Endocrine
Highly concentrated urine with elevated sodium despite hyponatremia confirms this diagnosis.
SIADH
A patient presents with severe epigastric pain radiating to the back, elevated lipase, and nausea after binge drinking. What mechanism is responsible?
A. Gastric mucus erosion
B. Premature activation of pancreatic enzymes
C. Bile duct obstruction
D. Decreased insulin release
✅ Correct Answer: B
Rationale: Pancreatitis occurs when digestive enzymes activate inside the pancreas, causing autodigestion
A patient with burning epigastric pain that improves after eating likely has this type of ulcer.
Duodenal Ulcers
This type of stool is bulky, greasy, foul-smelling, and floats due to excess fat in the feces
Steatorrhea
pH 7.31, PaCO₂ 46, HCO₃ 35
Partially compensated respiratory acidosis; pH is acidic and CO₂ is elevated = respiratory acidosis with partial metabolic compensation.
Patient presents: fruity breath, RR 36 deep, glucose 480, K⁺ 5.8. Identify the disease.
DKA
Hypotension, hyperkalemia, and hyponatremia are most associated with this disorder and what hormone deficiency.
Addison disease; deficient cortisol + aldosterone
What are examples of a negative and positive feedback loop?
Negative feedback loop: When body temperature rises, the body sweats to cool down.
Positive feedback loop: During childbirth, uterine contractions become stronger and more frequent until the baby is delivered.
A 58-year-old client arrives at the emergency department with a history of peptic ulcer disease. The client reports black, tarry stools, dizziness, and weakness. Vital signs show BP 88/54 mmHg and HR 118 bpm. What complication is the highest priority to prevent further deterioration?
What is gastrointestinal bleeding?
pH 7.39, PaCO₂ 48, HCO₃ 37
Fully compensated respiratory acidosis; pH is normal, CO₂ and HCO₃ are both high → full compensation.
This disorder occurs when excess thyroid hormones increase the body’s metabolic rate by overstimulating beta-adrenergic receptors, causing increased oxygen consumption, heat production, and sympathetic nervous system activity
What is Hyperthyroidism?
A patient has fatigue, cold intolerance, weight gain, dry skin, non-pitting edema, and a thickened tongue. Identify the disease and the underlying mechanism
severe hypothyroidism (myxedema) caused by deficient thyroid hormone leading to mucopolysaccharide deposition in tissues
Client reports recurrent ABD pain for 8 months that improves after BM. Which finding supports the diagnosis of IBS?
A. Fever, nocturnal diarrhea, & unintended weight loss
B. Alternating constipation and diarrhea with mucus in stool
C. Bloody diarrhea
D. Steatorrhea
B. IBS = functional disorder → NO inflammation, NO bleeding, NO weight loss
Mucus in stool is classic but often overlooked
Pyelonephritis may be distinguished from cystitis by
A. Microbes, leukocytes, and pus in the urine
B. Painful micturition
C. Urgency and frequency
D. Urinary casts and flank pain
D- Inflammation, stretching of the renal capsule
pH 7.28, PaCO₂ 34, HCO₃ 19
Partially compensated metabolic acidosis; Low pH = acidosis; low HCO₃ = metabolic cause; CO₂ lowered = partial compensation.
Client has hypoparathyroidism. Which assessment supports this diagnosis?
A. Tremor, heat intolerance, weight loss
B. Tingling lips, carpopedal spasms, +Trousseau sign
C. Bradycardia, weight gain, dry skin, delayed reflexes
D. Polyuria, polydipsia, polyphagia
B
A client with diabetes becomes suddenly confused, diaphoretic, and shaky. Which finding most strongly differentiates hypoglycemia from hyperglycemia?
A. Polyuria and polydipsia
B. Warm, dry skin and fruity breath
C. Diaphoresis and tremors
D. Slow onset of blurred vision and fatigue
C
Hypoglycemia triggers the sympathetic nervous system, causing sweating, shakiness, tachycardia, and anxiety.
Hyperglycemia develops more slowly and causes polyuria, polydipsia, dry skin, and fruity breath
Repeated vomiting most commonly causes what electrolyte and acid–base imbalance?
hypokalemia and metabolic alkalosis
A client presents with intermittent hematuria, unexplained weight loss, new-onset hypertension, and elevated hematocrit levels due to excess erythropoietin production from a renal mass. What is the most likely diagnosis
renal cell carcinoma
pH 7.42, PaCO₂ 53, HCO₃ 38
Fully compensated metabolic alkalosis; Normal pH with elevated CO₂ and high HCO₃ shows full metabolic compensation.
A client presents to the emergency department with weakness, dizziness, weight loss, and bronze skin discoloration. Vital signs show BP 84/50 mmHg and HR 112 bpm. Sodium 126 mEq/L Potassium 6.1 mEq/L Glucose 64 mg/dL.
What explains why this patient has hyperkalemia?
In Addison's disease, the adrenal cortex is destroyed due to an immune response, leading to decreased aldosterone secretion. Aldosterone normally promotes sodium reabsorption and potassium excretion in the kidneys. Without aldosterone, potassium is retained, causing hyperkalemia.
“A patient presents with moon face, buffalo hump, hyperglycemia, hypertension, and thin skin with easy bruising. Another patient presents with weight loss, hyperpigmentation, hypotension, hyponatremia, and hyperkalemia. Identify both disorders and explain the primary hormone imbalance."
What are Cushing’s syndrome and Addison’s disease?
Cushing’s syndrome: Excess cortisol
Addison’s disease: Deficiency of cortisol and aldosterone
A patient suddenly produces very little urine, develops swelling in the legs, shortness of breath, confusion, and has elevated potassium levels. These findings are classic for this sudden kidney condition:
What is acute renal failure (acute kidney injury)?
A patient has black, tarry, foul-smelling stools due to bleeding in the upper gastrointestinal tract. What pathophysiologic process causes the stool to appear black?
What is the digestion and oxidation of blood by gastric acid?
pH 7.6, PaCO₂ 29, HCO₃ 15
Partially compensated respiratory alkalosis; High pH + low CO₂ = respiratory alkalosis with partial metabolic compensation.