Thyroid Disease

Question 1

What thyroid indices should be checked in pregnancy?

Answer 1

Only check Free T4 Index in pregnancy

Question 2

What is a normal thyroid state in early pregnancy?

Answer 2

Transient hyperthyroidism

Question 3

what percent of early pregnancies will show transient hyperthyroidism?

Answer 3

15%

Question 4

What other pregnancy related complication can cause transiently elevated hyperthyroidism?

Answer 4

Hyperemesis gravidarum

Question 5

What is the number one cause of biochemical hyperthyroidism in pregnancy?

Answer 5

Hyperemesis gravidarum

Question 6

What is the number one cause of overt hyperthyroidism in pregnancy?

Answer 6

Graves disease

Question 7

How do you treat hyperthyroidism in the first trimester?

Answer 7

PTU 100 mg TID

Question 8

How do you treat hyperthyroidism in the 2nd and 3rd trimesters?

Answer 8

Methimazole 20 mg Q day

Question 9

What fetal complication is associated with methimazole in the first trimester?

Answer 9

Aplasia Cutis

Question 10

How do you treat Thyroid storm in pregnancy?

Answer 10

ICU care, IV Hydration, Propanolol IV, PTU 1000mg, Potassium Iodide, Dexamethasone

Question 11

What is the most common cause of hypothyroidism?

Answer 11

Hashimotos

Question 12

How do you treat hypothyroidism in pregnancy?

Answer 12

Levothyroxine 50 - 100 ug QD up to 200 ug

Question 13

How often should you follow thyroid studies in pregnancy for hypothyroidism

Answer 13

q 8 weeks

Question 14

What should be your cutoff for TSH in the 1st trimester?

Answer 14

< 2.5

Question 15

What should be your cutoff for TSH in the 2nd/3rd trimester?

Answer 15

< 3.0

Question 16

What is the percent increase in thyroid hormone requirement in pregnancy

Answer 16

50 - 100% increase in hormone requirement

Question 17

How much should you increase the dose of levothyroxine in the first trimester?

Answer 17

33%