 6- Individuals with hypothyroidism would mostly likely have which one of the

following conditions?
o A. Growth retardation if occurs during the perinatal period
o B. Increased cardiac output
o C. Weight loss
o D. Excessive production of TSH if the defect is in the hypothalamus
o E. Less than normal levels of cholesterol in the circulation
 7- Iodine deficiency used to be a common cause of thyroid enlargement (goiter) in
some parts of the world. Which abnormality in chronically iodine-deficient patients is
most directly related to the enlargement of the thyroid gland?
o A. Reduced activity of thyroperoxidase
o B. Impaired conversion of T4 to T3
o C. Reduced level of cAMP in the thyroid follicular cells
o D. An antibody that binds to the TSH receptor in the thyroid gland
o E. Elevated TSH level

 8. Which of the following effects may be caused high plasma levels of thyroid
hormones? (Check all that apply)
o A. Decreased cardiac output
o B. Increased gluconeogenesis
o C. Decreased plasma levels of triglycerides
o D. Decreased plasma levels of free fatty acids
o E. Increased pulse pressure
o F. Decreased intestinal peristalsis

9. Which of the following effects may be caused by insufficient plasma levels of thyroid
hormones? (Check all that apply)

o A. Oligospermia
o B. Decreased respiratory rate
o C. Decreased plasma triglycerides
o D. Decreased peripheral vascular resistance
o E. Osteoporosis
o F. Periorbital edema
o G. Diarrhea

 10. A 42-year-old man was undergoing surgery in order to remove a very large
nontoxic goiter, apparently due to iodide deficiency. A short course of potassium
 iodide was administered before surgery. Which of the following statements best
explains why this drug was given to the patient?
o A. To stimulate thyroid hormone synthesis before surgery
o B. To overcome iodine deficiency after surgery
o C. To reduce the size and vascularity of the thyroid gland
o D. To decrease the risk of hypothyroidism after surgery
o E. To inhibit the excessive secretion of TSH from the pituitary
 11. A 55-year-old woman with thyrotoxicosis was treated with radioactive iodine.
One month later she most likely started a therapy with which of the following drugs?
o A. Potassium iodide
o B. Levothyroxine
o C. Diiodotyrosine
o D. Monoiodotyrosine
o E. Reverse triiodothyronine

 12. A 59-year-old woman was admitted to the hospital with restlessness, insomnia,
tremor and a pronounced exophthalmos. The woman, who had been suffering from
hyperthyroidism for two months, had been treated with propylthiouracil but the
drug was discontinued because of the appearance of agranulocytosis. Which of the
following agents would be most appropriate for the patient at this time?
A. Methimazole
B. Radioactive iodine
C. Potassium iodide
D. Propranolol
E. Prednisone

 13. A 55-year old woman recently diagnosed with hyperthyroidism started an

appropriate treatment. One month later the following laboratory values were
obtained: RBC 4.6 x 10 /mcl, WBC 0.9 x 10 /mcl, platelets 45 6 3 x 103/mcl. Which of
the following drugs most likely causes these results?
o A. Radioactive iodine
o B. Potassium iodide
o C. Methimazole
o D. Propranolol
o E. L-thyroxine

 14. Few days after a normal delivery, a new born baby boy became lethargic, had
respiratory difficulties, hoarse cry, and sucks poorly. Physical examination revealed
 large fontanelles, macroglossia, a distended abdomen, a cyanotic skin, hypotonia,
slow reflexes and hypothermia. Which of the following drugs would be appropriate
for this baby?
A. Methimazole
B. Somatrem
C. Levothyroxine
D. Theophylline
E. Potassium iodide
F. Prednisone

 15.
A 35 year old woman, who was 2 months pregnant, was found to have FT4 of 3.3
ng/dL (normal 0.9-2) and TSH < 0.01 IU/mL (normal 0.5-4.7) during a follow up visit.
Which of the following chronic drug treatment would be most appropriate for this
patient?

o A. Radioactive iodine
o B. Propranolol
o C. Potassium iodide
o D. Ipodate
o E. Propylthiouracil

 16.
A 75-year-old woman came to the clinic for her regular checkup. Her only complaints
included very dry skin and constipation which she treats with milk of magnesia. She
had no other medical problems and took no other medications. Routine laboratory
tests are within normal limits except for a TSH of 15 mIU/mL (normal 0.5-5.5).
Further lab exams indicated the presence of thyroid peroxidase antibodies. Which of
the following drug would be appropriate for this patient?
A. Potassium iodide
B. Propranolol
C. Methimazole
D. Loperamide
E. Levothyroxine
F. Diltiazem

 17. A 60-year-old alcoholic woman was admitted to the emergency room because of
unrelenting chest pain not relieved by nitroglycerin. Her medical problems included
alcoholic cardiomyopathy and hypothyroidism. Although she had been advised
repeatedly to take her thyroxine regularly she continued to take it sporadically. An
IM injection of 10 mg of morphine sulphate was given for the pain. After the
injection the nurse noticed mental depression, lethargy, shallow breathing and her
 temperature was 80E F. Which of the following drugs should be included in the
emergency therapy of this patient?
A. IV potassium iodide
B. Oral methimazole
C. Oral levothyroxine
D. IV triiodothyronine
E. Oral propylthiouracil

 18. A 41-year-old man complained to his physician of increased appetite, palpitation

and diarrhea. Lab results confirmed the diagnosis of mild hyperthyroidism and a
treatment with methimazole was started. Which of the following actions most likely
mediated the therapeutic effectiveness of the drug in this patient?
A. Inhibition of iodine absorption from the gut
B. Stimulation of thyroid peroxidase
C. Blockade of iodine uptake by the thyroid gland
D. Damage of DNA of thyroid cells
E. Inhibition of tyrosine iodination

 19. A 47-year-old woman complained to her physician of painless enlargement of

thyroid gland and fullness in her throat. Lab results revealed high titers of thyroid
peroxidase antibodies. A diagnosis of Hashimoto’s thyroiditis was made and an
appropriate treatment was started. Which of the following drugs was most likely
prescribed?
A. Propranolol
B. Potassium iodide
C. Levothyroxine
D. Methimazole
E. Radioactive iodine

 20.
Which of the following drugs can block most effectively the conversion of T4 to T3 by
the liver?
A. Levothyroxine
B. Diiodotyrosine
C. Methimazole
D. Propylthiouracil
E. TSH