CIS 1: ENDO Flashcards
Hyperthyroidism increases the risk of _____ which increases the risk of _____
A. Fib
Thromboembolic stroke
What are the TSH and Free T4 levels in primary hyperthyroidism, subclinical hyperthyroidism, primary hypothyroidism, and subclinical hypothyroidism
1˚ hyper = low TSH, high/normal T4
Subclin. hyper = low TSH, normal T4
1˚ hypo = high TSH, low T4
Subclin. hypo = high TSH, normal T4
Which type of hyperthyroidism has the highest risk of A. Fib
Subclinical hyperthyroidism
What are 4 main meds for Tx of hyperthyroidism
ß-blocker
CCB (verapamil, diltiazem) if no HF
Digoxin
Amiodaron
When would you use electrical cardioversion for Tx
Known onset w/in 48 hrs
Pt is unstable
What is the protocol for electrical cardioversion in a pt who is stable and the onset is unknown and > 48 hrs ago
Anticoagulation q 4 wks
Cardioversion
Anticoagulation q 4 wks
If a thrombus is found via TEE in an atrial appendage, what is done with cardioversion
Delayed 4 wks with Warfarin therapy
What meds can be used for hyperthyroidism in pts with no A. Fib
PTU
Methimazole
Propranolol
What Abs are tested for in pts with suspected Graves or Hashimoto’s
Graves = Thyrotropin Receptor Ab Hashimoto = TPO Ab
Def: Thyroid storm
Acute event precipitated by antagonizing event causing tachycardia (> 140), HoTN, arrhythmia, hyperpyrexia (104-106), delirium, and coma
What are the TSH and Free T4 levels in thyroid storm
Low TSH
High T4 and T3
What are the meds used for Tx of Thyroid storm
*First consider precipitating factor ß-blocker Thionamide Iodine solution Glucocorticoids Bile acid sequestrates (cholestyramine)
What is the CHA2DS2-VASc score
C - CHF H - HTN A2 - age ≥ 75 (2 points) D - DM S2 - Stroke (2 points) V - Vascular disease A - age 65-74 yo Sc - Sex category
What SNS levels are of concern for thyroid issues
T1-5 (head/neck)
Which trigger point may be active in the presence of cardiac disease
Pec minor on the left
