Block 13 Thyroid Disorders And Drugs MCQ's

20 Questions | By Chachelly | Last updated: Mar 21, 2022 | Total Attempts: 2951

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Block 13 Thyroid Disorders And Drugs MCQ

The thyroid is charged with producing, storing and releasing hormones into the blood stream. If this function is not carried out as planned it may result in a number of disorders. Review what you learnt on Block 13 on thyroid disorders and drugs by taking this quiz. All the best!

Questions and Answers

1.

A 60-year-old woman presents with complaints of feeling nervous, moody, weak, and tired. On exam, she has hand tremors and a rapid heartbeat. Pulse 120/min. BP 110/78. She has been taking levothyroxine for hypothyroidism, and you suspect that she is taking more tablets than you prescribed. Which of the following sets of laboratory results is most consistent with her clinical presentation? A B C D E TSH Elevated Normal Elevated Normal Decreased T4 Elevated Elevated Decreased Decreased Elevated T3 Elevated Decreased Decreased Decreased Elevated
- A.
  
  A
- B.
  
  B
- C.
  
  C
- D.
  
  D
- E.
  
  E
2.

A 50 year old man presents with a thyroid neoplasm. Detailed history elicits that his aunt had died from a “thyroid illness”. His family and first order blood relatives are examined. His sister and a nephew also are found to have small thyroid tumors. His son is found to have a pheochromocytoma. Which of the following gene mutations are most likely to be associated with this condition?
- A.
  
  PTTG
- B.
  
  Cyclin D
- C.
  
  Ret
- D.
  
  MEN 1
- E.
  
  TBG
3.

A 34 year old man reports to your office complaining of weight loss and sweating. Among other findings you note the following, while examining his extraocular movements: What do we call this finding?
- A.
  
  Proptosis
- B.
  
  Ophthalmoplegia
- C.
  
  Lid lag
- D.
  
  Trochlear nerve palsy
- E.
  
  Levator palpebrae dysfunction
4.

A 44-year-old African American man presents to his family physician with a neck lump he noticed while shaving this morning. Physical examination reveals a 1 cm well-defined firm nodule in the right thyroid lobe. The mass is resected and sent for histopathologic examination. The microscopic appearance of the lesion is shown for your evaluation below. Elevation of which of the following serum markers can you expect in this patient?
- A.
  
  Thyroid stimulating hormone
- B.
  
  Calcitonin
- C.
  
  Thyroglobulin
- D.
  
  Carcinoembryonic antigen
5.

A 43-year-old Caucasian man presents to his family physician with a neck lump he noticed while shaving this morning. Physical examination reveals a 0.5 cm ill-defined firm nodule in the left thyroid lobe. Laboratory investigations reveal an elevated serum level of carcinoembryonic antigen, serotonin, parathormone, and calcitonin. 99mTechnetium thyroid scan and fine needle aspiration biopsy of the nodule is performed and the patient undergoes thyroidectomy. The thyroid scan and histology of the lesion are presented for your evaluation. Which of the following clinical syndromes is most likely to be found in this patient?
- A.
  
  Acromegaly
- B.
  
  Diabetes insipidus
- C.
  
  Severe hypertension
- D.
  
  Myxedema
6.

Individuals with hypothyroidism would mostly likely have which one of the following conditions?
- A.
  
  Growth retardation if occurs during the perinatal period
- B.
  
  Increased cardiac output
- C.
  
  Weight loss
- D.
  
  Excessive production of TSH if the defect is in the hypothalamus
- E.
  
  Less than normal levels of cholesterol in the circulation
7.

Iodine deficiency used to be a common cause of thyroid enlargement (goiter) in some parts of the world. Which abnormality in chronically iodine-deficient patients is most directly related to the enlargement of the thyroid gland?
- A.
  
  Reduced activity of thyroperoxidase
- B.
  
  Impaired conversion of T4 to T3
- C.
  
  Reduced level of cAMP in the thyroid follicular cells
- D.
  
  An antibody that binds to the TSH receptor in the thyroid gland
- E.
  
  Elevated TSH level
8.

Which of the following effects may be caused high plasma levels of thyroid hormones? (Check all that apply)
- A.
  
  Decreased cardiac output
- B.
  
  Increased gluconeogenesis
- C.
  
  Decreased plasma levels of triglycerides
- D.
  
  Decreased plasma levels of free fatty acids
- E.
  
  Increased pulse pressure
- F.
  
  Decreased intestinal peristalsis
9.

Which of the following effects may be caused by insufficient plasma levels of thyroid hormones? (Check all that apply)
- A.
  
  Oligospermia
- B.
  
  Decreased respiratory rate
- C.
  
  Decreased plasma triglycerides
- D.
  
  Decreased peripheral vascular resistance
- E.
  
  Osteoporosis
- F.
  
  Periorbital edema
- G.
  
  Diarrhea
10.

A 42-year-old man was undergoing surgery in order to remove a very large nontoxic goiter, apparently due to iodide deficiency. A short course of potassium iodide was administered before surgery. Which of the following statements best explains why this drug was given to the patient?
- A.
  
  To stimulate thyroid hormone synthesis before surgery
- B.
  
  To overcome iodine deficiency after surgery
- C.
  
