Thyroid dz Flashcards
when would you use thyroid scan and uptake?
hyperthyroidism
what is normal thyroid uptake at 4-6 hours?
5-15%
what is the normal thyroid uptake at 24 hours?
15-25%
what does the scan help you determine?
hetero or homogenous distribution
-determined by cold/hot areas of uptake on scan
what supplements can influence synthroid levels?
calcium and iron
what is a common side effect of synthroid?
CP
palpitations
what comorbidities can impact synthroid absorption?
malabsorption
GI conditions
what should you do when giving synthroid to an elderly person?
1/2 of a 25 mcg tablet twice a day
go slowly and make small dose changes
(risk of precipitating a cardiac event)
how often should you check TSH and free T4 levels?
every 6 weeks
what is armour thyroid?
pork thyroid extract
measured in grains
what is thyrotoxicosis?
hyperthyroidism
what is the dosing frequency of methimazole?
once daily
what is a significant side effect of antithyroid drugs?
agranulocytosis
which anti thyroid is the DOC during pregnancy?
PTU
which antithyroid drug inhibits conversion of T4-T3?
PTU (also has risk of hepatic failure)
which is the DOC during a thyroid storm?
PTU
what drug might you also consider if sxs don’t resolve quickly?
beta-blocker
(one month taper is common)
-reduces some peripheral conversion of T4-T3
what condition can worsen with RAI especially in smokers?
opthalmopathy
what has to happen before giving RAI?
stop antithyroid drugs for 7 dys before RAI
what is a typical presentation in the elderly of hyperthyroidism?
apathetic
AMS
what are the risk factors for thyroid nodules?
age female > male hx of head and neck irradiation family hx of thyroid cancer iodine deficiency
what factors increase the risk of malignancy?
pt 70 male > female hx of radiation family hx of thyroid cancer environmental toxins
when is a fine needle aspiration indicated?
palpable nodules and >10mm or with risk factors for malignancy
which type of thyroid nodule is the most common and has the best cure rate?
papillary
