Thyroid Disorders, 5th MBBS, ESUCOM

A 28-year-old woman presents with fatigue, weight loss, marked digital clubbing, and a markedly elevated serum TPO antibody. What is the most likely diagnosis?

1. Sick euthyroid syndrome
2. Subacute (de Quervain’s) thyroiditis
3. Graves’ disease
4. Toxic multinodular goitre

A patient with Graves’ disease has a thyroid scan. Which pattern would you expect?

1. Patchy uptake with hot and cold areas
2. Cold nodule
3. Diffuse increased uptake
4. Single hot nodule with suppressed rest of gland

In thyroid storm, which medication should be given first to control peripheral effects of excess thyroid hormone?

1. Lugol’s iodine
2. Propranolol
3. Dexamethasone
4. Carbimazole

A 45-year-old woman with hypothyroidism develops confusion, hypothermia, and bradycardia. What is the immediate next step in management?

1. Slow rewarming + IV fluids only
2. Carbimazole and propranolol
3. Intravenous levothyroxine + hydrocortisone
4. Oral levothyroxine only

Which of the following physiological effects is NOT caused by thyroid hormones?

1. Increased sensitivity to catecholamines
2. Decreased bone resorption
3. Increased gut motility
4. Positive inotropic effect

A patient has undetectable TSH, normal FT3 and FT4. What is the most likely diagnosis?

1. Subclinical hyperthyroidism
2. Overt hyperthyroidism
3. Secondary hypothyroidism
4. Sick euthyroid syndrome

Which drug is most likely to cause both hypothyroidism and thyrotoxicosis?

1. Carbimazole
2. Propranolol
3. Lithium
4. Amiodarone

In de Quervain’s (subacute) thyroiditis, which finding is typical?

1. Permanent hypothyroidism
2. Painful thyroid + elevated ESR
3. Hot nodule on scan
4. Hot nodule on scan