Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Specialized Pharmacology MN650 > Thyroid Disease > Flashcards

Thyroid Disease Flashcards

1
Q

a condition of excess secretion of thyroxine (T4) and triiodothyronine (T3)?

A

Hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are causes of hyperthyroidism?

A
  • Graves’ disease (most common cause)
  • subacute thyroiditis
  • Pituitary tumor (inc TSH)
  • Toxic nodular goiter or thyroid cancer
  • other autoimmune causes (pernicious anemia, diabetes mellitus, myasthenia gravis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

hyperthyroidism is most commonly seen at what age?

A

20 – 40 y/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the signs and symptoms of hyperthyroidism?

A
  • hypermetabolism (weight loss)
  • heat intolerance
  • fatigue
  • anxiety, nervousness
  • manic behavior, confusion, restlessness
  • find tremors
  • diaphoresis
  • hyperreflexia of deep tendon reflexes
  • tachycardia, palpitations, a-fib
  • increased appetite
  • fine thin hair
  • exophthalmos (eye bulging)
  • hypomenorrhea or irregular menstruation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most sensitive test for diagnosing hyperthyroidism?

A

TSH assay, low in most cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which labs are elevated in patients with hyperthyroidism?

A

T3, erythrocyte sedimentation rate, serum antinuclear antibody, calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which labs are decreased in patients with hyperthyroidism?

A

RBCs (anemia), granulocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Are T4 levels increased, decreased, or normal in hyperthyroidism?

A

Maybe normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

High iodine uptake during a radioactive iodine uptake test is indicative of?

A

Graves’ disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

low iodine uptake during a radioactive iodine uptake test is indicative of?

A

Subacute thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

11) Assess the following systems in a patient with hyperthyroidism?

A

• Cardiac, ophthalmology, neurological, thermal regulation, GI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

12) What drug is used to manage or provide symptomatic relief for resting heart rate > 90 BPM ?

A
  • beta blocker
  • Propranolol (Inderal): 10 - 40 mg PO 3-4 x day (may increase to 80)
  • Metoprolol (Lopressor): 25 mg PO q6-8 hrs (may increase to 50)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

13) Methimazole (Tapzole) Is what category of drug?

A
  • Anti-thyroid medication used for mild cases of hyperthyroidism
  • initial dose: 30 - 60 mg QD in 3 divided doses
  • maintenance dose: 5 – 15 mg PO QD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

14) What drug is used for patient’s intolerant of methimazole and/or in whom radioactive iodine or surgery is not appropriate?

A

Propylthiouracil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

15) Propylthiouracil Is used for which type of patients?

A

• Pts Intolerant of methimazole and/or in whom radioactive iodine or surgery is not appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

16) What is the initial and maintenance dosing for propylthiouracil?

A
  • 300 - 600 mg/day in 4 divided doses

* 100 -150 mg/day in 3 divided doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

17) Propylthiouracil is what category of drug?

A

• anti-thyroid medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is radioactive iodine used for and time frame of treatment?

A
  • used to shrink goiters
  • usually takes 3-4 months for pt to become euthyroid
  • may need to repeat in six months if persistent hyperthyroidism is noted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Thyroid surgery is recommended for which patients?

A

Pregnant patients, suspected cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the best treatment for subacute thyroiditis?

A

Propranolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the thyroid storm (thyrotoxic crisis)?

A

A deadly hyper metabolic state caused by inadequately controlled hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are symptoms of thyroid storm?

A
  • fever (100 - 106F)
  • flushing (d/t dilated vessels)
  • profuse diaphoresis (fluid loss up to 4L/24hr)
  • tachycardia , palpitations , SVT
  • mental status changes
    • agitation, delirium, psychosis, stupor, coma
  • hyperdefecation
  • hyperglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

23) Causes hyperthyroidism?

A
  • trauma
  • major stress
  • infection
  • subtotal thyroidectomy or other thyroid surgery
  • uncontrolled diabetes
  • pregnancy
  • thyroid drug OD
24
Q

What is the Burch-Warsofsky point scale used for?

A

To assist in diagnosing thyroid storm (≥ 45 thyroid storm, 25-44 impending storm, <25 unlikely)

25
Q

Why should Aspirin an NSAIDs be avoided in patients with hyperthyroidism?

A

they interfere with the binding of T4 and thyroid binding globulin , potentially resulting in exacerbated hypermetabolism

26
Q

Four classes of pharmacologic therapy used to treat hyperthyroidism?

A
  • anti-thyroid drugs (inhibit synthesis of thyroid hormone)
  • iodine preparations (inhibit release of thyroid hormone)
  • agents that block the effects of thyroid hormone (beta blockers, CCB)
  • Drugs the prevent conversion of T4 to T3
27
Q

What are the anti-thyroid drugs used to treat hyperthyroidism?

