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Pathophysiology Exam III - THYROID

Total questions: 74

Worksheet time: 43mins

Name
Class
Date
1.

Thyroxine

a)

T4

b)

T3

c)

Prohormone

d)

Active hormone

2.

Triiodothyronine

a)

T4

b)

T3

c)

Prohormone

d)

Active hormone

3.

T/F T3 and T4 are formed from the combination of iodinated tyrosine

a)

True

b)

False

4.

Adequate levels of thyroid hormones are necessary in infants for

a)

Normal CNS development

b)

Skeletal growth and maturation

c)

Normal function of multiple organ systems

5.

Adequate levels of thyroid hormones are necessary in children for

a)

Normal CNS development

b)

Skeletal growth and maturation

c)

Normal function of multiple organ systems

6.

Adequate levels of thyroid hormones are necessary in adults for

a)

Normal CNS development

b)

Skeletal growth and maturation

c)

Normal function of multiple organ systems

7.

T/F the thyroid is highly vascular and has one of the lowest rates of blow flow per gram of tissue of any organ

a)

True

b)

False

8.

The thyroid consists of

a)

Two lateral lobes

b)

Central isthmus

c)

One lateral lobe

d)

Three lateral lobes

9.

T/F an irregular thyroid is firm, reddish brown, and located in the front of the trachea

a)

True

b)

False

10.

Normal plasma level of T4

a)

0.08ug/dL

b)

8ug/dL

c)

12ug/dL

d)

0.15ug/dL

e)

0.22ug/dL

11.

Normal plasma level of T3

a)

0.08ug/dL

b)

8ug/dL

c)

12ug/dL

d)

0.15ug/dL

e)

0.22ug/dL

12.

T/F both T3 and T4 are bound to plasma proteins, including albumin, transthyretin, and thyroxine-binding globulin

a)

True

b)

False

13.

Biologic half-life of T4

a)

4-5 days

b)

6-7 days

c)

12 hours

d)

24 hours

e)

9-10 days

14.

Biologic half-life of T3

a)

4-5 days

b)

6-7 days

c)

12 hours

d)

24 hours

e)

9-10 days

15.

(1) is (2) more potent than (3) on a molar basis

a)

(1) T3

(2) 3-5 times

(3) T4

b)

(1) T4

(2) 3-5 times

(3) T3

c)

(1) T3

(2) 2-3 times

(3) T4

d)

(1) T4

(2) 2-3 times

(3) T3

e)

(1) T3

(2) 2x

(3) T4

16.

About (1) of circulating T3 derives from the peripheral conversion of T4 to T3, with the remaining (2) derived from thyroid secretion

a)

(1) 90%

(2) 10%

b)

(1) 80%

(2) 20%

c)

(1) 20%

(2) 80%

d)

(1) 70%

(2) 23%

17.

Three major thyroidal antigens include

a)

Thyroglobulin [Tg]

b)

Thyroidal peroxidase [TPO]

c)

TSH receptor

d)

TSH receptor autoantibody [TSH-R [stim] Ab [TSI]]

18.

Hyperthyroidism is most commonly

a)

Overproduction of thyroid hormones

b)

Lack of expression of thyroid hormones

c)

Due to Graves Diseas

d)

Due to Hashimoto

19.

Transient* hyperthyroidism

a)

Hashimoto

b)

Graves

20.

Inherited primary immunodeficiency disease [PIDD] which increases the body's susceptibility to infections caused by certain bacteria and fungi

a)

Chronic Granulatomatous Disease [GCD]

b)

Hypothyroidism

c)

Transient* hyperthyroidism

d)

Graves disease

e)

Hashimoto thyroiditis

21.

Smooth and uniformly enlarged

a)

Diffuse goiter

b)

Nodular goiter

22.

Caused by one or more nodules within the gland

a)

Diffuse goiter

b)

Nodular goiter

23.

In nodular goiter, the nodules may be

a)

Solid

b)

Filled with fluid

c)

Partly fluid and partly solid

d)

Thyroid nodules are common

e)

Smooth and uniformly enlarged

24.

T/F hyperthyroidism resulting from Graves disease is characterized by an increased serum TSH level

a)

True

b)

False

25.

TSH-secreting pituitary adenomas

a)

Secondary hyperthyroidism

b)

Secondary hypothyroidism

c)

Tertiary hyperthyroidism

d)

Tertiary hypothyroidism

e)

Primary hyperthytroidism

26.

