Adult Primary Care- Parathyroid/Thyroid

The side effects of corticosteroids include: A) a loss of collagen B) decreased leukocyte migration C) avascular bone necrosis D) hypercalcemia E) increased vascular permeability

A) a loss of collagen B) decreased leukocyte migration C) avascular bone necrosis

Neurologic manifestations of myxedema include: A) atrophy of the optic nerve B) paresthesia of the hands C) cerebellar symptoms D) a loss of vibration sensation in the legs E) hypacusis (hearing impairment) and tinnitus

B) paresthesia of the hands C) cerebellar symptoms E) hypacusis (hearing impairment) and tinnitus

Hyperparathyroidism is associated with: A) hypocalcemia B) psychosis C) constipation D) Trousseau's sign E) renal stones with the risk of urinary obstruction

B) psychosis C) constipation E) renal stones with the risk of urinary obstruction

Possible therapeutic interventions in thyrotoxic crisis include: A) a high dose of dexamethasone B) that the patient must be kept warm C) the administration of beta-blockers D) immediate propylthiouracil treatment E) the administration of iodine

C) the administration of beta-blockers D) immediate propylthiouracil treatment E) the administration of iodine

Which of the following statements regarding parathyroid hormone (PTH) are correct? Please select all that apply. a) Normal plasma levels of parathyroid hormone (PTH) stimulate osteoblast activity b) PTH decreases calcium excretion from the body c) PTH directly increases calcium absorption by the gut. d) PTH is secreted in response to elevated plasma calcium levels. e) High levels of circulating PTH demineralize bone and elevate plasma calcium

a) Normal plasma levels of parathyroid hormone (PTH) stimulate osteoblast activity b) PTH decreases calcium excretion from the body e) High levels of circulating PTH demineralize bone and elevate plasma calcium When plasma calcium levels are normal, PTH secretion stimulates bone formation through its action on osteoblasts. While PTH stimulates calcium absorption by the renal tubules, it has no direct action on the gut. It does, however, stimulate the production of 1,25 dihydroxycholecalciferol, which stimulates calcium absorption from the gut. Low plasma calcium levels stimulate PTH secretion; high plasma levels stimulate the secretion of calcitonin. When PTH levels are elevated, osteoclast activity is stimulated. This leads to the demineralization of bone and release of calcium into the plasma.

Which of the following statements regarding the thyroid gland are correct? Please select all that apply. a) A person with hypothyroidism has a low plasma TSH concentration. b) Calcitonin is secreted by the parafollicular cells of the thyroid gland. c) An inactive thyroid gland will contain more colloid than an active one. d) Calcitonin stimulates the activity of osteoclasts. e) Calcitonin is a steroid hormone.

b) Calcitonin is secreted by the parafollicular cells of the thyroid gland. c) An inactive thyroid gland will contain more colloid than an active one. A person with hypothyroidism is likely to have an elevated plasma level of TSH due to the removal of negative feedback inhibition normally caused by the thyroid hormone. Calcitonin inhibits the activity of osteoclasts (bone-resorbing cells) and tends to stimulate the activity of osteoblasts (cells which secrete bone matrix). Calcitonin is a peptide hormone.

Which of the following statements concerning thyroid function are correct? Please select all that apply. a) T3 and T4 stimulate the secretion of TSH by the anterior pituitary b) People who have an under-active thyroid gland have a low BMR c) A resting pulse rate of 65 beats per minute would suggest a diagnosis of thyrotoxicosis d) Most of the iodide in the body is present in the thyroid gland e) Thyroid hormones are essential for the early development and maturation of the central nervous system

b) People who have an under-active thyroid gland have a low BMR d) Most of the iodide in the body is present in the thyroid gland e) Thyroid hormones are essential for the early development and maturation of the central nervous system Thyroid hormones inhibit the secretion of TSH by negative feedback. Thyroid hormones stimulate metabolism and when TH levels are low, BMR is reduced. Thyrotoxicosis is caused by an overactive thyroid gland. High levels of TH will increase BMR and elevate the heart rate. The value given is normal. The thyroid gland avidly takes up iodine and incorporates it into thyroglobulin. Lack of TH in fetal and early neonatal life leads to a condition called cretinism in which there is mental retardation.

Which of the following are NOT symptoms of myxoedema? Please select all that apply. a) Dry cold skin b) Lethargy c) Weight loss d) Loss of hair e) Bulging eyes f) Puffiness of the face

c) Weight loss e) Bulging eyes Myxoedema is a condition characterized by a reduced secretion of thyroid hormones. Typically it results in a lowered BMR and a range of associated symptoms. Weight loss is associated with a raised BMR and is more often seen in patients with hyperthyroidism. Bulging eyes (exophthalmos) are also characteristic of hyperthyroidism.