factors. 10. C: Although weight gain may be a symptom of Hashimoto's disease, the majority of obese people have normal thyroid function; rarely is thyroid disorder the sole cause of obesity. Other symptoms of Hashimoto's disease include fatigue, cold intolerance, joint pain, myalgias, constipation, dry hair, skin and nails, impaired fertility, slow heart rate, and depression. 11. B: Prolactinomas can cause symptoms by releasing excessive amounts of prolactin into the blood or mechanically by pressing on surrounding tissues. In women, symptoms may include menstrual irregularities and infertility; in men erectile dysfunction and libido may be impaired. 12. D: In addition to the above-mentioned symptoms, PCOS may cause menstrual irregularities, thinning hair or male-pattern baldness, thick skin or dark patches of skin and excessive hair growth on the face, chest, abdomen, thumbs and toes. 13. A: Women with PCOS produce excessive amounts of androgens and do not release ova during ovulation, which seriously compromises their ability to conceive. Although women with PCOS can become pregnant, often by using assistive reproductive technology, they are at increased risk for miscarriage. 14. B: Multiple endocrine neoplasia type 1, also known as Werner's syndrome, is a heritable disorder that causes tumors in endocrine glands and the duodenum. Although the tumors associated with multiple endocrine neoplasia type 1 are generally benign, they can produce symptoms chemically by releasing excessive amounts of hormones or mechanically by pressing on adjacent tissue. 15. C: When hyperparathyroidism requires treatment, surgery is the treatment of choice and is considered curative for 95% of cases. Because untreated hyperparathyroidism may elevate blood and urine levels of calcium and deplete phosphorus, bones and teeth may lose the minerals needed to remain strong. 16. D: Declining pulmonary function is a hallmark of cystic fibrosis. Drugs such as Pulmozyme (dornase alfa) and Zithromax (azithromycin) can slow the progression of lung disease and mechanical physical therapy devices help CF patients to breathe more easily by loosening and dislodging mucus. For some patients with severe lung damage, lung transplantation is a treatment option. 17. C: In addition to the above-mentioned complications of uncontrolled hyperthyroidism in pregnancy, expectant mothers may suffer congestive heart failure and thyroid storm, which is life-threatening thyrotoxicosis with symptoms that include agitation, confusion, tachycardia, shaking, sweating, diarrhea, fever, and restlessness. 18. D: Turner syndrome results from a chromosomal abnormality and occurs in an estimated 1 in 2,500 female births. It occurs more frequently in preterm pregnancies. Affected women are shorter than average and are infertile because they lack ovarian function. They also
may have webbed necks, broad chests, arms that turn out from the elbow, lymphedema of the hands and feet and skeletal, cardiac, and renal problems. 19. D: Endocrine function may be influenced by myriad factors. In addition to the above-mentioned, there is evidence that exposure to naturally occurring and man-made endocrine disruptors such as tributyltin, certain bioaccumulating chlorinated compounds, and phytoestrogens is widespread and in susceptible individuals, may trigger endocrine disorders. 20. D: The results of the Women's Health Initiative study prompted the U.S. Food and Drug Administration (FDA) to advise against using hormone therapy (estrogen-alone or estrogen-plus-progestin) to prevent heart disease. When hormone replacement therapy is used to treat moderate to severe hot flashes and symptoms of vulvar and vaginal atrophy it should used at the lowest doses for the shortest duration needed to achieve treatment objectives.
