FCPS Model Test-05

1. Which statement is false?

A) Thyroid follicular cells synthesise predominantly thyroxine (T4)

B) Approximately 85% of T3 in blood is produced from T4

C) T3 has a longer half-life

D) > 99 % T3 and T4 circulate in plasma bound to transport proteins

4. A 45-year-old male athlete presents to you with weight loss, heat intolerance, episodic diarrhoea, palpitation for the last 6 months. His family members tell you, he is always in anxiety. O/E: thyroid gland is not palpable. You are suspecting it a case of thyrotoxicosis. You order a thyroid profile which shows: Increased FT4, FT3 and decreased TSH. There is no feature of Grave’s. What is the next best step to evaluate this patient?

A) Thyroid USG

B) FNAC of thyroid

C) Thyroid scintigraphy

D) CT scan of thyroid

5. Not true regarding treatment with levothyroxine in hypothyroidism –

A) Should be started with low dose

B) At least 6 weeks should pass before repeating thyroid function tests

C) Patients feel better within 2–3 weeks

D) Resolution of any effusions may take 2-3 months

7. Not true –

A) Subclinical thyrotoxicosis: Serum TSH – undetectable, serum T3 and T4 - upper end of the reference range

B) Subclinical hypothyroidism: Serum TSH – raised, serum T3 and T4 - lower end of the reference range

C) Non-thyroidal illness (sick euthyroidism): Serum TSH - low, serum T4 – raised, serum T3 -raised

D) Primary hypothyroidism: Serum TSH - high, serum T4 – low, serum T3 – low

8. Not true regarding Grave’s disease –

A) Most commonly affects women aged 30–50 years

B) Most common manifestation: thyrotoxicosis with or without a diffuse goiter

C) TRAb can be detected in the serum of 50-60 % of patients with Grave’s

D) Causes ophthalmopathy and rarely, pretibial myxoedema

10.A 50-year-old man comes to the office with a 2-day history of malaise, fever, fatigue, and pain in the front of his neck. He recovered from an upper respiratory illness a week prior to the onset of his current symptoms, but he previously had felt well. The patient was seen in the clinic occasionally in the remote past for sexually transmitted infections, but his medical history is otherwise unremarkable. He lives alone and is sexually active with both men and women. Temperature is 38.5 C (101.3 F), blood pressure is 150/70 mmHg, and pulse is 110/min. The thyroid gland diffusely enlarged and tender. Laboratory results are as follows:
Complete blood count:
Hemoglobin - 13.9 g/dL
Hematocrit - 44%
Platelets - 200,000/mms
Leukocytes - 10,500/mms
Neutrophils: 77%
Eosinophils: 1%
Lymphocytes: 14%
Monocytes: 8%
TSH - <0.001 IU/mL
Free T4 - 4.6 ng/dL (0.9-2.4 ng/dL)
Erythrocyte sedimentation rate - 100 mm/hr
Which of the following is the most likely diagnosis in this patient?

A) Disseminated gonococcal infection

B) Grave’s disease

C) Hashimoto thyroiditis

D) Subacute thyroiditis

FCPS Model Test-05

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