Hypothalamic disease with excessive TRH production

a)

Secondary hyperthyroidism

b)

Secondary hypothyroidism

c)

Tertiary hyperthyroidism

d)

Tertiary hypothyroidism

e)

Primary hyperthytroidism

27.

High or high normal plasma TSH level

a)

Secondary hyperthyroidism

b)

Secondary hypothyroidism

c)

Tertiary hyperthyroidism

d)

Tertiary hypothyroidism

e)

Primary hyperthytroidism

28.

Most common cause of hyperthyroidism among individuals in their third and fourth decades

a)

Chronic Granulatomatous Disease [GCD]

b)

Hypothyroidism

c)

Transient* hyperthyroidism

d)

Graves disease

e)

Hashimoto thyroiditis

29.

T/F graves disease is only apparent among individuals in their third and fourth decades

a)

True

b)

False

30.

Characteristics of Graves disease

a)

Thyroid gland is symmetrically enlarged

b)

Thyroid gland is asymmetrically enlarged

c)

Vascularity increased

d)

Vascularity decreased

e)

Gland may double or triple in weight

31.

T/F in graves disease, the follicular and endothelial cells are columnar in appearance and increased in number and size

a)

True

b)

False

32.

Which is true among follicular endothelial cells of graves disease?

a)

Follicles are large and dispersed

b)

Follicles are small and dispersed

c)

Follicles are small and closely packed

d)

Colloid is scanty

e)

Colloid is enlarged

33.

T/F becuase serum levels of TSI correlate poorly with graves disease severity, its presence is not helpful diagnostically

a)

True

b)

False

34.

T/F a genetic contribution to the development of Graves disease is possible

a)

True

b)

False

35.

Patients may later develop hypothyroidism from graves disease for which of the following reasons?

a)

Thyroid ablation by surgery

b)

Thyroid ablation by 131I radiation treatment

c)

Autoimmune thyroiditis, leading to thyroid destruction

d)

Myxedema, leading to thyroid destruction

e)

Development of antibodies that block TSH stimulation

36.

Untreated hyperthyroidism may decompensated into which of the following?

a)

Thyroid storm

b)

Autoimmune thytoiditis

c)

Myxedema

d)

Hypothyroidism

e)

Transient* hyperthyroidism

37.

Tachycardia, fever, agitation, nausea, vomiting, diarrhea, and restlessness or psychosis are symptoms of which of the following?

a)

Thyroid storm

b)

Autoimmune thytoiditis

c)

Myxedema

d)

Hypothyroidism

e)

Transient* hyperthyroidism

38.

Abnormally low serum T4 and T3 levels

a)

Thyroid storm

b)

Hyperthyroidism

c)

Myxedema

d)

Hypothyroidism

e)

Transient* hyperthyroidism

39.

Severely advanced hypothyroidism

a)

Thyroid storm

b)

Hashimoto thyroiditis

c)

Myxedema

d)

Goiter

e)

Transient* hyperthyroidism

40.

Serum TSH level is the most sensitive test for early

a)

Thyroid storm

b)

Hyperthyroidism

c)

Myxedema

d)

Hypothyroidism

e)

Transient* hyperthyroidism

41.

In frank hypothyroidism, serum TSH levels show

a)

Elevations of serum TSH

b)

Reductions of serum TSH

c)

Normal serum TSH

d)

Abnormal serum TSH - can be elevated or reduced

42.

Thyroid failure

a)

Primary hypothyroidism

b)

Secondary hypothyroidism

c)

Central hypothyroidism

d)

Myxedema

43.

In central hypothyroidism, serum TSH levels show

a)

Elevations of serum TSH

b)

Reductions of serum TSH

c)

Normal serum TSH

d)

Abnormal serum TSH - can be elevated or reduced

44.

Gland is diffusely enlarged, firm, rubbery, and nodular in the early stages and the gland becomes smaller as the disease progresses

a)

Thyroid storm

b)

Hashimoto thyroiditis

c)

Myxedema

d)

Goiter

e)

Transient* hyperthyroidism

45.

Destruction of thyroid follicles and lymphocytic infiltration with lymphoid follicles

a)

Thyroid storm

b)

Hashimoto thyroiditis

c)

Myxedema

d)

Goiter

e)

Transient* hyperthyroidism

46.

