Thyroid Disorders - Chapter 45

Question 1

Two Main Thyroid Hormones

Answer 1

Triiodothyronine (T3)
Thyroxidine (T4)

Question 2

Hyperthyroidism

Answer 2

Overactive thyroid

Question 3

Hypothyroidism

Answer 3

Underactive Thyroid

Question 4

Levothryoxine Brand Names

Answer 4

Synthroid
Levoxyl
Unithroid

Question 5

_______ is the drug of choice for hypothyrodisim

Answer 5

Levothryoxine

Question 6

Replacement dose for Levothryoxine

Answer 6

1.6 mcg/kg/day

Question 7

Main counseling point of levothyroxine

Answer 7

MUST be taken on an empty stomach (~60 minutes prior to first food and all other meds)

Question 8

Unique fact about Levothryoxine

Answer 8

Tablet colors are standard between manufacturers and brands

Question 9

Levothryoxine Tablet colors

Answer 9

25 mcg: orange
50 mcg: white
75 mcg: violet
88 mcg: olive
100 mcg: yellow
112 mcg: rose
125 mcg: brown
137 mcg: turquoise
150 mcg: blue
175 mcg: lilac
200 mcg: pink
300 mcg: green

Question 10

Which tablet size of levothyroxine is dye free?

Answer 10

50 mcg

Question 11

IV to PO conversion for levothryoxine

Answer 11

0.75:1

Question 12

BBW

Answer 12

Ineffective and potentially toxic when used for obesity and weight loss reduction. High doses can cause serious and life threatening toxic effects, especially with some anoertic drugs

Question 13

How often should you get TSH levels checked once you start levothryoxine?

Answer 13

Every 4-6 weeks until levels are stable

Then can move to 4-6 months

Then can move to yearly checks

Question 14

Levothryoxine is which hormone?

Answer 14

T4

Question 15

Thyroid Desiccated is which hormone?

Answer 15

T3 and T4 mixture

Question 16

Liothyronine is which hormone?

Answer 16

T3

Question 17

Hashimoto’s Disease

Answer 17

Autoimmune condition in which a patient’s own antibodies attack the thyroid gland

Question 18

Myxedema Coma

Answer 18

Uncommon by potentially fatal complication of hypothyroidism that can occur when left untreated for a long time.

It is considered a medical emergency

Question 19

Normal range T4

Answer 19

0.9-2.3 ng/dL

Question 20

Normal range TSH

Answer 20

0.3-3 mIU/L

Question 21

Hypothyroidism is diagnosed with a ____ free T4 and a ____ TSH

Answer 21

low; high

Question 22

TSH levels should be checked every _____ when figuring out the proper dose of medication

Answer 22

4-6 weeks

Question 23

Once stable on a dose, TSH levels should be checked every _____

Answer 23

year

Question 24

Too high of a thyroid replacement dose for elderly can lead to ______ and ______

Answer 24

Afib; fractures

Question 25

Which hormones are monitored when treating hypothyrodism in pregnancy?

Answer 25

TSH Free T4

Question 26

Antacids should be given ______ apart from levothyroxine

Answer 26

4 hours

Question 27

Sodium polystyrene sulfonate and patiromer (Veltassa) should be given _____apart from levothyroxine

Answer 27

3 hours

Question 28

Antacids ______ levothyroxine absorption

Answer 28

decrease

Question 29

Sodium polystyrene sulfonate and patiromer _____ levothryoxine absorption

Answer 29

decrease

Question 30

Lanthanum ______ levothryoxine

Answer 30

decrease

Question 31

Lanthanum should be given ______ apart from levothyroxine

Answer 31

2 hours

Question 32

Estrogens _____ levothyroxine absorption

Answer 32

decrease

Question 33

SSRIs ______ levothyroxine absorption

Answer 33

decrease

Question 34

Hepatic inducers _____ levothyroxine absorption

Answer 34

decrease

Question 35

Beta blockers _____ the effectiveness of levothyroxine by _____ the conversion of T4 to T3

Answer 35

decrease, decreasing

Question 36

Amiodarone _____ the effectiveness of levothyroxine by _____ the conversion of T4 to T3

Answer 36

decrease, decreasing

Question 37

Propylthiouricil (PTU) _____ the effectiveness of levothyroxine by ____ the conversion of T4 to T3

Answer 37

decrease, decreasing

Question 38

Systemic steroids ______ the effectiveness of levothyroxine by ____ the conversion of T4 to T3

Answer 38

decrease, decreasing

Question 39

Thyroid hormone is _______ protein bound

Answer 39

Highly

Question 40

Thyroid hormones _____ the effects of warfarin

Answer 40

increase

Question 41

Thyroid hormones _____ the levels of theophyillus

Answer 41

decrease

Question 42

True or False: you should continue to take the same brand and levothyroxine whenever possible

Answer 42

TRUE

Question 43

Hyperthyrodism

Answer 43

The thyroid gland over produces thyroid hormones leading to a decrease in TSH and an increase of FT4

Question 44

When left untreated hyperthyroidism could lead to

Answer 44

tachycardia arrhythmias heart failure osteoporosis

Question 45

Graves disease

Answer 45

An autoimmune disorder where antibodies stimulate the thyroid causing it to produce too much T4

Question 46

Graves disease most common appears in ________ aged ______

Answer 46

females; 30-50 years old

Question 47

Propylthiourcil (PTU) BBW

Answer 47

Severe liver failure Pregnancy - preferred in the first trimester

Question 48

Methimazole Brand Name

Answer 48

Tapazole

Question 49

Counseling point for both methimazole and PTU

Answer 49

Take with food

Question 50

Drug of choice for hyperthyroidism

Answer 50

Methimazole - less risk for liver toxicity

Question 51

Hyperthyroidism and pregnancy

Answer 51

First trimester - PTU Second and Third trimester - Methimazole

Question 52

Drug of choice in Thyroid Storm

Answer 52

PTU

Question 53

Side effects of PTU and Methimazole

Answer 53

GI upset Headache Rash Fever Constipation Loss of taste and smell

Question 54

Symptom management of thyroid storm

Answer 54

Beta Blockers (propranolol)

Question 55

Synthroid Generic

Answer 55

Levothyroxine

Question 56

Levoxyl Generic

Answer 56

Levothyroxine

Question 57

Unithroid Generic

Answer 57

Levothyroxine

Question 58

Armour Thyroid Generic

Answer 58

Desiccated Thyroid USP

Question 59

Desiccated Thyroid USP Brand

Answer 59

Armour Thyroid

Question 60

Liothyronine Brand

Answer 60

Cytomel

Question 61

Cytomel Generic

Answer 61

Liothyronine

Question 62

Methimazole Brand

Answer 62

Tapazole

Question 63

Tapazole Generic

Answer 63

Methimazole