Deck 38: Drugs Affecting the Thyroid and Parathyroid Glands and Bone Degener

Question 1

Identify the condition characterized by a significant reduction in bone mass.

A) Hypothyroidism
B) Agranulocytosis
C) Osteoporosis
D) Cretinism

Answer 1

Osteoporosis

Question 2

Use the drug interactions and adverse-effects profile of the replacement thyroid hormones to explain to a patient already taking cholestyramine the proper method of taking his thyroid hormone.

A) To avoid interference with intestinal absorption of the thyroid hormones, the patient should take the cholestyramine and the thyroid hormones on alternating days.
B) To avoid interference with intestinal absorption of the thyroid hormones, the patient should take the cholestyramine and the thyroid hormones 2 or 3 hours apart.
C) To avoid interference with intestinal absorption of the thyroid hormones, the patient should take the cholestyramine and the thyroid hormones 4 or 5 hours apart.
D) None of these are correct.

Answer 2

To avoid interference with intestinal absorption of the thyroid hormones, the patient should take the cholestyramine and the thyroid hormones 4 or 5 hours apart.

Question 3

Differentiate between osteoclasts and osteoblasts,and select the true statement related to the calcium balance mechanism.

A) The osteoclasts secrete enzymes that break down bone and release calcium ions.
B) The osteoblasts secrete a protein matrix to facilitate calcium ion deposition.
C) A crystalline calcium phosphate salt known as hydroxyapatite is needed for the calcium to be laid into bone.
D) All of these are correct.

Answer 3

All of these are correct.

Question 4

Identify the condition characterized by a significant reduction in the number of white blood cells.

A) Hypothyroidism
B) Agranulocytosis
C) Osteoporosis
D) Cretinism

Question 5

Select the true statement related to the body's response to calcium levels of more than 10.5 mg/dL.

A) When the plasma calcium level reaches 10.5 mg/dL, calcitonin is secreted. It lowers the circulating calcium level by antagonizing the effect of PTH on bone.
B) When the plasma calcium level reaches 10.5 mg/dL, calcitonin is secreted. It raises the circulating calcium level by potentiating the effect of PTH on bone.
C) When the plasma calcium level reaches 10.5 mg/dL, PTH is secreted. It lowers the circulating calcium level by antagonizing the effect of calcitonin on bone.
D) None of these are correct.

Question 6

Select the true statement related to the regulatory process that maintains calcium homeostasis.

A) Hypercalcemia stimulates calcitonin secretion, while hypocalcemia stimulates the secretion of PTH.
B) Plasma calcium is maintained at 9.0 to 10.4 mg/dL for men and 8.9 to 10.2 mg/dL for women.
C) Calcitriol is a form of vitamin D that facilitates calcium absorption from the GI tract, thus increasing circulating calcium.
D) All of these are correct.

Question 7

Explain the requirements that must be met for the bisphosphonate drug agents to be optimally effective.

A)The bisphosphonates must be taken with an adequate amount of oral calcium and vitamin D.
B)The bisphosphonates must be taken with an adequate amount of vitamin C.
C)The bisphosphonates must be taken with an adequate amount of iron.
D)The bisphosphonates must be taken with an adequate amount of folic acid.

Question 8

Select the statement that best explains the chemical process that leads to the physiological development of a goiter.

A) The hypothalamus secretes TRH (thyrotropin-releasing hormone), which travels to the anterior pituitary. The anterior pituitary is then stimulated to secrete TSH (thyroid-stimulating hormone) into the bloodstream. TSH binds to receptors on the plasma membrane of the thyroid gland, stimulating the production of T₃ and T₄.
B) When thyroid hormone secretion is suppressed, the feedback loop (TRH, TSH) stimulates the thyroid to secrete more T₃ and T₄. When little or no T₃ and T₄ circulates in the blood, TSH continues to stimulate the thyroid gland to release hormones that it cannot produce. This constant stimulation of the thyroid results in the development of the goiter.
C) The hypothalamus secretes TRH (thyrotropin-releasing hormone), which stimulates the incorporation of iodide into tyrosine and the condensation of monoiodotyrosine and diiodotyrosine, causing the thyroid to overproduce T₃ and T₄. This constant stimulation of the thyroid results in the development of the goiter.
D) None of these are correct.

Question 9

Using the available treatment options,select the primary treatment for the calcium disorder hypoparathyroidism.

A) Administration of the bisphosphonates.
B) Administration of intravenous calcium, followed by oral calcium salts and vitamin
C) Administration of the parathyroid hormone, teriparatide (Forteo).
D) All of these are correct.

Question 10

Select the statement that best describes the formation of triiodothyronine (T₃) and thyroxine (T₄).

A) The secretion of T₃ and T₄ is under the control of the hypothalamic-anterior pituitary-thyroid axis. The hypothalamus secretes TSH (thyroid-stimulating hormone), which travels in the portal vein to the anterior pituitary. The anterior pituitary is then stimulated to secrete TRH (thyrotropin-releasing hormone) into the bloodstream. TRH binds to receptors on the plasma membrane of the thyroid gland, stimulating the production of T₃ and T₄.
B) The secretion of thyrocalcitonin is under the control of the hypothalamic-anterior pituitary-thyroid axis. The hypothalamus secretes thyrocalcitonin, which travels in the portal vein to the anterior pituitary. The anterior pituitary is then stimulated to secrete TSH (thyroid-stimulating hormone) into the bloodstream. TSH binds to receptors on the plasma membrane of the thyroid gland, stimulating the production of T₃ and T₄.
C) The secretion of T₃ and T₄ is under the control of the hypothalamic-anterior pituitary-thyroid axis. The hypothalamus secretes TRH (thyrotropin-releasing hormone), which travels in the portal vein to the anterior pituitary. The anterior pituitary is then stimulated to secrete TSH (thyroid-stimulating hormone) into the bloodstream. TSH binds to receptors on the plasma membrane of the thyroid gland, stimulating the production of T₃ and T₄.
D) None of these are correct.