As Hashimoto thyroiditis progresses, there is

a)

An increasing amount of fibrosis

b)

A decreasing amount of fibrosis

47.

T/F serum levels of antibodies correlate with the severity of the hypothyroidism and their presence is helpful in diagnosis

a)

True

b)

False

48.

High antibody titers

a)

Hashimoto thyroiditis

b)

Elderly

c)

Graves disease

d)

Myxedema

e)

Transient* hyperthyroidism

49.

Moderate antibody titers

a)

Hashimoto thyroiditis

b)

Elderly

c)

Graves disease

d)

Myxedema

e)

Transient* hyperthyroidism

50.

Low antibody titers

a)

Hashimoto thyroiditis

b)

Elderly

c)

Graves disease

d)

Myxedema

e)

Transient* hyperthyroidism

51.

Hypothyroidism

a)

Pitting

b)

Nonpitting

c)

Promotes sodium and water retention

d)

Inhibits sodium and water retention

52.

Carotenemia

a)

May occur in hyperthyroidism

b)

May occur in hypothyroidism

c)

Hepatic conversion of carotene to Vitamin A

d)

Hepatic conversion of carotene to Vitamin C

e)

Carotene accumulates in the bloodstream and skin

53.

Myxedema coma may caused by severe untreated

a)

Hyperthyroidism

b)

Hypothyroidism

54.

Diffuse thyroid enlargement most commonly results from prolonged stimulation by TSH

a)

Thyroid storm

b)

Hashimoto thyroiditis

c)

Myxedema

d)

Goiter

e)

Transient* hyperthyroidism

55.

Stimulation by TSH in goiter may be a result of

a)

Hypothyroidism

b)

Hyperthyroidism

c)

May occur in a clinically euthyroid patient

56.

T/F goitrogens are factors that promote thyroid hormone synthesis

a)

True

b)

False

57.

Most patients remain clinically euthyroid in goiter due to (1) of TSH production

a)

Increase

b)

Decrease

58.

Goiter has a progressive (1) in serum T4 and progressive (2) in serum TSH

a)

(1) rise

(2) fall

b)

(1) fall

(2) rise

c)

(1) fall

(2) fall

d)

(1) rise

(2) rise

59.

Autonomous mutlinodular goiter

a)

Iodine deficiency

b)

Iodine abundance

c)

Nontoxic

d)

Toxic

60.

Subclinical thyroid dysfunction

a)

Low TSH levels

b)

High TSH levels

c)

Normal circulating T4 and T3 levels

d)

Abnormal circulating T4 and T3 levels

e)

Normal circulating T4 and abnormal T3 levels

61.

Subclinical hypothyroidism

a)

Elevated TSH level

b)

More common among men

c)

More common among women

d)

Individuals older than 65

e)

Individuals older than 40

62.

Subclinical hyperthyroidism

a)

Elevated TSH level

b)

Low TSH level

c)

Normal circulating thyroid hormone levels

d)

Individuals older than 65

e)

Abnormal circulating thyroid hormone levels

63.

Hyperthyroidism diseases

a)

Transient* hyperthyroidism

b)

Chronic granulomatous disease

c)

Graves disease

d)

Thyroid storm

e)

Hashimoto thyroiditis

64.

Hypothyroidism diseases

a)

Transient* hyperthyroidism

b)

Chronic granulomatous disease

c)

Graves disease

d)

Goiter

e)

Hashimoto thyroiditis

65.

Coupling of MIT + DIT

a)

T3

b)

rT3

c)

T4

66.

Coupling of DIT + DIT

a)

T3

b)

rT3

c)

T4

67.

Deiodinase II produces

a)

T3

b)

rT3

c)

T4

d)

T2

68.

Deiodinase III produces

a)

T3

b)

rT3

c)

T4

d)

T2

69.

Active

a)

T3

b)

rT3

c)

T4

d)

T2

70.

Inactive

a)

T3

b)

rT3

c)

T4

d)

T2

71.

T/F rT3 and T3 have the same structure

a)

True

b)

False

72.

1

a)

Colloid

b)

Follicular cells

c)

Stroma

73.

2

a)

Colloid

b)

Follicular cells

c)

Stroma

74.

3

a)

Colloid

b)

Follicular cells

c)

Stroma