MEDICINE: PRACTICE 14

SINGLE BEST OPTION SERIES

         INSTRUCTION: SELECT THE SINGLE BEST OPTION
 

1.        Concerning the thyroid gland and its hormones, which of the following is incorrect?
   a.       Dietary intake of iodide greater than 100 μg per day is required to maintain thyroid function
   b.      The reference range for free thyroxine (T4) may range from 9 to 21 picomole per litre
   c.       Thyroid stimulating hormone (TSH) is the least useful investigation of thyroid function
   d.      During  pregnancy, the level of thyroxine-binding globulin (TBG) is increased
   e.      Free triiodothyronine (T3) and thyroxine (T4) measurement is more advantageous when compared to total T3 and T4 measurements in assessing thyroid function
   2.       The transporters of thyroid hormones in the bloodstream include the following except:
   a.       Albumin
   b.      Transthyretin
   c.       Prealbumin
   d.      Thyroxine-binding globulin
   e.      None of the above
   3.       Concerning the causes of thyrotoxicosis, the following features are specific to Graves’ disease except:
   a.       Thyroid acropathy
   b.      Exophthalmos and periorbital oedema
   c.       Lid retraction and lid lag
   d.      Diplopia and conjunctival oedema
   e.      Pretibial myxoedema
   4.       In patients with thyrotoxicosis , the most important autoantibodies to assay for is:
   a.       Anti-thyroid stimulating hormone receptor antibodies
   b.      Anti-thyroglobulin antibodies
   c.       Anti-thyroid peroxidase antibodies
   d.      Lupus anti-coagulants
   e.      None of the above
   5.       Concerning factitious thyrotoxicosis, which of the following is incorrect?
   a.       It is usually induced by excessive consumption of L-thyroxine
   b.      Thyroxine to triiodothyronine ratio is typically 30 to 1
   c.       There is negligible iodide uptake on radio-isotope scan
   d.      It is characterized by low or undetectable thyroglobulin
   e.      Circulating triiodothyronine is exclusively from monodeiodination of thyroxine
   6.       Which of the following is incorrect about thyroxine-binding globulin (TBG)?
   a.       It carries the majority of thyroxine in the blood stream
   b.      It is synthesized primarily in the liver
   c.       The levels are high when oestrogen level is low in the blood
   d.      Corticosteroid therapy usually lower the level of TBG
   e.      TBG test becomes useful when patients have low or elevated total thyroid hormones in the absence of symptoms
   7.       The most common precipitant of thyroid storm is:
   a.        Subtotal thyroidectomy in an ill-prepared patient
   b.      Infection in an unrecognized or inadequately treated patients with thyrotoxicosis
   c.       Acute irradiation damage from ¹³¹I therapy
   d.      Hyperosmolar hyperglycaemic state
   e.      Addisonian crisis
   8.       Useful drugs in the management of thyrotoxic crisis include the following except:
   a.       Dexamethasone or sodium ipodate
   b.      Carbimazole
   c.       Propanolol and amiodarone
   d.      Ceftriaxone
   e.      None of the above
   9.       Unusual presentation of thyrotoxicosis include:
   a.       Goitre with a bruit
   b.      Diastolic hypertension
   c.       Palmar erythema
   d.      Psychosis
   e.      Fine tremors
   10.   Features common to both thyrotoxicosis and hypothyroidism does not include:
   a.       Carpal tunnel syndrome
   b.      Alopecia
   c.       Hypertension
   d.      Psychosis
   e.      Infertility and impotence 
   
   
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