00 Thyroid Disorders Flashcards

1
Q

Which hormone is Triiodothyronine?

A

T3

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2
Q

Which hormone is Thyroxine?

A

T4

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3
Q

What is the most common cause of Hypothyroidism?

A

Hashimoto’s Disease (autoimmune thyroiditis, a condition that destroys the thyroid gland)

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4
Q

What are some drugs that can induce hypothyroidism?

A

Octreotide, Amiodarone, Interferon, Lithium

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5
Q

What are the most common symptoms of Hypothyroidism?

A

Cold intolerance, Dry skin, Fatigue, Weight gain, Depression, Constipation

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6
Q

What are the hormone levels like in someone with Clinical Hypothyroidism?

A

High TSH, low T4 & T3

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7
Q

What is the generic name of Levothyroid?

A

Levothyroxine (T4 only)

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8
Q

What is the generic name of Synthroid?

A

Levothyroxine (T4 only)

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9
Q

What is the generic name of Levoxyl?

A

Levothyroxine (T4 only)

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10
Q

What is the generic name of Unithroid?

A

Levothyroxine (T4 only)

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11
Q

What is the generic name of Tirosint?

A

Levothyroxine (T4 only)

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12
Q

What is the generic name of Cytomel?

A

Liothyronine (T3 only)

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13
Q

What is the generic name of Armour Thyroid?

A

Desiccated Thyroid (T3 and T4)

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14
Q

What is the generic name of Nature Thyroid?

A

Desiccated Thyroid (T3 and T4)

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15
Q

Which thyroid medication is the DOC for pregnancy?

A

Levothyroxine

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16
Q

Which thyroid medication needs to be protected from light and moisture?

A

Levothyroxine

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17
Q

What are the dose equivalencies like between IV and PO levothyroxine?

A

IV = 50% of PO dose

18
Q

When would you want to start with a lower dose of Levothyroxine?

A

Heart disease. Elderly > 50 years

19
Q

What common medications can Levothyroxine effect?

A

Can Decrease: Digoxin, Theophylline, Antidiabetic agents. Can Increase: Effect of warfarin

20
Q

What is the BBW with Levothyroxine?

A

In euthyroid patients, thyroid supplements are ineffective and potentially toxic for weight reduction. High doses may produce serious or even life-threatening toxic effects, particularly when used with some anorectic drugs

21
Q

What is monitoring like for Levothyroxine?

A

Initial therapy or w/ dose changes: TSH Q1-2 months until euthyroid. Maintenance: TSH Q6-12 months or as clinically indicated

22
Q

When do you not want to use Levothyroxine?

A

Acute MI, Thyrotoxicosis, Uncorrected adrenal insufficiency

23
Q

What is the most common cause of Hypothyroidism?

A

Grave’s Disease (autoimmune disorder leading to over production and secretion of thyroid hormones)

24
Q

What medications could cause Hyperthyroidism?

A

Amiodarone. Interferon. Thyroid hormone supplements

25
Q

What are some symptoms of Hyperthyroidism?

A

Irritability, Insomnia, Heat intolerance, Sweating, Tachycardia, Tremor, Diarrhea

26
Q

What are the thyroid hormone levels like in someone with Clinical Hyperthyroidism?

A

Low TSH. High T4 & T3

27
Q

Usually subclinical hyperthyroidism isn’t treated, but when might you consider it?

A

> 65 years w/ heart disease. Pregnant. Symptoms of hyperthyroidism present

28
Q

What is the generic name of Propyl-Thyracil?

A

Propylthiouracil (PTU)

29
Q

What is the generic name of Tapazole?

A

Methimazole (MMI)

30
Q

What is different about PTU compared to Methimazole?

A

Both inhibit synthesis of thyroid hormones, but PTU also blocks CONVERSION of T4 to T3 at higher doses

31
Q

Which hyperthyroid treatment option is preferred in pregnancy?

A

PTU

32
Q

What is the BBW with PTU?

A

Hepatotoxicity

33
Q

What is the treatment of choice for Grave’s and Plummer’s Diseases?

A

Radioactive Iodine (RAI)

34
Q

When is Radioactive Iodine (RAI) contraindicated?

A

Pregnancy, Lactation, Thyroid cancer

35
Q

What are the Iodide therapy options?

A

Lugol’s Solution (Potassium iodide and iodine solution). SSKI (saturated solution of potassium iodide)

36
Q

Which beta-blockers can be used in Hyperthyroidism to help block symptoms?

A

Propranolol, Nadolol, Metoprolol, Atenolol, Esmolol

37
Q

Which beta-blockers may actually block the conversion of T4 to T3 at higher doses?

A

Propranolol and Nadolol

38
Q

What are some precipitating factors of thyroid storm (medical emergency)?

A

Infection, MI, diabetes, trauma

39
Q

What are the symptoms caused by Thyroid Storm?

A

Fever > 103. Tachycardia > 140. Tachypnea. Sweating. Agitation, psychosis, coma

40
Q

What is used to treat thyroid storm?

A

All used together: PTU (or Methimazole), Propranolol (or esmolol), SSKI (only start 1 hour after antithyroid medications), Hydrocortisone (or dexamethasone)

41
Q

What is hyperthyroidism treatment like in pregnancy?

A

PTU is preferred during 1st trimester. Switch to MMI during 2nd and 3rd trimester. If unable to tolerate these, consider surgery (2nd trimester is ideal for thyroidectomy)

42
Q

Which thyroid medication should be avoided in someone allergic to pigs?

A

Armour Thyroid