Thyroid

Question 1

Euthyroid

Answer 1

normal thyroid gland function

Question 2

Goiter

Answer 2

Visible enlargement of the thyroid gland

Question 3

Graves Disease

Answer 3

antibody mediated autoimmune disease resulting in hyperthyroidism

Question 4

Hashimoto’s Thyroiditis:

Answer 4

Autoimmune disease often resulting in hypothyroidism

Question 5

Thyroid Stimulating Hormone (TSH)

Answer 5

Secretion of T3, T4
via a negative feedback mechanism
Level of thyroid hormone in then lose determines release of TSH

Question 6

Normal Thyroid levels

Answer 6

TSH (0.4 to 4.5)
If less than 0.4 = hyperthyroid/overactive
If above 4.5 – hypothyroid
T4 (4-11)
T3 (80-180)

Question 7

Symptoms of Hypothyroidism

Answer 7

Fatigue
Depression
Dry Skin
Constipation
Bradycardia
Altered menstrual cycles
Weight gain
Changes in hair
Cold intolerance

Question 8

Hypothyroidism

Answer 8

Decrease in hormone production
Can be a primary problem, can be autoimmune (Hashimoto’s, Thyroiditis)

Question 9

Myxedema

Answer 9

severe hypothyroidism

Question 10

Levothyroxine
Hypothyroid medication

Answer 10

Synthetic form of T4

Half-life of 6-7 day
(4-7 weeks to feel better)

Should be taken on an empty stomach 30 minutes before breakfast

Highly protein bound (high drug interactions)

Side effects are usually similar to hyperthyroidism if dose too high

Question 11

Hypothyroid Medication

Answer 11

Levothyroxine
Armour Thyroid (desiccated)

Question 12

Hyperthyroid Medication

Answer 12

Methimazole
Propylthiouracil (PTU)
Iodine Solutions

Question 13

Desiccated Thyroid

Answer 13

AKA: Amour Thyroid (NOT given regularly)

Is a thyroid extract that comes from animal thyroid glands that have been dried and powdered

Contains both T3 and T4

Variable bioavailability

Side effects: Change in appetite, chest pain, diarrhea

Question 14

Hyperthyroidism

Answer 14

Increased in circulating T3 and T4 which comes from overactive thyroid or excessive thyroid hormone production

Can be mild or if not treated can lead to death
Graves Disease, an autoimmune disease is caused by hyper functioning of the gland

Question 15

Thioamides

Answer 15

Lower levels by inhibiting formation of thyroid hormones in the cells

Inhibit conversion of T4 to T3

Prior to starting, must obtain baseline CBC and liver profile

Medications should be taken on an empty stomach 30 minutes before eating
Can take several weeks to see effect

Question 16

Symptoms of Hyperthyroidism

Answer 16

Anxiety
Restlessness
Diaphoresis
Diarrhea, N/V
Tachycardia (check for A fib)
Weight loss
Heat intolerance (hot all the time)
Exophthalmos- Bulging Eyes
Changes in menstrual cycle
Insomnia

Question 17

Thyroid function

Answer 17

Metabolic activity
Produce me heat
Stimulates carbs, fat and protein
Increase erythropoiesis
Increase glucose absorption
Mood
Growth hormone
Insulin and Sex steroids

Question 18

Nurse considerations

Answer 18

Avoid given calcium (antacid, iron supplements)
Assess heart rate
Life long medication
Have TSH checked 6-8 weeks
Safe if pregnant

Question 19

Methimazole

Answer 19

Hyperthyroid medicine
Give once a day
Side effects: less GI side effects, can cause bone marrow suppression.

Do not give to pregnant patients

Question 20

Propylthiouracil (PTU)

Answer 20

Converts T4 to T3..given to Graves’ disease

First trimester of pregnancy

Black box-liver

Question 21

Iodine

Answer 21

Lugols solution- short term, non radioactive

Inhibits release of T3 and T4

Can cause iodinism (metallic taste, stomatitis, sore throat

Avoid seafood

Question 22

I-131 (iodine)

Answer 22

Radioactive, used for thyroid cancer

Increase fluid intake (flushes iodine out of body)
Not given when pregnant

Question 23

Adjuvant therapy
Beta blockers

Answer 23

Propranolol and atenolol (control symptoms of hyperthyroidism) while waiting for meds to take effect