Thyroid—Goitre & Hyperthyroidism MCQ Quiz | Head & Neck

Quiz Introduction

Welcome to this specialized MCQ quiz on Thyroid—Goitre & Hyperthyroidism, a crucial topic within the Head & Neck module for MBBS students. This quiz is designed to test your understanding of the etiology, pathophysiology, clinical manifestations, diagnosis, and management of various thyroid disorders. Covering key conditions like Graves’ disease, toxic multinodular goitre, and thyroid storm, these 25 questions will challenge your clinical knowledge and recall of high-yield facts. After completing the quiz, you can submit your answers to see your score and review the correct responses. For your future revision, a convenient option to download all questions with their correct answers in PDF format is also available. Good luck!

1. What is the most common cause of hyperthyroidism worldwide?

Graves’ disease Toxic multinodular goitre Toxic adenoma Iodine deficiency

2. The presence of Thyroid-Stimulating Immunoglobulins (TSI) is pathognomonic for which condition?

Hashimoto’s thyroiditis Subacute thyroiditis Graves’ disease Toxic multinodular goitre

3. Which of the following clinical signs is specific to Graves’ disease and not typically seen in other causes of hyperthyroidism?

Tachycardia Weight loss Heat intolerance Pretibial myxedema

4. What is the initial investigation of choice for a patient presenting with a solitary thyroid nodule?

Ultrasound of the neck Fine Needle Aspiration Cytology (FNAC) Thyroid function tests (TSH, T3, T4) Radioiodine uptake scan

5. A ‘hot’ nodule on a thyroid scintigraphy scan typically indicates:

A high risk of malignancy An autonomously functioning nodule with a low risk of malignancy A thyroid cyst Hashimoto’s thyroiditis

6. Which of the following is NOT part of the standard initial management for a thyroid storm?

Beta-blockers (e.g., Propranolol) Thionamides (e.g., Propylthiouracil) Radioactive iodine (I-131) Iodine solution (Lugol’s or SSKI)

7. Agranulocytosis is a rare but life-threatening side effect associated with which class of drugs used to treat hyperthyroidism?

Beta-blockers Corticosteroids Thionamides (Methimazole, PTU) Radioiodine

8. Pemberton’s sign, characterized by facial flushing and venous distension upon raising the arms, is indicative of:

Graves’ ophthalmopathy Thyroid storm Retrosternal goitre causing thoracic inlet obstruction Hypocalcemia following thyroidectomy

9. The most common cause of goitre on a global scale is:

Graves’ disease Iodine deficiency Hashimoto’s thyroiditis Thyroid cancer

10. What is the characteristic biochemical profile of subclinical hyperthyroidism?

Low TSH, low free T4/T3 High TSH, high free T4/T3 Low TSH, normal free T4/T3 Normal TSH, high free T4/T3

11. The Jod-Basedow phenomenon refers to:

Hypothyroidism caused by excess iodine Hyperthyroidism induced by administration of iodine or iodide Autoimmune destruction of the thyroid gland Painful thyroiditis following a viral infection

12. Which anti-thyroid drug is preferred during the first trimester of pregnancy?

Methimazole Carbimazole Propranolol Propylthiouracil (PTU)

13. A 65-year-old patient with a long-standing nodular goitre develops hyperthyroidism. This condition is best described as:

Plummer’s disease (Toxic multinodular goitre) Graves’ disease De Quervain’s thyroiditis Riedel’s thyroiditis

14. For a patient with severe thyrotoxic symptoms like palpitations and tremors, which medication provides the most rapid relief?

Methimazole Radioactive Iodine Propranolol Levothyroxine

15. Which definitive treatment for Graves’ disease carries a risk of worsening pre-existing ophthalmopathy?

Propylthiouracil (PTU) therapy Radioactive iodine (I-131) ablation Total thyroidectomy Long-term beta-blocker use

16. A smooth, diffusely enlarged, non-tender thyroid gland (diffuse goitre) is a classic physical finding in:

Multinodular goitre Graves’ disease Thyroid cancer Toxic adenoma

17. What is a unique mechanism of action of Propylthiouracil (PTU) that is not shared by Methimazole?

Inhibition of thyroid peroxidase Inhibition of the peripheral conversion of T4 to T3 Blocking the sodium-iodide symporter Binding to TSH receptors

18. A patient with a large, long-standing goitre presents with stridor. This symptom is most likely due to:

Esophageal compression Recurrent laryngeal nerve palsy Tracheal compression Superior vena cava syndrome

19. In Graves’ ophthalmopathy, which extraocular muscle is most commonly affected, leading to vertical diplopia?

Superior rectus Medial rectus Inferior rectus Lateral rectus

20. Which of the following is NOT a characteristic feature of a thyroid storm (thyrotoxic crisis)?

Hyperpyrexia (fever >38.5°C) Tachycardia disproportionate to fever Central nervous system dysfunction (e.g., agitation, delirium) Bradycardia and hypothermia

21. A radioactive iodine uptake scan showing diffuse, homogeneously increased uptake is most consistent with:

Toxic multinodular goitre Graves’ disease Subacute thyroiditis Factitious hyperthyroidism

22. The Wolff-Chaikoff effect describes which physiological phenomenon?

A reduction in thyroid hormone synthesis in response to a large iodine load Iodine-induced hyperthyroidism in a patient with a goitre Increased thyroid vascularity caused by TSH stimulation Escape from the inhibitory effect of iodine over time

23. De Quervain’s (subacute granulomatous) thyroiditis is typically characterized by:

A painless, “rock-hard” thyroid gland High titers of anti-TPO antibodies and permanent hypothyroidism A very painful and tender thyroid gland, often following a viral URI Exophthalmos and pretibial myxedema

24. What is the primary role of beta-blockers in the management of hyperthyroidism?

To decrease the synthesis of thyroid hormones To provide symptomatic control of adrenergic effects To act as a definitive curative therapy To reduce the size of the goitre

25. The pathophysiology of toxic multinodular goitre is primarily due to:

Autoimmune stimulation of the TSH receptor Somatic mutations in the TSH receptor gene leading to autonomous function Chronic inflammation and fibrosis of the thyroid gland A pituitary adenoma secreting excess TSH

Thyroid—Goitre & Hyperthyroidism MCQ Quiz | Head & Neck

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