Thyroid

Question 1

Thyroid hormone effects

Answer 1

1. Metabolism
2. Cardiac function
3. Growth (infants and kids)
4. Development

Question 2

TSH

Answer 2

Screening and dx of hypothyroidism

Question 3

Elevated tsh

Answer 3

Hypothyroidism

Question 4

Hypothyroidism clinical presentation

Answer 4

Pale, puffy face
➢Cold, dry skin
➢Brittle hair or loss of hair
➢Lowered heart rate and temperature
➢Lethargy and fatigue
➢Intolerance to cold
➢Impaired mentality

Question 5

Hypothyroidism causes

Answer 5

➢Usually due to malfunction of the thyroid
➢Hashimoto disease: Chronic autoimmune thyroiditis
➢Insufficient iodine in the diet
➢Surgical removal of thyroid and destruction of thyroid with radioactive iodine
➢Insufficient secretion of TSH and thyrotropin-releasing hormone (TRH)

Question 6

Hyperthyroidism cause

Answer 6

Thyroid-stimulating immunoglobulins (TSIs)

Question 7

Hyperthyroidism tx

Answer 7

Surgical removal of thyroid tissue
➢Destruction of thyroid tissue
➢Suppression of thyroid hormone synthesis
➢Beta blockers (e.g., propranolol)
➢Nonradioactive iodine

Question 8

Levothyroxine

Answer 8

Synthetic preparation of thyroxine (T4) and drug of choice for hypothyroidism
➢Conversion to T3

Question 9

Levothyroxine half life

Answer 9

7 days

Question 10

Levothyroxine AE

Answer 10

Tachycardia
•Angina
•Tremors
•Can intensify effects of warfarin

Question 11

Levothyroxine drug interactions

Answer 11

Drugs that reduce levothyroxine absorption
•Drugs that accelerate levothyroxine metabolism
•Warfarin
•Catecholamines

Question 12

Methimazole

Answer 12

Hyperthyroidism
Does not cause liver damage associated with ptu
Agranulocytosis
More dangerous than PTU during lactation and during the first trimester of pregnancy

Question 13

Levothyroxine euthyroid state

Answer 13

Takes 3-12 weeks

Question 14

Methimazole uses

Answer 14

Sole form of therapy for Graves disease
➢Adjunct to radiation therapy until the effects of radiation become manifest
➢Suppresses thyroid hormone synthesis in preparation for thyroid gland surgery (subtotal thyroidectomy)
➢Thyrotoxic crisis

Question 15

Propylthiouracil inhibits

Answer 15

Thyroid hormone synthesis

Question 16

Propylthiouracil half life

Answer 16

90 minutes

Question 17

Ptu uses

Answer 17

➢Graves disease
➢Adjunct to radiation therapy
➢Preparation for thyroid gland surgery
➢Thyrotoxic crisis

Question 18

Ptu AE

Answer 18

Agranulocytosis (most serious)
➢Hypothyroidism
➢Pregnancy and lactation
➢Can cause severe liver damage

Question 19

Low T3 and t4

Answer 19

Hypothyroidism

Question 20

Low tsh

Answer 20

Hyperthyroidism

Question 21

High t3 and t4

Answer 21

Hyperthyroidism

Question 22

If you don’t see regular problem with tsh, t3, t4

Answer 22

Secondary problem with hypothalamus or anterior pituitary

Question 23

Triiodothyronine

Answer 23

T3

Question 24

Thyroxine

Answer 24

T4

Question 25

Synthetic T3

Answer 25

Liothyronine

Question 26

Synthetic t4

Answer 26

Levothyroxine

Question 27

Do not start start full replacement dose of levothyroxine in ppl with

Answer 27

Preexisting heart disease Elderly Recheck tsh every 3-6 weeks until wnl