Quiz 4 Flashcards
Which of the following is not a typical symptom of hypothyroidism? Select one: a. Weight gain b. Bradycardia c. Cold intolerance d. Hair loss e. Diarrhea
Diarrhea
Graves disease is associated primarily with elevated plasma levels of:
Select one:
a. Anti-TSH (thyroid-stimulating) antibodies
b. Anti-deiodinase antibodies
c. Anti-TPO antibodies
d. Anti-thyroglobulin antibodies
e. None of the above
Anti-TSH (thyroid-stimulating) antibodies
A 45-year-old woman presents to her doctor with feelings of fatigue, increased appetite, increased sweating, and palpitations. Her doctor also notes that her eyes appear unusual: her lids appear retracted and it appears the eyeball is protruding further than is normal. She receives pharmacologic treatment for her condition, but soon develops a fever and multiple infections in her throat and gastrointestinal tract. Her doctor quickly discontinues the medication. Which medication was she most likely prescribed? Select one: a. Propylthiouracil (PTU) b. Levothyroxine c. Folic acid d. Radioactive iodine e. Propranolol
Propylthiouracil (PTU)
All of the following would be typically associated with cretinism, except: Select one: a. Delayed puberty b. Atrial fibrillation c. Myxedema d. Short stature e. Delayed mental development
Atrial fibrillation
A 25-year-old woman who was recently diagnosed with hypothyroidism comes to the clinic for a follow-up examination. In addition to levothyroxine, she has been taking a number of daily supplements to help accelerate her recovery. Although she initially reported an improvement in her symptoms, the patient now complains of constipation, brittle hair, and fatigue. Which one of the following supplements best accounts for the decline in the patient's clinical course? Select one: a. Vitamin C b. Zinc c. Vitamin E d. Magnesium e. Iodine
Iodine
A 34-year-old non-pregnant female presents to the clinic with a TSH of 0.3 mIU/L, a free T4 of 0.6 ng/L (normal range: 0.8-1.8 ng/L), and a free T3 of 2.5 (normal range: 2.3-4.2 pg/ml). Her TgAb and TPOAb levels are within normal limits. Without knowing her clinical history, these lab values would suggest she has: Select one: a. Primary hypothyroidism b. Central hypothyroidism c. Central hyperthyroidism d. Primary hyperthyroidism e. None of the above
Central hypothyroidism
Which statement is most true regarding malignant thyroid nodules?
Select one:
a. Are more likely to be “hot” nodules vs. “cold” nodules as detected by RAIU testing
b. Tend to be more likely to occur in young adult males than in older males
c. Are typically cystic vs. solid
d. Tend to be most common in older women with multi-nodular goiter
Tend to be more likely to occur in young adult males than in older males
Which statement is true regarding thyroid carcinoma?
Select one:
a. Papillary thyroid cancer tends to metastasize via lymph nodes instead of through the blood
b. Medullary carcinoma accounts for the majority of thyroid cancers
c. None of the above
d. All thyroid masses < 1 cm should be referred for fine needle aspiration biopsy (FNAB)
e. Anaplastic carcinoma of the thyroid has a 5-year survival rate > 80% following biomedical treatment
Papillary thyroid cancer tends to metastasize via lymph nodes instead of through the blood
All of the following would be indicated therapies for patients with thyrotoxicosis in Graves disease, except: Select one: a. Methimazole b. I-131 therapy c. Propranolol d. None of the above e. Liothyronine
Liothyronine
The most common cause of hypothyroidism in the USA is: Select one: a. None of the above b. Selenium deficiency c. Autoimmune thyroiditis d. Iodine deficiency e. Goiter
Autoimmune thyroiditis
If the following condition is present in a patient with hypothyroidism, appropriate treatment for this condition must be instituted before any thyroid hormone replacement is given, in order to prevent potentially lethal circulatory collapse:
Select one:
a. Addisons disease (adrenal insufficiency)
b. Acromegaly
c. Pituitary dwarfism
d. Hypoparathyroidism
e. Cushing’s disease
Addisons disease (adrenal insufficiency)
A 44-year-old female with a history of pernicious anemia presents to your office complaining of anxiety and occasional palpitations. She has unexplained weight loss of 10lbs and multiple daily bowel movements. She has not had a menstrual period in four months. She has a thyroid bruit and a 4x3 cm oval, non-tender soft-tissue mass lateral to the thyroid cartilage. Which of the following is the most likely etiology of the patient’s disease?
Select one:
a. Papillary thyroid cancer
b. Idiopathic replacement of thyroid tissue with fibrous tissue
c. Thyroid adenoma
d. Autoantibody stimulation of thyroid-stimulating hormone receptors
e. Viral infection leading to destruction of thyroid tissue
Thyroid adenoma
In Grave’s disease, TSH levels are elevated, free T3 & free T4 levels are increased, and TPOAb’s are elevated:
Select one:
True
False
False
According to the guidelines of the American Association of Clinical Endocrinologists (AACE) and the American Thyroid Association (ATA), which of the following would be the most appropriate lab(s) to order to screen for hypothyroidism?
Select one:
a. TSH + free T4 + free T3
b. TSH only
c. TSH + free T4 + free T3 + reverse T3 (rT3)
d. TSH + anti-TSH IgG
e. TSH + anti-thyroglobulin IgG + anti-TPO IgG
TSH only
In a patient with a 1.5 cm thyroid nodule with normal thyroid function tests, the next best step in assessment would be
Select one:
a. MRI of thyroid/neck
b. Radionuclide scan (RAIU test)
c. CT of thyroid/neck
d. Send for immediate surgical consult
e. Thyroid ultrasound with possible fine needle aspiration biopsy
Thyroid ultrasound with possible fine needle aspiration biopsy
