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Naplex 2025 > Thyroid > Flashcards

Thyroid Flashcards

1
Q

What is produced from the thyroid gland and are the some of the things that it helps affect?

A
  • Produces Thyroid Hormone
  • Helps regulate; metabolism, cardiac/nervious system functions, body temp, muscle strength, weight.
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2
Q

What are the 2 types of thyroid disorder?

A
  • HYPERthyroidism : overactive thyroid
  • HYPOthyroidism: underactive thyroid
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3
Q

What are the 2 thyroid hormones that are made from the Thyroid Gland?

A
  • Triiodothronine (T3)
  • Throxine (T4)

T3 is made from the breakdown of T4
T3 is more potent BUT has shorter half life

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4
Q

What the is hormone that is released that helps with the regulation of the 2 thyroid hormones?

A
  • Thyroid Stimulating Hormone
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5
Q

What is the negative feedback loop in relation to the Thyroid Hormones?

A
  • Hypothalamus makes TRH activiating the Pituitary
  • The Pituitary makes TSH activiating the Thyroid
  • The Thyroid makes ** T3 and T4**

When high amounts of T3/4, then the Hypothalamus/Pituitary stops making their respectable things and vice versa

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6
Q

What is HYPOthyroidism?

A
  • Low levels of T4 (& T3) with High Levels of TSH
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7
Q

What are some of the signs and symptoms of HYPOthyroidism?

A
  • Cold
  • Dry Skin
  • Fatigue
  • Muscle Cramps
  • Constipation
  • Weight Gain
  • Goiter

The oppisite of HYPERThroidism

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8
Q

What is the most common cause of HYPOthyroidism?

What is it???

A
  • Hashimoto’s Disease: autoimmune disease where antibodies attack the thyroid gland
  • Some drugs can cause HYPO too (different card)
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9
Q

What are some of the Drugs that can cause HYPOthyroidism?

Remember ITALC

A
  • Interferons
  • Tyrosine Kinase Inhibitors
  • Amiodarone
  • Lithium
  • Carbamazepine

Other are: Oxcarbazepine, Eslicabazepine, Phenytion

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10
Q

What are the 2 lab results that help make the diagnosis of HYPOthyroidism?

A
  • Low free T4 (normal is 0.9 - 2.3)
  • High TSH (normal is 03. - 3)
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11
Q

How long should the TSH and symptoms be monitored for in someone that has HYPOthyroidism?

A
  • Every 4 - 6 weeks
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12
Q

What are the main treatment options for someone that has HYPOthyroidism?

And what is the difference between them

A
  • Levothyroxine (T4)
  • Liothyronine (T3)
  • Armour Thyroid (T3 + T4)
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13
Q

What is the intial dose we should use for someone that is going to be taking Levothyroxine for their HYPOthyroidism?

A
  • 1.6 mg/kg/day
  • If known CAD: start with 12.5-25 mcg
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14
Q

What are the warnings for some one taking Levothyroxine, Liothyronine, Armour Thyroid for their HYPOthyroidism?

A
  • Decrease dose if the patient has any cardiovascular disease or bone mineral density issues
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15
Q

What are the side effects for some one taking Levothyroxine, Liothyronine, Armour Thyroid for their HYPOthyroidism?

A
  • “HYPERthyroidism” like: increased HR, palpitations, sweating, weight loss, arrhythmias
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16
Q

What is important to know about taking Levothyroxine PO for someone with HYPOthyroidism?

A
  • Taken with water at the same time everyday and at least 60 minutes before breakfast or AT bedtime
17
Q

What is important to know about taking Levothyroxine IV for someone with HYPOthyroidism?

A
  • IV to PO: 0.75:1
18
Q

What are the tablet colors for Levothyroxine?

Remember: Orangutans Will Vomit On You Right Before They Become Large, Proud Giants

A
  • Orange = 25 mcg
  • White = 50 mcg
  • Violet = 75 mcg
  • Olive - 88 mcg
  • Yellow = 100 mcg
  • Rose = 112 mcg
  • Brown = 125 mcg
  • Turquoise = 137 mcg
  • Blue = 150 mcg
  • Lilac = 175 mcg
  • Pink = 200 mcg
  • Green = 300 mcg
19
Q

What are some of the important drug interactions for those that are taking a HYPOthyroidism medication?

A
  • DECREASE Levothyroxine absorption: Antacids (Fe, Ca, AL, Mg… separate by 4 hours)
  • SSRIs and Estrogen can decrease TSH levels
20
Q

What are some of the key counseling points for HYPOthyroid medications?

Levothyroxine

A
  • Drug interactions are due to binding
  • Take with water and 60 minutes before meals OR right before bed
  • Pill Color
  • Pregnant?
  • Blood Work regularly (TSH and T4 level x 4-8 weeks)
21
Q

What is HYPERthyroidism?

A
  • When the thyroid is overactive
  • High T4 & Low TSH

The oppisite of HYPO

22
Q

What are the signs and symptoms of HYPERthyroidism?

A
  • Hot
  • Weight Loss
  • Agitation
  • Palpitations and Tachycardia
  • Thinning hair

The oppisite fo HYPO

23
Q

What is the most common cause of HYPERthyroidism?

A
  • Graves disease: autoimmune disease where the antibodies stimulate the thyroid to make too much T4
24
Q

What are some of the drugs that could cause HYPERthyroidism?

A
  • Iodine
  • Amiodarone
  • Interferons
25
Q

What are some of the treatment options for HYPERthyroidism?

-

A
  • Propylthiouracil (Thionamides)
  • Methimazole (Thionamides)
  • Radioactive Iodine (RAI-131)
  • Surgery
26
Q

What is one thing that you can giev someone taking a HYPERthyroidism medication to help control their symptoms?

A
  • Beta-Blockers [helps with palpitations, tremors, tachycardia]
27
Q

How longs does it take when taking an anti-thyroid medication before you start seeing controlled symptoms?

A
  • 1 - 3 months of treatmentat high doses
  • Once controlled = reduce the dose
28
Q

What is the boxed warnings for PTU in HYPERthyroidism?

A
  • Severe liver injury
  • PTU: preferred in the 1st trimester of Pregnancy
29
Q

What are the warnings for the HYPERthyroidism medications?

A
  • Hepatoxicity, Bone Marrow Suppression [agranulocytosis], DILE
30
Q

What are the side effects for the HYPERthyroidism medications?

A
  • GI Upset, headache, rash, constipation, loss of taste
31
Q

What are some important notes about the HYPERthyroidism medications?

A
  • Methimazole is DOC
  • PTU is best for Thyroid Storm
  • PTU is best in 1st trimester BUT Methimazole is best in 2nd and 3rd trimesters
32
Q

What is the importance of Potassium Iodine for the use of after exposure to radiation?

A
  • Helps block the accumulation of Radioactive iodine = preventing thyroid cancers
33
Q

What is Thyroid Storm

A
  • Life threatening emergency by a decompenstaed HYPERthyroidism cause by infection, trauma, surgery, radioactive iodine, or stopping anti-thyroid medications
34
Q

What are the signs and symptoms of Thyroid Storms

A
  • Fever
  • Tachycardia
  • Tachypenia
  • Dehydration
  • Sweating
  • Delirium
  • Coma
35
Q

What is the Drug Treatment for Thyroid Storm?

-

A
  • PTU is preferred [500 - 1000 mg LD]
  • Inorganic Iodine (SSKI or Lugol’s Solution)
  • Beta Blockers (Propranolol) [40 - 80 mg q6h]
  • Steroids (Dexamethasone) [2 - 4 mg q6h]

Naplex 2025 (23 decks)

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