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Flashcards in Exam 3 likely questions for exam Deck (18)
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1
Q

what is the drug of choice for thyroid hormone replacement?

A

levothyroxine/synthroid

2
Q

besides hypothyroidism what else is levothyroxine indicated for?

A

For TSH suppression in select nodules and thyroid cancers

3
Q

what does long term elevation of T4 (from high dose replacement or hyperthyroidism) increase the risk of?

A

may accelerate cardiac disease and osteoporosis

4
Q

What is important about treating Addison’s disease patients with hypothyroidism?

A

Thyroid hormone replacement must be done with cortisol, otherwise it is FATAL!

5
Q

What are the equivalent doses of thyroid hormone? (synthroid, armour, and cytomel)

A

100 mcg of T4 (Synthroid) ~ =
60 mg Thyroid USP (Armour) ~ =
25 mcg of T3 (Cytomel)

6
Q

the most common cause of hyperthyroidism is called?

A

Grave’s Disease (autoimmune)– antibodies stimulate TSH receptors

7
Q

hyperthyroidism due to graves disease is usually accompanied by what?

A

goiter and exophthalmos

also: pretibial myxedema

8
Q

what is the definitive tx for hyperthyroidism?

A

surgical removal or radioactive ablation of thyroid gland

9
Q

How are the MOA of methimazole and PTU similar? different?

A

they both inhibit the transformation of inorganic iodine to organic iodine blocking the production of thyroxine and inhibiting the formation of T3 and T4.

**PTU blocks the peripheral conversion of T4 to T3 while methimazole has minimal effects.

10
Q

what is the most feared side effect of methimazole or PTU?

A

Agranulocytosis

11
Q

what category is PTU?

A

Category D, considered safer than methimazole (and used in pregnancy only when benefit out weighs risk)

12
Q

Does propanolol affect the thyroid gland?

A

No, it mitigates sxs such as anxiety, tremors, palpitations, etc.

13
Q

MOA of iodine/SSKI?

A

large doses of iodine inhibit the release of thyroxine from thyroid gland

14
Q

how long is iodine/SSKI effective for?

A

2-3 weeks as the thyroid gland adapts and resumes secretion of thyroxine.

15
Q

what category drug is radioactive iodine (131 I)

A

Category X, given during pregnancy can irreversibly damage the fetal thyroid tissue. When given to a nursing mother, radioactive iodine can reach a baby through the breast milk

16
Q

How are men effected by radioactive iodine?

A

Men who receive RAI treatment for thyroid cancer may have decreased sperm counts and temporary infertility for periods of roughly two year

17
Q

what is the most severe manifestation of hyperthyroidism?

A

Thyroid storm

18
Q

what are some signs of thyroid storm?

A

high fever, irritability, delirium, vomiting, diarrhea, dehydration, hypotension and vascular collapse.
(Coma and death may occur…too late for signs then!)