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NAPLEX Endocrine Conditions > Thyroid Disorders > Flashcards

Thyroid Disorders Flashcards

1
Q

What labs are monitored in patients being treated for thyroid disorders?

A
  • TSH
  • Free T4 (FT4)

FT4 = unbound, active form of T4

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2
Q

What are the s/sx of hypothyroidism?

A
  • Cold intolerance/sensitivity
  • Dry skin
  • Fatigue
  • Muscle cramps
  • Voice changes
  • Constipation
  • Weight gain
  • Goiter (possible; can be due to low iodine intake)
  • Myalgias
  • Weakness
  • Depression
  • Bradycardia
  • Coarse hair or loss of hair
  • Menorrhagia
  • Memory and mental impairement
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3
Q

What is the most common cause of hyperthyroidism?

A

Graves’ disease

An autoimmune condition in which a patient’s own antibodies stimulate the thyroid to produce too much T4.

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4
Q

How often should TSH be monitored in patients with thyroid disease?

A

Every 4-6 weeks until levels are normal, then 4-6 months later, then yearly.

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5
Q

What complications can be seen in elderly patients if a too high dose of a thyroid hormone replacement therapy is used?

A
  • Atrial fibrillation
  • Fractures
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6
Q

What is the most common cause of hypothyroidism?

A

Hashimoto’s disease

An autoimmune condition in which a patient’s own antibodies attack the throid gland.

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7
Q

List the drugs that can cause hypothyroidism

A
  • Interferons*
  • Tyrosine kinase inhibitors (e.g., sunitinib)
  • Amiodarone*
  • Lithium
  • Carbamazepine

*can also cause hyperthyroidism

I TALC

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8
Q

What is the uncommon but potentially fatal complication of hypothyroidism?

A

Myxedema coma

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9
Q

What are the s/sx of myxedema coma?

A
  • Poor circulation
  • Hypothermia
  • Hypometabolism
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10
Q

What is the initial treatment for myxedema coma?

A

IV levothyroxine

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11
Q

What is the full replacement dose of levothyroxine?

A

1.6 mcg/kg/day
Use IBW

Start with full replacement dose in otherview healthy, young (< 50 years) pts with markedly elevated TSH.
If known CAD, start with 12.5-25 mcg daily.

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12
Q

What are the side effects of thyroid hormone replacement therapy?

A

Hyperthyroid symptoms can occur when the dose is too high:
* ↑HR
* Palpitations
* Sweating
* Weight loss
* Arrhythmias
* Irritability

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13
Q

How to take PO levothyroxine?

A
  • Take with water at the same time every day
  • Take at least 60 minutes before breakfast or at bedtime (at least 3 hours after the last meal)
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14
Q

What is the IV:PO conversion for levothyroxine?

A

0.75:1

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15
Q

Levothyroxine tablet colors

A

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

Orangutans Will Vomit On You Right Before They Become Large, Proud Giants.

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16
Q

Thyroid hormone replacement therapy can increase the effect

A

Warfarin

17
Q

Thyroid hormone replacement therapy can decrease the level of

A

Theophylline

18
Q

Thyroid hormone replacement dose may need to increase/decrease in pregnany?

A

30-50% increase

19
Q

Hyperthyroidism is also known as

A

Overactive thyroid or thyrotoxicosis

20
Q

What are some complications can be seen in patients with untreated hyperthyroidism?

A
  • Tachycardia
  • Arrhythmias
  • Heart failure
  • Osteoporosis
21
Q

What are the s/sx of hyperthyroidism?

A
  • Heat intolerance or increased sweating
  • Weight loss
  • Agitation, nervousness, irritability, anxiety
  • Palpitations and tachycardia
  • Fatigue and muscle weakness
  • Frequent bowel movements or diarrhea
  • Insomnia
  • Tremor
  • Thinning hair
  • Goiter (possible)
  • Exophthalmos (protrusion of the eyeballs), diplopia
  • Light or absent menstrual periods
22
Q

List the drugs that can cause hyperthyroidism

A
  • Iodine
  • Amiodarone
  • Interferons
23
Q

Treatment options for hyperthyroidism

A
  • Antithyroid medications
  • Radioactive iodine (RAI-131)
  • Surgery

Surgery: thyroidectomy (partial or complete)

24
Q

Which drug class is used for symptom control in patients w/ hyperthyroidism?

A

Beta-blcokers

To reduce palpitations, tremors and tachycardia

25
Q

Role of antithyroid medications in hyperthyroidism treatment

A
  • Antithyroid medications: Prophylthiouracil (PTU) and Methimazole.
  • Takes 1-3 months of treatement at high doses to control symptoms. Once symptoms are controlled, the dose should be reduced to prevent hypothyroidism.
  • Can be used as a temporary measure until surgery is complete.
26
Q

MOA of antithyroid medications

A
  • Inhibit synthesis of thyroid hormones by blocking the oxidation of iodine in the thyroid gland.
  • PTU also inhibits peripheral conversion of T4 to T3.
27
Q

Why is methimazole the drug of choice for hyperthyroidism?

A

Lower risk of liver damage compared to PTU

28
Q

PTU is the preferred treatment for hyperthyroidism when

A
  • Patient is having a thyroid storm
  • Patient is in the 1st trimester of pregnancy
29
Q

Role of potassium iodide

A
  • Use after exposure to radiation.
  • Blocks the accumulation of radiocative iodine in the thyroid gland, thus preventing thyroid cancer.
30
Q

MOA of potassium iodide

A

Temporarily inhibit secretion of thyroid hormones

31
Q

What are the s/sx of a thyroid storm?

A
  • Fever (> 103 F)
  • Tachycardia
  • Tachypnea
  • Dehydration
  • Profuse sweating
  • Agitation
  • Delirium
  • Psychosis
  • Coma
32
Q

How to treat a thyroid storm?

A

Antithyroid medication
+
Inorganic iodide therapy
+
Beta-blcoker
+
Systemic steroid
+
Aggresive cooling

NAPLEX Endocrine Conditions (8 decks)

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