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Question 1
What is hyperthyroidism characterized by?
Low thyroid hormone levels
Normal thyroid hormone levels
Excess thyroid hormone
Insufficient thyroid gland function
Question 2
What are the primary causes of hyperthyroidism?
Liver dysfunction
Pancreatic problems
• over functioning of thyroid • pituitary tumor • inflammation of thyroid
Kidney issues
Question 3
Symptoms of hyperthyroidism?
Sweating
• weight loss • heat intolerance • rapid heart rate • sweating, hyperactivity, anxiety, insomnia
Heat intolerance
Rapid heart rate
Question 4
What are the methods to target the thyroid gland in hyperthyroidism management?
• Surgical removal/gland destruction • Inhibition of thyroid hormone synthesis • Preventing release of thyroid hormone
Stimulating thyroid hormone production
Using chemotherapy
Increasing iodine intake
Question 5
What can you use to Treat peripheral symptoms of thyroid hormone?
Inhibition of thyroid hormone synthesis
Surgical removal
Preventing release of thyroid hormone
β-blockers for cardiovascular effects
Question 6
What is the mechanism of action (MOA) of Thyroid Synthesis Inhibitors?
block the absorption of thyroid hormones
stimulate the production of thyroid hormones
inhibit the release of thyroid hormones
concentrate in thyroid and block synthesis of thyroid hormones
Question 7
What is the primary indication for using Thyroid Synthesis Inhibitors?
pregnancy support
weight loss management
hypothyroidism treatment
hyperthyroidism treatment
Question 8
Which Thyroid Synthesis Inhibitor is known to cause salivary gland swelling?
Methimazole
Thyroxine
Propylthiouracil
Thioamides
Question 9
What is the primary mechanism of action for a hormone release blocker?
inhibits iodination of tyrosine during T3 and T4 synthesis, inhibits release of thyroid hormone from thyroglobulin
inhibits the conversion of T4 to T3
increases the production of thyroid-stimulating hormone
stimulates the release of thyroid hormones
Question 10
Indication for using a hormone release blocker?
hyperthyroidism
topical antiseptic solution
thyroid storm treatment
hypothyroidism
Question 11
What is a common adverse effect of hormone release blockers?
diarrhea
metallic taste
headache
nausea
Question 12
What is the primary cause of hypothyroidism?
High stress levels
Thyroid gland not making enough thyroid hormone
Insufficient iodine intake
Damage to the pituitary gland
Question 13
What is secondary cause of hypothyroidism - central hypothyroidism?
A bacterial infection
An autoimmune disease
A genetic disorder
Occurs due to tumor on the anterior pituitary or damage to the hypothalamus
Question 14
Symptoms of hypothyroidism?
Higher body temperature
• weight gain • cold sensitivity • slower heart rate • mental slowness, lethargy • constipation
Increased appetite
Mental sharpness
Question 15
Goal of hypothyroidism management?
Calcium deficiency
Iron deficiency
increase T3 and T4 levels
Vitamin D deficiency
Question 16
Treatment for hypothyroidism?
• iodine deficiency → iodine rich foods • primary, secondary, tertiary, or congenital → synthetic hormone replacement
Question 17
What is one food rich in iodine recommended for hypothyroidism management?
Spinach
Fish
Carrots
Broccoli
Question 18
What is Levothyroxine?
synthetic analogue of T4
Question 19
What is Liothyronine?
synthetic analogue of T3
Question 20
Which synthetic analogue is a mixture of T4 and T3 in a 4:1 ratio?
Liotrix
Liothyronine
Levothyroxine
Triiodothyronine
Question 21
What is the primary use of Liotrix?
short-term thyroid replacement
thyroid supplement
used to treat/prevent enlargement of thyroid gland
hypothyroidism treatment
Question 22
Which synthetic analogue is the medication of choice for long-term hypothyroidism treatment?
Levothyroxine
Liotrix
Liothyronine
Triiodothyronine
Question 23
Which synthetic analogue is contraindicated in patients with a prior history of cardiovascular diseases?
Liothyronine
Levothyroxine
Propranolol
Dexamethasone
Question 24
Which synthetic analogue has a faster onset of action and is more potent?
Levothyroxine
Hydrocortisone
Methotrexate
Liothyronine
Question 25
Which synthetic analogue has a longer duration of action and is better tolerated by patients?
Levothyroxine
Metformin
Atenolol
Liothyronine
Question 26
What is the suffix for glucocorticoids?
-hydrocortisone
-cortisone
-betamethasone
-asone, -olone
Question 27
Indications for glucocorticoid use?
