Mark Klimek Electrolytes and Endocrine Practice Test

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• A patient has K+ 2.8 mEq/L with muscle weakness. List the immediate treatment steps and the rationale.
• Which antithyroid drug is often preferred in the first trimester of pregnancy due to teratogenic risks?
• Which signs are classic for postoperative hypocalcemia?
• After bilateral adrenalectomy, the patient must be on lifelong steroids to prevent what condition?
• During DKA treatment, how often should glucose be checked?
• According to the provided material, SIADH is associated with which fluid status?
• After starting insulin therapy for DKA, which electrolyte shifts first and requires monitoring?
• During insulin therapy for DKA, what is the recommended potassium management when initial serum potassium is greater than 5.2 mEq/L?
• What hormone is deficient in central diabetes insipidus and what drug is used diagnostically to test for DI?
• In type 1 vs type 2 diabetes, which type is more prone to DKA and what is a key metabolic feature?
• Hyperkalemia treatment includes which of the following?
• Hypercalcemia s/s typically present as:
• Calcitonin role in hypercalcemia.
• Which statement about SIADH and urine gravity is true?
• In severe hypercalcemia, which medication provides a rapid but temporary reduction in calcium levels?
• What is the earliest sign of an electrolyte disorder?
• What are the hallmark ECG changes of hyperkalemia and the initial urgent treatment steps?
• Which autoimmune thyroid disease is associated with exophthalmos and which antibody is typically present?
• A patient presents with hypotension, hyponatremia, and hyperkalemia suggesting adrenal crisis. What are the initial management steps?
• In hyponatremia, what signs indicate severe symptoms requiring hypertonic saline, and what is the typical hypertonic solution used?
• A patient on renal failure has a serum magnesium of 5.0 mg/dL and diminished deep tendon reflexes. What is the management?
• Moon face is a classic sign of which endocrine disorder?
• Name three hallmark features of thyroid storm and the immediate management priorities.
• During the initial treatment phase of DKA with IV insulin, which statement best describes potassium management?
• SIADH is most accurately explained by which mechanism leading to hyponatremia in the setting of small cell lung carcinoma?
• Addison's disease is treated with what type of medication?
• Which lab findings characterize SIADH?
• What is the primary acid–base disturbance in an ABG with pH 7.30, PaCO2 48 mmHg, and HCO3- 22 mEq/L, and what does this imply about compensation?
• Calculate the corrected sodium for a patient with measured Na 130 mEq/L and glucose 300 mg/dL.
• Why must hyponatremia correction be cautious to prevent osmotic demyelination, and what is a typical 24-hour correction cap?
• Which condition would most likely lead to dehydration due to polyuria?
• What statement about osmotic demyelination syndrome is true?
• What oxygen flow rate is commonly used in thyroid storm management according to the notes?
• Which of the following is NOT considered a standard treatment for hyperthyroidism?
• Adrenal crisis often presents with which electrolyte pattern?
• Compared to D5W with insulin, Kayexelate lowers potassium how?
• In hyperkalemia, which pattern best describes the signs?
• A patient with respiratory acidosis should be managed with which initial step?
• In DKA management, when would you consider phosphate replacement, and what level would trigger it?
• Isotonic saline in hypercalcemia.
• What are the typical manifestations of hypomagnesemia, and how is it treated?
• DI s/s typically include:
• Which signs indicate neuromuscular irritation in calcium disturbances?
• A patient hyperventilates with low PaCO2 and high pH; what acid-base disorder is this?
• Addison's disease is caused by which of the following?
• Hypermagnesemia signs follow which pattern?
• In managing thyroid storm, what is the first step in cooling the patient?
• What is the standard formula for the anion gap and a normal range?
• In diabetic ketoacidosis, which IV fluid is used for initial resuscitation?
• What EKG changes are commonly seen with hypokalemia?
• Low urine output/fluid overload/SiADH results in ______ specific gravity.
• Which sign is associated with hypernatremia?
• What is considered the universal sign of electrolyte imbalance?
• In Graves' disease, what autoimmune target leads to hyperthyroidism and what is a classic extrathyroidal manifestation?
• SIADH has a _______ specific gravity.
• Which medication is used for immediate symptomatic relief in hyperthyroidism?
• In patients with hypothyroidism undergoing surgery, what is the correct perioperative management?
• After radioactive iodine therapy for hyperthyroidism, what is a recommended precaution?
• Which adverse effect is most concerning and commonly monitored with methimazole and propylthiouracil in thyroid storm management?
• What are the typical signs of postoperative hypocalcemia after thyroid/parathyroid surgery?
• How should potassium be replaced in a patient with hypokalemia and a non-emergent IV access, and why is rapid infusion dangerous?
