UW revision amiodarone 03-15 (1)

Question 1

Amiodarone. xray findings?

Answer 1

localized or diffuse reticular or ground-glass opacities.

Question 2

Amiodarone. Pulmonary symptoms?

Answer 2

progressive dyspnea, nonproductive cough, bilateral inspiratory crackles, chest x ray findings.

INTERSTITIAL PNEUMONITIS - chronic, occurs months within start of use

Question 3

Amiodarone. PFT findings?

Answer 3

Restrictive pattern, decr. DLCO

Question 4

Amiodarone table. Cardiac?

Answer 4

Bradycardia, QT prolongation

Question 5

Amiodarone table. Pulmonary?

Answer 5

Interstitial pneumonitis
Organizing pneumonia, lung nodules

Question 6

Amiodarone table. Endocrin?

Answer 6

hypo or hyper thyroidism

Question 7

Amiodarone table. Hepatic?

Answer 7

Hepatitis

Question 8

Amiodarone table. Ophthalmic?

Answer 8

Corneal microdeposits
Optic neuritis

Question 9

Amiodarone table. Dermatologic?

Answer 9

Blue-gray skin discoloration

Question 10

Amiodarone table. Neurologic?

Answer 10

Peripheral neuropathy

Question 11

Amiodarone pulmonary vs viral?

Answer 11

viral = fever, fast time course of symptoms

Question 12

Hypothyroidism. mechanism?

Answer 12

Cause iodine overload –> suppress thyroid hormone synthesis (Wolff-Chaikoff effect).
ALSO amiodarone inhibits T4 -> T3 conversion

Question 13

Hyperthyroidism. Mechanism?

Answer 13

Hyperthyroidism in patients with nodular thyroid disease OR latent graves disease (type 1) OR destructive thryoiditis with released hormone (type 2)

Question 14

Amiodarone on thyroid.
Disorder: Decr. T4 -> T3. levels?

Answer 14

T4 incr.
T3 decr.
TSH normal or increased.

Question 15

Amiodarone on thyroid.
Disorder: Decr. T4 -> T3. Tx?

Answer 15

No Tx needed

Question 16

Amiodarone on thyroid.
Disorder: Inhibition of thyroid hormone synthesis. Levels?

Answer 16

T4 decr.
TSH incr.

Question 17

Amiodarone on thyroid.
Disorder: Inhibition of thyroid hormone synthesis. Tx?

Answer 17

Levothyroxine

Question 18

Amiodarone on thyroid.
Disorder: AIT type 1 (iodine-induced increased in thyroid hormone synthesis). levels?

AIT = amiodarone induced thyrotoxicosis

Answer 18

T3 incr.
T4 incr.
TSH decr.
RAIU decr.
increased vascularity on UG

Question 19

Amiodarone on thyroid.
Disorder: AIT type 1 (iodine-induced increased in thyroid hormone synthesis). Tx?

Answer 19

Antithyroid drugs

Question 20

Amiodarone on thyroid.
Disorder: AIT type 2 (destructive thyroiditis). levels?

Answer 20

T3 incr.
T4 incr.
TSH decr.
RAIU UNDETECTABLE
Decreased vascularity on UG

Question 21

Amiodarone on thyroid.
Disorder: AIT type 2 (destructive thyroiditis). Tx?

Answer 21

Glucocorticoids