1. Which of the following statements regarding medullary thyroid carcinoma is true?
   • A. Multiple endocrine neoplasia type IIa is less aggressive than multiple endocrine neoplasia type IIb.
   • B. Family genetic screening is indicated in all cases.
   • C. Thyroidectomy should be delayed until adolescence in children whose relatives have positive genetic screening.
   • D. All first-degree relatives should have serum calcitonin follow-up regardless of the results of genetic screening.
   • E. Serum calcium should be followed up in both multiple endocrine neoplasia type IIa and multiple endocrine neoplasia type IIb patients.
2. Thyroid cancer
   • A. does not occur in multinodular goiter.
   • B. is frequently undetectable by palpation.
   • C. constitutes 50% of endocrine malignancies.
   • D. is found as an occult malignancy in 1% of autopsies.
   • E. is more frequent than benign thyroid lesions in irradiated thyroid glands.
3. Thyroid cancer in an irradiated thyroid gland
   • A. is more likely to occur if the patient is male.
   • B. is more likely to occur if the patient is an adult.
   • C. is more likely to occur if there is a family history of thyroid cancer.
   • D. does not occur if the dose is higher than 2000 Gy.
   • E. does not occur later than 20 years after radiation exposure.
4. Prognosis of differentiated thyroid cancer is improved by
   • A. male gender.
   • B. coexistent Graves' disease.
   • C. less extensive surgery.
   • D. radioactive iodine therapy.
   • E. thyroid hormone therapy to keep thyroid-stimulating hormone in the high-normal range.
5. Which of the following statements regarding thyrogloblulin in the follow-up of thyroid cancer is true?
   • A. It is helpful only after total thyroid ablation.
   • B. Readings are adjusted to the amount of antithyroglobulin antibodies present in serum.
   • C. Undetectable thyroglobulin levels exclude tumor recurrence.
   • D. Thyroglobulin levels are affected by estrogen administration.
   • E. Levels should be measured until tests are negative for 3 years.
6. Radioactive iodine scan in the follow-up of thyroid cancer
   • A. uses iodine-123.
   • B. is not needed if thyroglobulin is undetectable.
   • C. excludes metastasis if it is negative.
   • D. should be repeated after a therapeutic dose even if the diagnostic scan is negative.
   • E. indicates massive liver metastases if there is diffuse hepatic uptake.
7. Which of the following statements regarding radioactive iodine therapy of thyroid cancer is true?
   • A. It necessitates hospitalization if the dose is 20 mCi or higher.
   • B. It should be done after normalizing thyroid-stimulating hormone levels.
   • C. It is performed following 2 days of a low-iodine diet.
   • D. It is repeated until the tumor no longer concentrates radioactive iodine.
   • E. l-thyroxine is used to control subsequent hypothyroidism.

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