NAPLEX > Thyroid > Flashcards

Thyroid Flashcards

(47 cards)

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1
Q

what do thyroid hormones regulate

A

metabolism

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2
Q

two hormones made by the thyroid gland

A

T3 - triiodothyronine
T4 - thyroxine

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3
Q

which thyroid hormone is more potent and shorter half life

A

T3

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4
Q

thyroid hormone production is regulated by

A

thyroid stimulating hormone (TSH)

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5
Q

the thyroid gland can absorb

A

iodine

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6
Q

which thyroid is monitored in thyroid disorders

A

free T4 (FT4)
unbound active form

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7
Q

insufficiency or T4 and elevation TSH

A

hypothyroidism

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8
Q

symptoms of hypothyroidism

A

cold intolerance/sensitivity, dry skin, fatigue, muscle cramps, voice changes, constipation, weight gain, goiter, myalgias, weakness, depression, bradycardia, coarse hair or loss of hair, menorrhagia, memory/mental impairment

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9
Q

autoimmune condition where antibodies attack the thyroid gland, common cause of hypothyroid

A

Hashimotos

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10
Q

life threatening emergency that is a complication of hypothyroidism, treated with IV levothyroxine

A

myxedema coma

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11
Q

lab diagnosis of hypothyroidism

A

low FT4
high TSH

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12
Q

how often should TSH be monitored until normal

A

every 4 to 6 weeks

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13
Q

what can happen from too high of a thyroid hormone replacement dose

A

Afib, fractures

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14
Q

drugs that cause hypothyroidism
I TALC

A

Interferons
Tyrosine kinase inhibitors
Amiodarone
Lithium
Carbamazepine

conditions- hashimotos

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15
Q

treatment options of hypothyroid

A

levothyroxine (T4) - choice, consistent preparation
liothyronine (T3)
desiccated thyroid (T3 &T4)

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16
Q

brand names of levothyroxine (3)

A

synthroid, levoxyl, unithroid

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17
Q

check therapeutic equivalence of levothyroxine in the

A

orange booke

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18
Q

full replacement dose of levothyroxine = ___

what about if CAD?

A

1.6 mcg/kg/day

CAD = 12.5 - 25mcg daily

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19
Q

brand name of desiccated T3/T4 thyroid

Study These Flashcards
A

Armour Thyroid

20
Q

brand name of liothyronine

21
Q

warning for thyroid replacement

Study These Flashcards
A

use initial lower dose in CV disease

22
Q

how to take levothyroxine

Study These Flashcards
A

water at least 60 min before breakfast or at bedtime (3 hr after last meal)

23
Q

IV to PO levothyroxine ratio

24
Q

which thyroid replacement has shorter half life causing fluctuations

25
tablet colors for levothyroxine are
standard
26
levothyroxine tablet colors Orangutans Will Vomit On You Right Before They Become Large Proud Giants
25- orange 50- white 75- violet 88- olive 100- yellow 112- rose 125- brown 137- turquoise 150- blue 175- lilac 200- pink 300- green
27
drugs that decrease the effect of thyroid replacement
antacids, iron, calcium, Al, Mg, multivitamins, cholestyramine, sevelamer, sucralfate --- separate
28
thyrotoxicosis, occurs when FT4 is high and TSH is low
hyperthyroidism
29
symptoms of hyperthyroidism
heat intolerance/inc sweating weight loss agitation, nervousness, irritability, anxiety palpitations, inc HR fatigue, muscle weakness frequent bowel movements, diarrhea insomina tremor thinning hair goiter exophthalmos, diplopia light/absent periods
30
autoimmune condition that stimulates the thyroid to produce too much T4
Graves' disease
31
3 drug induced causes of hyperthyroidism
iodine (radiographic contrast dye) amiodarone interferons
32
treatment of hyperthyroid includes
antithyroid meds surgery radioactive iodine beta blocker for symptom control (palpitations, tremor, tachycardia)
33
how long does it typically take with high dose treatment to control symptoms of hyperthyroid
1-3 months then reduce dose to prevent hypothyroidism
34
inhibit synthesis of thyroid hormones
thionamides PTU also inhibits peripheral conversion of T4 to T3
35
2 thionamides
propylthiouracil (PTU) methimazole
36
BBW thionamides
severe liver injury, acute liver failure pregnancy - PTU preferred 1st trimester
37
warnings thionamides
hepatotoxicity, agranulocytosis
38
AEs of thionamides
GI upset
39
which thionamide is choice?
methimazole
40
which thionamide is preferred for thyroid storm
PTU
41
which thionamide is preferred in pregnancy
PTU 1st trimester methimazole 2nd and 3rd
42
temporarily inhibits secretion of thyroid hormons
iodides
43
blocks the accumulation of radioactive iodine in the thyroid gland, thus preventing thyroid cancer
potassium iodide (KI)
44
life threatening emergency characterized by decompensated hyperthyroidism
thyroid storm
45
symptoms of thyroid storm
fever >103 tachycardia tachypnea dehydration profuse swearing agitation delirium psychosis coma
46
5 things done/used to treat thyroid storm
PTU + inorganic iodide (SSKI or Lugol's solution) + propranolol + dexamethasone + cooling
47
what is used to treat hypothyroid in pregnancy? dose adjustment?
levothyroxine is safe and recommended 30-50% dose increase
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