Endocrine: other Flashcards
Which of the following is not a common physical sign of hypothyroidism?
A. Ascites
B. Bradycardia
C. Slowed speech and movements
D Lethargy
a. ascities
Myxedema coma is a severe form of hypothyroidism that most commonly occurs in which of the following?
A. Male patients with hypothyroidism and excessive weight gain
B. Female patients with galactorrhea and menstrual disturbances secondary to hypothyroidism
C. Patients with hypothyroidism and decreased appetite, sleepiness, hair loss, and dry skin
D. Patients with untreated hypothyroidism who are subjected to an external stress
D
Which of the following is the initial treatment indicated for young-middle aged adults with hypothyroidism?
A. Levothyroxine at a dose of 1.6 mcg/kg/day
B. Levothyroxine at a dose of 4 µg per kilogram of lean body weight as an intravenous bolus, with 100 µg administered 24 hours later
C. Desiccated thyroid at a dose of 15-30 mg orally per day
D. Liothyronine at a dose of 25 µg orally per day
A
A 32-year-old woman presents to the clinic complaining of fatigue and weight gain for the past 2 months. She endorses cold intolerance, constipation, and dry skin but denies fever, diarrhea, swelling, chest pain, or shortness of breath. A physical examination demonstrates a lethargic, stocky patient with brittle hair. Her past medical history is significant for asthma that is well controlled with her rescue inhaler. Her laboratory studies demonstrate elevated levels of thyroid stimulating hormone and a decreased free T4. What is the diagnosis and initial treatment?
Primary Hypothyroidism
T4 replacement (levothyroxine) for most patients
A patient has an extremely high T3 and T4 level. Which of the following signs and symptoms DO NOT present with this condition?
A. Weight loss
B. Intolerance to heat
C. Smooth skin
D. Hair loss
D
The thyroid hormones, T3 and T4, play many roles in the human body. Which of the following functions are performed by T3 and T4? Select all that apply
A. Storing calories
B. Increasing the Heart Rate
C. Stimulating the Sympathetic Nervous System
D. Decreasing the body’s temperature
E. Regulating TSH produced by the anterior pituitary gland
B, C, E
A patient is admitted with complaints of palpations, excessive sweating, and unable to tolerate heat. In addition, the patient voices concern about how her appearance has changed over the past year. The patient presents with protruding eyeballs and pretibial myxedema on the legs and feet. Which of the following is the likely cause of the patient’s signs and symptoms?
A. Thyroiditis
B. Deficiency of iodine consumption
C. Grave’s Disease
D. Hypothyroidism
C
A 49 year old female begins to notice weakness . She also notices that she no longer eats her lunch outside, because as she cannot tolerate the heat. She complains of loose stools and weight loss. She has a nervous demeanor and a slight tremor. On physical examination her heart rate is 105 and her blood pressure is 120/80. She has a brisk return of her Achilles tendon reflex. Her skin is warm and moist. She has exophthalmos. her thyroid is palpable. TSH is low and Free T3 is elevated. What is the possible diagnosis and further exam?
Hyperthyroidism
Radioactive iodine uptake (RAIU)
Which of the following are treatment options for hyperthyroidism? Select all that apply.
A. Thyroidectomy
B. Thionamides
C. Liothyronine Sodium “Cytomel”
D. Radioactive Iodine
A, B, D
A patient was recently discharged home for treatment of hypothyroidism and was ordered to take Synthroid for treatment. The patient is re-admitted with signs and symptoms of the following: heart rate 42, blood pressure 70/56, blood glucose 55, and body temperature of 96.8 ‘F. The patient is very fatigued and drowsy. The family reports the patient has not been taking Synthroid since being discharged home from the hospital. Which of the following conditions is this patient most likely experiencing?
A. Thryoid Storm
B. Myxedema Coma
C. Iodism
D. Toxic Nodular Goiter
B
A 40-year-old man presents to his primary care physician for palpitations. He had previously presented to the emergency room for similar reasons, when his EKG was found to be tachycardic but otherwise regular rhythm. He was sent home after intravenous hydration at that time. He reports that ever since an upper respiratory infection a few months ago, he has lost weight, felt fatigued, and experienced intermittent palpitations. He has no significant medical history. He also reports having increasing jaw and anterior neck pain. On physical exam, his thyroid is very tender to palpation. No goiter was palpated. His T3 and T4 levels come back elevated, and his physician prescribes him 2 medications for this disease with reassurance that symptoms usually resolve over time.
What type of thyroiditis does this patient have?
What are the 2 medications?
Subacute
Aspirin, Beta blocker
Which of the following side effects are possible for a patient taking an anti-thyroid medication?
A. Agranulocytosis
B. Tachycardia
C. Skin discoloration
D. Joint pain and eczema
A
A patient is admitted with thyroid storm. Which sign and symptoms are NOT present with this condition? Select all that apply.
A. Temperature of 104.9’F
B. Heart rate of 125 bpm
C. Respirations of 42
D. Heart rate of 20 bpm
E. Intolerance to cold
F. Restless
D, E
A patient hospitalized with hypoparathyroidism is about to order lunch. Which food selection is best for this patient based on their dietary needs at this time?
A. Baked chicken, green beans, and boiled potatoes
B. Broccoli salad, cottage cheese, and peaches
C. Roast beef, carrots, and pinto beans
D. Hamburger, fries, and sorbet
B
Which of the following is most likely to cause a syndrome resembling anorexia nervosa in patients with hypopituitarism?
A. Growth hormone (GH) deficiency
B. Hypothalamic lesions
C. Pituitary apoplexy
D. Vasopressin deficiency
B