  To reduce the size and vascularity of the thyroid gland
- D.
  
  To decrease the risk of hypothyroidism after surgery
- E.
  
  To inhibit the excessive secretion of TSH from the pituitary
11.

A 55-year-old woman with thyrotoxicosis was treated with radioactive iodine. One month later she most likely started a therapy with which of the following drugs?
- A.
  
  Potassium iodide
- B.
  
  Levothyroxine
- C.
  
  Diiodotyrosine
- D.
  
  Monoiodotyrosine
- E.
  
  Reverse triiodothyronine
12.

A 59-year-old woman was admitted to the hospital with restlessness, insomnia, tremor and a pronounced exophthalmos. The woman, who had been suffering from hyperthyroidism for two months, had been treated with propylthiouracil but the drug was discontinued because of the appearance of agranulocytosis. Which of the following agents would be most appropriate for the patient at this time?
- A.
  
  Methimazole
- B.
  
  Radioactive iodine
- C.
  
  Potassium iodide
- D.
  
  Propranolol
- E.
  
  Prednisone
13.

A 55-year old woman recently diagnosed with hyperthyroidism started an appropriate treatment. One month later the following laboratory values were obtained: RBC 4.6 x 10 /mcl, WBC 0.9 x 10 /mcl, platelets 45 6 3 x 103/mcl. Which of the following drugs most likely causes these results?
- A.
  
  Radioactive iodine
- B.
  
  Potassium iodide
- C.
  
  Methimazole
- D.
  
  Propranolol
- E.
  
  L-thyroxine
14.

Few days after a normal delivery, a new born baby boy became lethargic, had respiratory difficulties, hoarse cry, and sucks poorly. Physical examination revealed large fontanelles, macroglossia, a distended abdomen, a cyanotic skin, hypotonia, slow reflexes and hypothermia. Which of the following drugs would be appropriate for this baby?
- A.
  
  Methimazole
- B.
  
  Somatrem
- C.
  
  Levothyroxine
- D.
  
  Theophylline
- E.
  
  Potassium iodide
- F.
  
  Prednisone
15.

A 35 year old woman, who was 2 months pregnant, was found to have FT4 of 3.3 ng/dL (normal 0.9-2) and TSH < 0.01 IU/mL (normal 0.5-4.7) during a follow up visit. Which of the following chronic drug treatment would be most appropriate for this patient?
- A.
  
  Radioactive iodine
- B.
  
  Propranolol
- C.
  
  Potassium iodide
- D.
  
  Ipodate
- E.
  
  Propylthiouracil
16.

A 75-year-old woman came to the clinic for her regular checkup. Her only complaints included very dry skin and constipation which she treats with milk of magnesia. She had no other medical problems and took no other medications. Routine laboratory tests are within normal limits except for a TSH of 15 mIU/mL (normal 0.5-5.5). Further lab exams indicated the presence of thyroid peroxidase antibodies. Which of the following drug would be appropriate for this patient?
- A.
  
  Potassium iodide
- B.
  
  Propranolol
- C.
  
  Methimazole
- D.
  
  Loperamide
- E.
  
  Levothyroxine
- F.
  
  Diltiazem
17.

A 60-year-old alcoholic woman was admitted to the emergency room because of unrelenting chest pain not relieved by nitroglycerin. Her medical problems included alcoholic cardiomyopathy and hypothyroidism. Although she had been advised repeatedly to take her thyroxine regularly she continued to take it sporadically. An IM injection of 10 mg of morphine sulphate was given for the pain. After the injection the nurse noticed mental depression, lethargy, shallow breathing and her temperature was 80E F. Which of the following drugs should be included in the emergency therapy of this patient?
- A.
  
  IV potassium iodide
- B.
  
  Oral methimazole
- C.
  
  Oral levothyroxine
- D.
  
  IV triiodothyronine
- E.
  
  Oral propylthiouracil
18.

A 41-year-old man complained to his physician of increased appetite, palpitation and diarrhea. Lab results confirmed the diagnosis of mild hyperthyroidism and a treatment with methimazole was started. Which of the following actions most likely mediated the therapeutic effectiveness of the drug in this patient?
- A.
  
  Inhibition of iodine absorption from the gut
- B.
  
  Stimulation of thyroid peroxidase
- C.
  
  Blockade of iodine uptake by the thyroid gland
- D.
  
  Damage of DNA of thyroid cells
- E.
  
  Inhibition of tyrosine iodination
19.

A 47-year-old woman complained to her physician of painless enlargement of thyroid gland and fullness in her throat. Lab results revealed high titers of thyroid peroxidase antibodies. A diagnosis of Hashimoto’s thyroiditis was made and an appropriate treatment was started. Which of the following drugs was most likely prescribed?
- A.
  
  Propranolol
- B.
  
  Potassium iodide
- C.
  
  Levothyroxine
- D.
  
  Methimazole
- E.
  
  Radioactive iodine
20.

Which of the following drugs can block most effectively the conversion of T4 to T3 by the liver?
- A.
  
  Levothyroxine
- B.
  
  Diiodotyrosine
- C.
  
  Methimazole
- D.
  
  Propylthiouracil
- E.
  
  TSH