1) indications for surgery in hyperthyroidism, all except:
a) childhood
b) pregnancy
c) reoperation for hyperthyroidism
d) toxic adenoma
e) toxic multinodular goiter
2) a 30yo nurse presents with a 3 week history of malaise and weakness. Her thyroid gland is diffusely enlarged and tender. Her ESR is slightly elevated, and her T4 is twice normal. What should be done:
a) total thyroidectomy
b) radioactive iodine ablation
c) treatment with NSAIDS and rest
d) treatment with propanolol and PTU
e) FNA
3) a 35yo male has an asymmetrically enlarged thyroid gland. The ESR is 60. T4 is 180 and iodine uptake is 4%. He most likely has:
a) Graves
b) Ridel’s struma
c) Haschimotos disease
d) subacute thyroiditis
e) toxic multinodular goitre
4) Hashimoto’s thyroididtis may be associated with:
a) follicular thryroid ca
b) papillary thyroid ca
c) lymphoma
d) leukemia
e) Hurtle cell tumors
5) which of the following statements regarding Hashimoto’s thyroiditis is not true:
a) it is the commonest type of thyroiditis
b) there is a familial predisposition
c) the gland is infiltrated with giant cells
d) it occurs mostly in the middle age females
e) antithyroid Ab may be present
Answers:
ReplyDelete1-C, 2-C, 3-D, 4-C, 5-?
5-A:
ReplyDelete-Hashi's is the most common cause of HYPOthyroidism, no specific reference to most common cause of thyroiditis but suggests subacute thyroiditis as the "major" cause of pain in the thyroid.
- moderate genetic predisposition to Hashi with identified HLA markers,
- Histology shows lymphocytic infiltration with germinal centers, follicular cells can undergo metaplasia to Hurthle cells - which are predominant in Hashimoto's thyroiditis.
- Female predominance 9:1, mean age 30-60
- hashi's is an autoimmnune disorder with presence of anti-thyroid TPO antibodies