[PHARMA] THYROID GLAND

Question 1

synthetic T4

Answer 1

Levothyroxin

Question 2

synthetic T3

Answer 2

thyronine Na+

Question 3

DOC in myxedema & cretinism

Answer 3

levothyroxin

Question 4

used in myxedema coma

Answer 4

thyronine Na+

Question 5

thyronine Na+ characteristics

Answer 5

synthetic T3
short duration
faster acting
more expensive

Question 6

block iodide trapping

Answer 6

Radioactive iodine

Question 7

blocks oxidation

Answer 7

thionamides

Question 8

blocks organificaiton/iodination

Answer 8

thionamides
iodides

Question 9

blocks coupling

Answer 9

thionamides

Question 10

blocks release

Answer 10

lithium
iodides

Question 11

blocks conversion

Answer 11

Propanolol
PTU
coricosteroids

Question 12

blocks tissue uptake

Answer 12

L-carnitine

Question 13

thionamides members

Answer 13

methimazole
PTU

Question 14

DOC in pregnancy

Answer 14

PTU

Question 15

thionamides mechanism of action

Answer 15

(-) peroxidase
(-) oxidation, iodination, coupling
= (-) T3 & T4 synthesis
(-) T4–>T3 conversion= T4 converted to rT3

Question 16

thionamides uses (4)

Answer 16

1-hyperthyroidism (young patients)
2-pre-op: subtotal thyroidectomy
3- reduce symptoms
4- thyrotoxic storm

Question 17

thionamides adverse effects (5)

Answer 17

1-maculopapular rash
2-arthralgia
3-agranulocytosis
4- hepatic necrosis; cholestatic jaundice
5- Fetal goitre

Question 18

TTT given to avoid overt hyperthyroidism & S/E to mother & baby?

Answer 18

PTU in 1st trimester
Methimazole after organogenesis

Question 19

Lugol’s iodine mechanism of action

Answer 19

(-) iodination
(-) release
↓ size & vascularity

Question 20

escape phenomenon happens w/?
why?

Answer 20

iodides
due to compensatory ↑ in TSH= (+) T3 & T4= loss of iodide effect

Question 21

lugol’s iodine uses

Answer 21

thyrotoxic storm
Pre-op: thyroidectorm

Question 22

DOC in: preparation for thyroidectomy

Answer 22

iodides

Question 23

Radioactive iodine mechanism of action

Answer 23

emits beta rays=cytotoxic
damages thyroid severely without damaging surrounding structures

Question 24

Radioactive iodine uses (3)

Answer 24

1-hyperthyroidism (45+ years)
2-hyperthyroidism not fit for surgery
3-recurrence

Question 25

Radioactive iodine adverse effects (3)

Answer 25

1-hypothyroidism 2-recurrence 3-radiation thyroditis

Question 26

radiation thyroiditis? caused by?

Answer 26

↑↑ thyroid hormones= cardiac complications Radioactive iodine

Question 27

Radioactive iodine CI (3)

Answer 27

1-young 2-pregnant 3-lactating

Question 28

radioactive thyroiditis can be avoided by

Answer 28

ATDs before radioactive iodine to deplete stores

Question 29

propanolol mechanism of action

Answer 29

antagonizes sympathetic overactivity (-) conversion

Question 30

propanolol uses (3)

Answer 30

1-Symptomatic control 2-Storm: thyrotoxic storm S-3urgery: pre-op

Question 31

drugs given pre-op (thyroidectomy)

Answer 31

thionamides iodides beta-blockers

Question 32

drugs given post-op (thyroidectomy)

Answer 32

thyroid supplements

Question 33

thyroid storm drugs should ALWAYS be given

Answer 33

parenterally via nasogastric tube

Question 34

thyroid storm occurs in

Answer 34

untreated patients precipitated by surgery, severe infection, illness

Question 35

thyroid storm TTT (7)

Answer 35

1-Propanolol 2- PTU 3-Iodides 4-Hydrocortisone 5-Lithium 6- Plasmapheresis 7- Peritoneal dialysis

Question 36

TTT of resistant thyrotoxic storm

Answer 36

plasmapheresis perioteneal dialysis