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Which of these causes of thyrotoxicosis does not result in normal or elevated radioactive iodine uptake in the neck on 1-123 scintigraphy?
Which of these medications does not reduce the conversion of circulating levels of free T4 into free T3?
Which of these is not an expected side effect of methimazole
Which of these statements about the natural history of Graves ophthalmopathy is incorrect.
A 47-year-old man with nonischemic cardiomyopathy complicated by atrial fibrillation is admitted to the heart failure service due to refractory atrial fibrillation. He is currently on metoprolol, amiodarone, lisinopril, spironolactone and soluble aspirin. His thyroid function test is remarkable for elevated free T3 and T4 levels, 4x above the upper limit of normal, with a suppressed TSH <0.01. The consulting endocrinologist is concerned about amiodarone-induced thyrotoxicosis. What is the best next step in elucidating the cause of amiodarone-induced thyrotoxicosis (AIT)?
A 32-year-old woman with a two-year history primary hypothyroidism in the setting of Hashimoto’s thyroiditis, presents to her primary care doctors office with chronic fatigue, hair loss, and weight gain. Her TSH is elevated at 53 (0.5-4.2). Her current dose of levothyroxine is 112mcg daily. Patient endorses compliance with therapy. She has no other medical comorbidities and is not any medications which might interfere with thyroid hormone absorption.
A 28-year-old female with Gestational diabetes mellitus presented with palpitations and insomnia during her six-week postpartum visit. She has no known history of thyroid disease. These were the results of her thyroid function tests.
TSH <0.01 (0.30 - 4.20) Free T3 5.2 pg/mL (2.0 - 4.4) Free T4 1.53 ng/dL (0.9 – 1.7)
The consulting endocrinologist is concerned about postpartum thyroiditis. What should be the next step in the evaluation of this patient?
45-year-old woman with an incidental 1.6cm thyroid nodule involving the isthmus. She has no history of thyroid disease, neck irradiation or a family history of thyroid cancer. She has no compressive neck symptoms or symptoms suggestive of thyroid dysfunction. There is a palpable firm isthmic nodule on physical examination but no cervical lymphadenopathy.
TSH is 2.4 mIU/L (0.5 to 5.0). Thyroid ultrasound shows a 1.6cm mixed cystic nodule. What should be done next?
Which of these is not a biochemical feature of the sick euthyroid syndrome?
A 62-year-old man with sporadic metastatic medullary thyroid carcinoma is referred to you for further management. He had a complete thyroidectomy 4 years prior and has since then been on active surveillance. His calcitonin levels have progressively increased over the past 2 years. There is evidence of pulmonary metastasis and locally aggressive disease in the neck threatening the airway. He is started on treatment and monitored based on the RECIST Response Evaluation Criteria in Solid Tumors criteria. What therapy was recently started due to this patient’s extensive disease?
Based on the American Thyroid Association guidelines which of these does not represent a low-risk thyroid nodule on thyroid ultrasound?
61-year-old Hispanic man with a known history of hypertension, obstructive sleep apnea and type 1 diabetes mellitus, is found to have an incidental thyroid nodule noted during a carotid ultrasound. He has a left thyroid lobe 0.8cm hypoechoic nodule with high-risk sonographic features. FNAB was suspicious for papillary thyroid cancer. He has no sonographic evidence of cervical lymphadenopathy. There is no family history of thyroid cancer. What would you recommend?
67-year-old Caucasian female is diagnosed with medullary thyroid cancer and undergoes total thyroidectomy and extensive neck dissection due to involved cervical lymph nodes. He has no family history of MTC and no personal history of primary hyperparathyroidism or pheochromocytoma. Which of these options is the next best step?
Which of these is not a cause of an inappropriately normal serum TSH in the setting of thyroid hormone excess (i.e elevated free T4)?
Which of these patterns of TSH and free thyroid hormone levels is consistent with acute nonthyroidal illness?
A 55-year-old woman presents with a rapid onset of dysphagia, dyspnea and progressive hoarseness of voice. Physical examination is consistent with a hard-thyroid gland and a positive Trousseau’s sign. The patient undergoes a total thyroidectomy. Histopathology of the parathyroid gland is consistent with extensive plasma cell infiltration. What is the recommended therapy of this patient’s primary diagnosis?
Which of these is not a recommended screen for patients on tyrosine kinase inhibitor therapy for progressive differentiated thyroid cancer.
A 72-year-old man with a huge nontoxic goiter presents with exertional dyspnea and a choking sensation of 4 weeks duration. Pemberton’s sign was positive. What is the most likely mechanism for this clinical sign?
A patient with Grade III Graves ophthalmopathy is evaluated in the endocrine clinic. Which of these is NOT a reason for unilateral eyelid retraction?
A patient is evaluated for an elevated serum free T4 and an inappropriately normal serum TSH. Which of these additional biochemical tests is consistent with a TSH secreting pituitary adenoma?
Which of these is not a reason why a patient with primary hypothyroidism may develop galactorrhea?
A 39-year-old female with class III obesity, celiac disease, and severe obstructive sleep apnea. Which of these is not an indication for treatment of subclinical hypothyroidism in this patient?