A
  • propylthiouracil

- methimazole

28
Q

What are the iodine preparations used to treat hyperthyroidism?

A

Lugol’s solution and Potassium iodide (SSKI)

29
Q

What agents are used to block the effects of thyroid hormone in patient with hyperthyroidism?

A

Beta blockers and calcium channel blockers

30
Q

What drugs are used to prevent the conversion of T4 to T3 in patients with hyperthyroidism?

A

Hydrocortisone and dexamethasone

31
Q

What is the dosage of propylthiouracil in the treatment of hyperthyroidism?

A

500-1000 mg loading dose PO followed by 250 mg PO q4hr

32
Q

What is the dosage of methimazole in the treatment of hyperthyroidism?

A

60 -80 mg/day PO

33
Q

What are the actions of lugol solution and potassium iodide?

A

They inhibit the release of thyroid hormone, should be administered one hour after administration of anti-thyroid drugs

34
Q

What is the dosage of Propranolol in the treatment of hyperthyroidism?

A

1-2 mg IV Bolus, may repeat q10-15 min PRN

35
Q

What is the drug of choice for the treatment of hyperthyroidism when beta blockers are contraindicated?

A

Calcium channel blockers (verapamil or diltiazem)

36
Q

What drugs can be used in the treatment of hyperthyroidism when beta blockers are contraindicated?

A
  • Calcium channel blockers (verapamil /diltiazem)

* Reserpine

37
Q

When is Reserpine and used in the treatment of hyperthyroidism?

A

when beta blockers are contraindicated

38
Q

Why are hydrocortisone and dexamethasone used in the treatment of hyperthyroidism?

A

They inhibit the conversion of T4 to T3

39
Q

What is the dosage of hydrocortisone in the treatment of hyperthyroidism?

A

300 mg IV followed by 100 mg q8hr until stable

40
Q

What is the dosage of dexamethasone in the treatment of hyperthyroidism?

A

2-5 mg IV q6hr

41
Q

A rare condition of greatly decreased metabolism resulting from a deficient amount of circulating thyroid hormone is called?

A
  • Hypothyroidism
42
Q

What is the most common thyroid disease?

A
  • Hypothyroidism
43
Q

What are risk factors for hypothyroidism?

A
  • > 60 y/o
  • Women
  • iodine deficiency
44
Q

What are causes of hypothyroidism?

A
  • Iodine deficiency
  • autoimmune diseases (Hashimotos)
  • pituitary tumor (TSH)
  • Thyroidectomy
  • high dose amiodarone
  • medication noncompliance
45
Q

What are the signs and symptoms of hypothyroidism ?

A
  • fatigue
  • changes in LOC (confusion, depression, coma)
  • puffy face
  • decreased breathing
  • Brady cardia
  • hypothermia
  • hypoglycemia
  • anorexia
  • decreased bowel sounds
  • weight gain with poor appetite
  • Constipation
  • dry cracked skin
  • coarse brittle hair and nails
  • cold intolerance
  • decreased deep tendon reflexes
  • paresthesia
  • decreased diaphoresis
  • ataxia
  • hair loss
  • menorrhagia (abn Heavy or prolonged bleeding)
46
Q

Lab findings for patient with hypothyroidism?

A 
Increased:
   -TSH 
   - LFT
   - cholesterol
   - triglycerides
Decreased or normal T4 level 
Decreased
   - resin T3 uptake 
   - hypoglycemia 
   - hyponatremia 
   - anemia (normochromic, normocytic)
47
Q

The presence of thyroid peroxidase (TPO) antibody is indicative of?

A

Autoimmune disease such as Hashimotos or graves disease

48
Q

Levothyroxine is also known as?

A

Synthroid or T4

49
Q

What medication used to treat hypothyroidism?

A

Levothyroxine

50
Q

What is the dosage of levothyroxine for pts < 60 y/o and w/o CAD?

A

50 -100 mcg QD, increase dosage 25 mcg every 1-2weeks until symptom stabilization

51
Q

What lab is checked eight weeks after dose adjustments for patients taking levothyroxine?

A

TSH

52
Q

Levothyroxine should be taken how long prior to breakfast?

A

30-60 mins

53
Q

How long should a patient wait after they have eaten before taking their levothyroxine?

A

4 hours

54
Q

What is the name for severe hypothyroidism leading to decreased mental status, and multisystem organ failure?

A

myxedema coma

55
Q

What is the dosage of levothyroxine for pts > 60 y/o and w/ CAD?

A

25 -50 mcg QD, increase dosage by 25 mcg q 1-2wks until symptoms stabilization

56
Q

TSH is checked how often in patients with hypothyroidism and receiving levothyroxine?

A

eight weeks after dose adjustments

Specialized Pharmacology MN650 (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions