L11: Thyroid/Parathyroid Flashcards
Levothyroxine is used to treat ____ while 131 I is used to treat ____
A. hyperthyroidism; hypothyroidism
B. hypothyroidism; hyperthyroidism
B. hypothyroidism; hyperthyroidism
Alendronate, Risendronate, Ibandronate, and Zoledronate are bisphosphates used to treat….
A. hypercalcemia
B. osteoporosis
C. paget’s disease
B. osteoporosis
Zoledronate is used to treat which two conditions?
Osteoporosis and Hypercalcemia
True or False: Pamidronate, Calcitonin, and Zolendronate treat hypocalcemia
False - hypercalcemia
What is severe hypothyroidism in adults known as?
Myxedema
- Congestive heart
- Baggy eyes
- Non-pitting edema
True or False: If an adult has mild hypothyroidism, they may be weak, lethargic, and have decreased weight gain due to have decreased metabolism, depression , and reduced CO
False - they have INCREASED weight gain
True or False: Adult hyperthyroidism can result in an endemic goiter
False - hypothyroid
What are 3 causes of adult hypothyroidism?
- Inadequate Iodine in diet and little T3/4 formed
- Goitrogens
- Hashimoto Thyroiditis
_____: Directly or indirectly inhibit I2 transport into thyrocytes; it is associated with ADEQUATE I2 but minimal T3/4 made
Goitrogens
_____ is an autoimmune disease that is the most common cause of hypothyroidism in the US
Hashimoto Thyroiditis
A woman who is postpartum may experience antibodies damaging the thyroid tissue, releasing thyroid passively.
Which of the following describes this?
A. hyperthyroidism
B. hypothyroidism
A. hyperthyroidism
A woman who is postpartum may experience declining levels of thyroid levels, producing either temporary or permanent thyroid failure.
Which of the following describes this?
A. hyperthyroidism
B. hypothyroidism
B. hypothyroidism
If hypothyroidism is ___, it can be treated with IV therapy with T4 or T3
If hypothyroid is ___, it can be treated with oral synthetic T4 (Levothyroxine)
A. severe; mild
B. mild; severe
A. severe; mild
True or False: When taking Levothyroxine, T4 is converted into T3 in effector/peripheral tissue via: deiodinase
True
When prescribing levothyroxine, you may have to increase dose for which two patient populations?
- Pregnant patients
- Those on estrogen therapy
Weight loss, nervousness, restlessness, fatigue, weakness, and heat intolerance are symptoms most closely associated with…
A. hyperthyroidism
B. hypothyroidism
A. hyperthyroidism
Exophthalmos is a example of:
A. hyperthyroidism
B. hypothyroidism
A. hyperthyroidism
Normal T4/T3 levels and low TSH are symptoms of…
A. hyperthyroidism
B. hypothyroidism
A. hyperthyroidism
Older patients with atrial arrythmias often have subclinical ____ as a cause
hyperthyroidism
What is the most common cause of hyperthyroidism?
Graves Disease
The presence of ___ antibodies is present in Graves Disease
A. IgM
B. IgA
C. IgG
D. IgF
C. IgG
Which condition is characterized by thyroid stimulating immunoglobulin—which mimics TSH and increases T3/4 release–which suppresses TSH to zero?
Graves Disease
True or False: Patients who have hyperthyroidism may eventually become hypothyroid because the gland is “burned out”
True
____ is a beta particle emitter that kills tissue and use used to treat hyperthyroidism
131 I Therapy
True or False: Thyroid gland is the most efficient, high affinity iodide transporter – other iodide transporting glands (e.g salivary) are not as affected by 131 I use
True
True or False: 131 I Therapy is contraindicated in nursing mothers and can be used to treat thyroid cancer
True
What are the effects of estrogen, calcitonin, PTH, and calcitriol on osteoclasts and osteoblasts?
True or False: Calcitriol and PTH increase osteoblast activity
True
True or False: Calcitonin decreases osteoclasts
True
Which drug class contains P-O-P bonds
that have been replaced by P-C-P bonds and slow bone turnover by incorporating into bone?
