NR 565 Final Exam
1. What labs are used to diagnose thyroid problems?: Free and total
T3 Free and total T4
TSH
Anti-TPO
2. Hypothyroidism labs: increased TSH, decreased T3 &T4
3. hyperthyroidism labs: decreased TSH and increased T3 &T4
4. When to recheck labs after starting levothyroxine?: 6-8 weeks or after
dose change, then 12 months once stabilized
5. S/S hypothyroidism: pale, puffy, and expressionless face, cold and
dry skin, brittle hair/hair loss, low heart rate and body temperature,
lethargy, fatigue, cold intolerance, mental status changes, thyroid
enlargement
Think "hypo low and slow"
6. S/S hyperthyroidism: strong and rapid heart rate, dysrhythmias,
angina, ner- vousness, insomnia, rapid thought flow and speech,
muscle weakness/atrophy, increased metabolic rate (increased heat
production, increased body tempera- ture, heat intolerance),
,warm/moist skin, increased appetite, weight loss despite increased
caloric intake
think "hyper as in fast"
7. result of not treating hypothyroidism during pregnancy: permanent neu-
ropsychological deficits in the child. First trimester: fetus unable to
produce their own thyroid hormones. Fetal thyroid gland is fully
functional in the second trimester.
8. Medication to treat SYMPTOMS of hyperthyroidism: beta blocker
(decrease HR)
non-radioactive iodine
9. How to take levothyroxine with food?: take on an empty stomach in the
morn- ing, 30-60 minutes before breakfast
10.Supplement/drug interactions with levothyroxine: antacids, iron, calcium
11.Confirm diabetes diagnosis prior to treatment: fasting plasma glucose
greater than or equal to 126, A random plasma glucose of greater than
or equal to 200 plus symptoms of diabetes, an oral glucose tolerance
test of two hours, plasma glucose of greater than or equal to 200, or a
hemoglobin A1c, a 6.5 or higher (on two occasions)
, 12.A1c general goal: <7%
13.Older adult A1c goal: <8%
14.When should insulin be considered?: For patients with an A1c
>10%, a fasting blood glucose >300 or are markedly symptomatic
1. What labs are used to diagnose thyroid problems?: Free and total
T3 Free and total T4
TSH
Anti-TPO
2. Hypothyroidism labs: increased TSH, decreased T3 &T4
3. hyperthyroidism labs: decreased TSH and increased T3 &T4
4. When to recheck labs after starting levothyroxine?: 6-8 weeks or after
dose change, then 12 months once stabilized
5. S/S hypothyroidism: pale, puffy, and expressionless face, cold and
dry skin, brittle hair/hair loss, low heart rate and body temperature,
lethargy, fatigue, cold intolerance, mental status changes, thyroid
enlargement
Think "hypo low and slow"
6. S/S hyperthyroidism: strong and rapid heart rate, dysrhythmias,
angina, ner- vousness, insomnia, rapid thought flow and speech,
muscle weakness/atrophy, increased metabolic rate (increased heat
production, increased body tempera- ture, heat intolerance),
,warm/moist skin, increased appetite, weight loss despite increased
caloric intake
think "hyper as in fast"
7. result of not treating hypothyroidism during pregnancy: permanent neu-
ropsychological deficits in the child. First trimester: fetus unable to
produce their own thyroid hormones. Fetal thyroid gland is fully
functional in the second trimester.
8. Medication to treat SYMPTOMS of hyperthyroidism: beta blocker
(decrease HR)
non-radioactive iodine
9. How to take levothyroxine with food?: take on an empty stomach in the
morn- ing, 30-60 minutes before breakfast
10.Supplement/drug interactions with levothyroxine: antacids, iron, calcium
11.Confirm diabetes diagnosis prior to treatment: fasting plasma glucose
greater than or equal to 126, A random plasma glucose of greater than
or equal to 200 plus symptoms of diabetes, an oral glucose tolerance
test of two hours, plasma glucose of greater than or equal to 200, or a
hemoglobin A1c, a 6.5 or higher (on two occasions)
, 12.A1c general goal: <7%
13.Older adult A1c goal: <8%
14.When should insulin be considered?: For patients with an A1c
>10%, a fasting blood glucose >300 or are markedly symptomatic
