NR565 PHARMACOLOGY FINAL EXAM
QUESTIONS WITH CORRECT
ANSWERS GRADED A+ FOR 2025-
2026 ASSURED EXCEL!!
Signsrandrsymptomsrofrhypothyroidismr-rrCORRECTrANSWERSFacerisrpale,rpuffy,randrexpressionless.
Skinrisrcoldrandrdry.r
hairrisrbrittle,randrhairrlossroccurs.r
Heartrraterandrtemperaturerarerlowered.rTherpatientrlethargy,rfatigue,randrintolerancertorcold.r
Mentationrmayrberimpaired.
Signsrandrsymptomsrofrhyperthyroidismr-
rrCORRECTrANSWERSHeartrRaterisrRapid;rPossiblerarrhythmia/angina
Nervousness,rinsomnia,rrapidrthoughtrflow,randrrapidrspeech
Skeletalrmusclesrmayrweakenrandratrophy
Metabolicrraterisrraised,rresultingrinrincreasedrheatrproduction,rincreasedrbodyrtemperature,rintolerancert
orheat,randrskinrthatrisrwarmrandrmoist
Weightrlossroccursrifrcaloricrintakerfailsrtormatchrtherincreaserinrmetabolicrrate
Severerhypothyroidismr-rrCORRECTrANSWERSMyxedema
HypothyroidrTreatmentr-
rrCORRECTrANSWERSLevothyroxinerisrtherdrugrofrchoicerforrmostrpatientsrwhorrequirerthyroidrhormonerre
placement.
Levothyroxiner(Synthroid)rTherapeuticrGoalr-
rrCORRECTrANSWERSResolutionrofrsignsrandrsymptomsrofrhypothyroidismrandrrestorationrofrnormalrlabor
atoryrvaluesrforrserumrthyroid-stimulatingrhormoner(TSH)randrfreerthyroxiner(T4).
,Majorrformsrofrhyperthyroidismr-
rrCORRECTrANSWERSGravesrdiseaserandrtoxicrnodularrgoiterr(alsorknownrasrPlummerrdisease).
GravesrDiseaser-rrCORRECTrANSWERSMostrcommonrcauserofrexcessiverthyroidrhormonersecretion
Whatradjunctivertherapyrisrgoodrtorprescribertorcontrolrsymptomsrofrhyperthyroidismrotherrthanrthyroidrs
pecificrmedications?r-rrCORRECTrANSWERSβ-
Blockersrandrnonradioactiveriodinermayrberusedrasradjunctivertherapy.r
β-Blockersrsuppressrtachycardiarbyrblockingrβ-receptorsronrtherheart.r
Nonradioactiveriodinerinhibitsrsynthesisrandrreleaserofrthyroidrhormones.
MonitoringrneedsrandrintervalsrforrLevothyroxiner-rrCORRECTrANSWERSCheckrTSHr6-
8rweeksrafterrinitiatingrtherapyrandrafterranyrdosagerchange.r
CheckrTSHratrleastronceraryearrafterrserumrTSHrisrstabilized.
HyperthyroidrTreatmentr-rrCORRECTrANSWERSthionamiderdrugs—
methimazolerandrpropylthiouracilr(PTU)—suppressrsynthesisrofrthyroidrhormones.
MethimazolerTherapeuticrGoalr-
rrCORRECTrANSWERS(1)rreductionrofrthyroidrhormonerproductionrinrGraves'rdisease,r(2)rcontrolrofrhyperth
yroidismruntilrthereffectsrofrradiationronrtherthyroidrbecomermanifest,r(3)rsuppressionrofrthyroidrhormoner
productionrbeforersubtotalrthyroidectomy,r(4)rtreatmentrofrthyrotoxicrcrisis.
MonitoringrneedsrandrintervalsrforrMethimazoler-
rrCORRECTrANSWERSCheckrCBCrwithrdifferentialrifrsignsrorrsymptomsrofrinfection.rCheckrLFTsrifrsignsrorrsy
mptomsrofrliverrdysfunction.
HighrRiskrPatientsrforrMethimazoler-
rrCORRECTrANSWERSShouldrberavoidedrinrtherfirstrtrimesterrofrpregnancy.
MethimazolerToxicityr-rrCORRECTrANSWERSAgranulocytosisrisrthermostrdangerousrtoxicity.
,PTUrHighrRiskrWarningr-
rrCORRECTrANSWERSCarriesrarriskrforrliverrtoxicity.rAlthoughrrare,rtherFDArrecommendsragainstrusingrasrarfi
rst-linertreatmentrduertorpotentialrforrhepaticrtoxicity.
