Quiz Answers

1. Which of the following symptoms would you expect to accompany Ms. L.M’s new diagnosis of Grave’s Disease?

a. Cold Intolerance and Night Sweats ( cold intolerance is indicative of hypothyroidism, night sweats can be associated with hyper and hypothyroid states) (incorrect)

b. Heat intolerance and pretibial edema (both present in Grave’s Disease) (correct)

c. Hair Loss and Finger Clubbing (hypothyroidism results in hair loss, finger clubbing is indicative of Graves Disease) (incorrect)

d.Facial Edema and Dry Skin (facial edema and dry skin are indicative of Hypothyroidism) (incorrect)

 

2. Which lab value would lead Ms. L.M’s health care provider to a specific diagnosis of Grave’s Disease?

a. Low Thyrotropin and High Free Thyroxine (indicative of hyperthyroid state, but further testing needed to further differentiate diagnosis to Graves Disease (incorrect)

b. High Triiodothyronine (indicates triiodothyronine toxicosis, but further testing needed to differentiate diagnosis to Graves Disease) (incorrect)

c. Positive Thyrotropin- Receptor Antibodies (positive indicator for Grave’s Disease) (correct)

d. High Serum Thyrotropin (incorrect, indicative of hypothyroidism)

 

3. Which of the following best describes the pathology behind Ms. L.M’s ophthalmopathy?

a. T cells secrete inflammatory cytokines, which causes hypertrophy and hyperplasia of fibroblast cells, which then secrete glycosaminoglycans, resulting in swelling of muscle and connective tissue (Correct)

b. B and T cell infiltration combined with hyperplasia and decreased apoptosis (enlargement of thyroid gland) (incorrect)

c. Progressive depletion of thyroid epithelial cells, which are replaced by fibrosis and mononuclear cells (Hashimoto’s Thyroiditis) (incorrect)

d. Pituitary Gland fails to produce adequate amount of Thyroid-Stimulating Hormone (TSH) (incorrect, indicative of hypothyroidism)

 

4.Which of Ms. L.M’s pre-existing health conditions is associated with Graves Disease?

a. Celiac Disease (presence of one autoimmune disease can predispose individuals for development of another)

b. Overweight (obesity is not related to Graves Disease)

c. Anxiety (stress can be a precipitating factor for the development of Graves Disease)

d. Post-Traumatic Stress Disorder (stress can be a precipitating factor for the development of Graves Disease)

e. A,B,C above (obesity has no direct link to Graves Disease)

f. A,C, D above (PTSD and anxiety increase stress, which can be a precipitating factor to development of Graves Disease. Celiac Disease is an autoimmune disease, which is linked to the development of Graves Disease)

g. All of the above

 

5. After explaining the physiologic process behind Graves Disease to Ms. L.M and asking her to teach back to you, which response indicates her understanding of the illness?

a. My immune system is producing antibodies that increase Thyroid-Stimulating Hormone, which makes my thyroid overproduce thyroid hormones (correct, indicative of Graves Disease)

b. My immune system is producing antibodies against my thyroid gland, resulting in inflammation and destruction of hormone-secreting thyroid cells (incorrect, indicative of Hashimoto’s Thyroiditis)

c. Mutations in my thyroid cells caused the cells to change from normal to tall and poorly differentiated (false, indicative of thyroid cancer)

d. Because I don’t get enough iodine in my diet, my thyroid can’t make enough thyroid hormones (false, indicative of iodine deficiency goiters)