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Self-Assessment Questions

Family Medicine

Hypothyroidism: Review Questions

Thomas F. Heston, MD, FAAFP

Dr. Heston is a physician in Family Medicine and nuclear medicine, Kellogg, ID, and Online Education Coordinator, University of Health Sciences Antigua, Dow Hill, Antigua.


Choose the single best answer for each question.

1. Which of the following can cause myxedema coma?
  1. Advanced progression of hypothyroidism
  2. End-stage Graves’ disease
  3. Overdose of propylthiouracil
  4. Uncontrolled diabetes
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2. Which of the following is the most common cause of hypothyroidism?

  1. Acute thyroiditis
  2. Hashimoto’s disease
  3. Radioactive iodine exposure
  4. Thyroidectomy
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3. A patient has a normal serum thyrotropin (TSH) level, but a low thyroxine (T4) level. What is the most appropriate diagnosis and treatment?

  1. Euthyroid sick syndrome; no treatment necessary
  2. Hyperthyroidism; administer Lugol’s solution
  3. Pituitary dysfunction; delay treatment until further work-up has been completed
  4. Primary hypothyroidism; administer levothyroxine
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4. Which of the following is the most common cause of goiter?

  1. Iodine deficiency
  2. Iodine excess
  3. Kwashiorkor
  4. Marasmus
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  5. Which of the following is the best therapy for hypothyroidism?
  1. Dessicated thyroid
  2. Levothyroxine
  3. Liothyronine
  4. Liotrix
  5. Methimazole
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6. What is the recommended dosage of levothyroxine in elderly adults with stable primary hypothyroidism?

  1. Initial dose of 25 µg daily, titrated every 4 to 6 weeks to achieve a normal serum TSH level
  2. Initial dose of 50 µg daily, titrated every 2 weeks to achieve a normal serum TSH level
  3. Initial dose of 75 µg daily, titrated every 2 weeks until the TSH level is suppressed below 0.1 mU/L
  4. Initial dose of 100 µg daily, titrated every 2 months to achieve a normal T4 level
  5. Initial dose of 100 µg daily, titrated every 4 weeks to achieve a normal T4 level
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7. Which of the following is NOT a clinical symptom of hypothyroidism?

  1. Cold intolerance
  2. Depression
  3. Diarrhea
  4. Muscle cramps
  5. Weight gain
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