Effectsrofrmaternalrhypothyroidismronroffspringrandrappropriaterpatientrteachingrrelatedrtorneedrforrtreat
ment.r-
rrCORRECTrANSWERSCanrcauserdelayrinrmentalrdevelopmentrandrderangementrofrgrowth.rInrtherabsencero
frthyroidrhormones,rtherchildrdevelopsrarlargerandrprotrudingrtongue,rpotbelly,randrdwarfishrstature.rDeve
lopmentrofrthernervousrsystem,rbones,rteeth,randrmusclesrisrimpaired.
CongenitalrHypothyroidismrTreatmentr-
rrCORRECTrANSWERSrequiresrreplacementrtherapyrwithrthyroidrhormones.rIfrtreatmentrisrinitiatedrwithinr
arfewrdaysrofrbirth,rphysicalrandrmentalrdevelopmentrwillrbernormal.
replacementrtherapyrshouldrcontinuerforr3ryears,rafterrwhichritrshouldrberstoppedrforr4rweeksrtordetermin
erwhetherrthyroidrdeficiencyrisrpermanentrorrtransient.
PatientrTeachingrforrMethimazoler-
rrCORRECTrANSWERSTellryourrhealthcarerprovidersrthatryourarertakingrthisrdrug.r
Checkrbloodrworkrasrdirected.
Takingrthisrdrugrmayrcauserharmrtortherunbornrbabyrifryourarerpregnant,respeciallyrinrtherfirstrtrimester.
Ifryourarerpregnantrorrbecomerpregnantrwhilertakingrthisrdrug,rcallryourrhealthcarerproviderrrightraway.
Tellryourrhealthcarerproviderrifryourarerbreast-feedingrtordiscussrrisksrtortherbaby.
Haveryourrbaby'srthyroidrcheckedrifryourarerusingrthisrdrugrandrbreast-feeding.
Agranulocytosisrisrthermostrdangerousrtoxicityrriskrforrthisrmedicationrbutrisrveryrrare.rSorerthroatrandrfeve
rrshouldrberreportedrimmediately.r
PatientrTeachingrforrLevothyroxiner-
rrCORRECTrANSWERSworksrbestrifryourtakeritronranremptyrstomach,r30rtor60rminutesrbeforerbreakfast.
takerthermedicineratrthersamertimereachrday.
IdealrHbA1Crgoalrforrdiabetic,rnon-pregnantradultsr-rrCORRECTrANSWERSlessrthanr7%.
, HbA1Cr8%r-
rrCORRECTrANSWERShistoryrofrsevererhypoglycemia,rlimitedrliferexpectancy,rorradvancedrmicrovascularrorr
macrovascularrcomplications
HBA1CrValuerconsideredrdiagnosticrofrdiabetes.r-rrCORRECTrANSWERSarvaluerofr6.5%rorrgreater
HbA1CrMeasuringrIntervalr-
rrCORRECTrANSWERSeveryr3rmonthsruntilrvaluerisr<7%;reveryr6rmonthsrthereafter
HbA1CrGoalrforrOlderrAdultsr-
rrCORRECTrANSWERS<7.5%r[58rmmol/mol]),rwhilerthoserwithrmultiplercoexistingrchronicrillnesses,rcognitiv
erimpairment,rorrfunctionalrdependencershouldrhaverlessrstringentrglycemicrgoalsr(suchrasrA1Cr<8.0-
8.5%r[64-69rmmol/mol]).
CriteriarforrtherDiagnosisrofrDiabetesrMellitusr-rrCORRECTrANSWERS-Fastingrplasmarglucoser≥126rmg/dL
-Randomrplasmarglucoser≥r200rmg/dLrplusrsymptomsrofrdiabetes
-Oralrglucosertolerancertestr(OGTT):r2-hrplasmarglucoser≥200rmg/dLcor
-HemoglobinrA1cr6.5%rorrhigher
T1DMrEtiologyrandrMOAr-rrCORRECTrANSWERSAutoimmunerprocess;rLossrofrpancreaticrβrcells;
T2DMrEtiologyrandrMOAr-rrCORRECTrANSWERSUnknown—
butrthererisrarstrongrfamilialrassociation,rsuggestingrthatrheredityrisrarriskrfactor;rInsulinrresistancerandrinap
propriaterinsulinrsecretion
thertotalrdailyrdoser(TDD)rofrinsulinrcalculationr-
rrCORRECTrANSWERStotalrweightrofrtherpatientrinrkilogramsr(kg),rmultipliedrbyr0.6runits
Basalrinsulinrreplacementr-
rrCORRECTrANSWERS50%rofrthertotalrdailyrinsulinrdoserwhichrreplacesrinsulinrfromrfastingr(overnight)randr
betweenrmeals.