1. Amyloid plaques and neurofibrillary tangles are the hallmarks of: a. Alzheimer's disease b. Amyotrophic lateral sclerosis c. Ataxia Telengiectasia d. Autism 2. Difficulty speaking and understanding speech is termed: a. Apnea b. Ataxia c. Aphasia d. Dyslexia 3. The most common form of transient facial paralysis is: a. Alzheimer's disease b. Transient ischemic attack c. Bell's palsy d. Erb's palsy 4. Gradually increasing pain and weakness and numbness in the hand or wrist that radiates up the arm suggest: a. Amyotrophic lateral sclerosis b. Carpal tunnel syndrome c. Bloch-Sulzberger Syndrome d. Dystonia 5. All of the following may be associated with Guillain-Barr Syndrome except: a. Weakening or tingling sensation in the legs b. Weakness in the arms and upper body c. Nearly complete paralysis d. First symptom is altered mental status 6. Which of the following statement about herpes zoster is not true? a. It is caused by the varicella-zoster virus b. It causes burning, tingling pain and lesions, generally on one side of the body c. Anyone who has had chickenpox is at risk of postherpetic neuralgia d. It is a sexually transmitted disease 7. Diagnostic tests for epilepsy include all of the following except:
a. Simple blood tests b. EEG c. Brain scan d. Wada test 8. Treatment for epilepsy to eliminate or sharply reduce the frequency of seizures may involve all of the following except: a. Cognitive-behavioral therapy b. Narrow-spectrum and broad-spectrum antiepileptic drugs c. Vagus-nerve stimulation d. Surgery 9. The most common inherited neurological disorder is: a. Bloch-Sulzberger Syndrome b. Charcot-Marie-Tooth disease c. Alper's disease d. Asperger Syndrome 10. A severe form of epilepsy that appears during the first year of life is called: a. Dandy-Walker syndrome b. Devic's syndrome c. Dravet syndrome d. Fabry disease 11. Lack of ceramide trihexosidase, also known as alpha-galactoside-A causes: a. Fahr's syndrome b Fabry disease c. Fisher syndrome d. Gaucher's disease 12. Symptoms of trigeminal neuralgia may include all of the following except: a. Extreme, intermittent facial pain in the jaw or cheek b. Tingling or numbness on one side of the face c. Pain triggered by contact with the face or facial movements d. Inability to swallow 13. All of the following are true about Tourette syndrome except: a. Drug treatment completely eliminates symptoms b. It is involuntary and may be a chronic condition c. Symptoms are generally most severe during adolescence d. Symptoms are generally detected in children 14. Huntington's disease is a heritable disorder that involves: a. Sudden paralysis b. Chorea, loss of cognitive abilities, and emotional disturbance c. Uncontrollable swearing and repetitive actions d. Inability to recognize faces 15. All of the following statements about amyotrophic lateral sclerosis are true except: a. It causes degeneration and death of upper and lower motor neurons b. Patients lose strength and control of voluntary muscles c. It impairs cognition and senses d. It progresses rapidly and is fatal 16. Children with Angelman syndrome generally display all of the following except: a. Developmental delays and speech impairment b. Feeding problems c. Seizures d. Loss of hearing and sense of smell
17. All of the following are true about autism except: a. Affected persons have communication, interpersonal, and behavioral problems b. Affected persons display obsessive or repetitive behaviors and interests c. It is the direct result of immunization with thimerosal-containing vaccines d. Early intervention is associated with improved outcomes 18. Brain and spinal tumors may be treated with any or all of the following modalities except: a. Surgery b. Radiation c. Chemotherapy d. Positron emission tomography 19. Symptoms of Parkinson's disease include all of the following except: a. Tremors of the hands, arms, legs, jaw, and face b. Stiff limbs c. Bradykinesia and impaired balance d. Impaired cognition 20. Narcolepsy is a disorder characterized by: a. Narcotic abuse b. Grand mal seizures c. Reliance on soporific drugs d. Inability to regulate sleep-wake cycles
