Thyroid + adrenal practice questions

Question 1

What two drugs can cause both hypo and hyperthyroidism?
a) Amiodarone
b) Iodine
c) Lithium
d) Dronedarone

Answer 1

a) Amiodarone
c) Lithium

Question 2

What are some absolute contraindications for radioactive iodine use? Select all that apply
a) Pregnancy/lactation/planning pregnancy
b) HCC
c) Thyroid cancer
d) Breast cancer
e) Inability to comply with radiation safety guidelines

Answer 2

a) Pregnancy/lactation/planning pregnancy
c) Thyroid cancer
e) Inability to comply with radiation safety guidelines

Question 3

Can you use radioactive iodine more than once?

Answer 3

Yes, if the patient still has hyperthyroidism after 6 months

Question 4

What disrupts hormone synthesis by incorporating into thyroid hormones and TG, and will destroy overactive thyroid cells via beta ionizing particles in the thyroid follicular cell?
a) MMI
b) PTU
c) Saturated Solution (SSKI)
d) Radioactive iodine

Answer 4

d) Radioactive iodine

Question 5

A patient has a TSH of 12. What does this indicate?
a) Hyperthyroidism
b) Hypothyroidism
c) Euthyroid state

Answer 5

b) Hypothyroidism

Question 6

You need to start a pregnant patient in her first trimester on a hyperthyroidism med. What do you start her on & what dose?

Answer 6

150-450 mg/day of PTU

Question 7

What has a BBB for severe liver injury and acute liver failure?
a) MMI
b) PTU
c) Saturated Solution (SSKI)
d) Radioactive iodine

Answer 7

b) PTU

Question 8

For which medication should a pt drink lots of water because of the side effect of painful swelling and enlargement of salivary glands?
a) MMI
b) PTU
c) Saturated Solution (SSKI)
d) Radioactive iodine

Answer 8

d) Radioactive iodine

Question 9

Which of the following drugs should you use for thyroid storm? Select all that apply
a) PTU loading dose 1 gram, then 900–1200 mg/day PO
b) Sodium iodide up to 2 g/day IV
c) Propranolol 40–80 mg Q6hrs
d) Hydrocortisone 300mg as an initial bolus followed by 100mg TID

Answer 9

a) PTU loading dose 1 gram, then 900–1200 mg/day PO
b) Sodium iodide up to 2 g/day IV
c) Propranolol 40–80 mg Q6hrs
d) Hydrocortisone 300mg as an initial bolus followed by 100mg TID

Question 10

(+) TPOAb (antibodies) likely indicate what condition?
a) Grave’s
b) Hashimoto’s
c) Congenital primary hypothyroidism
d) Hyper-functioning goiter

Answer 10

b) Hashimoto’s

Question 11

A patient just had a thyroidectomy. What do you want to give them?
a) Levothyroxine
b) Liothyronine
c) Leotrix
d) Nature thyroid

Answer 11

c) Leotrix

Question 12

A patient is on IV 75 mcg of levothyroxine for myxedema coma. What would be their PO dose?
a) 100 mcg PO
b) 56.25 mcg PO
c) 75 mcg PO
d) 50 mcg PO

Answer 12

a) 100 mcg PO
-IV:PO ratio of 0.75:1

Question 13

What is the treatment of choice for Hashimoto’s disease?
a) Surgical resection of the tumor
b) Hydrocortisone 15 mg daily (BID dosing)
c) Radioactive Iodine I-131 3-15mCi oral liquid
d) Levothyroxine titrated to 12.5-25 mcg/day

Answer 13

d) Levothyroxine titrated to 12.5-25 mcg/day

Question 14

Which drug should you avoid if the patient wants to get pregnant within the next 5 years?
a) Mitotane (Lysodren®)
b) Mifepristone (Korlym®)
c) Etomidate (Amidate®)
d) Metyrapone (Metopirone®)

Answer 14

a) Mitotane (Lysodren®)

Question 15

What is the treatment of choice for Addison’s disease?
a) Surgical resection of the tumor
b) Hydrocortisone 15 mg daily (BID dosing)
c) Radioactive Iodine I-131 3-15mCi oral liquid
d) Levothyroxine titrated to 12.5-25 mcg/day

Answer 15

b) Hydrocortisone 15 mg daily (BID dosing)

Question 16

Which of the following is radioactive iodine NOT the DOC for?
a) Toxic autonomous nodules
b) Toxic multinodular goiters
c) Graves’ disease
d) Addison’s disease

Answer 16

d) Addison’s disease