Thyroid Disorders

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. The first sign of the developing thyroid can be seen:

a) At the end of the first trimester
b) Eight weeks after conception
c) When an ultrasound is done at five months gestation
d) In a seventeen day embryo

2. The ancient Greeks gave the thyroid its English name because it is "shield shaped."

a) True
b) False

3. When the entire gland is symmetrically enlarged it is called a goiter.

a) Subacute
b) Diffuse
c) Benign
d) Nodular

4. The parathyroid glands:
  1. Regulate metabolism
  2. Release a thyroid hormone
  3. Are usually four in number
  4. Need iodine to remain healthy
  5. Increase the activation of vitamin D

a) 1, 2, and 4
b) 1 and 4
c) 2, 3, and 5
d) 3 and 5
e) 3 only

5. The thyroid gland releases around percent of its thyroid hormone as T4, called that because it has atoms for each hormone molecule.

a) 20, calcium
b) 50, phosphorous
c) 80, iodine
d) 60, hydrogen

6. A normal and healthy amount of thyroid hormone is known as:

a) Thyrotoxicosis
b) Hyperthyroidism
c) Euthyroidism
d) Hypothyroidism

7. The thyroid stimulating hormone is produced by the:

a) Pituitary gland
b) Parathyroids
c) Thyroid
d) Adrenal glands

8. Thyroglobulin levels have the most importance in the follow-up of people with a history of:

a) Hypothyroidism
b) Thyroid cancer
c) Goiter
d) Thyrotoxicosis

9. Antithyroid peroxidase antibodies attack the portion of the thyroid cell responsible for making thyroid hormones. The disease associated with these antibodies is:

a) Grave's disease
b) Cancer
c) Goiter
d) Hashimoto's disease

10. Radioactive iodine scans of the entire body are used to evaluate you for only after you have had your thyroid gland removed by surgery and been adequately prepped.

a) Thyroid cancer
b) Grave's disease
c) Myxedema coma
d) Hashimoto's disease

11. If the texture of the thyroid gland is firm and bosselated, it suggests:

a) Thyroid cancer
b) Hashimoto's thyroiditis
c) Thyroid nodules
d) Hypothyroidism

12. There is no type of contrast dye for CT scans that does not contain iodine.

a) True
b) False

13. When a FNA is performed:<
  1. A cytologist evaluates the slide
  2. The patient must be on a low iodine diet one week prior to testing
  3. A urine sample is collected concurrently
  4. It is done in the office
  5. A thoracic inlet obstruction evaluation is done

a) 1, 3, and 5
b) 2, 4, and 5
c) 1 and 4
d) 2 and 3

14. People who have their thyroid gland surgically removed develop:

a) Thyroiditis
b) Iatrogenic hypothyroidism
c) Secondary hypothyroidism

15. People who lived in a "goiter belt" may live:

a) Along the east coast
b) Near the Gulf of Mexico
c) In the Great Lakes Region
d) On the Aleutian Islands

16. The most classic symptoms of hypothyroidism is:

a) Weight gain
b) Cold intolerance
c) Depression
d) Skin changes
e) Fatigue and sleepiness

17. Under perfect storage conditions, pills loose at least 5% of their potency after a year.

a) True
b) False

18. Too much thyroid hormone is:

a) Hyperthyroidism
b) Thyrotoxicosis

19. One of the first signs of thyrotoxicosis is:

a) Diplopia
b) Hyperdefecation
c) Clubbing of the fingers
d) Rapid, forceful heartbeat
e) Muscle weakness

20. Prescribing levothyroxine sodium as a weight loss drug to speed up metabolism and loose weight is known as off-labeling prescribing.

a) True
b) False

21. Some illnesses that are autoimmune disorders are:
  1. Grave's disease
  2. Type 1 diabetes mellitus
  3. Certain types of cancer
  4. Cystic fibrosis
  5. Rheumatoid arthritis

a) 1, 2, and 3
b) 3, 4, and 5
c) 1, 2, and 5
d) 1 and 4

22. Which of the following is correct regarding who will get Hashimoto's thyroiditis:

a) A male over 50 years of age
b) A woman over 30 years of age
c) Anyone with a parent who has the disease
d) A postpartum female