10. C: Dravet syndrome, also known as severe myoclonic epilepsy of infancy, presents with frequent fever-related seizures during the first year of life. Other types of seizures generally occur over time, and children with Dravet syndrome are often developmentally delayed in language, motor, and interpersonal skills. 11. B: Persons with Fabry disease cannot efficiently metabolize lipids and as a result, excessive lipid deposition occurs in the eyes, kidneys, cardiovascular system, and autonomic nervous system. Symptoms of this heritable disease include burning sensations in the hands, raised skin lesions, and in boys especially, corneal changes. Persons with Fabry disease are at increased risk of heart disease and stroke. 12. D: Trigeminal neuralgia is characterized by sudden onset of severe pain that lasts less than a minute. It presents most commonly in persons age 50 and older and among women. The frequency and severity of attacks recurs and remits, progressively worsening over time. While the disorder may be debilitating, it is not life threatening. 13. A: Tourette Syndrome is characterized by tics - repetitive, involuntary behaviors, vocalizations and movements such as eye blinking, grimacing, and shrugging or jerky muscle movements. Tics also may include self-harm such as repetitively punching oneself as well as coprolalia and echolalia. Persons with Tourette syndrome frequently suffer behavioral problems such as hyperactivity, impulsivity, attention disorders, and repetitive behaviors. 14. B: Huntington's disease is a progressive brain disorder that causes the degeneration of cells in a pair of nerve clusters deep in the brain. The disease affects both the body and the mind. HD is caused by a single dominant gene and affects men and women of all races and ethnic groups. It generally begins during the third and fourth decades of life; however, there is a form of the disease that can affect children and adolescents. 15. C: Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, causes muscle weakness and atrophy. As it progresses ALS patients have difficulty moving, swallowing, speaking, and ultimately, breathing on their own. Many ALS patients require mechanical ventilation and most die from respiratory failure three to five years from the time initial symptoms are detected. 16. D: Angelman syndrome is a genetic disorder that causes developmental delays and multiple neurological problems such as motor difficulties that impair functions. Children with Angelman syndrome are often hyperactive and suffer from movement, balance, and sleep disorders. They have characteristic small, flat heads and protruding tongues. Jerky movements are also characteristic of the disorder. 17. C: Although the etiology of autism remains unknown, it is thought to arise from a combination of genetic predisposition and environmental triggers. A review of the evidence conducted by the Institute of Medicine concluded that there is no causal relationship between thimerosal-containing vaccines and autism. 18. D: Brain and spinal tumors may be benign or malignant and benign tumors may be asymptomatic depending on their location. Symptoms of brain tumors include the following: headache; seizures; nausea and vomiting; vision, hearing, and motor problems; and sensory and cognitive changes. Symptoms of spinal cord tumors include pain, sensory changes, and motor problems. 19. D: Symptoms of Parkinson's disease often begin on one side of the body and over time affect the entire body. The four characteristic symptoms of Parkinson's disease are tremor, rigidity, slowness of movement, and postural instability. Tremor is generally most apparent at rest or when the patient is stressed and improves with deliberate movement. 20. D: Narcolepsy is a neurological disorder that causes affected individuals to experience irresistible bouts of sleep, causing them to fall asleep for periods ranging from seconds to minutes throughout the day. Along with excessive daytime sleepiness, persons with narcolepsy also suffer from cataplexy, hallucinations at the onset of sleep and/or upon awakening, and transient complete paralysis at the onset or end of sleep.
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1. Fruits, vegetables and cereals are potent sources of: a. Antioxidants b. Unsaturated fat c. Saturated fat d. Free radicals 2. The leading source of antioxidants in the U.S. diet is: a. Citrus fruits b. Spinach c. Coffee d. Egg yolks
3. The essential fatty acids that must be derived from the diet are: a. Stearidonic acid and eicosatetraenoic acid b. Eicosapentaenoic acid and docosapentaenoic acid c. Linoleic and alpha-linoleic acid d. Gamma-linoleic acid and arachidonic acid 4. All of the following statements about omega-3 fatty acids are true except: a. They help to maintain healthy triglyceride and high-density lipoprotein b. They have significantly contributed to the obesity epidemic c. They are necessary for healthy infant growth and development d. They play an important role in the production of hormones that govern numerous metabolic and biological processes 5. All of the following may be associated with scurvy except: a. Loss of appetite and irritability b. Diarrhea and fever c. Tenderness and swelling in legs d. First symptom is altered mental status 6. The only fat-soluble antioxidant synthesized in the body