thyroid pp

Question 1

small organ in front of neck that wraps around the trachea

Answer 1

thyroid

Question 2

what does the thyroid gland do

Answer 2

releases and controls thyroid hormones that control metabolism

Question 3

uses energy too quickly

Answer 3

hyperthyroidism

Question 4

where is TRH released

Answer 4

hypothalamus

Question 5

where is TSH released

Answer 5

pituitary

Question 6

THR stimulates the release of TSH which stimulates the release of

Answer 6

T4 and T3 from the thyroid

Question 7

T4 and T3 active or inactive

Answer 7

T4 inactive
T3 active

Question 8

TSH>4.5
T4<4.5

Answer 8

primary overt hypothyroidism

Question 9

TSH>4.5
normal T4

Answer 9

primary subclinical hypothyroidism

Question 10

low T4
normal or low TSH

Answer 10

secondary hypothyroidism

Question 11

what’s is the best test to assess thyroid function

Answer 11

TSH
normal 0.5-4.5

Question 12

FT4 normal level

Answer 12

0.8-1.5

Question 13

total T4 normal level

Answer 13

4.5-12.55

Question 14

test for hyperthyroidism

Answer 14

RAI

Question 15

test for hasimatos

Answer 15

anthyroid peroxidase antibody (TPOAb)

Question 16

test for graves

Answer 16

anti TSH receptor antibody (TRAb)

Question 17

excessive levels of T4 and/or T3

Answer 17

hyperthyroidism (thyrotoxicosis)

Question 18

hyperthyroidism causes

Answer 18

graves disease
amiodarone

Question 19

longterm over treatment increases risk of

Answer 19

a fib
anxiety
depression
altered mental staus
osteoporosis

Question 20

which thionmide also inhibits peripheral conversion of T4 to T3

Answer 20

PTU

Question 21

which thionamide can be used in the 1st trimester of pregnancy

Answer 21

PTU

Question 22

which class of drugs decrease the size and vascularity of the gland

Answer 22

iodides

Question 23

what adrenergic blockers are used

Answer 23

propranolol
nadolol

Question 24

sodium iodide 131 concentrates in the thyroid, disrupting hormone synthesis by incorporating into thyroid hormones and thyroglobulin

Answer 24

RAI

Question 25

causes of primary hypothyroidism

Answer 25

Hashimoto iatrogenic cause (radiation, total thyroidectomy, excessive thionamide doses) iodine deficiency enzymatic defects thyroid hypoplasia ingestion of goitrogens

Question 26

causes of secondary hypothyroidism

Answer 26

pituitary failure destruction of thyrotrophs surgical external radiation postpartum pituitary necrosis (Sheehan syndrome) trauma metastatic tumors TB

Question 27

extreme form of hypothyroidism where the bodys functions slow down

Answer 27

myxedema coma

Question 28

myxedema coma s/s

Answer 28

extreme weakness confusion decreased responsiveness low body temp respiratory depression coma

Question 29

levothyroxine counselig

Answer 29

take 30min before breakfast with water or plain black coffee food can decrease absorption

Question 30

amiodarone interactions

Answer 30

can cause hypothyroidism or hyperthyroidism in anyone

Question 31

lithium interactions

Answer 31

can cause hypothyroidism in anyone

Question 32

pregnancy considerations

Answer 32

higher doses are required +40-50% increase dose of levothyroxine to 9 doses weekly as soon as pregnancy occurs monitor TSH monthly

Question 33

preexisting cardiac disease age >50-60 considerations

Answer 33

12.5 initially then increase very 6-8 weeks

Question 34

post thyroidectomy considerations

Answer 34

use higher doses

Question 35

osteopenia or osteoporosis considerations

Answer 35

lower starting doses because over treatment can cause bone loss

Question 36

over treatment with levothyroxine s/s

Answer 36

tachycardia arrhythmia angina MI tremor HA nervousness insomnia irritability hyperactivity diarrhea vomiting cramps weight loss fatigue menstrual irregularities excessive sweating heat intolerance fever muscle weakness hair loss decreased bone mineral density

Question 37

under treatment of hypothyroidism can cause

Answer 37

myxedema coma heart disease cretinism (dwarfism and mental retardation)

Question 38

levothyroxine and Synthroid suggestions

Answer 38

avoid switching between manufactures in generic formulations avoid switching between brand and generic if switch must happen they need TSH drawn in 6 weeks

Question 39

TSH levels should normalize after how long of therapy

Answer 39

2-6 weeks