1. Which pathologic condition would most likely cause increased thyroid radioact
ID: 267945 • Letter: 1
Question
1. Which pathologic condition would most likely cause increased thyroid radioactive iodine uptake? a. primary hypothyroidism b. secondary hypothyroidism c. Grave’s disease d. Hashimoto thyroiditis
2. T4 rather than T3 is generally thought to be the most appropriate treatment for hypothyroidism. T4 normally is the most appropriate hormone to use because it: a. is the more potent hormone b. has a higher binding affinity for the thyroid hormone receptor c. has a larger extrathyroid pool with a slower turnover rate. d. is the only form of thyroid hormones that can be transported into cells e. all of the above.
3. Mr. Z. is a 27-year-old man with readily apparent thyroid goiter. He comments that he gained 5 pounds in the last year, and you notice that his weight is approximately 20 pounds greater than normal. What can you conclude about this patient’s thyroid function? a. the goiter indicates that he is hyperthyroid b. the combination of excessive weight and goiter indicates that he is hypothyroid c. the combination of excessive weight and goiter indicates that he is hyperthyroid d. he is probably euthyroid, because the weight gain eliminates the possibility of hyperthyroidism e. it is not possible to make a conclusion from this information provided.
4. For an answer to be correct, both the symptom and the explanation must be correct. Which answer is incorrect? a. the resting heart rate increases because circulating levels of catecholamines increase. Excess thyroid hormones stimulate the release of more adrenal catecholamines. b. myocardial contractility increases because thyroid hormones act directly on the heart and act indirectly by potentiating the effect of catecholamines on the myocardium. c. peripheral resistance decreases because of cutaneous vasodilation as a thermoregulatory response. d. the circulating half-lives of most exogenously administered drugs decrease because the rate of metabolism increases and drug inactivation is more rapid.
5. Ms. M. is a 59-year-old postmenopausal woman. The serum T4 is 8 microg/dl (n. 6 – 12); TSH is 4 microg/dl (n. 2 – 10). Body weight – 190 pounds, and she complains of depression. Her physician prescribes a low dosage of T4 to “pep her up”. What changes would you expect to see 4 weeks after the initiation of treatment? a. the size of thyroid will be reduced b. serum TSH will decrease c. serum T4 will decrease d. the basal metabolism rate will be elevated.
6. Biologic actions of thyroid hormones include all of the following except: a. stimulate protein synthesis and proteolysis b. increase Na-K- ATP-ase activity c. increase oxidative phosphorylation d. stimulate growth and vascularity of the thyroid gland. e. stimulate glycogenesis
7. Which pair of symptoms and causes is most appropriate for hypothyroidism? a. the skin is warm and moist because of peripheral vasodilation b. diarrhea occurs because of increased GI secretion and motility c. puberty is delayed or absent because TSH crossreacts LH and FSH receptors d. myxedema occurs because mucopolysaccarides accumulate in the extracellular spaces. e. there is a tendency to gain weight because appetite increases.
8. If you withdraw insulin from insulin-dependent diabetic patient, you would expect to see all of the following except: a. a decrease in urinary bicarbonate levels b. an increase in renal ammonium production c. an increase release of alanine and glutamate from skeletal muscle d. a decrease in BUN (blood urea nitrogen) e. a decrease in PaCO2
9. Correct cause-and-effect relationships following insulin withdrawal in a person with diabetes mellitus include: a. the ratio of K+ concentration inside the cell to K+ concentration outside the cell decreases in untreated diabetes for multiple reasons, including intracellular H+ buffering, which results in a shift of K+ to the extracellular compartment. b. ketonemia does not increase urine flow because it is entirely reabsorbed in the renal tubule c. urinary phosphate decreases because renal excretion of H+ results in increased phosphate reabsorption. d. serum sodium rises because of fluid shift from the extracellular compartment to intracellular compartment. e. glomerular filtration rate increases as a result of increased serum glucose concentration.
10. The most effective direct stimulus for the release of glucagon is: a. an increase in serum glucose b. an decrease in serum glucose c. somatostatin d. insulin (direct action on the alpha cells).
Explanation / Answer
Please find the answers below:
Answer 1: Choice d (Hashimoto's thyroiditis is an autoimmune disease in which the TSH secretion and hence T3/T4 generation are very high. Resultantly, iodine uptake too is very high)
Answer 2: Choice e (loss of iodine form T4 generates T3 but T4 represents the major concentration of thyroxine in the body)
Answer 3: Choice b (hypothyroidism is associated with weight loss due to lowered metabolic rate in the body, hence appearance of goitre physically)
Answer 4: Choice d (in the medical cases of hyperthyroidism, the basal metabolic rate increases much higher than normal causing rapid elimination of the exogenous drugs/metabolites from the circulation)
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