• In SIADH, which finding is typical?
• Diabetes insipidus means there is a fluid:
• Beyond blood glucose monitoring, what are two critical nursing priorities when a patient is on IV insulin for DKA?
• How does hypophosphatemia occur during refeeding or DKA treatment, and when should phosphate replacement be considered?
• Which signs indicate neuromuscular irritation in hypocalcemia?
• Which ketone bodies accumulate in diabetic ketoacidosis?
• A patient has tachycardia, heat intolerance, and weight loss with suppressed TSH and elevated free T4. What is the diagnosis?
• In postsurgical hypocalcemia due to hypoparathyroidism, which serum phosphate trend is expected?
• Normal calcium range?
• Which statement best differentiates central diabetes insipidus from nephrogenic diabetes insipidus after desmopressin challenge?
• In hyponatremia, what is the recommended correction target in the first 6 hours?
• Diabetes insipidus (DI) is caused by:
• A positive Trousseau sign indicates which electrolyte imbalance?
• Which of the following is a cause of hypernatremia?
• In hyperkalemia, what happens to urinary output?
• Which electrolyte disturbance is described as having sedative-like signs?
• SIADH commonly presents with which electrolyte issue?
• SIADH means there is a fluid:
• Which statement is true regarding aldosterone in secondary adrenal insufficiency?
• Which combination of findings best distinguishes myxedema coma and what is the initial treatment?
• In diabetic ketoacidosis, why can serum potassium be high at presentation despite total body potassium depletion?
• Normal potassium range?
• Which test helps distinguish SIADH from primary polydipsia?
• How is primary hypothyroidism typically diagnosed and what are common symptoms?
• In adrenal crisis, which electrolyte abnormalities are present?
• Subtotal thyroidectomy increases risk for which complication?
• A patient presents with fatigue, weight gain, cold intolerance; morning TSH is elevated with low free T4. What is the diagnosis?
• Very low thyroid function causes which condition?
• In SIADH, as urine volume decreases, urine specific gravity tends to
• Which statement best describes the thyroid function pattern seen in Graves’ disease?
• How do DKA and HHS typically differ in patient population, ketone status, and acid-base profile?
• What is the typical lab pattern in primary hypothyroidism and the standard initial therapy?
• Paresthesias, carpopedal spasm, and a positive Trousseau sign after thyroidectomy. What electrolyte disturbance is likely and how is it treated?
• Which ketone is predominant in diabetic ketoacidosis?
• SIADH is caused by:
• In SIADH, what is the expected urine osmolality?
• Cushings disease is caused by which of the following?
• A patient needs 120 ml over 60 minutes with a drop factor of 15 gtt/ml. What is the gtt/min?
• Which condition is typically associated with hyponatremia due to enhanced ADH activity?
• How is corrected sodium calculated in the setting of hyperglycemia, and what is the clinical significance?
• In a primary adrenal crisis, hydrocortisone helps by?
• How does secondary adrenal insufficiency differ from primary in terms of electrolyte abnormalities and management?
• Interpret this ABG: pH 7.25, PaCO2 28 mmHg, HCO3- 12 mEq/L. Primary disorder and compensation?
• Hypomagnesemia s/s pattern?
• A patient with persistent hypercalcemia presents with stones, bones, groans, and psychiatric overtones. What are first-line treatments?
• What does the abbreviation DF stand for in IV infusion contexts?
• Desmopressin testing helps differentiate central from nephrogenic diabetes insipidus based on what response?
• Specific gravity is a measure of how concentrated urine is.
• Hypercalcemia general sign pattern:
• Why should hypernatremia be corrected gradually in hospitalized patients?
• Why is post-thyroidectomy hypocalcemia common and how is it prevented or managed?
• Which physical finding is commonly associated with Cushing's syndrome?
• Which metabolic change is commonly seen in Cushing's syndrome?
• Which statement best describes the relationship between total and subtotal thyroidectomy regarding complications in the early postoperative period?
• In hypermagnesemia, what symptoms and ECG changes occur, and what is the reversal agent?
• Thyroidectomy can also cause which electrolyte abnormality?
• Which therapy is used for guideline-adherent management of acute adrenal crisis as an initial glucocorticoid replacement?
• Which formula best approximates serum osmolality?
• In hypokalemia, which two signs are increased?
• What is the Trousseau sign and what does it indicate?
• In primary hypothyroidism, which pattern of TSH and free T4 is typically observed?
• What explains hypocalcemia after thyroid surgery in terms of PTH and calcium/phosphate interaction?
• What is the key pathophysiologic difference between hyperosmolar hyperglycemic state (HHNS) and diabetic ketoacidosis (DKA)?
