Tiroides

Question 1

¿Qué significa T4?
a) Tetrayodotironina
b) Triyodotironina
c) tiroxina

Answer 1

a) Tetrayodotironina y c) tiroxina son correctas

Question 2

¿Qué significa T3?
a) Tetrayodotironina
b) Triyodotironina
c) tiroxina

Answer 2

b) Triyodotironina

Question 3

Hormona tiroidea en mayor cantidad pero menor potencia:
a) T3
b) T4
c) T5

Answer 3

b) T4

Question 4

Hormona tiroidea en menor cantidad pero mayor potencia:
a) T3
b) T4
c) T5

Answer 4

a) T3

Question 5

¿Cuál enunciado es correcto?
a) T3, tiroxina, se convierte en iodinasa en tejidos.
b) T4, tiroxina, se convierte en iodinasa en tejidos.
c) T4 se convierte en T3 en los tejido con iodinasa
d) T3 se convierte en T4 en los tejido con iodinasa

Answer 5

c) T4 se convierte en T3 en los tejido con iodinasa

Question 6

Enfermedad de Graves, Adenoma tóxico, bocio multinodular e ….. farmacológico son tipos de enfermedades de :
a) hipotiroidismo
b) hipertiroidismo

Answer 6

b) hipertiroidismo

Question 7

Bocio por deficiencia de yodo, tiroiditis crónica y destrucción de la glándula son tipos de enfermedades de :
a) hipotiroidismo
b) hipertiroidismo

Answer 7

a) hipotiroidismo

Question 8

Tratamientos para enfermedades tiroideas:

Answer 8

Tioamidas,
yodo radioactivo,
preparados de hormonas tiroideas

Question 9

¿Cuál es el mecanismo de acción de la Tioamida: Metimazol?
a) inhibe tioperoxidasa > bloquea organificación del yodo
b) inhibe conversión de T4 a T3 en tejidos
c) ambas son correctas

Answer 9

a) inhibe tioperoxidasa > bloquea organificación del yodo

Question 10

¿Cuál es el mecanismo de acción de la Tioamida: Propiltiouraiclo (PTU)?
a) inhibe tioperoxidasa > bloquea organificación del yodo
b) inhibe conversión de T4 a T3 en tejidos
c) ambas son correctas

Answer 10

c) ambas son correctas

Question 11

Fármacos para hipertiroidismo usados p/prepar px para tiroidectomía o yodo reactivo; y en crisis tirotóxicas:

Answer 11

Metimazo y PTU

Question 12

Con tiaminas se logra remisión completa (30-40%) en más de año y medio en la:
a) Sx Sjörgen
b) enfermedad de Graves
c) tiroiditis

Answer 12

b) enfermedad de Graves

Question 13

Fármaco que se reserva para pacientes alérgicos o intolerantes al metimazol. Para px embarazadas 1er trimestre o que busquen embarazarse. Y en tormenta tiroidea:
a) metimazol
b) propiltiouracilo - PTU

Answer 13

b) propiltiouracilo - PTU

Question 14

Son efectos adversos de las tioamidas:
a) lesión hepática (mortal) y leucopenia transitoria benigna
b) lupus eritematoso y exantema maculopapular
c) neutropenia y agranulocitosis (grave)

Answer 14

Todas son correctas

Question 15

¿Cómo es la dosificación de las tioamidas?

Answer 15

Se comienza con dosis elevada y se va reduciendo posteriormente.

Question 16

¿Cuáles son los yodos radioactivos?

Answer 16

I-131 y I-123

Question 17

____ entra a la glándula tiroides, emite rayos beta destruyendo el tejido.
a) I-123
b) I-131
c) I-121
d) I-132

Answer 17

b) I-131

Question 18

____ se usa con fines diagnóstico.
a) I-123
b) I-131
c) I-121
d) I-132

Answer 18

a) I-123

Question 19

¿Cuáles son las indicaciones para yodo radioactivo?

Answer 19

Hipertiroidismo y Posteriori a tiroidectomía en cáncer tiroideo.

Question 20

El yodo radioactivo es CONTRAINDICADO en embarazo o previo a él, ¿por qué?

Answer 20

Porque destruye igualmente el tejido tiroideo fetal.

Question 21

Al usar yodo radioactivo se deben evitar el consumo de _____ pues reduce eficacia terapéutica.

Answer 21

Tioamidas.

Question 22

Menciona los 3 preparados de hormonas tiroideas:

Answer 22

Levoriroxina, Liotironina y Combinación de ambas.

