Thyroid gland

By Mohamed Falih aldubooni

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Myxedema coma is a serious condition. Treatment of
myxedemacoma includes all the following EXCEPT
A.Thyroxine
B. IV fluids to maintain BP
C. Magnesium sulfate
D.Hydrocortisone
E.Assisted ventilation

PRESENTATION TITLE 2
Many treatments can be used for treating
Hyperthyroidism.Pharmacological treatment of
hyperthyroidism include
A.Thionamides
B. Lodides
C.Adrenergic blockers
D.Radioactive iodine
E. All can be used

PRESENTATION TITLE 3
For the treatment of hyperthyroidism during the first
trimesterof pregnancy. Which one of the following
medications can be usedduring first trimester of pregnancy
A. Propylthiouracil
B. Radioactive iodine
C. carbimazole
D. Both A and B
E. None of the above

PRESENTATION TITLE 4
Hypothyroid patients are evaluated every 4-8 weeks. The
mostsensitive and specific parameter for adjustment of L-
thyroxine dose is
A.Serum TSH
B.Serum total T3
C.Serum free T3
D. Serum total T4
E.Serum free T4

PRESENTATION TITLE 5
The followings are correct regarding the pathophysiology
ofhyperthyroidism EXCEPT:
A.Thyrotoxicosis occurs when autonomous follicles generate
morethyroid hormones than required.
B. Toxic adenoma is a thyroid mass whose function is
independentof pituitary control
C.Painless subacute granulomatous thyroiditis often develops
afterviral syndrome
D.Thyrotoxicosis factitia is hyperthyroidism by ingestion
ofexogenous thyroid hormone.
E. Amiodarone may induce thyrotoxicosis.

PRESENTATION TITLE 6
A 45-year-old woman has received a diagnosis of Graves'
disease.She is reluctant to try ablative therapy and wants to
attempt oralpharmacotherapy first. Her thyroid laboratory
values today includeTSH 0.25 mlU/L (normal 0.5-4.5 mlU/L)
and a free TA concentrationof 3.6 ng/dL (normal 0.8-1,9
ng/dL), She is anxious and always feelswarm when others
say it is too cold. Which would be considered thebest drug for
initial treatment of her condition
A. Lugol's solution.
B. Propylthiouracil (PTU).
C. Atenolol.
D. Methimazole.
E. Radioactive iodine
PRESENTATION TITLE 7
Regarding Graves’ disease. All of the following are true
except
A. It is a curable condition
B. Nervousness, anxiety, and palpitations are common
symptoms
C. Exophthalmos, pretibial myxedema, and thyroid
acropachy areextrathyroidal findings
D. it is characterized by high levels of T3, T4 and TSH
E. it is the most common cause hyperthyroidism

PRESENTATION TITLE 8
Regarding levothyroxine .All of the following are true Except
A. it is chemically stable, relatively inexpensive, active when
givenorally , and free of antigenicity.
B. it is a main source of thyroxine that is readily converted
totriiodothyronine.
C. it is the drug of choice for hypothyroid pregnant women.
D. Higher than normal dose is usually indicated for the
treatment ofthyroid storm.
E. Excessive doses may lead to heart failure, angina
pectoris andmyocardial infarction

PRESENTATION TITLE 9
lodide is very useful in various forms of thyrotoxicosis.
Despitethe multiple indications of iodide inthyrotoxicosis,
it is contraindicated in
A. Preparing patients for thyroidectomy
B. Graves disease
C. Painful thyroiditis
D. Toxic multinodular goiter
E. All of the above

PRESENTATION TITLE 10
A 25 years old non pregnant female was treated
successfullyfrom hyperthyroidism using methimazole .
Few months later, relapseoccurs. The preferred second
line pharmacologic treatment would be
A.Second course of methimazole
B.Use of radioactive iodine
C. switch to propyl thiouracil
D.Thyroidectomy
E.None of the above

PRESENTATION TITLE 11
Regarding hyperthyroidism, what is the type of
hyperthyroidismdue to ingestion of exogenous thyroid
hormone
A.Painful subacute thyroiditis
B. Painless thyroiditis
C. Thyrotoxicosis factitia
D. multinodular goiter
E. Graves’ disease