• A patient with low Mg (1.2 mg/dL) is at risk for refractory hypokalemia. What is the management?
• Which is a cause of hyponatremia?
• Which of the following is recommended when handling waste after radioactive iodine therapy?
• Which of the following statements best describes the cause of hypernatremia in hospitalized patients?
• Given Na 140 mEq/L, Cl 100 mEq/L, HCO3 18 mEq/L, what is the anion gap?
• Which of the following statements constitutes a positive initial screen for Cushing's syndrome?
• There is an ________ relationship between urine volume and urine specific gravity.
• Which statement about potassium administration is true?
• Which tests are essential to monitor when using thionamides like methimazole or propylthiouracil in thyroid storm management?
• During initial DKA management, which IV fluid is used first and why, and when do you switch to dextrose-containing fluids?
• Secondary adrenal insufficiency electrolyte pattern: which is preserved?
• Vomiting and diuretic use often cause what acid-base disorder, and what are typical electrolyte patterns?
• Graves’ disease commonly presents with what ocular finding and what is a key lab feature?
• How does insulin therapy affect potassium distribution, and what monitoring should accompany DKA treatment?
• In a patient with severe hypercalcemia (Ca >14 mg/dL) who is dehydrated and confused, what is the initial management, and what is a rapid reduction option?
• For Regular insulin used in meals, which description matches its onset, peak, and duration?
• If you infuse 200 ml over 120 minutes with a drop factor of 20 gtt/ml, what is the gtt/min?
• A patient presents with confusion and seizures and a serum sodium of 118 mEq/L after excessive fluid intake. What is the electrolyte disorder and the safest initial treatment approach?
• Thyroid storm can occur when you are ______thyroid.
• Hypokalemia increases the risk of digoxin toxicity. True or false?
• In a patient with hyponatremia and low serum osmolality with inappropriately concentrated urine, which syndrome is most likely and what is the initial management?
• Why is magnesium status important in hypoparathyroidism and what is the clinical consequence of hypomagnesemia on PTH?
• Hypocalcemia s/s typically present as:
• Diabetes insipidus is caused by a lack of which hormone?
• What is the standard expression for calculating drops per minute (gtt/min) given dose in milliliters, time in minutes, and drop factor (DF)?
• Which extrathyroidal manifestation is commonly associated with Graves' disease?
• What is the normal range for serum sodium (Na+)?
• In hypokalemia, which electrolyte should be corrected if it is low?
• Which electrolyte disturbance is a concern when starting insulin in DKA even if the initial potassium is normal?
• Dehydration and diabetes insipidus cause which change in urine specific gravity?
• What is the potential consequence of correcting hyponatremia too quickly?
• What are the characteristic symptoms of hyperthyroidism and its immediate symptomatic treatment?
• What is the maximum potassium dose per IV administration?
• Kayexelate can cause which electrolyte imbalance?
• Which of the following is a hallmark sign of Addison's disease?
• If urine spills occur after radioactive iodine therapy, who should clean it?
• After thyroidectomy, a patient develops tingling, muscle cramps, and facial twitching; which lab abnormality is likely and what is the urgent treatment?
• After IV insulin and dextrose for hyperkalemia therapy, which laboratory value should improve first?
• Calcitonin in hypercalcemia is used primarily for which reason?
• When evaluating natremia, which clinical parameter should be checked?
• What are common etiologies of hypernatremia in hospitalized patients and the primary management principle?
• In a patient with hypercalcemia and risk of soft-tissue calcifications with immobilization, what is the key management principle?
• Which condition is associated with high urine specific gravity due to concentrated urine?
• In hypokalemia, which pattern is typical?
• For long-term control of hypercalcemia in immobilization, which medication is commonly considered?
• During the first 12 hours after thyroid surgery, what is the primary airway management priority?
• In primary hyperparathyroidism, what electrolyte pattern is typical and what is a reasonable initial management approach?
• If electrolyte-related symptoms involve nerves or skeletal muscle, which electrolyte is most likely affected?
• In thyroid storm management, which drug is used to rapidly reduce peripheral conversion of T4 to T3?
• What is the classic ECG finding in hypokalemia and the initial treatment approach?
• Why is hydrocortisone given in myxedema coma?
• A patient on total parenteral nutrition develops confusion and respiratory distress with low phosphate. What is the likely disorder and how to treat?
• What is the initial treatment sequence for thyroid storm?
• The anion gap is calculated using which electrolytes?
• In diabetic ketoacidosis, the metabolic pattern typically includes:
• Fluid overload and SIADH cause which change in urine specific gravity?
• Fluid overload commonly leads to which electrolyte abnormality?
