Question 1

Which of the following is the best type of medication to treat myxedematous coma?&#10;A) narcotic analgesic&#10;B) steroid&#10;C) central nervous system depressant&#10;D) sedative

Accepted Answer

If myxedema coma should occur,the dentist should call for medical aid; while waiting for this assistance,the dentist can inject 100 to 300 mg of hydrocortisone,cover the patient to conserve heat,and apply cardiopulmonary resuscitation (CPR)as indicated.Once medical aid becomes available,parenteral levothyroxine is administered,and intravenous hypertonic saline and glucose are given as needed.

Question 2

Which of the following populations is most commonly affected by Hashimoto's thyroiditis?&#10;A) young and middle-aged women&#10;B) elderly men&#10;C) children of both genders&#10;D) adolescents

Accepted Answer

Hashimoto's thyroiditis usually affects young and middle-aged women.It also can occur in men,although much less commonly (it is three to four times more likely to occur in women),and in persons of any age.A family history of Hashimoto's thyroiditis or other autoimmune thyroid disorder often is reported.

Question 3

Which of the following is a form of thyroid hyperfunction?&#10;A) myxedema&#10;B) cretinism&#10;C) thyrotoxicosis&#10;D) Hashimoto's thyroiditis

Accepted Answer

On a functional basis,thyroid enlargement can be divided into three types: primary goiter (simple goiter and thyroid cancer),thyrostimulatory secondary goiter (Graves' disease and congenital hereditary goiter),and thyroinvasive secondary goiter (Hashimoto's thyroiditis,subacute painful thyroiditis,Riedel's thyroiditis,and metastatic tumors to the thyroid).The goiter of Graves' disease is associated with hyperthyroidism.

Question 4

Multiple endocrine neoplasia type 2 (MEN2)involves which of the following histologic types of cancer?&#10;A) differentiated&#10;B) medullary&#10;C) anaplastic&#10;D) H&#252;rthle cell

Accepted Answer

MEN2 consists of medullary thyroid carcinoma (MTC),pheochromocytoma in 50% of cases,and parathyroid hyperplasia or adenoma in 10% to 35% of cases.Differentiated cancers are subdivided into papillary,follicular,mixed,and Hürthle cell carcinomas.

Question 5

Which of the following is characteristic of red blood cells in thyrotoxic patients?&#10;A) pancytopenia&#10;B) leukopenia&#10;C) thrombocytopenia&#10;D) polycythemia

Accepted Answer

Polycythemia is an increase in the number of circulating red blood cells.Individual red blood cells (RBCs)in patients with thyrotoxicosis usually are normal; however,the RBC mass is enlarged to carry the additional oxygen needed for increased metabolic activities.In addition to the increased total numbers of circulating RBCs,the bone marrow reveals erythroid hyperplasia,and requirements for vitamin B₁₂ and folic acid are increased.

Question 6

Which of the following is the preferred initial treatment for patients with Graves' disease in North America?&#10;A) subtotal thyroidectomy&#10;B) antithyroid agents that block hormone synthesis&#10;C) radioactive iodine&#10;D) iodides

Accepted Answer

Administration of radioactive iodine is the preferred initial treatment for patients with Graves' disease in North America.This agent is contraindicated in pregnant women and in those who are breast-feeding.Radioactive iodine can induce or worsen ophthalmopathy,particularly in smokers.The main adverse effect associated with radioactive iodine treatment is hypothyroidism.

Question 7

Which of the following is the correct sequence leading to the release of thyroid hormones?
1.Thyroid-stimulating hormone (TSH)is released.
2.T4 and T3 are secreted.
3.Thyrotropin-releasing hormone (TRH)is released.

A) 1, 2, 3
B) 1, 3, 2
C) 2, 1, 3
D) 3, 1, 2

Accepted Answer

Under normal conditions,thyrotropin-releasing hormone (TRH)is released by the hypothalamus in response to external stress (e.g.,illness,metabolic demand,low levels of T₃ and,to a lesser extent,T₄).TRH stimulates the pituitary to release thyroid-stimulating hormone (TSH),which causes the thyroid gland to secrete T₄ and T₃.T₄ and T₃ also have a direct influence on the pituitary.High levels turn off the release of TSH,and low levels turn it on.In the blood,T₄ and T₃ are almost entirely bound to plasma proteins.

Question 8

Which of the following signs and symptoms are associated with Graves' disease?
1.weight loss
2.weight gain
3.rapid heartbeat
4.slow heartbeat

A) 1, 3
B) 2, 3
C) 1, 4
D) 2, 4

Accepted Answer

The most common signs and symptoms in Graves' disease are nervousness,fatigue,rapid heartbeat or palpitations,heat intolerance,and weight loss.These manifestations are reported in more than 50% of all diagnosed patients.With increasing age,weight loss and decreased appetite become more common,and irritability and heat intolerance are less common.Atrial fibrillation is rare in patients younger than 50 years of age,but it occurs in approximately 20% of older patients.

Question 9

Which of the following is a characteristic of hypothyroidism in older children and adults?&#10;A) warm, moist skin&#10;B) alopecia of the outer third of the eyebrows&#10;C) increased size of the tongue&#10;D) a and b&#10;E) b and c

Accepted Answer

The onset of hypothyroidism in older children and adults is manifested by characteristic changes in physical appearance: dull expression; puffy eyelids; alopecia of the outer third of the eyebrows; palmar yellowing; dry,rough skin; dry,brittle,coarse hair; and increased tongue size.Other features include slowing of physical and mental activity,slurred and hoarse speech,anemia,constipation,increased sensitivity to cold,increased capillary fragility,weight gain,muscle weakness,and deafness.

Question 10

Ophthalmopathy is strongly linked to which of the following thyroid diseases?&#10;A) Hashimoto's thyroiditis&#10;B) multiple endocrine neoplasia type 2 (MEN2)&#10;C) Graves' disease&#10;D) myxedema

Accepted Answer

Graves' ophthalmopathy,which is identified in approximately 50% of patients,is characterized by edema and inflammation of the extraocular muscles,as well as an increase in orbital connective tissue and fat.Ophthalmopathy is an organ-specific autoimmune process that is strongly linked to Graves' hyperthyroidism.Although hyperthyroidism may be successfully treated,ophthalmopathy often produces the greatest long-term disability for patients with this disease.

Question 11

The term _____________ refers to an excess of T&#8324; and T&#8323; in the bloodstream.&#10;A) thyrotoxicosis&#10;B) myxedema&#10;C) cretinism&#10;D) acropachy

Accepted Answer

The answer of The term _____________ refers to an excess...

Question 12

Which of the following is true regarding the incidence and prevalence of thyroid diseases?&#10;A) Graves' disease is usually detected prior to adolescence.&#10;B) During the past 10 years or so, the incidence of thyroid cancer has increased at a rate of about 5% per year.&#10;C) Postpartum thyroiditis is a form of subacute painful thyroiditis.&#10;D) Riedel's thyroiditis is a form of congenital hypothyroidism present in about 1 in 4,000 newborns.

Accepted Answer

The answer of Which of the following is true regarding...

Question 13

Which of the following oral changes is most likely encountered in adults with acquired hypothyroidism?&#10;A) pemphigoid&#10;B) an enlarged tongue&#10;C) sicca syndrome&#10;D) leukoedema

Accepted Answer

The answer of Which of the following oral changes is...

Deck 16: Thyroid Diseases