thyroid

Question 1

triiodothyronine

Answer 1

t3

Question 2

thyroxine

Answer 2

t4

Question 3

what is more potent t3 or t4

Answer 3

t3

Question 4

what is active t3 or t4

Answer 4

t4, which is what is monitored and watched in patients

Question 5

drugs and conditions that can cause hypothyroidism

Answer 5

I TALC
I interferons
T tyrosine Kinase Inhbitors 
A Amiodarone
L Lithium
C Carbamazepine

+Hasimotos+

Question 6

drugs that can cause hyper or hypothyroid

Answer 6

Interferons and Amiodarone

Question 7

hypothyroid is

Answer 7

decrease in t4 and increase in tsh

Question 8

symptoms of hypo

Answer 8

cold intolerance
dry skin
fatigue
muscle cramps
voice changes
constipation
weight gain
goiter
myalgias
weakness
depression
bradycardia
caorse hair/loss of hair
menorrhagia (heavier than normal menstrual periods)
memory and mental impairment

Question 9

primary test for function of thyroid

Answer 9

tsh

Question 10

monitor tsh levels every

Answer 10

4-6 weeks until levels are normal

Question 11

too high thyroid replacement dose in elderly can cause

Answer 11

afib and fractures

Question 12

DOC for hypothyroidism

Answer 12

levothyroxine (Synthroid)

Question 13

other meds for hypothyroid

Answer 13

desiccated thyroid (armour thyroid)
liothyronine (cytomel)

Question 14

cytomel

has

Answer 14

liothyronine

t3

Question 15

dessicated thyroid has

Answer 15

t3 and t4

Question 16

levothyroxine has only

Answer 16

t4

Question 17

levothyroxine full replacement dose

Answer 17

1.6 mcg/kg/day use IBW

Question 18

what weight to use for levothyroxine

Answer 18

IBW!

Question 19

if patient less than 50 use

Answer 19

1.6 mcg/kg/day IBW

Question 20

initial starting dose CAD of levothyroxine

Answer 20

12.5 mcg- 25 mcg

Question 21

Iv to po levothyroxine

Answer 21

0.75:1

Question 22

levothyroxine is highly protein bound yes or no

Answer 22

yes

Question 23

how to take levothyroxine

Answer 23

full glass of water
at the same time each day for consistent absorption
60 min before breakfast!
or at bedtime at least 3 hours after the last meal

Question 24

levothyroxine tablet colors

Answer 24

orangutans - orange (25)
will -  white (50) no dye
vomit - violet (75)
on - olive (88)
you - yellow (100) 
right - rose (112)
before- brown (125)
they- turquoise (137)
become- blue (150) 
large- lilac (175)
proud - pink (200)
giants- green (300)

Question 25

if you become pregnant and on levothyroxine you will likely need to

Answer 25

increase dose

Question 26

drugs that decrease levothyroxine absorption

Answer 26

``` antacids iron calcium aluminum magnesium multivitamins cholestyramine orlistat(alli,xenical) sevelamer, sucralafate ``` seperate doses by 4 hours

Question 27

estrogen and ssris decrease

Answer 27

levothyroxine

Question 28

beta blockers amiodarone ptu and systemic steroids decrease

Answer 28

levothyroxine effectiveness

Question 29

warfain and levothyroxine

Answer 29

increases effect of warfarin | increase in PT and INR

Question 30

levothyroxine and theophylline

Answer 30

decrease in theophylline

Question 31

levothyroxine causes an effect on two major drugs

Answer 31

warfarin (increase) | theophylline (decrease)

Question 32

levothyroxine how soon before breakfast

Answer 32

an hour

Question 33

hyperthyroidism symptoms

Answer 33

``` heat intolerance or increased sweating weight loss agitation nervousness irritability anxiety tachycardia,palpitations fatigue muscle weakness insomia tremor thinning hair goiter exophthalmous (protrusion of the eyeballs) diplopia light or absent menstrual periods ```

Question 34

autoimmune condition for hyperthyroid

Answer 34

graves disease | antibodies

Question 35

drugs that can cause hypo

Answer 35

amiodarone iodine interferons

Question 36

what can you use for hyperthyroid symptoms

Answer 36

propanolol any beta blockers

Question 37

propylthiouracil and methimazole have a boxed warning for

Answer 37

severe liver injury and acute liver failure | PTU preferred in first trimester

Question 38

warnings with ptu and methimazole

Answer 38

hepatotoxicity agranulocytosis DILE

Question 39

SE with PTU and Methimazole

Answer 39

GI upset

Question 40

how to take PTU/methimazole

Answer 40

with food to decrease risk of gi upset

Question 41

which is the DOC ptu or methimazole

Answer 41

methimazole | unless thyroid storm or 1st trimester preg.

Question 42

if pregnant use PTU in first trimester than switch to

Answer 42

methimazole in 2nd and 3rd trimesters to reduce risk of liver toxicity

Question 43

what to use after exposure to radiation

Answer 43

potassium iodide (KI) it prevents thyroid cancer

Question 44

signs and sym of thyroid storm

Answer 44

``` fever greater than 103 tachycardia tachypnea dehydration profuse sweating agitation delirium psychosis coma ```

Question 45

how to treat thyroid storm

Answer 45

``` PTU SSKI or Lugol soln Beta blocker (propanolol) Steroid (dexamethasone) Cooling (blankets and tylenol) ```

Question 46

levothyroxine once pregnant

Answer 46

increase dose by 30 to 50 percent

Question 47

liotrix has

Answer 47

t4 and t3 in a 4:1 ratio

Question 48

greater than 60 starting dose

Answer 48

25 to 50 mcg QD

Question 49

levothyroxiNe

Answer 49

normal saline and use immediately