23. An example of polyglandular autoimmune disease is having Grave's disease and:

a) Hypertension
b) Coronary artery disease
c) Chronic obstructive pulmonary disease
d) Anemia

24. Women tend to have more severe symptoms of Grave's disease than men.

a) True
b) False

25. The most common treatment for Grave's disease in the United States is:

a) Thyroidectomy
b) Thyroid ablation
c) Oral medication
d) Radioactive iodine therapy

26. This is the most common type of goiter in the world:

a) Euthyroid
b) Hypothyroid
c) Thyrotoxic

27. When a nodule is part fluid and part solid parts it is called a(n):

a) Cyst
b) Autonomous toxic nodule
c) Complex cyst
d) Colloid nodule

28. Colloid is the thick pink material normally found inside the thyroid follicles and frequently present in thyroid nodules.

a) Benign
b) Malignant
c) Indeterminate

29. There are two major types of thyroid cells that tend to turn into cancers: follicular thyroid cells which make thyroid hormone, and parafollicular thyroid cells which make calcitonin.

a) True
b) False

30. About 80 percent of thyroid cancers are:

a) Anaplastic
b) Follicular
c) Papillary

31. A total ipsilateral lobectomy and isthmusectomy is removal of:
  1. One half of the thyroid gland
  2. A lobe containing the nodule
  3. The central portion of the thyroid gland
  4. Parathyroid glands
  5. Lymph nodes on one side of the neck

a) 1 and 4
b) 1 and 5
c) 3 and 4
d) 2 and 3
e) 3 and 5

32. If you miss your morning dose of levothyroxine you should take two doses the next day.

a) True
b) False

33. The disadvantage of T3 alone as the treatment for hypothyroid people is:

a) Short half-life
b) Long half-life
c) Poor absorption with antacids
d) Peak and valley effects

34. Thionamides are the only safe and effective form of treatment to treat hyperthyroidism during pregnancy, aside from surgery to remove the thyroid gland.

a) True
b) False

35. A saturated solution of potassium iodide is used prior to surgery to:

a) Prevent a thyroid storm
b) Decrease blood flow to the thyroid gland
c) Increase the clotting factors
d) Maintain a therapeutic level of iodine in the body

36. When treating hypoparathyroidism, you must take which of the following:

a) Beta-blockers and iodine
b) Lithium and potassium
c) Vitamin D and calcium
d) Synthyroid and hormones

37. Radioactive iodine is used to treat:
  1. Hyperthyroidism
  2. Hypoparathyroidism
  3. Hypothyroidism
  4. Thyroid cancer

a) 1 and 2
b) 1 and 4
c) 2 only
d) 3 and 4
e) 4 only

38. Which of the following are more common in overt or subclinical hypothyroidism:

a) Elevated HCG, decreased TSH and edema
b) Gestational hypertension, preeclampsia and eclampsia
c) Numbness in the extremities, fatigue, and proteinuria
d) Fluid retention, premature labor, and seizures

39. Postpartum thyroiditis occurs in 5 to 18 percent of postpartum women and resolves on its own after:

a) Six weeks to six months
b) One year
c) Six to nine months
d) Two months

40. The most recent research suggests that women do best on "FDA-approved bioidentical hormones."

a) True
b) False

41. When a person is thyrotoxic, remove bone faster than it can be replaced by and you wind up with too much bone removal.

a) Osteoclasts, osteoblasts
b) Osteoblasts, osteoclasts

42. When a baby hasn't any thyroid gland at all it is called:

a) Pendred syndrome
b) A hypoplastic thyroid
c) Athyreotic
d) Thyroid dyshormonogenesis

43. This type of thyroid cancer is most common in children:

a) Follicular
b) Papillary
c) Medullary

44. A person who is normal weight would have a body mass index of:

a) 18.5-24.9
b) 25-29.9
c) 30-34.9
d) 35-39.9

45. In older people, hypothyroidism tends to be more insidious and quietly damages the thyroid until it atrophies.

a) True
b) False

46. When there is hyperthyroidism without clear symptoms of thyrotoxicosis, it is called:

a) Grave's disease
b) An ectopic thyroid
c) Subclinical hyperthyroidism
d) Apathetic hyperthyroidism