Antibacterial therapy
Treatment of common cold
1. Replacement hormone for adrenal insuff. 2. Suppress inflammation 3. Autoimmune disease 4. Allergies 5. lung maturation in premature fetus
Vitamin supplementation
Question 28
How are glucocorticoids administered?
intramuscularly
via topical or systemic route
intravenously
orally
Question 29
What are the classifications of glucocorticoids based on their duration of action?
rapid, sustained, gradual
short, intermediate, long-acting corticosteroids
fast, moderate, slow-acting
immediate, delayed, extended
Question 30
Adverse effects of glucocorticoids?
correspond to drug dose and interval of treatment
Question 31
Which side effects are associated with the use of glucocorticoids?
increased risk of infection, peripheral edema, increased risk of diabetes/hypertension/osteoporosis
skin rashes, itching, hives
insomnia, anxiety, depression
nausea, vomiting, diarrhea
Question 32
Why are patients advised against sudden stop of glucocorticoids?
serious side effects: • suppression of hypothalamus, pituitary, adrenal axis • can lead to potentially fatal adrenal insufficiency
Question 33
What is the primary use of Ketoconazole in medical treatment?
Prevents hair loss
Inhibits adrenal steroid synthesis, used for hyperadrenalism (e.g., Cushing syndrome)
Treats bacterial infections
Lowers cholesterol levels
Question 34
What is the primary use of Etomidate in medical treatment?
• “anesthetic drug” • inhibits steroid synthesis • via IV for emergency treatment of Cushing's
Question 35
What are the female sex hormones?
estrogen and progesterone
Question 36
3 forms of estrogen
estradiol estrone estriol
Question 37
What does estradiol control
sex specific changes at puberty • monthly ovulation • menstruation • secondary sex characteristics
Question 38
Primary site of estrogen and progesterone?
Placenta
Ovaries
Adrenal cortex
Liver
Question 39
Which of the following is the primary
source
of estrogen and progesterone during the reproductive period?
Adrenal glands
Ovary
Placenta
Fat cells
Question 40
During pregnancy, which hormones are produced by the placenta?
Testosterone
Estrogen and estriol
DHEA
Progesterone
Question 41
In the after menopause stage, which cells produce estrone?
Bone marrow
Fat cells and adrenals
Placenta
Adrenal glands
Question 42
What hormone is responsible for the development of the follicle in the ovary?
FSH and LH
LH
Progesterone
Estrogen
Question 43
Which cell within the follicle produces progesterone?
Theca cell
Oocyte
Follicle
Granulosa cell
Question 44
What hormone is released by the hypothalamus to stimulate the pituitary gland?
Follicle-Stimulating Hormone (FSH)
Gonadotropin-Releasing Hormone (GnRH)
Luteinizing Hormone (LH)
Thyroid-Stimulating Hormone (TSH)
Question 45
Functions of the corpus luteum?
Stimulates Follicle Growth
Inhibits Ovulation
• Synthesizes Progesterone • maintains the uterine lining
Regulates Menstruation
Question 46
What is caused by high levels of estrogen?
• endometrium thickens • endometrial gland growth • emergence of spiral arteries • pituitary becomes more sensitive to GnRH
Question 47
two phases of ovulation?
follicular and luteal phase
Question 48
What effect does estrogen have systemically?
Cortisol
protective effect
• blood vessels’ walls flexible • helps sustain bone density • Protects against CV disease • lowering LDL
Testosterone
Insulin
Question 49
estrogen effect on bone density?
increase OB, decrease OC
Question 50
Progesterone systemic function
Adrenaline
Thyroid Hormone
Testosterone
plays a role in bone strength and keeping the skin elastic
Question 51
What are synthetic estrogens primarily used for in therapeutic settings?
• primary hypogonadism • primary amenorrhea • contraceptives • estrogen deficiency
Bone density treatment
Pain management
Antibiotics
Question 52
What is the primary purpose of hormone replacement therapy for women with an intact uterus?
Regulate menstrual cycles
Prevent endometrial hyperplasia
Manage depression
Treat osteoporosis
Question 53
What hormone combination is recommended for all women with an intact uterus?
Progestin + Estrogen
Progesterone only
Estrogen only
Testosterone + Estrogen
Question 54
What is the increased risk associated with the use of DES in utero?
Increased risk of prostate cancer
Risk of lung cancer
Increased risk of ovarian cancer
• vaginal bleeding • nausea • breast tenderness • risk of thromboembolic events • risk of endometrial cancer (when given without progesterone) • risk of breast cancer
Question 55
What happens when females are exposed to DES in utero?
Risk of endometrial cancer
Breast tenderness
• vaginal adenosis • clear cell adenocarcinoma
Risk of thromboembolic events
Question 56
What are progestins?
Synthetic progestogens with similar effects to natural progesterone.
Synthetic forms of estrogen
Vitamins essential for bone health
Enzymes that break down proteins
Question 57
What type of derivatives do progestins include?