Question 23

Fármaco de selección para tx sustitutiva, disminución de TSH y previo a tiroidectomía:

Answer 23

Levotiroxina (T4)

Question 24

Fármaco poco usado, de vía intravenosa al tx coma mixedematoso:

Answer 24

Liotironina (T3)

Question 25

Alimentos y otros fármacos disminuyen abolición de _______, por ello consumir con 2 hrs de diferencia. a) liotironina (T3) b) combinación de ambos c) levotiroxina (T4)

Answer 25

c) levotiroxina (T4)

Question 26

Levothyroxine use is contraindicated in px with which one of these conditions? a) hypertension b) uncorrected adrenal insufficiency c) end-stage renal disease d) cirrhosis

Answer 26

b) uncorrected adrenal insufficiency

Question 27

In general, adverse effects associated with levothyroxine are due to incorrect or excessive dosing. Which one of these adverse effects is more commonly associated with levothyroxine use? a) Decreased appetite b) Weight gain c) Polyuria d) Angina pectoris

Answer 27

d) Angina pectoris

Question 28

Which statement is most accurate regarding levothyroxine toxicity? a) onset of sign san symptoms of levothyroxine toxicity has been delayed as long as 10 days b) a one-time ingestion of as much as 2 mg of levothyroxine typically causes severe complications in children and adults c) common signs and symptoms associated with levothyroxine toxicity include constipations, extreme fatigue, and bradycardia d) serious health concerns related to levothyroxine toxicity are more common in children than in adults for the same overdose ingested

Answer 28

a) onset of sign san symptoms of levothyroxine toxicity has been delayed as long as 10 days

Question 29

Which medica>on is most well recognized as a cause of hypothyroidism? a) Lithium b) Amoxicilin c) Metoprolol d) Metformin

Answer 29

a) Lithium

Question 30

Which is most commonly recognized as a sign or symptom of hypothyroidism? a) Emotional lability b) Weight loss c) Tachycardia d) Hyperhidrosis

Answer 30

a) Emotional lability

Question 31

What's the first tx for thyroid eye disease? a) teprotumumab b) mertormin c) levothyroxine

Answer 31

a) teprotumumab

Question 32

"Un inhibidor de IGF-IR del receptor del factor de crecimiento similar a la insulina 1 (dentro de la órbita del ojo)" es el mecanismo de acción de:

Answer 32

Teprotumumab

Question 33

Untreated hyperthyroidism + stress like infections or illness can lead to a life threatening disease called:

Answer 33

thyroid storm

Question 34

____________ is the primary mechanism of action of methimazole.

Answer 34

Inhibition of thyroid peroxidase

Question 35

Methimazole is recommended for use during the (1st/2nd/3rd/no) _____________ trimester of pregnancy in patients with hyperthyroid.

Answer 35

2nd and 3rd

Question 36

Propylthiouracil (is/is not) ______ safe for use during the first trimester of pregnancy in patients with hyperthyroidism.

Answer 36

is

Question 37

_________ and methimazole are two hyperthyroidism medications that can cause agranulocytosis and aplastic anemia.

Answer 37

Propylthiouracil (PTU)

Question 38

_______ is a thioamide that inhibits the enzyme thyroid peroxidase only, and does not have peripheral activity.

Answer 38

Methimazole

Question 39

______ and propylthiouracil are two medications used in the treatment of hyperthyroidism.

Answer 39

Methimazole

Question 39

______ is a possible teratogenic complication of Methimazole.

Answer 39

Aplasia cutis

Question 40

______ is the black box warning of propylthiouracil.

Answer 40

Hepatotoxicity

Question 41

______ is a rare hematological complication of propylthiouracil and methimazole use.

Answer 41

Agranulocytosis

Question 42

______ and methimazole are thioamides used in hyperthyroidism and are associated with agranulocytosis.

Answer 42

Propylthiouracil (PTU)

Question 43

______ is a thioamide that inhibits thyroid peroxidase and 5'-deiodinase at peripheral tissues.

Answer 43

Propylthiouracil (PTU)

Question 44

Propylthiouracil (inhibits/stimulates) ______ conversion of T4 to T3.