QUESTIONS WITH CORRECT
ANSWERS GRADED A+ FOR 2025-
2026 ASSURED EXCEL!!
Signsrandrsymptomsrofrhypothyroidismr-rrCORRECTrANSWERSFacerisrpale,rpuffy,randrexpressionless.
Skinrisrcoldrandrdry.r
hairrisrbrittle,randrhairrlossroccurs.r
Heartrraterandrtemperaturerarerlowered.rTherpatientrlethargy,rfatigue,randrintolerancertorcold.r
Mentationrmayrberimpaired.
Signsrandrsymptomsrofrhyperthyroidismr-
rrCORRECTrANSWERSHeartrRaterisrRapid;rPossiblerarrhythmia/angina
Nervousness,rinsomnia,rrapidrthoughtrflow,randrrapidrspeech
Skeletalrmusclesrmayrweakenrandratrophy
Metabolicrraterisrraised,rresultingrinrincreasedrheatrproduction,rincreasedrbodyrtemperature,rintolerancert
orheat,randrskinrthatrisrwarmrandrmoist
Weightrlossroccursrifrcaloricrintakerfailsrtormatchrtherincreaserinrmetabolicrrate
Severerhypothyroidismr-rrCORRECTrANSWERSMyxedema
HypothyroidrTreatmentr-
rrCORRECTrANSWERSLevothyroxinerisrtherdrugrofrchoicerforrmostrpatientsrwhorrequirerthyroidrhormonerre
placement.
Levothyroxiner(Synthroid)rTherapeuticrGoalr-
rrCORRECTrANSWERSResolutionrofrsignsrandrsymptomsrofrhypothyroidismrandrrestorationrofrnormalrlabor
atoryrvaluesrforrserumrthyroid-stimulatingrhormoner(TSH)randrfreerthyroxiner(T4).
,Majorrformsrofrhyperthyroidismr-
rrCORRECTrANSWERSGravesrdiseaserandrtoxicrnodularrgoiterr(alsorknownrasrPlummerrdisease).
GravesrDiseaser-rrCORRECTrANSWERSMostrcommonrcauserofrexcessiverthyroidrhormonersecretion
Whatradjunctivertherapyrisrgoodrtorprescribertorcontrolrsymptomsrofrhyperthyroidismrotherrthanrthyroidrs
pecificrmedications?r-rrCORRECTrANSWERSβ-
Blockersrandrnonradioactiveriodinermayrberusedrasradjunctivertherapy.r
β-Blockersrsuppressrtachycardiarbyrblockingrβ-receptorsronrtherheart.r
Nonradioactiveriodinerinhibitsrsynthesisrandrreleaserofrthyroidrhormones.
MonitoringrneedsrandrintervalsrforrLevothyroxiner-rrCORRECTrANSWERSCheckrTSHr6-
8rweeksrafterrinitiatingrtherapyrandrafterranyrdosagerchange.r
CheckrTSHratrleastronceraryearrafterrserumrTSHrisrstabilized.
HyperthyroidrTreatmentr-rrCORRECTrANSWERSthionamiderdrugs—
methimazolerandrpropylthiouracilr(PTU)—suppressrsynthesisrofrthyroidrhormones.
MethimazolerTherapeuticrGoalr-
rrCORRECTrANSWERS(1)rreductionrofrthyroidrhormonerproductionrinrGraves'rdisease,r(2)rcontrolrofrhyperth
yroidismruntilrthereffectsrofrradiationronrtherthyroidrbecomermanifest,r(3)rsuppressionrofrthyroidrhormoner
productionrbeforersubtotalrthyroidectomy,r(4)rtreatmentrofrthyrotoxicrcrisis.
MonitoringrneedsrandrintervalsrforrMethimazoler-
rrCORRECTrANSWERSCheckrCBCrwithrdifferentialrifrsignsrorrsymptomsrofrinfection.rCheckrLFTsrifrsignsrorrsy
mptomsrofrliverrdysfunction.
HighrRiskrPatientsrforrMethimazoler-
rrCORRECTrANSWERSShouldrberavoidedrinrtherfirstrtrimesterrofrpregnancy.
MethimazolerToxicityr-rrCORRECTrANSWERSAgranulocytosisrisrthermostrdangerousrtoxicity.
,PTUrHighrRiskrWarningr-
rrCORRECTrANSWERSCarriesrarriskrforrliverrtoxicity.rAlthoughrrare,rtherFDArrecommendsragainstrusingrasrarfi
rst-linertreatmentrduertorpotentialrforrhepaticrtoxicity.
