HYPOTHYROIDISM

Question 1

What endocrine disorder can present with symptoms such as

1. weakness
2. cold intolerance
3. constipation
4. depression
5. menorrhagia
6. hoarseness
7. dry skin
8. bradycardia

Answer 1

Hypothyroidism

Question 2

In what thyroid condition may you see delayed return of deep tendon reflexes?

Answer 2

Hypothyroidism

Question 3

In what condition will serum free tetraiodothyronine (aka thyroxine (T4) low and TSH elevation?

Answer 3

Hypothyroidism

Question 4

Primary Hypothyroidism is due to what?

Answer 4

thyroid gland disease

Question 5

Secondary Hypothyroidism is due to a lack of what?

Answer 5

Pituitary TSH

Question 6

True or False

Maternal hypothyroidism during pregnancy results in cognitive impairment in the child

Answer 6

True

generally need to increase doses of thyroid replacement hormone (levothyroxine) by 30%

Question 7

These can all be causes of what?

1. autoimmune:
   a. Hashimoto’s Disease
   b. Thyroiditis
2. Subacute (de Quervain’s thyroiditis)(after initial hyperthyroidism)
3. Iodine deficiency (seen in developing countries)
4. Genetic thyroid enzyme defects

Answer 7

Hypothyroidism with goiter

Question 8

These can all be causes of what?

1. Hepatitis
2. Drugs:
   a. lithium
   b. amiodarone
   c. propylthiouracil
   d. methimazole
   e. phenylbutazone
   f. sulfonamides
   g. interferon
3. food goitrogens in idodine-deficient areas
4. Peripheral resistance in thyroid hormone
5. infiltrating diseases

Answer 8

Hypothyroidism with goiter

Question 9

These can all be causes of what?

1. thyroid surgery, irradiation, radioiodine treatment
2. deficiency pituitary TSH
3. Severe illness
4. drugs:
   a. lithium
   b. amiodarone
   c. propylthiouracil
   d. methimazole
   e. phenylbutazone
   f. sulfonamides
   g. Interferon a & b
   h. iodine

Answer 9

Hypothyroidism WITHOUT goiter

Question 10

True or False
Radiation therapy to the head-neck-chest-shoulder region can cause hypothyroidism with or without goiter or thyroid cancer many years later

Answer 10

True

Question 11

“Subclinical” hypothyroidism, i.e., clinically euthyroid individual with high TSH, normal t4, occurs commonly in who?

Answer 11

Elderly women (10% incidence)

Question 12

Amiodarone, due to high iodine content, causes clinical hypothyroidism in what percentage of patients?

Answer 12

8%

Question 13

True or False
High iodine intake from other sources may also cause hypothyroidism, especially in those with underlying lymphocytic thyroiditis

Answer 13

True

Question 14

What is caused by interstitial accumulation of the hydrophilic mucopolysacchardies, leading to fluid retention and lymphedema?

Answer 14

Myxedema

Question 15

These can all be early symptoms of what?

1. fatigue, lethargy, weakness
2. arthralgias, myalgias, muscle cramps
3. cold intolerance
4. difficulty concentrating
5. constipation
6. dry skin
7. headache
8. weight gain
9. menorrhagia

Answer 15

Hypothyroidism

Question 16

These can all be late symptoms of what?

1. slow speech
2. peripheral edema
3. pallor
4. hoarseness
5. decreased sense of taste, smell, hearing
6. dyspnea
7. adsent sweating
8. amenorrhea or menorrhagia
9. galactorrhea

Answer 16

Hypothyroidism

Question 17

These can be early signs of what thyroid disorder?

1. thin, brittle nails
2. thinning of the hair
3. pallor
4. poor turgor of mucosa
5. delayed return of deep tendon reflexes

Answer 17

Hypothyroidism

Question 18

These can be late signs of what thyroid disorder?

1. goiter
2. puffiness in face and eyelids
3. thinning of outer eyebrows
4. tongue thickening
5. hard pitting edema
6. pleural, peritoneal, pericardial, and joint effusions

Answer 18

Hypothyroidism

Question 19

True or False

Serum TSH is increased in primary hypothyroidism but low or normal in secondary hypothyroidism (pituitary insufficiency)

Answer 19

True

Question 20

Is serum triiodothyronine (T3) a good test for routine hypothyroidism?

Answer 20

Nope

Question 21

These are lab findings associated with what?

1. Free T4 may be low or low normal
2. Serum cholesterol, troglycerides, liver enzymes, creatine kinase, prolactin increased
3. hyponatremia occurs due to imparied renal tubular sodium reabsorption
4. hypoglycemia
5. anemia

Answer 21

Hypothyroidism

Question 22

What is the treatment for adult hypothyroidism?

Answer 22

Levothyroxine 25-75 mcg/day PO

Question 23

How often should thyroid function tests be repeated for medication titration until TSH is at goal?

Answer 23

4-6 weeks

Question 24

What is the disposition of a hypothyroidism patient?

Answer 24

MEDEVAC depending on signs and symptoms

may retain if no major issues

Question 25

Long term untreated hypothyroidism can lead to what condition characterized by 1. hypothermia 2. hypotension 3. hypoventilation 4. hypoxia 5. hypercapnia 6. hyponatremia 7. convulsions 8. abnormal CNS signs

Answer 25

Myxedema Coma

Question 26

True or False | Angina pectoris, congestive heart failure, and cardiac dysrhythmias may be participated by too rapid thyroid replacement

Answer 26

True