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Subject: Tommy's Concepts

Subject: Tommy's Concepts
Tommy's Concepts for the USMLE Step 1

Question

Another “recalled question” in endocrine/pharm<br />
A 40-year-old woman named Gwyneth Paltrow has a palpable nodule in the Left lobe of her thyroid gland. The nodule <u>measures 2 cm and is firm</u>. The rest of the thyroid gland cannot be felt and <b>is not</b> tender. She also describes losing weight in spite of a ravenous appetite, palpitations, and heat intolerance. She is thin, fidgety, and constantly moving, with moist skin and a pulse of 115/min. She has no exophthalmos or pretibial edema. Her TSH is reported as much lower than normal, and she has elevated levels of free T4. What do you do?<br />
1-Administer alprazolam<br />
2-Administer midazolam<br />
3-Administer propanolol<br />
4-Reassurance, return office visit in two years<br />
5-Radionuclide thyroid scan<br />
6-Repeat free T4 levels<br />
7-bound T4 levels<br />
8-free T3 levels<br />
9-Surgical inspection<br />
10-Pituitary adenoma<br />
11-Papillary carcinoma of the thyroid<br />
12-Follicular carcinoma of the thyroid<br />
(Even if you “guessed” correctly, make SURE you know why the wrong answers ARE wrong, OK?)

Answer