Effectsrofrmaternalrhypothyroidismronroffspringrandrappropriaterpatientrteachingrrelatedrtorneedrforrtreat
ment.r-
rrCORRECTrANSWERSCanrcauserdelayrinrmentalrdevelopmentrandrderangementrofrgrowth.rInrtherabsencero
frthyroidrhormones,rtherchildrdevelopsrarlargerandrprotrudingrtongue,rpotbelly,randrdwarfishrstature.rDeve
lopmentrofrthernervousrsystem,rbones,rteeth,randrmusclesrisrimpaired.
CongenitalrHypothyroidismrTreatmentr-
rrCORRECTrANSWERSrequiresrreplacementrtherapyrwithrthyroidrhormones.rIfrtreatmentrisrinitiatedrwithinr
arfewrdaysrofrbirth,rphysicalrandrmentalrdevelopmentrwillrbernormal.
replacementrtherapyrshouldrcontinuerforr3ryears,rafterrwhichritrshouldrberstoppedrforr4rweeksrtordetermin
erwhetherrthyroidrdeficiencyrisrpermanentrorrtransient.
PatientrTeachingrforrMethimazoler-
rrCORRECTrANSWERSTellryourrhealthcarerprovidersrthatryourarertakingrthisrdrug.r
Checkrbloodrworkrasrdirected.
Takingrthisrdrugrmayrcauserharmrtortherunbornrbabyrifryourarerpregnant,respeciallyrinrtherfirstrtrimester.
Ifryourarerpregnantrorrbecomerpregnantrwhilertakingrthisrdrug,rcallryourrhealthcarerproviderrrightraway.
Tellryourrhealthcarerproviderrifryourarerbreast-feedingrtordiscussrrisksrtortherbaby.
Haveryourrbaby'srthyroidrcheckedrifryourarerusingrthisrdrugrandrbreast-feeding.
Agranulocytosisrisrthermostrdangerousrtoxicityrriskrforrthisrmedicationrbutrisrveryrrare.rSorerthroatrandrfeve
rrshouldrberreportedrimmediately.r
PatientrTeachingrforrLevothyroxiner-
rrCORRECTrANSWERSworksrbestrifryourtakeritronranremptyrstomach,r30rtor60rminutesrbeforerbreakfast.
takerthermedicineratrthersamertimereachrday.
IdealrHbA1Crgoalrforrdiabetic,rnon-pregnantradultsr-rrCORRECTrANSWERSlessrthanr7%.
, HbA1Cr8%r-
rrCORRECTrANSWERShistoryrofrsevererhypoglycemia,rlimitedrliferexpectancy,rorradvancedrmicrovascularrorr
macrovascularrcomplications
HBA1CrValuerconsideredrdiagnosticrofrdiabetes.r-rrCORRECTrANSWERSarvaluerofr6.5%rorrgreater
HbA1CrMeasuringrIntervalr-
rrCORRECTrANSWERSeveryr3rmonthsruntilrvaluerisr<7%;reveryr6rmonthsrthereafter
HbA1CrGoalrforrOlderrAdultsr-
rrCORRECTrANSWERS<7.5%r[58rmmol/mol]),rwhilerthoserwithrmultiplercoexistingrchronicrillnesses,rcognitiv
erimpairment,rorrfunctionalrdependencershouldrhaverlessrstringentrglycemicrgoalsr(suchrasrA1Cr<8.0-
8.5%r[64-69rmmol/mol]).
CriteriarforrtherDiagnosisrofrDiabetesrMellitusr-rrCORRECTrANSWERS-Fastingrplasmarglucoser≥126rmg/dL
-Randomrplasmarglucoser≥r200rmg/dLrplusrsymptomsrofrdiabetes
-Oralrglucosertolerancertestr(OGTT):r2-hrplasmarglucoser≥200rmg/dLcor
-HemoglobinrA1cr6.5%rorrhigher
T1DMrEtiologyrandrMOAr-rrCORRECTrANSWERSAutoimmunerprocess;rLossrofrpancreaticrβrcells;
T2DMrEtiologyrandrMOAr-rrCORRECTrANSWERSUnknown—
butrthererisrarstrongrfamilialrassociation,rsuggestingrthatrheredityrisrarriskrfactor;rInsulinrresistancerandrinap
propriaterinsulinrsecretion
thertotalrdailyrdoser(TDD)rofrinsulinrcalculationr-
rrCORRECTrANSWERStotalrweightrofrtherpatientrinrkilogramsr(kg),rmultipliedrbyr0.6runits
Basalrinsulinrreplacementr-
rrCORRECTrANSWERS50%rofrthertotalrdailyrinsulinrdoserwhichrreplacesrinsulinrfromrfastingr(overnight)randr
betweenrmeals.
