Quiz On CPC Certification Exam! Trivia Questions

1.

A 38-year-old woman presented with fatigue and neck swelling. Which of the following cardiovascular signs is more suggestive of hypothyroidism?

A.

Tachycardia
B.

Bradycardia
C.

Increased cardiac output
D.

Atrial fibrillation
E.

Palpitations

Correct Answer
B. Bradycardia

Explanation
Thyroid hormones increase metabolism, increase cardiac rate and output. Deficiency of thyroid hormones cause low output and Bradycardia.

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2.

The image below shows the facial features of a 49-year-old woman who presented with anxiety. On examination, she has sweaty palms and a palpable neck swelling. Which of the following is the most likely diagnosis?

A.

Hashimoto's disease
B.

Thyroid cancer
C.

Graves disease
D.

Granulomatous thyroiditis
E.

Acute renal failure

Correct Answer
C. Graves disease

Explanation
Note the exopthalmos typical of Graves disease with proptosis and staring gaze.

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3.

A 46-year-old female presents with lethargy and constipation. On examination, she has bradycardia and delayed reflexes with no neck swelling. What is the most likely diagnosis?

A.

Graves Disease
B.

Hashimoto's disease
C.

Papillary carcinoma
D.

Multinodular goitre
E.

Follicular carcinoma

Correct Answer
B. Hashimoto's disease

Explanation
Middle aged patient with typical features of hypothyroidism, commonest cause is Hashimoto's. Note she has no goitre.

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4.

A 36-year-old female presented with features of hyperthyroidism not responding to treatment. On examination, there is a nodular swelling over the right lobe of the thyroid. The image below shows the gross appearance of the resected specimen. What is the most likely diagnosis?

A.

Graves disease
B.

Hashimoto's disease
C.

Thyroid adenoma
D.

Papillary carcinoma
E.

Follicular carcinoma

Correct Answer
C. Thyroid adenoma

Explanation
The most likely diagnosis in this case is a thyroid adenoma. This is supported by the presence of a nodular swelling over the right lobe of the thyroid, which is a characteristic feature of adenomas. Additionally, the fact that the patient's hyperthyroidism is not responding to treatment suggests that the underlying cause may be a benign tumor such as an adenoma.

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5.

A 50-year-old female presented with fatigue, heat intolerance and weight loss. The image below shows the microscopic feature from the biopsy of the thyroid gland. What is the most likely diagnosis?

A.

Graves disease
B.

Hashimoto's disease
C.

Thyroid adenoma
D.

Papillary carcinoma
E.

Follicular carcinoma

Correct Answer
A. Graves disease

Explanation
Note the prominent proliferation of lining cells of the follicle with peripheral vacuolation of colloid in the lumen suggestive of hyperactivity of the gland as in Graves disease.

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6.

A 35-year-old woman presents with a solitary firm nodule in the neck. A biopsy is taken and pathology confirms the diagnosis of carcinoma thyroid. In regards to thyroid cancer statistics, what is the most common type of thyroid cancer?

A.

Papillary carcinoma
B.

Follicular carcinoma
C.

Mixed papillary carcinoma
D.

Medullary carcinoma
E.

Anaplastic carcinoma

Correct Answer
A. Papillary carcinoma

Explanation
Papillary carcinoma with good prognosis (98% 10 year survival) is the most common type 75%. Next is follicular having worst prognosis in about 10-20% cases.

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7.

A 75-year-old woman was admitted to the Emergency Department with confusion, blurred vision, muscle weakness, hypothermia, and bradycardia. She was found to have a blood sugar level (BSL) of 14.0 mmol/L. The CT scan of her brain is normal. Of the following, which is the most likely diagnosis?

A.

Hyperosmolar diabetic coma
B.

Glucagonoma
C.

Hypothyroidism
D.

Gastrinoma
E.

Addisonian crisis

Correct Answer
C. Hypothyroidism

Explanation
The most likely diagnosis for the 75-year-old woman with confusion, blurred vision, muscle weakness, hypothermia, bradycardia, and a high blood sugar level is hypothyroidism. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone, leading to a decrease in metabolism. Symptoms of hypothyroidism include confusion, blurred vision, muscle weakness, and hypothermia. The high blood sugar level could be due to impaired glucose metabolism caused by the decreased thyroid hormone levels. The normal CT scan of the brain suggests that the symptoms are not due to any structural abnormalities in the brain.

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8.

A 46-year-old man with a chronic illness is found on examination to have a delayed relaxation phase of his deep tendon reflexes. Of the following, which is the most likely diagnosis?

A.

Myxoedema
B.

Peripheral neuropathy
C.

Hypokalaemia
D.

Meningioma of the falx cerebri
E.

Autonomic neuropathy

Correct Answer
A. Myxoedema

Explanation
Myxoedema is the most likely diagnosis in this case because it is commonly associated with delayed relaxation phase of deep tendon reflexes. Myxoedema refers to severe hypothyroidism, which can cause a variety of symptoms including fatigue, weight gain, cold intolerance, and slowed reflexes. This condition can be seen in individuals with chronic illnesses, and the delayed relaxation phase of deep tendon reflexes is a characteristic finding. Peripheral neuropathy, hypokalaemia, meningioma of the falx cerebri, and autonomic neuropathy are not typically associated with this specific reflex abnormality.

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9.

A 40-year-old woman complains of chronic constipation and irregular menses for the last 8 months. Her vital signs are normal. Physical examination reveals peripheral edema and a firm, diffusely enlarged thyroid gland. Serum levels of T3 and T4 are abnormally low. A thyroid biopsy is shown in the below image. What is the most likely diagnosis?

A.

Acute necrotizing thyroiditis
B.

Hashimoto's disease
C.

Multinodular goitre
D.

Papillary carcinoma
E.

Thyroid adenoma

Correct Answer
B. Hashimoto's disease

Explanation
The most likely diagnosis for this patient is Hashimoto's disease. This is supported by the findings of a diffusely enlarged thyroid gland, low levels of T3 and T4, and the presence of peripheral edema. Hashimoto's disease is an autoimmune disorder that leads to chronic inflammation of the thyroid gland, resulting in hypothyroidism. The thyroid biopsy may reveal lymphocytic infiltration and destruction of thyroid follicles, confirming the diagnosis. Acute necrotizing thyroiditis, multinodular goitre, papillary carcinoma, and thyroid adenoma are less likely based on the clinical presentation and laboratory findings.

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10.

A 40-year-old woman presents with weight loss, pigmentation, tiredness, hypotension, and hypokalaemia. Of the following conditions, which is the most likely pathology?

A.

Adrenal cortical carcinoma
B.

Addison's disease
C.

Cushing's syndrome
D.

Hypothyroidism
E.

Hypoparathyroidism

Correct Answer
B. Addison's disease

Explanation
The most likely pathology in this case is Addison's disease. Addison's disease is a condition characterized by the insufficient production of hormones by the adrenal glands. Symptoms include weight loss, pigmentation (hyperpigmentation), tiredness, hypotension (low blood pressure), and hypokalaemia (low potassium levels). Adrenal cortical carcinoma is a type of cancer that affects the adrenal glands and typically presents with different symptoms. Cushing's syndrome is characterized by excessive cortisol production, leading to weight gain and other symptoms. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, and hypoparathyroidism is a condition where the parathyroid glands do not produce enough parathyroid hormone. These conditions do not match the symptoms described in the case.

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