Which is the only curative treatment option for primary hyperparathyroidism (PHPT)?
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Parathyroidectomy.
A low thyroid-stimulating hormone (TSH) can lead to:
1.
Osteoporosis.
2.
Weight gain.
3.
Bradycardia.
4.
Brittle hair.
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, Osteoporosis.
Rationales
Option 1:
Hyperthyroidism presents with a suppressed TSH and elevated free
thyroxine (T4). Manifestations include weight loss, tachycardia, diarrhea,
anxiety, and warm, silky skin. The increased metabolic state of
hyperthyroidism can cause cardiac dysrhythmias and osteoporosis. The
clinical manifestations can also occur when there is excessive thyroid
replacement.
Option 2:
Manifestations of hyperthyroidism include weight loss (not weight gain).
Option 3:
Manifestations of hyperthyroidism include tachycardia (not bradycardia).
Option 4:
Manifestations of hyperthyroidism include warm, silky skin (not brittle hair).
A 35-year-old female presents to your primary care office for review of her
laboratory results. Her physical exam shows a blood pressure (BP) of 140/90, pulse (P)
of 105, oxygen saturation of 97%, and temperature of 98.6°F. She has complaints of
palpitations, weight loss, hair loss, and anxiety. Her labs are all normal except for a
low thyroid-stimulating hormone (TSH) and an elevated thyroxine (T4). What would
your next course of treatment be?
1.
Start metoprolol and propylthiouracil (PTU).
2.
Refer the patient to psychiatry for treatment of anorexia.
3.
Refer the patient for radioactive iodine treatment.
4.
Refer the patient for thyroidectomy.
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, 1.
Start metoprolol and propylthiouracil (PTU).
Jeffrey, age 17, has gynecomastia. You should also assess him for:
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Testicular cancer
Which of the following conditions is a common pathological cause of hirsutism?
1.
Polycystic ovary syndrome.
2.
Addison disease.
3.
Hyperthyroidism.
4.
Alopecia.
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1.
Polycystic ovary syndrome.
Betty, age 40, has had type 1 diabetes for 20 years and takes a combination of neutral
protamine Hagedorn (NPH) and regular insulin every day. She comes to the office
because she has developed a severe upper respiratory infection with chills, fever, and
production of yellow sputum. Because of her acute infection, you know that Betty is
likely to require:
, 1.
A decrease in her daily insulin dosage.
2.
An increase in her daily insulin dosage.
3.
A high-calorie dietary intake and no insulin change.
4.
A change in her insulin from NPH to insulin aspart (NovoLog).
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2.
An increase in her daily insulin dosage.
What is the most common cause of Cushing disease?
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Pituitary adenoma.
Sadie, age 40, has just been given a diagnosis of Graves disease. She has recently lost
25 lb, has palpitations, is very irritable, feels very warm, and has a noticeable bulge on
her neck. The most likely cause of her increased thyroid function is:
1.
Hyperplasia of the thyroid.
2.
An anterior pituitary tumor.
3.
A thyroid carcinoma.
4.
An autoimmune response.
Give this one a try later!
Give this one a try later!
Parathyroidectomy.
A low thyroid-stimulating hormone (TSH) can lead to:
1.
Osteoporosis.
2.
Weight gain.
3.
Bradycardia.
4.
Brittle hair.
Give this one a try later!
, Osteoporosis.
Rationales
Option 1:
Hyperthyroidism presents with a suppressed TSH and elevated free
thyroxine (T4). Manifestations include weight loss, tachycardia, diarrhea,
anxiety, and warm, silky skin. The increased metabolic state of
hyperthyroidism can cause cardiac dysrhythmias and osteoporosis. The
clinical manifestations can also occur when there is excessive thyroid
replacement.
Option 2:
Manifestations of hyperthyroidism include weight loss (not weight gain).
Option 3:
Manifestations of hyperthyroidism include tachycardia (not bradycardia).
Option 4:
Manifestations of hyperthyroidism include warm, silky skin (not brittle hair).
A 35-year-old female presents to your primary care office for review of her
laboratory results. Her physical exam shows a blood pressure (BP) of 140/90, pulse (P)
of 105, oxygen saturation of 97%, and temperature of 98.6°F. She has complaints of
palpitations, weight loss, hair loss, and anxiety. Her labs are all normal except for a
low thyroid-stimulating hormone (TSH) and an elevated thyroxine (T4). What would
your next course of treatment be?
1.
Start metoprolol and propylthiouracil (PTU).
2.
Refer the patient to psychiatry for treatment of anorexia.
3.
Refer the patient for radioactive iodine treatment.
4.
Refer the patient for thyroidectomy.
Give this one a try later!
, 1.
Start metoprolol and propylthiouracil (PTU).
Jeffrey, age 17, has gynecomastia. You should also assess him for:
Give this one a try later!
Testicular cancer
Which of the following conditions is a common pathological cause of hirsutism?
1.
Polycystic ovary syndrome.
2.
Addison disease.
3.
Hyperthyroidism.
4.
Alopecia.
Give this one a try later!
1.
Polycystic ovary syndrome.
Betty, age 40, has had type 1 diabetes for 20 years and takes a combination of neutral
protamine Hagedorn (NPH) and regular insulin every day. She comes to the office
because she has developed a severe upper respiratory infection with chills, fever, and
production of yellow sputum. Because of her acute infection, you know that Betty is
likely to require:
, 1.
A decrease in her daily insulin dosage.
2.
An increase in her daily insulin dosage.
3.
A high-calorie dietary intake and no insulin change.
4.
A change in her insulin from NPH to insulin aspart (NovoLog).
Give this one a try later!
2.
An increase in her daily insulin dosage.
What is the most common cause of Cushing disease?
Give this one a try later!
Pituitary adenoma.
Sadie, age 40, has just been given a diagnosis of Graves disease. She has recently lost
25 lb, has palpitations, is very irritable, feels very warm, and has a noticeable bulge on
her neck. The most likely cause of her increased thyroid function is:
1.
Hyperplasia of the thyroid.
2.
An anterior pituitary tumor.
3.
A thyroid carcinoma.
4.
An autoimmune response.
Give this one a try later!
