General Medicine

20 learning units • 100 chapter sections • 200 explained questions. Assess the patient, choose investigations and build a monitored management plan across adult medical specialties.

Original RAHBAR study material for the Year 4 learning pathway. Clinical cases support supervised undergraduate learning. Treatment choices, doses and procedures must follow current local protocols and the responsible clinical team. References & further reading ↓

MODULE 15 / 20

Thyroid & Adrenal Disorders

Interpret paired hormone results and recognise endocrine crises that can resemble common medical illness.

Choose an answer and check it immediately. Change your choice to try again. This is a self-study exercise; results are not saved.

Question 01. High TSH with low free T4 most strongly suggests what? A. Primary thyrotoxicosisB. Normal thyroid function in every caseC. Primary hypothyroidismD. Isolated adrenal excess

Question 02. Low free T4 without appropriately raised TSH raises concern for what? A. Central hypothyroidismB. Primary thyroid failure onlyC. Definite Graves diseaseD. Guaranteed assay normality

Question 03. Which presentation can be caused by thyrotoxicosis? A. Only a painless neck lumpB. Atrial fibrillation and weight lossC. Mandatory bradycardia in every caseD. Isolated microcytosis by definition

Question 04. Why determine the cause of thyrotoxicosis? A. Every cause receives identical therapyB. It replaces hormone testingC. It proves all symptoms are thyroid-relatedD. Thyroiditis and increased synthesis need different management

Question 05. Fever, marked tachycardia and delirium with thyrotoxicosis suggest what? A. Thyroid stormB. Uncomplicated mild hypothyroidismC. Stable subclinical disease onlyD. Isolated iron deficiency

Question 06. Which feature is more characteristic of primary adrenal insufficiency? A. Persistent cortisol excessB. Hyperpigmentation with possible hyperkalaemiaC. Universal hypertensionD. Always normal sodium

Question 07. Does normal potassium exclude secondary adrenal insufficiency? A. Yes, invariablyB. Only if fatigue is absentC. Yes, when steroids were recently stoppedD. No

Question 08. Why ask about prolonged glucocorticoid exposure? A. It always increases adrenal reserve permanentlyB. It excludes infectionC. It can suppress endogenous adrenal functionD. It makes all endocrine tests unnecessary

Question 09. What should happen in suspected adrenal crisis with shock? A. Wait several days for outpatient testingB. Stop all steroids immediatelyC. Urgent protocol-led treatment without waiting for routine confirmationD. Give only dietary advice

Question 10. What is an important prevention measure in adrenal insufficiency? A. Avoiding all medical identificationB. Sick-day education and an emergency steroid planC. Stopping therapy when feeling wellD. No plan for vomiting

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References & Further Reading

Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.

Reference review: 27 September 2026. Consult current local protocols for prescribing, procedures and escalation.