Question 11

Describe the results of long-term use of thyroxine in postmenopausal women.

A) Hypothyroidism
B) Agranulocytosis
C) Cretinism
D) Osteoporosis

Question 12

Select the statement that best explains the mechanism of action of alendronate (Fosamax),pamidronate (Aredia),risedronate (Actonel),and zoledronate (Reclast).

A) The nonnitrogen bisphosphonates are attracted to bone calcium and have greater resorption inhibition potency. These drugs [alendronate (Fosamax), pamidronate (Aredia), risedronate (Actonel), and zoledronate (Reclast)] compete with osteoclast ATP, causing the cells to die; thus, bone resorption decreases.
B) The nonnitrogen bisphosphonates [alendronate (Fosamax), pamidronate (Aredia), risedronate (Actonel), and zoledronate (Reclast)] compete with osteoclast ATP, causing the cells to die; thus, bone resorption decreases.
C) The nitrogen bisphosphonates are more readily attracted to bone calcium and have greater resorption inhibition potency. These drugs [alendronate (Fosamax), pamidronate (Aredia), risedronate (Actonel), and zoledronate (Reclast)] prevent protein synthesis in the osteoclast cell membrane by interrupting the HMG-CoA reductase pathway.
D) None of these are correct.

Question 13

Describe the physical ramifications of the presence of hypothyroidism in infants and children.

A) Mental and physical retardation
B) Exophthalmos
C) Goiter development
D) None of these are correct.

Question 14

Use the contraindications and special considerations of the replacement thyroid hormones to explain to a diabetic patient the outcome of discontinuing thyroid treatment without notifying the physician.

A) Stopping thyroid therapy may bring about hyperglycemia unless the antidiabetic medication is adjusted upward after stopping thyroid treatment.
B) Stopping thyroid therapy may bring about hypoglycemia unless the antidiabetic medication is adjusted downward after stopping thyroid treatment.
C) Stopping thyroid therapy may bring about exophthalmos.
D) None of these are correct.

Question 15

Select the class of drugs used as co-therapy to inhibit the increased sympathetic responses that accompany hyperthyroidism in the treatment of thyrotoxic crisis.

A) Beta-adrenergic blocking drugs
B) Leukotriene inhibitors
C) Calcium channel blockers
D) None of these are correct.

Question 16

Using your knowledge of the mechanism of action of the bisphosphonates,select the true statement related to their use in the treatment of osteoporosis.

A) It is advisable not to take the bisphosphonates within 2 hours of calcium supplements, caffeine, or antacids because absorption will be increased.
B) It is advisable not to take the bisphosphonates within 1 hour of calcium supplements, caffeine, or antacids because absorption will be decreased.
C) It is advisable not to take the bisphosphonates within 1 hour of calcium supplements, caffeine, or antacids because absorption will be increased.
D) It is advisable not to take the bisphosphonates within 2 hours of calcium supplements, caffeine, or antacids because absorption will be decreased.

Question 17

Explain the physiological effects in the body that are stimulated by the presence of the thyroid hormones,T₃ and T₄.

A) Thyroid hormone stimulates protein synthesis.
B) Thyroid hormone increases carbohydrate breakdown as well as blood glucose and insulin-dependent entry of glucose into cells.
C) Thyroid hormone decreases serum cholesterol.
D) All of these are correct.

Question 18

Use the contraindications and special considerations of the replacement thyroid hormones to explain to a patient who just found out that she is pregnant how she should use her thyroid hormones.

A) Discontinue treatment until the third trimester, when there is no longer a risk of affecting fetal development.
B) Discontinue treatment because the thyroid hormones administered to pregnant women readily cross the placental barrier to affect fetal development.
C) Continue treatment as usual because the thyroid hormones administered to pregnant women do not readily cross the placental barrier to affect fetal development.
D) None of these are correct

Question 19

Select the statement that best explains the results of excessive use of calcium and vitamin D in the treatment of hypocalcemia.

A) Excessive use of calcium and vitamin D may lead to convulsions and parasthesia.
B) Excessive use of calcium and vitamin D may lead to hypercalcemia and kidney stone formation.
C) All of these are correct.
D) Excessive use of calcium and vitamin D may lead to carpopedal spasms.

Question 20

Using mechanism of action,select the true statement about the antithyroid drugs,including propylthiouracil,methimazole,and methylthiouracil.

A) The thioamide drugs inhibit the incorporation of iodide into tyrosine and the condensation of monoiodotyrosine and diiodotyrosine.
B) The thioamide drugs inhibit the feedback loop (TRH, TSH) from stimulating
C) the thyroid to secrete more T₃ and T₄.
D) The thioamide drugs inhibit the anterior pituitary from secreting TSH (thyroid-stimulating hormone) into the bloodstream.
E) None of these are correct