is? a. Vitamin D b. Thiamine c. Ascorbic acid d. CoQ10 7. Good source of vitamin D include all except: a. blueberries b. Sunlight c. Salmon, tuna sardines and mackerel d. Fortified milk and other dairy products 8. One of the fat-soluble vitamins involved in coagulation is: a. Vitamin K b. Vitamin A c. Vitamin D d. Vitamin E 9. Products that contain live microorganisms in sufficient numbers to alter intestinal microflora and promote intestinal microbial balance are known as: a. Antibiotics b. Probiotics c. Fruits and vegetables d. Digestive enzymes 10. Nondigestible food ingredients that stimulate the growth and activity of certain bacteria in the colon are called: a. Insoluble fiber b. Probiotics c. Prebiotics d. Cellulose 11. A deficiency of thiamine (vitamin B1) in the diet causes: a. Osteopenia b Beri-beri c. Protein malnutrition d. Scurvy
12. Symptoms of trigeminal neuralgia may include all of the following except: a. Extreme, intermittent facial pain in the jaw or cheek b. Tingling or numbness on one side of the face c. Pain triggered by contact with the face or facial movements d. Inability to swallow 13. All of the following are true about Tourette syndrome except: a. Drug treatment completely eliminates symptoms b. It is involuntary and may be a chronic condition c. Symptoms are generally most severe during adolescence d. Symptoms are generally detected in children 14. The USDA Dietary Guidelines for Americans advise: a. Limiting carbohydrates to 10 percent of daily calories b. Limiting total fat intake to 20 to 35 percent of calories c. Limiting protein to 10 percent of daily calories d. Limiting intake of fats and oils to 10 percent of daily calories 15. All of the following statements about vitamin B3 (niacin) are true except: a. It helps to release energy in carbohydrates, fat, and protein b. It improves blood lipid levels c. Deficiency causes beriberi d. It is involved in the synthesis of sex hormones 16. The average American consumes approximately how much sodium per day? a. 2,300 mg b. 230 mg c. 340 mg d. 3,400 mg 17. All of the following are potentially modifiable risk factors for osteoporosis except: a. Anorexia nervosa b. Chronically low intake of calcium and vitamin D c. Chronically low intake of vitamins C and B6 d. Excessive alcohol consumption 18. Consuming fewer than 130 grams of carbohydrate per day may lead to: a. Hypoglycemia b. Kwashiorkor c. Marasmus d. Ketosis 19. Characteristics of successful dieters include all of the following except: a. Maintaining a daily food journal b. Counting calories c. Adhering to a strict eating plan d. Eliminating all carbohydrates from their diets 20. Iron supplements are frequently recommended for all of the following except: a. Women who are pregnant b. Infants and toddlers c. Teenage girls d. Post-menopausal women
with symptoms such as canker sores, depression, fatigue, indigestion, weakness, skin problems, and inflammation. Chronic niacin deficiency is called pellagra. 16. D: The average American consumes about 50% more sodium than the 2,300 mg per day recommended in the Dietary Guidelines for Americans. Excessive sodium consumption is associated with increased risk for hypertension, which is associated with increased risk of developing cardiovascular disease. 17. C: Long-term inadequate intake of calcium is associated with low bone mass, rapid bone loss, and high risk of fracture. In addition to the above-mentioned risk factors, chronic use of glucocorticoids, some anticonvulsants, inactivity, smoking, and changes in sex hormones such as amenorrhea, menopause, and low testosterone may increase the risk for osteoporosis. 18. D: Low carbohydrate diets promote ketosis, the process of breaking down fat as opposed to carbohydrate to generate energy. Ketones are acidic chemicals, which can build up in the blood and urine. Diet-induced ketosis may be intentional as a treatment for some people with epilepsy, however, for some people, long-term adherence to a very low carbohydrate diet may produce damage to the liver and kidneys. 19. D: Along with the above-mentioned characteristics, successful dieters monitor their weight, practice portion control, increase physical activity, and aim for healthy realistic weight loss ranging from 10% to 20% of initial bodyweight in a year. Successful dieters maintain their motivation by celebrating the achievement of weight-loss milestones. 20. D: In addition to the above-mentioned populations, supplemental iron may be given to treat anemia that occurs during pregnancy or as a result of heavy menstrual periods, kidney disease, or chemotherapy. Supplemental iron also may be recommended for vegetarians and women who are lactating. Iron requirements decrease for post-menopausal women.