Thyroid

Question 1

Hypo thyroid tx in Pregnancy?

Answer 1

Hypothyroidism associated w/loss of pregnancy, low birth weight, premature birth and lower IQ in children. Levothyroxine is safe in pregnancy and recommended.
▪ May require 30-50% dose ↑

Question 2

Orange Whales Vomit Over You Right Before They Become Lame Pink Gum

Answer 2

25: Orange
50: White
75: Violet
88: Olive
100: Yellow
112: Rose
125: Brown
137: Turquoise
150: Blue
175: Lilac
200: Pink
300: Green

Question 3

how to dose levothyroxine?

Answer 3

Full replacement dose: 1.6mcg/IBW(kg)/day

▪ If known CAD: 12.5 - 25mcg daily

Question 4

what is the IV:PO ratio for synthroid?

Answer 4

IV → PO ratio is 0.75: 1

Question 5

what drugs can cause hypothyroidism?

Answer 5

I TALC
interfereons
TK inh
amiodarone
lithium
CBZ

Question 6

what drugs can cause hyperthyroidism?

Answer 6

Iodine, Amiodarone, Interferons

Question 7

how do you treat hyPERthyroidism?

Answer 7

1. Beta-blockers for symptom control (↓palpitation, tremors and tachycardia)
2. PTU or Methimazole
3. RAI-131
4. Surgery
   May take 1-3 months of higher doses to control sx but later must reduce dose to avoid hypothyroidism

Question 8

what drugs have a BBW for liver injury?

Answer 8

PTU and methimazole

Question 9

how to treat thyroid storm?

Answer 9

PTU (preferred) +
SSKI or Lugol’s solution +
propranolol + dexamethasone + aggressive cooling with APAP and cooling blankets

Question 10

how to tx hyperthyroidism in pregnancy?

Answer 10

PTU preferred in 1st trimes; MMI in 2nd & 3rd