Answer 44

inhibits

Question 45

______ is a hyperthyroid medication that inhibits both thyroid peroxidase and 5′-deiodinase.

Answer 45

Propylthiouracil (PTU)

Question 46

______ is a short acting thioamide.

Answer 46

Propylthiouracil (PTU)

Question 47

A 6-hour-old male delivered at 37 weeks’ gestation is found to have a lesion on the right side of his scalp, with out skin. On further inspection, the lesion is non-inflammatory and involves both the epidermis and upper dermis. The infant was delivered by normal vaginal delivery and has microcephaly and polydactyly of the right hand. The mother had little prenatal care and has no past medical history, aside from hyperthyroidism which was treated with methimazole throughout the pregnancy. Which of the following is the most likely diagnosis? a) Aplasia cutis congenita b) Birth trauma c) Epidermolysis bullosa d) Focal dermal hypoplasia e) Neonatal herpes infection

Answer 47

a) Aplasia cutis congenita

Question 48

An 18-year-old woman comes to the clinic because of tachycardia, nervousness, decreased exercise tolerance, and weight loss over the past 6 months. She was previously healthy and takes no medications. Her sister has Graves disease. Her pulse is 124/min, respirations are 18/min, and blood pressure is 128/78 mm Hg. Her BMI is 19 kg/m2. There is no proptosis. Examination of the neck shows a smooth and enlarged thyroid gland. Cardiac examination shows regular tachycardia. Her lungs are clear to auscultation. Laboratory studies are obtained and show: Thyroid-stimulating hormone: <0.01 µU/mL Thyroxine (T4 ): 15.5 μg/dL Triiodothyronine (T3 ): 240 ng/L Which of the following is the most appropriate treatment for this patient? a)Propranolol b) Propranolol and methimazole c) Methimazole d) Propylthiouracil e) Radioactive iodine and methimazole

Answer 48

b) Propranolol and methimazole

Question 49

A 29-year-old woman comes to the clinic because of heat intolerance, excessive sweating, and thinning hair. She has a family history of auto-immune disease, including rheumatoid arthritis. She is 8 weeks' pregnant and has had no other issues during the pregnancy. Medical history includes hyperthyroidism. Laboratory serum studies are positive for thyroid stimulating immunoglobulin. Which of the following drugs is most appropriate for the treatment of the patient's condition? a) Methimazole b) Oxytocin c) Propylthiouracil d) Radioactive iodine e) Synthetic T4

Answer 49

c) Propylthiouracil

Question 50

______ is a thyroid hormone produced from its prohormone, thyroxine.

Answer 50

Triiodothyronine (T3)

Question 51

In cells, thyroxine is a thyroid hormone that is converted by deiodinases to its more potent form, _________.

Answer 51

Triiodothyronine (T3)

Question 52

Patients on thyroid replacement therapy such as levothyroxine require ______ weeks to achieve steady state.

Answer 52

6 to 8 weeks

Question 53

Intravenous ______ and levothyroxine are the treatments for myxedema coma.

Answer 53

liothyronine

Question 54

For patients with Hashimoto thyroiditis or any form of hypothyroidism, _______ is the drug of choice.

Answer 54

levothyroxine

Question 55

The side effects of levothyroxine are the symptoms of ______, namely, palpitations, diarrhea, weight loss, and increased appetite.

Answer 55

Hyperthyroidism

Question 56

______ is a recombinant form of T4 that served as a thyroxine replacement and is an agonist at the thyroid hormone receptor.

Answer 56

Levothyroxine

Question 57

Triiodothyronine has a (shorter/longer) ______ half-life than thyroxine.

Answer 57

shorter

Question 58

A 20-year-old woman, gravida 1, para 0, is brought to the obstetrics clinic for her first prenatal visit. Patient's medical history include diabetes mellitus type 1 and hypothyroidism controlled with levothyroxine. Levothyroxine is explained to the patient as a category A drug. Which of the following best describes a category A medication? a) Positive evidence of human fetal risk that may or may not outweigh the potential benefit b) Well-controlled studies in women fail to demonstrate a risk to the mother c) Well-controlled studies in women fail to demonstrate a risk to the fetus in the first trimester d) Clearly defined risk of fetal abnormality outweighing the potential benefit e) Animal studies demonstrating adverse effects that are not supported by well controlled human studies

Answer 58

c) Well-controlled studies in women fail to demonstrate a risk to the fetus in the first trimester

Question 59

A 25-year-old woman is brought to the dermatology clinic because of palpitations and hyperhidrosis of the palms and soles for the past month. Her temperature is 38°C (100.4°F), pulse is 106/min, respirations are 18/min, and blood pressure is 142/80 mm Hg. The patient's medications include bupropion and levothyroxine. Which of the following physical examination findings are most consistent with this patient's clinical picture? a) Angular cheilitis b) Hirsutism c) Koilonychia d) Plummer’s nails e) Psoriasis

Answer 59

d) Plummer’s nails