PRESENTATION TITLE 12
60-year-old female with a known history of
hypothyroidismpresents to the emergency
departmentStuporous state. She has a low body
temperature of 33.5°C,bradycardia, and respiratory
depression.laboratory tests confirm the diagnosis of
myxedema coma. What isthe appropriate initial
treatment forthis patient?
A.IV bolus levothyroxine
B.IV liothyronine
C. IV hydrocortisone
D. bolus levothyroxine and IV hydrocortisone
E. None of the above
PRESENTATION TITLE 13
Regarding thyroid storm, all the following are
characteristics ofthyroid storm Except
A. Tachycardia
B. Tachypnea
C. Dehydration
D. Constipation
E. Nausea and vomiting

PRESENTATION TITLE 14
Regarding thyroid gland disorders, all of the following
arepotential causes of hypothyroidism EXCEPT
A. Hashimoto's thyroiditis
B. Ketoconazole therapy
C. Radioactive lodine therapy
D. Pituitary failure
E. Over-treatment with thionamides

PRESENTATION TITLE 15
Related to the antithyroid pharmacotherapy. The only
conditionsfor which B-blockers are the primarytherapy
for thyrotoxicosis are those associated with
A. Thyroiditis
B. Graves' disease
C. Thyroid storm
D. Toxic nodules
E. Hashimoto's disease

PRESENTATION TITLE 16
R.P is 45 years old female with History of Hypertension
andArrhythmia and she is now maintained on Valsartan
and Amiodaronewith bisoprolol, she is now experiencing
new symptoms like coldintolerance,weight gain, fatigue
and hair loss. Her doctor told her that she mayhave
thyroid issue due to amiodarone.What is the most likely
effect of amiodarone on thyroid gland?
A.Hypothyroidism
B.Hyperthyroidism
C.TSH stimulation
D.TRH stimulation
E.TSH inhibition
PRESENTATION TITLE 17
All the following treatments for thyrotoxicosis are non-safe
inpregnancy Except
A. Methimazole
B. 5-flurouracil
C. Carbamazepine
D. carbimazol
E. Propyl-thiouracil

PRESENTATION TITLE 18
T.R is 32 years old patient with history of Hashimoto's
disease,she is maintained on thyroxin 75 mcgdaily, she
was presented to the emergency department
withhypothermia, reduced level of
consciousness,bradycardia andperiorbital puffiness.What
is the best management plan?
Propyl thiouracil IV followed by iodide and Corticosteroid
andother conservative measures
B.Thyroxin IV followed by hydrocortisone and other
conservativemeasures
C.High dose of oral Methimazole
D. Oral thyroxin
E. warm the patient and administer IV fluids and
corticosteroid PRESENTATION TITLE 19
Elderly female patient with a history oh graves' disease,
treatedwith radioactive lodine previously,presented with
symptoms of hear intolerance and weight loss.
Herlaboratory values show a reduction in TSH and an
abnormally high T4What is the best treatment
recommendation right now
A.Start methamazol
B.Start lugol solution
C.Start PTU
D.Start metaprlol
E.Start thyroxin
PRESENTATION TITLE 20
Regarding levothyroxine .All of the following are true
Except
A. it is chemically stable, relatively inexpensive, active
when givenorally , and free of antigenicity.
B. it is a main source of thyroxine that is readily
converted totriiodothyronine.
C. it is the drug of choice for hypothyroid pregnant
women.
D. Higher than normal dose is usually indicated for the
treatment ofthyroid storm.
E. Excessive doses may lead to heart failure, angina
pectoris andmyocardial infarction
PRESENTATION TITLE 21
Regarding Graves’ disease. All of the following are true
except
A.It is a curable condition
B.Nervousness, anxiety, and palpitations are common
symptoms
C. Exophthalmos, pretibial myxedema, and thyroid
acropachy areextrathyroidal findings
D. it is characterized by high levels of T3, T4 and TSH
E.None of the above

PRESENTATION TITLE 22
‫الحمد هلل ‪ ،‬الى هنا تم جمع جميع األسئلة الوزارية‬
‫لجابترالثايرود ‪..‬‬
‫نسألكم الدعاء…‬
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