47. Each person with resistance to thyroid hormone:

a) Develops it later in life
b) Is born with it
c) Will be asymptomatic
d) Has thyroid nodules

48. According to the Barnes method, if your morning temperature is below 97.8 degrees you are hypothyroid.

a) True
b) False

49. The two most common cancers rumored to be linked with radioactive iodine are:

a) Thyroid cancer and bone cancer
b) Lung cancer and oral cancer
c) Leukemia and breast cancer
d) Colon cancer and ovarian/prostate cancer

50. Soybeans are a phytoestrogen and also a(n):

a) Insoluble fiber
b) Soluble fiber

51. Which of the following would you avoid on a low iodine diet:
  1. Red food dye #3
  2. Egg yolks
  3. Frozen vegetables
  4. Dairy products
  5. Fresh meats

a) 1, 2, and 5
b) 3 and 4
c) 2 and 5
d) 1, 2, and 4
e) 3 only

52. On a high glycemic index diet you may experience a "sugar crash" where after a meal you get tired or sleepy, and a few hours later you:

a) Become very hungry
b) Secrete large amounts of insulin
c) Are hyperactive
d) Have absorbed most of the carbohydrates

53. The total fat consumption in a Mediterranean diet is than our fat guidelines in North America.

a) Lower
b) Higher

54. This is the highest standard of care money can buy:

a) The specialist standard of care
b) The reasonable standard of care
c) State-of-the-art standard of care

55. A description of the treatment, effects, time of recovery, alternative options and risks are examples of:

a) Capacity and competency
b) Voluntariness
c) Disclosure

56. A health-care provider must strive to maximize benefits and minimize potential harms is the definition of:

a) Nonmaleficence
b) Beneficence
c) Justice

57. A common symptom of excessive thyroid hormone is:

a) Dry eyes
b) Double vision
c) Bloodshot and red eyes
d) Lid retraction

58. Which of the following happens during the hot phase of TED:

a) Swelling around and behind the eye
b) Sensitivity to light
c) Grittiness
d) Excessive watering of the eyes

59. Often the first step in treating TED is to:

a) Take steroids to decrease swelling and inflammation
b) Begin diuretics to remove excess fluid
c) Use artificial tears during the day
d) Have external beam radiation

60. Dry eyes are becoming increasingly common in young people as a result of:

a) Smoking
b) Focusing on television and computer display screens too long
c) Dry air from furnaces and air conditioning
d) Wind, sun and pollution
e) Contact lens

61. One of the most telling signs of depression is a loss of interest in activities that used to excite you, enthuse you or give you pleasure. This is called:

a) Anhedonia
b) A flat affect
c) Unipolar depression
d) A low mood

62. In somatization disorder more women are affected than men.

a) True
b) False

63. By the time the blood pressure is as high as many people are prescribed antihypertensive drugs.

a) 120/80
b) 140/85
c) 150/90

64. The classic heart complications associated with thyrotoxicosis are:

a) Peripheral vascular disease and arrhythmia
b) Slow pulse and peripheral edema
c) Hypertension and irregular heart rhythm
d) A very fast pulse and heart palpitations

65. sleep apnea occurs when the brain fails to send the appropriate signals to the breathing muscles that cause you to breath in and out.

a) Central
b) Obstructive

66. Congress formally recognized endocrine-disrupting chemicals as a public health concern in 2010 when it passed the Food QualityProtection Act and amendments to the Safe Drinking Water Act.

a) True
b) False

67. Potassium iodide:
  1. Must be taken after 24 hours of radioactive iodine
  2. Is the same form of iodine used to iodize table salt
  3. Has a shelf life of five to eleven years
  4. Is a nonprescription drug
  5. Should be taken even if you don't have a thyroid gland

a) 1, 2, and 3
b) 1 and 5
c) 3 and 4
d) 4 and 5
e) 2, 3, and 4