Chapter 18

Question 1

What is the thyroid gland?

Answer 1

Butterfly-shaped organ that is located anterior to the trachea
Normal size is 2-2.5 cm width and 3-5 cm length

Question 2

What is the action of thyroid hormones produced by the thyroid gland?

Answer 2

Determine metabolic rate
Growth rate
Other specific body mechanisms

Question 3

What is euthyroid?

Answer 3

Term used to describe an individual with a normally functioning thyroid gland.

Question 4

What is hypothyroidism (myxedema)?

Answer 4

Insufficient thyroid hormone is produced by the thyroid gland

Question 5

What are some causes of hypothyroidism?

Answer 5

Autoimmune disorders (Hashimoto’s thyroiditis)
Pituitary tumors
Surgery
Irradiation

Question 6

Patients with documented hypothyroidism should be asked which of the following questions?

Answer 6

Are they taking their medications
Is their dosage stabilized
Do they have routine blood work performed to insure adequate medication levels

Question 7

True or False

In young individuals myxedema manifests as cold intolerance, weight gain, dry skin, constipation, and mental and physical slowing.

Answer 7

True

Question 8

What is hyperthyroidism?

Answer 8

Too much thyroid hormone is produced by the thyroid gland

also known as thyrotoxicosis - result of a condition called graves’ disease

Question 9

What is Graves’ disease?

Answer 9

disorder associated with enlarged thyroid gland, which will feel soft on palpation - hereditary in nature - autoimmune disorder

Question 10

What is nodular goiter?

Answer 10

enlarged thyroid gland with multiple nodules - another cause of hyperthyroidism

Question 11

What are some signs displayed by hyperthyroidism?

Answer 11

weight loss
nervousness
insomnia
bulging eyes (exophthalmos)
tremors
increased sweating
rapid heart rate
diarrhea
Opposite of hypothyroidism

Question 12

What are the three ways that patients with hyperthyroidism are treated?

Answer 12

surgery
ablation therapy
antithyroid drugs

Question 13

What is ablation therapy?

Answer 13

involves using radioactive iodine to disable the thyroid gland

Question 14

What are some medications used for synthetic hormone replacement to control hyperthyroidism?

Answer 14

methimazole

propylthiouracil

Question 15

True or False

When thyroid hormone levels become too low, the patient may experience a potentially life-threatening condition called myxedema coma

Answer 15

True

Question 16

True or False

When thyroid hormone levels become too high, the patient will most likely experience a serious condition called thyroid storm.

Answer 16

True

Question 17

What is myxedema coma?

Answer 17

Occurs when the body is unable to compensate for the severe deficiency of the thyroid hormones often because of some precipitating event

Question 18

What can myxedema coma result from?

Answer 18

Undiagnosed hypothyroidism
incorrect treatment
precipitating factor such as trauma, infection or sepsis, hemorrhage, hypoglycemia, or surgery

Question 19

True or False

Myxedema coma is more commonly found in individuals over 70 years of age and is rarely seen in individuals younger than 60.

Answer 19

True

Question 20

What are some signs and symptoms of myxedema coma?

Answer 20

Deterioration of the patient's mental state: confusion, apathy, depression
Hypothermia (< 95 dg)
hair loss
certain facial conditions: puffiness, macroglossia, ptosis, periorbital edema
cool, dry skin with non pitting edema
bradycardia
changes in blood pressure with elevation in the early stages and lowered in later
constipation
seizures
impaired mobility
hypoventilation
coma (rare)

Question 21

What is the major goal when treating myxedema coma?

Answer 21

normalize patient’s temperature and maintain respirations

admit to the hospital as soon as possible

Question 22

What is thyroid storm?

Answer 22

life-threatening emergency characterized by an exacerbation of hyperthyroid state; often result of undiagnosed thyroid disease; overzealous treatment of hypothyroidism; precipitating factor (trauma, infection, diabetic ketoacidosis, cerebrovascular accident, stress, toxemia of pregnancy)

Question 23

What are some signs and symptoms of thyroid storm?

Answer 23

fever ( as high as 108)
diaphoreses
restlessness
confusion
anxiety
psychosis
gastrointestinal symptoms (nausea, vomiting, jaundice, diarrhea)
tachycardia
increased systolic blood pressure
widened pulse pressure
arrhythmias

Question 24

What is the preferred treatment of thyroid storm?

Answer 24

ensure the patient is in comfortable position
administer oxygen 4-6 L/minute
monitor vital signs

Question 25

The most accepted method for treating hyperthyroidism is

Answer 25

ablation therapy

Question 26

Which of the following is a sign of thyroid storm?

Answer 26

Fever

Question 27

All of the following are strategies for managing thyroid storm except one. Which one is the exception?

Answer 27

wrapping in blankets to increase body temperature

Question 28

Hypothyroidism is characterized by

Answer 28

cold intolerance

Question 29

The emergent condition arising from severe hypothyroidism is

Answer 29

myxedema coma

Question 30

The most common medication a patient would take for hypothyroidism is

Answer 30

levothyroxine

Question 31

All of the following are treatment management strategies for myxedema coma except

Answer 31

administering sedatives and tranquilizers

Question 32

The hereditary autoimmune disorder whereby the individual has an increased level of thyroid hormone production is known as

Answer 32

graves’ disease