Endocrine

Question 1

a) What are the 3 hormones that the thyroid produces?

b) What does the thyroid hormones give us?

Answer 1

a) 1. T3
2. T4
3. Calcitonin – takes Ca out of the blood and puts in bone
b) Energy

Question 2

What mineral is needed in order to make thyroid hormones?

Answer 2

Dietary iodine (the drug iodine has completely different action)

Question 3

Is serum thyroxine (T4) going to be increased or decreased in hyperthyroidism (Grave’s dz)?

Will the TSH be high or low?

Answer 3

T4 is going to be high.

TSH low.

Question 4

How long must a patient be off of their meds that contain iodine before receiving a thyroid scan using radioactive iodine?

How long must they wait to resume the meds after the scan?

Answer 4

Off for 1 week.

Stay off for 6 weeks after resuming.

Question 5

What other procedures might you see for diagnosing hyperthyroidism?

Answer 5

– ultrasound
– MRI
– CT
These are much easier and faster than a thyroid scan

Question 6

Which population should NOT be given beta blockers?

Answer 6

Those with asthma or diabetes.

Beta blockers can cause an asthma attack.
BB’s can mask the symptoms of hypoglycemia r/t their anti-anxiety effect… and that they don’t allow the release of epi or norepinephrine.

Question 7

1. What prescriptions are used to treat hyperthyroidism? What are they used for and how do they work?
2. Name 2 kinds of iodine compounds?
3. What are their mechanism of action?

Answer 7

1. methimazole (Tapazole)
propylthiouracil (TPU)
a) Stops thyroid from making thyroid hormones
b) Used pre-op to stun the thyroid
c) Goal is euthyroid meaning normal.

2. potassium iodine (SSKI) and Lugol’s solution.
3. These decrease the size and vascularity of the gland. Can be given pre-op to help decrease the risk bleeding.

Question 8

1. What should be considered when administering iodine compounds?
2. What is the purpose of supportive therapy for hyperthyroidism?
3. What precautions should be followed following a treatment dose of radioactive iodine?

Answer 8

1. Give in milk or juice and with a straw to prevent staining teeth
2. They may not help with the issue of hormones but they do help with the symptoms that are felt
3. Stay away from babies and do not kiss anyone for a week.

Question 9

What class of medication ends with -lol?

What is their mechanism of action?

Answer 9

Beta blockers.

They decrease myocardial contractility (which could also decrease cardiac output) and decrease HR and BP.
BB’s also decrease anxiety and prevent the release of epi and norepinephrine.

Question 10

Thyroid toxic crisis and thyroid storm are the same thing.

It’s hyperthyroidism x 100. What are some possible outcomes of this event?

Answer 10

Heart attack.
ICU.
This can occur to anyone with hyperthyroidism at any time, but it’s also a risk after radioactive procedure… it’s a rebound effect when the gland reacts to the sudden loss of hormone (d/t thyroid tissue being destroyed) and reacts by making more.