Organ Function tests and Hormones
Biochemistry · Topic 11
Source: NMC CBME Curriculum 2024 · Volume I · Biochemistry · Topic 11 · combined PDF page 167
Practice questions
- A patient has a low serum free T4 and a markedly increased TSH. Which interpretation best fits this biochemical pattern?
- A patient has low free T4 with a TSH concentration within the laboratory reference interval. Which interpretation should be considered?
- Which laboratory pattern is most consistent with subclinical hypothyroidism as defined in the supplied review?
- Which tests does the supplied review identify as first-line investigations for suspected hypothyroidism?
- A patient with low free T4 has a mildly increased measured TSH, but pituitary disease is suspected. Which explanation is compatible with the supplied review?
- A patient with suspected central hypothyroidism has low free T4 and a low-normal TSH. Which interpretation is most appropriate?
- A patient with confirmed primary chronic hypothyroidism is receiving levothyroxine. According to the supplied review, which biochemical measure should generally be brought into the normal range with full replacement therapy?
- A patient with central hypothyroidism is being considered for levothyroxine. What precaution is emphasized in the supplied review?
- An older patient has nonspecific symptoms and a laboratory pattern of low free T4 with increased TSH. Which statement best reflects the supplied review?
- A patient has low free T4 and increased TSH. Which additional finding would make the pattern subclinical hypothyroidism rather than the pattern described?
- An overnight oral metyrapone test is being considered in a patient with suspected adrenal insufficiency. What function is this test used to assess according to the supplied study?
- In the supplied study comparing analytes in the overnight oral metyrapone test, which analyte had the strongest reported diagnostic performance for adrenal insufficiency?
- At the reported 11-deoxycortisol cutoff in the supplied metyrapone study, which combination of performance characteristics was reported?
- A report cites 11-deoxycortisol at 197 nmol/L as the study cutoff, with sensitivity of 83% and specificity above 90%. Which conclusion is best supported by the supplied evidence?
- In the supplied metyrapone study, which finding had a reported specificity of 96% for prediction of adrenal insufficiency?
- Which pituitary-axis finding had a reported sensitivity of 61% for prediction of adrenal insufficiency in the supplied study?
- Combined dysfunction of which axes was reported to have 97% specificity for predicting adrenal insufficiency in the supplied study?
- A clinician wants to characterize adrenal function after oral metyrapone. According to the supplied study, which approach best reflects the authors' conclusion when 11-deoxycortisol is available?
- Which limitation did the investigators explicitly acknowledge about the reported performance of 11-deoxycortisol in the metyrapone study?
- A patient has abnormal liver tests during interferon-beta 1b treatment. In the supplied prospective study, when was the probability of liver alteration higher than baseline?
- In the supplied one-year interferon-beta 1b study, what happened to the probability of liver-test alteration by month 9?
- In the interferon-beta 1b cohort, which organ-function alteration showed the clearest statistically significant increase in probability during early treatment compared with baseline?
- Which statement accurately describes thyroid dysfunction in the supplied interferon-beta 1b study?
- Which statement best summarizes the autoantibody findings in the supplied interferon-beta 1b cohort?
- A patient develops a liver-test abnormality during the first months of interferon-beta 1b treatment, while thyroid tests remain unchanged. Which interpretation best matches the supplied study?
- Which design best describes the supplied study of liver and thyroid function during interferon-beta 1b treatment for multiple sclerosis?