Elsevier: Goodman & Snyder: Differential Diagnosis for Physical Therapists Screening for Referral|| Chapter 11 (Answer Key)

1. What are the most common musculoskeletal symptoms associated with endocrine disorders?

Proximal muscle weakness, myalgia, carpal tunnel syndrome, periarthritis, adhesive capsulitis (shoulder) (see Table 11-1)

2. What systemic conditions can cause carpal tunnel syndrome?

Endocrine disorders, infectious diseases, collagen disorders, cancer, liver disease (see Table 11-2).

3. What are the mechanisms by which carpal tunnel syndrome
occurs?

Depends on the underlying disease process. For example, thickening of the transverse carpal ligament is associated with acromegaly and myxedema. Increased volume of the contents of the carpal tunnel occurs with pregnancy, neoplasm, gouty tophi deposits, and lipids in diabetes mellitus. Hormonal changes (e.g., menopause, pregnancy) can also result in carpal tunnel syndrome (CTS). See also liver-related causes in Chapter 9).

4. Disorders of the endocrine glands can be caused by:

a. Dysfunction of the gland
b. External stimulus
c. Excess or insuffciency of hormonal secretions
d. a and b
e. b and c
f. All the above

5. List three of the most common symptoms of diabetes mellitus.
Polydipsia, polyuria, polyphagia

6. What is the primary difference between the two hyperglycemic states: diabetic ketoacidosis (DKA) and hyperglycemic, hyperosmolar, nonketotic coma (HHNC)?

The major differentiating factor between diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) is the absence of ketosis in HHS.

7. Is it safe to administer a source of sugar to a lethargic or unconscious person with diabetes?

Yes. If their glucose levels are high, you will not endanger them any further with a small amount of sugar, and you may help someone who is experiencing hypoglycemia associated with diabetes mellitus

8. Clients with diabetes insipidus (DI) would most likely come to the therapist with which of the following clinical symptoms?

a. Severe dehydration, polydipsia
b. Headache, confusion, lethargy
c. Weight gain
d. Decreased urine output

 9. Clients who are taking corticosteroid medications should be monitored for the onset of Cushing’s syndrome. You will need to monitor your client for which of the following problems?

a. Low blood pressure, hypoglycemia
b. Decreased bone density, muscle wasting
c. Slow wound healing
d. b and c

10. Signs and symptoms of Cushing’s syndrome in an adult taking oral steroids may include:

a. Increased thirst, decreased urination, and decreased appetite
b. Low white blood cell count and reduced platelet count
c. High blood pressure, tachycardia, and palpitations
d. Hypertension, slow wound healing, easy bruising

11. Parathyroid hormone (PTH) secretion is particularly important in the metabolism of bone. The client with an oversecreting parathyroid gland would most likely have:

a. Increased blood pressure
b. Pathologic fractures
c. Decreased blood pressure
d. Increased thirst and urination

12. Which glycosylated hemoglobin (A1C) value is within the recommended range?

a. 6%
b. 8%
c. 10%
d. 12%

13. A 38-year-old man comes to the clinic for low back pain. He has a new diagnosis of Graves’ disease. When asked if there are any other symptoms of any kind, he replies “increased appetite
and excessive sweating.” When you perform a neurologic screening examination, what might be present that would be associated with the Graves’ disease?

a. Hyporeflexia but no change in strength
b. Hyporeflexia with decreased muscle strength
c. Hyperreflexia with no change in strength
d. Hyperreflexia with decreased muscle strength

14. All of the following are common signs or symptoms of insulin resistance except:

a. Acanthosis nigricans
b. Drowsiness after meals
c. Fatigue
d. Oliguria

ANSWER KEY