Testosterone derivatives
Progesterone and testosterone derivatives
Cortisol derivatives
Insulin derivatives
Question 58
Side effects noted at typical doses of progestins?
Muscle cramps
• fluid retention • ↑ blood pressure • fatigue • mood changes & depression • breast discomfort • changes in libido • menstrual irregularities (breakthrough bleeding)
Headache
Seizures
Question 59
What is a potential long-term effect of high doses of progestins?
Hair loss
• Delay in ovulation • decraese in bone density
Delay in ovulation
Increased appetite
Question 60
How does the unbound sex hormone enter the cell?
by receptor-mediated endocytosis
via phagocytosis
by diffusion and binding to receptors
by passive diffusion
Question 61
What does the activated steroid-receptor complex interact with?
cytosol
cell membrane
ribosomes
nuclear chromatin to initiate hormone-specific RNA synthesis
Question 62
What is the final result of hormone-specific RNA synthesis?
production of energy
release of neurotransmitters
synthesis of specific proteins that mediate physiologic functions
formation of lipids
Question 63
What are Selective Estrogen Receptor Modulators (SERMs)?
Hormones that mimic estrogen effects
Estrogen receptor blockers
Synthetic forms of progesterone
Estrogen inhibitors
Question 64
What are SERMS used to treat?
• ER positive breast cancer • osteoporosis • infertility
Question 65
What are full agonists used to treat?
breast cancer resistant to tamoxifen
Question 66
Examples of SERMS
• tamoxifen • raloxifene • clomiphene
Question 67
What is tamoxifen primarily used to treat?
Osteoporosis
Infertility
ER-Positive Breast Cancer
Breast cancer resistant to tamoxifen
Question 68
What effect can estrogen have on corticosteroids?
Estrogen can neutralize the effects of corticosteroids
Estrogen can decrease the effects of corticosteroids
Estrogen has no effect on corticosteroids
Estrogen can increase the effects of corticosteroids.
Question 69
Progestins drug-drug interactions?
Hepatic enzyme-inducing medications have no effect on progestins
Some hepatic enzyme-inducing medications increase progestins' effects
Some hepatic enzyme-inducing medications neutralize progestins' effects
Some hepatic enzyme-inducing medications decrease progestins' effects
Question 70
What is the potential impact of antibiotics on oral contraceptives?
Antibiotics enhance oral contraceptive efficacy
Antibiotics may reduce oral contraceptive efficacy.
Antibiotics increase oral contraceptive efficacy
Antibiotics have no effect on oral contraceptives
Question 71
androgens drug-drug interactions
• anticoagulants, antidiabetics, insulin, and cyclosporine are ↑ w/ androgens • androgens + corticosteroids = ↑ edema and exacerbate cardiac or hepatic disease
Question 72
What is the first step in assessing dental implications for a pregnant or menopausal patient?
Blood test
thorough history including asking key questions from physician and patient
Visual inspection only
Initial X-ray
Question 73
Questions to ask pregnant patient?
What trimester?
Any intraoral changes?
Any sign or symptoms of a high-risk pregnancy?
• What trimester? • Any sign or symptoms of a high-risk pregnancy (e.g. hypertension) • Any intraoral changes?
Question 74
Questions to ask menopausal pateint?
Any oral pain/dryness/burning?
Question 75
Questions to ask patient physician?
Dietary restrictions
Any special concerns?
Medications for pain control
• Delivery date? • Is it a high-risk pregnancy? • Any special concerns? • What medications for pain control, antibiotic, anesthetic?
Question 76
What is the recommended trimester for elective dental treatment during pregnancy?
Mid-third trimester
Any trimester
Fourth trimester
second trimester or early half of the third trimester
Question 77
When is emergency dental treatment during pregnancy typically needed?
Only after the second trimester
Only in the third trimester
Only during the second trimester
Only in the first trimester
Question 78
What should be considered when dental radiographs are required during pregnancy?
Untreated dental infections may pose a greater risk to fetus than potential radiation exposure
Only if the mother is in the first trimester
Radiation exposure is always harmful
Only if the mother is in the third trimester
Question 79
What is one of the key dental implications related to early oral hygiene education?
Improved dental implants
Increased risk of gum disease
Reduced need for fillings
Cleaning and improved OH care
Question 80
What is a potential interaction to consider when prescribing antibiotics to a woman taking oral contraceptives?
Decreased efficacy of oral contraceptives
Enhanced bone density
Reduced need for dental check-ups
Increased risk of tooth decay
Question 81
Untitled question
• Increased body’s inflammatory response to oral irritants • Increased risk of dry socket and post-op pain
Question 82
Symptoms of menopausal oral mucosal symptoms?
• Pain or burning sensation • altered taste • dryness: palliative treatments
Reduced risk of cavities
Increased tooth sensitivity
Enlarged salivary glands