FAMILY MEDICINE COMAT NEW EXAM QUESTIONS AND CORRECT
ANSWERS FOR TOP PERFORMANCE
B (although treatment with methimazole, proylthiouracil, radioactive iodine,
and surgical removal of the thyroid gland are plausible treatments for Grave's
disease, methimazole is recommnded as a first line agent over propylthiouracil
due to potential hepatotoxicity) ANSWER A 56-year-old female complains
-
of palpitations and an unintentional 20 lb weight loss in the past six months.
History reveals that her menstrual periods stopped approximately 7 years ago.
Vital signs include a blood pressure of 135/85 and a heart rate of 110. Physical
examination reveals a non-tender enlarged thyroid gland without nodules.
Structural examination reveals tissue texture changes at T2 associated with an
upper thoracic flexion hump. Laboratory studies reveal the following
TSH: 0.05
free T3: 380
free T4: 22
A thyroid stimulating immunoglobulin test is positive. The most appropriate
initial management is
A. levothyroxine
B. methimazole
C. proylthiouracil
D. radioactive iodine ablation
E. thyroidectomy
D (the most likely diagnosis is onychomycosis - microscopic evaluation is the
best first step to make the diagnosis) (A; bacterial infection is less likely than
fungal) (B; Sabouraud's agar is used to grow fungal specimens - culture results
,
,
,
ANSWERS FOR TOP PERFORMANCE
B (although treatment with methimazole, proylthiouracil, radioactive iodine,
and surgical removal of the thyroid gland are plausible treatments for Grave's
disease, methimazole is recommnded as a first line agent over propylthiouracil
due to potential hepatotoxicity) ANSWER A 56-year-old female complains
-
of palpitations and an unintentional 20 lb weight loss in the past six months.
History reveals that her menstrual periods stopped approximately 7 years ago.
Vital signs include a blood pressure of 135/85 and a heart rate of 110. Physical
examination reveals a non-tender enlarged thyroid gland without nodules.
Structural examination reveals tissue texture changes at T2 associated with an
upper thoracic flexion hump. Laboratory studies reveal the following
TSH: 0.05
free T3: 380
free T4: 22
A thyroid stimulating immunoglobulin test is positive. The most appropriate
initial management is
A. levothyroxine
B. methimazole
C. proylthiouracil
D. radioactive iodine ablation
E. thyroidectomy
D (the most likely diagnosis is onychomycosis - microscopic evaluation is the
best first step to make the diagnosis) (A; bacterial infection is less likely than
fungal) (B; Sabouraud's agar is used to grow fungal specimens - culture results
,
,
,