A. Bisphosphonates
B. Estrogen Therapy
C. Biologic Drugs
A. Bisphosphonates
True or False: Some bisphosphonates may induce apoptosis of osteoclasts
True
True or False: Zolendronic Acid, a bisphosphonate, inhibits osteloclasts
True
True or False: Calcium pyrophosphate makes up hydroxyapatite while Na Etidronate is one of the oldest biphosphonates
True
Which of the following
is an amino substituted bisphosphonate that is more potent thatn other members AND can inhibit bone resorption WITHOUT impairing bone mineralization?
A. Risendronate
B. Zolendronate
C. Ibandronate
D. Alendronate
D. Alendronate
True or False: Alendronate can be used to treat Paget’s Disease or Osteoporosis
True
True or False: Side effect associated with the bisphosphonates inculde: AFF, ONJ, and esophageal erosion
True
Which of the following is a pyridinal bisphosphonate that is chemically UNLIKE the others and decreases turnover by binding to HYDROXYAPETITE in bone?
A. Risendronate
B. Zolendronate
C. Ibandronate
D. Alendronate
A. Risendronate
True or False: Risendronate can treat Osteoporosis or Paget Disease
True
Which of the following bisphosphonates has two forms –
1) is administered once a year via IV and acts to INHIBIT osteoclast activity and induce APOPTOSIS and
2) treats hypercalcemia?
A. Risendronate
B. Zolendronate
C. Ibandronate
D. Alendronate
B. Zolendronate
Which bisphosphonate is given monthly and, at higher doses, can cause constipation, flu-like symptoms, and pain in extremities?
A. Risendronate
B. Zolendronate
C. Ibandronate
D. Alendronate
C. Ibandronate
True or False: Ibandronate is associated with femoral shaft fractures while Alendronate is associated with femur fractures
True
Why is estrogen therapy no longer used to treat osteoporosis?
Risks outweighs benefits
- Increased breast cancer risk and coronary heart disease
Raloxifene is a selective estrogen receptor modulator use approved to treat _____
Risk associated with use?
post-menopausal ostoeporosis
- Venous Thromboembolism
Teriparatide, Abaloparatide, and Romosozumab are both anabolic agents and ___ hormones that can be used to treated osteoporosis
PTH
Which patient populations are eligible for anabolic agents to treat osteoporosis?
Those who do not tolerate bisphosphonate therapy
____ is a biologic drug. More specifically, it is a monoclonal antibody that binds to osteoclast ligand, thereby inhibit osteoclast activation and proliferation
Denosumab
True or False: Denosumab, a biologic drug, reduces osteoclast activity and reduces proliferation, while also increasing bone density
True
____ is the most potent Vit D metabolite, which increase calcium absorption in the intestine while decreasing calcium and phosphorous excretion by kidneys
Cilcitriol
Which two conditions can Vit D, Calcitriol be used to treat?
Osteoporosis and Hypoparathyroidism
True or False: Vit D Calcitriol does not depend on liver or kidneys for activation
True
What causes hypercalcemia?
- Hyperparathyroidism
- Lung/Breast tumor, producing parathyroid-related protein
What effects does PTH have on the bone and kidney?
Both Pamidronate and Zoledronate treat ____
A. Osteoporosis
B. Hypercalemia
B. Hypocalemia
B. Hypercalemia
Which of the following is primarily used to reduce bone pain and fractures in multiple myeloma and metastatic breast cancer?
A. Pamidronate
B. Zoledronate
A. Pamidronate
Which of the following drugs used to treat hypercalcemia can result in necrosis of the jaw, if given in multiple doses?
A. Pamidronate
B. Zoledronate
B. Zoledronate
____ is secreted from parafollicular cells (C cells) in the thyroid gland and lowers the serum Ca by inhibiting osteolysis and increasing calcium excretion (via: kidney)
Calcitonina
There are two types of calcitonin, ___ is from salmon and causes antibodies to develop
while ___ is a synthetic human form
A. Calcimar, Cibacalcin
B. Cibacalcin, Calcimar
A. Calcimar, Cibacalcin
Which two conditions can be treated with Calcitonin?
- Paget’s Disease
- Osteoporosis