• Which action is performed by parathyroid hormone in the kidney?
• For HHS management, what is the main fluid strategy and what is a key difference from DKA regarding insulin use?
• Which condition would typically show a concentrated urine (high specific gravity)?
• Calcitriol is used in hypoparathyroidism to enhance intestinal calcium absorption because PTH-driven activation of vitamin D is reduced.
• In an Addisonian crisis, what is the typical initial intravenous hydrocortisone dose?
• In SIADH, which therapies may be used in select cases?
• Between 1 hour and 48 hours after thyroid surgery, which complication is expected with subtotal thyroidectomy?
• In diabetic ketoacidosis management, when should you switch from normal saline to dextrose-containing fluids?
• In a patient with hypoglycemia and an unconscious state, what is the immediate treatment?
• Normal magnesium range?
• Loss of parathyroid function after thyroidectomy most commonly causes which electrolyte disturbance?
• Which electrolyte abnormality increases the risk of digoxin toxicity?
• Which patient population is most commonly affected by hyperosmolar hyperglycemic state (HHNS)?
• A patient with chronic kidney disease has hyperphosphatemia and low calcium. What is the typical management?
• In a patient with hyponatremia who has low serum osmolality, high urine osmolality, and high urine sodium, what is the first-line fluid management and the safe correction rate?
• Which symptom best reflects hypothyroidism?
• What is a treatment option for Cushings disease?
• In diabetic ketoacidosis, what is the initial fluid of choice and why?
• Why must rapid correction of hyponatremia be avoided?
• In nephrogenic diabetes insipidus, what is the typical mechanism and one key treatment option?
• What is the role of PTH in calcium homeostasis and which organs are involved in its actions?
• What is the recommended sequence of therapies in thyroid storm management after recognizing a storm?
• If symptoms are not related to nerves or skeletal muscle, which electrolyte is most often implicated?
• When is bicarbonate therapy indicated in metabolic acidosis such as DKA?
• In type 1 diabetes, what effect does insulin have on potassium distribution?
• What are classic signs of acute hypocalcemia and what is the initial ED treatment?
• In CKD with hyperphosphatemia, what therapy reduces phosphate absorption from the gut?
• A patient with dehydration develops hypernatremia with serum Na 155 mEq/L. What is the recommended correction strategy to avoid cerebral edema?
• Which of the following are classic signs of a thyroid storm?
• What is the Chvostek sign and what does it indicate?
• Hydrocortisone is used in adrenal crisis primarily because it provides both glucocorticoid and mineralocorticoid activity to correct cortisol deficiency and support electrolyte balance.
• Calcitriol is used in hypoparathyroidism to enhance intestinal calcium absorption because PTH-driven activation of vitamin D is reduced.
• Thiazide diuretics in nephrogenic diabetes insipidus are used primarily because:
• Which mechanism explains how insulin lowers potassium during hyperkalemia treatment?
• In diabetic ketoacidosis, what is the typical anion gap and major anions contributing to it?
• PTU (propylthiouracil) primarily does what to the thyroid?
• A patient presents with peaked T waves, wide QRS, and a potassium level of 6.2 mEq/L. What is the first-line emergency management?
• In a conscious patient with suspected hypoglycemia, what is the recommended first-line treatment and the steps if symptoms persist?
• Hypermagnesemia s/s pattern?
• Which antithyroid drug is most commonly associated with agranulocytosis and requires CBC monitoring?
• What is the maximum IV potassium infusion rate per hour?
• In suspected SIADH vs DI, which pattern would distinguish each condition?
• A patient presents with myxedema coma. What is the appropriate management?
• Between 1 hour and 48 hours after thyroid surgery, which complication is expected with total thyroidectomy?
• When initiating insulin in DKA, what potassium threshold must be met and why?
• In central diabetes insipidus, what labs characterize the condition and how does desmopressin testing help?
• Monitoring during potassium replacement.
• In thyroid storm management, why is iodine given after a thionamide?
• SIADH s/s describe which combination among the following?
• Which statement best describes the relationship between SIADH and fluid balance as described in the material?
• Which corticosteroid is commonly used as part of thyroid storm management?
• In an Addisonian crisis, which corticosteroid is typically given first?
• In CKD with hyperphosphatemia and low calcium, what is typical management?
• A patient presents with slowly rising PaCO2 and decreased responsiveness. What acid-base disturbance is this?
• Hypocalcemia general sign pattern:
• What are the four key phases of DKA management and the main electrolyte/metabolic targets?
• In an Addisonian crisis, which action is most appropriate to help increase blood pressure?
• What are the hallmark features of an adrenal crisis and the initial treatment steps?