Hypothyroidism 2 Flashcards

1
Q

Which of the following is true about evaluation of Autoimmune hypothroidism

a. T3 measurements are not indicated
b. There may be decreased creatine phosphokinase
c. cholesterol and triglycerides may be decreased
d. microcytic anemia may be found

A

A

a. T3 measurements are not indicated
b. There may be increased creatine phosphokinase
c. cholesterol and triglycerides may increaed
d. normocytic or macrocytic anemia may be found

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2
Q

After RAI for hyperthyroidism , what is used to measure thyroid function

A

Because TSH levels are suppressed by
hyperthyroidism, unbound T4
levels
are a better measure of thyroid function

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3
Q

Responsible for the hypothyroidism that

occurs in up to 13% of patients treated with amiodarone

A

Iodine excess

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4
Q

If there is no residual thyroid function, the daily replacement
dose of levothyroxine is usually

A

1.6 μg/kg body weight (typically

100–150 μg)

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5
Q

In patients who develop hypothyroidism after the treatment of Graves’ disease, there is often underlying autonomous function, necessitating lower replacement doses of?

A

typically 75–125 μg/d

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6
Q

Adult patients under 60 years old without evidence of heart

disease may be started on what dose of levothyroxine

A

50–100 μg levothyroxine (T4) daily

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7
Q

When treating, who often should TSH be measured

A

2 months after instituting treatment

1,2,3,4, Mnemonic:
TSH
2 month
FT3
FT4
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8
Q

Drugs that interfere with T4 absorption or metabolism are the following except:

a. Bile acid sequestrants
b. Calcium supplements
c. Ranitidine
d. Ferrous sulfate

A

C.

bile acid sequestrants, ferrous sulfate, calcium supplements,
selevamer, sucralfate, proton pump inhibitors, lovastatin, aluminum
hydroxide, rifampicin, amiodarone, carbamazepine, phenytoin, and
tyrosine kinase inhibitors

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9
Q

When is levothyroxine recommended in cases of Subclinical hypothyroidism

A

If the patient
is a woman who wishes to conceive or is pregnant, or when TSH
levels are above 10 mIU/L

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10
Q

When TSH levels are below

10 mIU/L, a trial of treatment may be considered when

A

patients

have suggestive symptoms of hypothyroidism, positive TPO antibodies, or any evidence of heart disease

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11
Q

How is treatment of subclinical hypothyroidism started

A

Treatment is administered by starting with a low
dose of levothyroxine (25–50 μg/d) with the goal of normalizing
TSH

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12
Q

For hypothyroid women planning conception, what would be the target TSH be

A

<2.5 mIU/L for

hypothyroid women

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13
Q

How often should thryoid function be evaluated in pregnant hypothyroid women

A
  • After pregnancy is confirmed
  • Every 4 weeks
    during the first half of the pregnancy,

with less frequent testing after
20 weeks’ gestation (every 6–8 weeks depending on whether levothyroxine dose adjustment is ongoing).

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