Thyroid Disorders Part 2

Question 1

the treatment of choice for patients with very large glands or multinodular goiters.

Answer 1

near-total thyroidectomy

Question 2

done by withdrawing blood from a vein in the
arm. These blood tests help to diagnose thyroid diseases.

Answer 2

THYROID BLOOD TEST

Question 3

show the size and condition of the goiter, overactivity of some parts or whole thyroid.

Answer 3

THYROID SCAN & ULTRASOUND-

Question 4

a procedure that involves taking small samples of
thyroid nodules if present. The samples are sent to a laboratory for examination

Answer 4

BIOPSY

Question 5

A synthetic T4, it should be taken 30min before or 1 hour after meals

Answer 5

Levothyroxine (Levoxyl)

Question 6

synthetic T3, it is used for emergency states of
hypothyroidism. Short half-life

Answer 6

Liothyronine (Cytomel, Triostat)

Question 7

Liothyronine is not used alone for long term treatment
because of increase risk for cardiac side effect. T/F

Answer 7

True

Question 8

Ratio of Liotrix

Answer 8

4:1 ratio (T4:T3)

Question 9

Where Desiccated Thyroid is sourced

Answer 9

Animal

Question 10

Thioamides

Answer 10

Propylthiouracil (Generic)
Methimazole (Tapazole, Tapdin)
Carbimazole

Question 11

Inhibit the enzyme thyroid peroxidase (Inhibit
organification and coupling)
Blocks peripheral conversion of T4 to T3
(PTU)

Answer 11

Thioamides

Question 12

Pharmacokinetics:
Almost completely absorbed in the GIT
Can cross placental barrier (lesser with PTU)
Methimazole 10x more potent than PTU
PTU more protein-bound.

Answer 12

Thioamides

Question 13

Used for treatment of mild thyrotoxicosis and in
preparation of surgery.
Propylthiouracil is relatively safe and preferred in
pregnancy.

Answer 13

Thioamides

Question 14

ADVERSE EFFECTS:
1. maculopapular rash
2. agranulocytosis
3. hepatitis (PTU)
4. cholestatic jaundice (Methimazole)
5. vasculitis

Answer 14

Thioamides

Question 15

MOA:
- Block uptake of iodide by the
gland by competitive inhibition
- Effects can be overcome by large
doses of iodides

Answer 15

Inorganic Anions

Question 16

MOA:
- acutely blocks release of thyroid hormone from the gland by
inhibiting thyroglobulin proteolysis (> 6 mg daily),
- inhibit iodide organification

Answer 16

Iodides

Question 17

A/E: Aplastic anemia (that is why it is rarely used)

Answer 17

Inorganic Anions

Question 18

CAUTION:
- Not used alone because the gland will
escape from inhibition after 2-8 weeks
- Chronic use in pregnancy should be avoided – fetal goiter

Answer 18

Iodides

Question 19

inhibits conversion of T4 to T3 in the liver, kidney, brain
and pituitary
inhibition of hormone release

Answer 19

Iodinated Contrast Dye

Question 20

Useful in thyroid storms (adjunctive therapy)

Answer 20

Iodinated Contrast Dye

Question 21

Inhibits T4 to T3

Answer 21

Beta blockers and Glucocorticoids

Question 22

the only isotope used in treatment of thyrotoxicosis

Answer 22

Sodium iodide 131

Question 23

MOA:
- Trapped within the gland and enter
intracellularly and delivers strong
beta radiations destroying follicular
cells

Answer 23

Radioactive Iodine

Question 24

accelerate T4 breakdown (by hepatic enzyme induction) and may be helpful both as sedatives and to lower T4 levels.

Answer 24

Barbiturates

Question 25

90–120 mg three or four times daily, can be used to control tachycardia in patients in whom -blockers are contraindicated, eg, those with asthma.

Answer 25

Diltiazem,