1. Which of the following is true of thyroid stimulating Hormone (TSH) during pregnancy? a. Decreased levels early b.

Crosses the placenta and stimulater fetal thyroxine production c. Increase levels early because of the effects of human chorionic gonadotropin d. None of the above 2. Thyroid peroxidase antibodies are indentified in approximately what percentage of pregnant woman? a. 2% b. 10% c. 20% d. 30% 3. Symptomatic thyrotoxicosis or hyperthyroidism occurs in what percentage of pregnancy? a. 1% b. 0.1 % c. 0.5% d. 0.25% 4. Complications from thionamides include which of the following? a. Agranulocytosis b. Hepatotoxity c. Serious vasculitis d. All the above 5. In this graph , what is the incidence of antithyroid peroxidase antibodies in women with subclinical hypothyroidism? (SH = subclinical hypothyroidism; IMH = isolated maternal hypothyroxinemia) a. 4% b. 5% c. 31% d. 61% 6. What is the reported perinatal mortality rate associated with uncontrolled hyperthyroidism in pregnancy?

a. b. c. d.

5% 10% 15% 20%

7. This sonogram images illustrates what morbidity consistent with fetal thyrotoxicosis? a. Hepatomegaly b. Nonimmune hydrops c. Fetal pleural effusion d. All of the above 8. When treating maternal thyroid storm with heart failure , which of the following is true? a. Initially, sodium iodide is administered and then continued every 8 hours b. If there is a history of iodineinduced anaphylaxis lugol solution is given every 6 hours c. Initislly 1 g of a thionamide is given by NGT d. Dexamethasone is contraindicated 9. Concerning gestational thyrotoxicosis which orf the following is true? a. It should be treated with low dose thionamides b. There is abnormal massive thyrotropin release c. It should not be treated with antithyroid drugs d. None of the above 10. Which is the following is true of the condition illustrated by this newborn, who was delivered by a mother with thyroid desease? a. Goitrous hypothyroidism b. A common adverse fetal effect of maternal propylthiouracil (PTU) treatment c. Will not occur if the mother has had thyroid gland radioablation

d. A fetal arteriovenous malformation 11. Subclinical hypothyroidism is characterizes by which of the following? a. High serum thyroxine level b. Low free thyroxine (FT4) level c. High serum thyrotropin and normal FT4 levels d. Low serum thyrotropin level 12. Which of the following is the most common cause of hypothyroidism in pregnancy? a. Grave desease b. Paraneoplastic syndrome c. Hashimoto thyroiditis d. None of the above 13. Concerning treatment of hypothyroidism, which of the following is true? a. Approximately 100 mikrogram thyroxine should be given daily b. Thyrotropin levels should be measures at 4 to 6 week intervals c. The thyroxine dose should be adjusted in 25-5- microgram increments to achieve TSH levels between 0.5 and 2.5 mU/L d. All of the above 14. Which is the following is true routine thyrotropin screening in pregnancy? a. It is advocated by the American College Obstetricians and gy necologist b. It leads to improved outcome of neonateswhose mother have subclinical hypothyroidism c. It is not advocated by the American Association of clinical Endocrinologist d. It should be perfomed on symptomatic women or those with a history of thyroid disease

15. Which of the following iss true isolated maternal hypothyroxinemia? a. It is characterizes by high TSH and low FT4 levels b. It has similar prevalence of antithyroid antibodies as subclinical hypothyroidism c. In some women , it is associated with twofold incidence of macrosomia d. It has no apparent serious adverse effects on pregnancy outcome 16. Which of the following is true of postpartum thyroiditis? a. It affects 5-10% of women during the first year postpartum b. It is released to increasing levels of thyroid autoantibodies c. It occurs in 25% of women with type I diabetes mellitus d. All of the above 17. Which of the following is true of thyroid nodules during pregnancy? a. When smaller than 0.5 cm, they can be detected by sonography b. They are not assessed properly with fine-needle aspiration c. If cancerous they can confer a worse prognosis than if found in nonpregnant controls d. They can be safely removed before 24-26 weeks 18. Which of the following is true of 1,25 dihydroxy vitamin D? a. Level increase threefold during pregnancy b. It increase GIT calcium absoroption c. It is mostly of maternal origin during pregnancy d. All of the above 19. Which of the following is true of hyperparathyroidism?

a. It may be masked by pregnancy due to significant calcium shunting to the fetus b. It is caused mainly by hyperfunction of all four parathyroid glands c. It has a reported prevalence of 2-3 per 10000 women d. It is generally disease of young females 20. Of women with hyperparathyroidism in pregnancy which is the following is true? a. If symptomatic, surgical remoova; of the parathyroid adenoma shoulde be delayed until postpartum b. Asymptomatic women may be treated with oral phosphate, 11.5 g daily in divided doses c. If hypercalcemic crisis occurs, the patient should have fluids restricted d. Adjunctive theraphy includes doxorubicin, which inhibits bone resorption 21. Which of the following is true of pheochromocytoma? a. They are found in o.1 % of hypertensive patients during pregnancy b. They are called 10 percent tumor c. They are detected by a 24 hour urine collection for free cathecolamines, metanephrine or vanillyl mandelic acid (VMA) d. All of the above 22.