THYROID Flashcards
Acute exacerbation of Addison’s disease can lead to ECG changes and cardiovascular collapse as a result of:
A. electrolyte imbalance and low blood volume secondary to potassium retention and sodium excretion
B. electrolyte imbalance secondary to increased mineralcorticoid secretion from the adrenal glands
C. electrolyte imbalance secondary to fluid retention, potassium excretion, and sodium retention
D. decreased mineralcorticoid secretion resulting in increased sodium and potassium excretion
A.
electrolyte imbalance and low blood volume secondary to potassium retention and sodium excretion
A 36-year-old female is conscious and alert, complaining of tachycardia. The patient states that she awoke this morning and “felt my heart racing.” She denies chest pain, difficulty breathing, or loss of consciousness but does have dizziness with exertion. Upon further questioning, she states that she has been experiencing frequent episodes of agitation, insomnia, poor heat tolerance, and loss of weight. Physical exam reveals exophthalmos and an enlarged thyroid gland. HR=142 and regular, BP=110/70, RR=14 and regular. Appropriate treatment of this patient would include:
A. 100% oxygen via nonrebreather mask 10 lpm, cardiac monitor, IV of NS KVO, 50% dextrose IV
B. 100% oxygen via nasal cannula 4 lpm, IV of NS, 250cc NS fluid challenge, transport
C. 100% oxygen via nonrebreather mask lpm, cardiac monitor, IV of NS KVO
D. 100% oxygen via nasal cannula 4 lpm, cardiac monitor, IV of NS KVO, propranolol IV, dexamethasone IV
D.
100% oxygen via nasal cannula 4 lpm, cardiac monitor, IV of NS KVO, propranolol IV, dexamethasone IV
Which of the following statements about the epidemiology of Graves’s disease is true?
A. Graves disease typically manifests late in adulthood
B. Grave’s disease is about six time more common in women than in men
C. Obesity and poor dietary habits increase the risk of Grave’s disease
D. Heredity does not predispose people to Grave’s disease
B.
Grave’s disease is about six time more common in women than in men
A 3-year-old male patient has a history of an underdeveloped cell-mediated immune system. Which of the following MOST likely contribute to this deficiency?
A. Thymus gland insufficiency and a lack of thymosin secretion
B. HIV infection
C. Type I diabetes mellitus
D. Hypoadrenalism
A
Thymus gland insufficiency and a lack of thymosin secretion
Which of the following pathologies would necessitate the careful preparation of an IV site due to skin fragility and increased risk of infection?
A. Cushing’s syndrome
B. Grave’s disease
C. Addison’s disease
D. Myxedema
A.
Cushing’s syndrome
Which of the following is NOT a possible precipitating factor of thyrotoxic crisis?
A. Infection
B. Trauma
C. Overdose of thyroid hormone
D. Cold environment
D.
Cold environment
A 63-year-old female with a history of hypothyroidism presents in a stuporous state, responsive only to pain. Physical exam reveals thin hair, a puffy face, and enlarge tongue, and very cold, doughy skin. Her heart rate is 100 and regular, RR is 10 and regular, BP is 96/62, and temperature of 86 F via a tympanic thermometer. Your treatment of this patient should NOT include:
A. D50 IV if blood glucose is less than 80 mg/dL
B. IV initiation
C. endotracheal intubation
D. active rewarming
D.
active rewarming
You are presented with a 72-year-old male patient who is conscious and alert, but a bit lethargic. The patient’s daughter called EMS today because she has noticed her father becoming noticeably more lethargic, unemotional, and easily fatigued over the past 2 months. She also states that he has had a decreased appetite and has gained weight over the same period. When asked about any complaints, the patient only says, “I’m constipated and always cold.” Which of the following additional signs and/or symptoms would be consistent with this patient presentation?
A. A puffy face, an enlarged tongue, and pale, doughy skin
B. Goiter, atrial fibrillation, nausea, and vomiting
C. A “moon-faced” appearance and hyperpigmentation of the skin
D. Hypothermia, tachycardia, and hypertension
A.
A puffy face, an enlarged tongue, and pale, doughy skin
Which of the following is NOT a situation that is likely to precipitate Addisonian crisis in a patient with Addison’s disease?
A. The patient has a history of adrenal insufficiency and suffers chest trauma secondary to a fall
b. The patient develops pneumonia
C. The patient has adrenal insufficiency and initiates prednisone therapy
D. The patient ceases long-term steroid treatment
D.
The patient ceases long-term steroid treatment
