Deck 68: Thyroid Disorders

Question 1

You are concerned that a person presenting with fatigue, altered menses, and weight changes may have a thyroid disorder. To rule in/rule out thyroid dysfunction, the initial diagnostic test(s) that you should order is/are:

A) Free T₄ and serum antithyroid antibodies
B) Thyroid ultrasound
C) Highly sensitive thyroid-stimulating hormone (TSH)
D) Free T₃ and thyroid scintigraphy

Answer 1

C

Question 2

Diagnostic study results that confirm a diagnosis of primary hypothyroidism are:

A) Increased highly sensitive TSH and decreased free T₄
B) Decreased highly sensitive TSH and decreased Free T₄
C) Abnormal thyroid ultrasound and elevated antithyroid antibodies
D) Normal thyroid ultrasound and increased free T₃

Answer 2

A

Question 3

You are caring for a pregnant woman who has Graves' disease. Her signs and symptoms are relatively mild. She shows no evidence of cardiovascular compromise. The most appropriate medication for treating this condition is:

A) Iodide
B) Levothyroxine
C) Methimazole
D) Propylthiouracil

Answer 3

D

Question 4

A person with subclinical hypothyroidism will usually have:

A) Mild symptoms of thyroid dysfunction and mildly decreased levels of free T₄
B) No symptoms of thyroid dysfunction and an elevated TSH level
C) Mild symptoms of thyroid dysfunction and normal thyroid function tests
D) None of the above

Question 5

Which of the following symptoms and signs are consistent with a person with primary hypothyroidism?

A) Palpitations and fine tremor
B) Constipation and exophthalmos
C) Dysthymia and weight gain
D) Nervousness and hyperactive bowel sounds

Question 6

There are several risk factors associated with thyroid cancer. Which one of the factors is not specifically associated with thyroid cancer?

A) Head or neck irradiation
B) A nonnodule
C) Recent growth of single nodule
D) Ingestion of dietary goitrogens

Question 7

Ms. W is a 35-year-old female with a diagnosis of toxic multinodular goiter. She has decided to proceed with a course of methimazole. The best test for assessing an adequate response to this treatment would be:

A) A free T₄
B) A highly sensitive TSH
C) TSH receptor antibodies
D) A radioactive iodine uptake scan

Question 8

Which of the following statements about thyroid nodules is false?

A) Most thyroid nodules are benign.
B) A predominant nodule in a multinodular gland should be biopsied.
C) Thyroid nodules are more common in women than men.
D) A multinodular thyroid gland is often associated with a malignant process.

Question 9

Mr. H. is 70-year-old person who has been started on levothyroxine for the treatment of hypothyroidism following radioactive treatment for a toxic uninodular goiter. Mr. H should be told that:

A) Hypothyroidism is a chronic condition and will require lifetime use of levothyroxine.
B) His thyroid gland will return to normal in a few years at which time he can stop the levothyroxine.
C) He should avoid taking iodine-rich food while taking levothyroxine.
D) He should take potassium iodide while his body is acclimating to levothyroxine.

Question 10

A medication that should be immediately ordered to blunt symptoms of hyperthyroidism is:

A) Radioactive iodine (¹²³I)
B) Propylthiouracil
C) Propanolol
D) Amiodarone