NMS Q&A Family Medicine

chapter 33Thyroid DiseasesExamination questions: Unless otherwise instructed, choosethe ONE lettered answer or completion that is BEST ineach case.1 Each of the following statements is true regardingmanagement of myxedema crisis except for whichone?(A) Hypothermic patients may be treated by warmintravenous (IV) fluids.(B) Levothyroxine 400 g given IV is often indicated.(C) IV glucocorticoid may be indicated.(D) Maintenance dosage of levothyroxine IV may beas low as 50 g.(E) Infections coexisting must be treated moreaggressively than in euthyroid patients.2 Which of the following starting dosages of levothyroxineis most appropriate for hypothyroid pregnantwomen?(A) 25 to 50 g daily(B) 50 to 100 g daily(C) 75 to 100 g daily(D) 100 to 150 g daily(E) 200 to 250 g daily3 A 35-year-old woman has developed digital clubbing,digital swelling, and a periosteal reaction in bones ofthe extremities, along with sinus tachycardia as wellas ophthalmopathy. Which of the following is thiscondition?(A) Chronic obstructive pulmonary disease(B) A variant of hepatic cirrhosis(C) Toxic multinodular goiter(D) Paget disease(E) Thyroid acropachy4 A 55-year-old Caucasian woman has been on maintenanceamiodarone to prevent recurrent atrial fibrillationfor 2 years, and bipolar disorder has also beenon a lithium preparation. She begins developingupper lid retraction (Dalrymple sign), lid lag withdownward gaze (Graefe sign), and a stare (Kochersign). Each of the following processes may be themechanism of thyrotoxicosis except for which one?(A) Toxic nodular goiter(B) Side effect of lithium(C) Graves disease(D) Factitious hyperthyroidism(E) Amiodarone side effect5 In screening for primary thyroid disease (hypothyroidismor hyperthyroidism), which of the followingserum tests is the most sensitive?(A) Free tetraiodothyronine (FT4 )(B) Triiodothyronine (T3 ) resin uptake(C) Total tetraiodothyronine (T4 )(D) Thyroid-stimulating hormone (thyrotropin, orTSH)(E) Antithyroglobulin antibodies6 A 25-year-old woman complains of fatigue and coldintolerance increasing over the past 3 months. Onexamination, she manifests a somewhat dry skin,which she says is a change from her usual. She admitsto being puzzled and saddened over the situation.Her apical heart rate is 68 in a regular rhythm. Bloodpressure is 110/68. The TSH level is 0.3 IU/mL (0.4to 4.8). She gives a further history of being on bromocriptinefor a microprolactinoma. Which of thefollowing is the likely cause of her condition?(A) Hashimoto thyroiditis(B) Panhypopituitarism(C) Secondary hypothyroidism(D) Primary hypothyroidism(E) Primary hyperthyroidism7 A 45-year-old white woman is undergoing a routineannual preventive health examination. After reviewingthe routine mammogram and before performingthe routine breast and pelvic examination, you proceedto a head-to-toe brief physical examination. Youdiscover a palpable thyroid nodule that seems to beabout 2.5 cm in diameter. Which of the followingblood tests would be the most logical, in addition tocertain routine medical profiles?203