NR565 Final Exam-Questions with Correct Answers/
Verified
What labs are used to diagnose thyroid function? - ✔✔1. Serum thyroid-stimulating hormone test
(TSH)
2. Serum thyroxine test (Total or Free T4)
3. Serum triiodothyronine test (Total or Free T3)
s/s hypothyroidism - ✔✔Signs and symptoms of hypothyroidism depend on disease severity. The
face is pale, puffy, and expressionless; skin is cold and dry; hair is brittle; hair loss occurs;Heart rate
and temperature are lowered. The patient may complain of lethargy, fatigue, and intolerance to
cold. Mentation may be impaired.
s/s hyperthyroidism - ✔✔Exophthalmos; Heartbeat is rapid and strong; dysrhythmias and angina
may develop; nervousness; insomnia, rapid thought flow; rapid speech; Skeletal muscles may
weaken and atrophy; Metabolic rate is raised, resulting in increased heat production, increased body
temperature, intolerance to heat, and skin that is warm and moist. Appetite is increased, but weight
loss may still occur.
When should you re-check labs after initiating Levothyroxine? - ✔✔TSH 6-8 weeks after initiation or
dose changes.
S/S of Thyrotoxic Crisis (Thyroid Storm) - ✔✔profound hyperthermia (105°F or even higher), severe
tachycardia, restlessness, agitation, and tremor. Unconsciousness, coma, hypotension, and heart
failure may occur
*Excessive levels of thyroid hormones (occurs after surgery or intercurrent illness (e.g. sepsis)
Treatment of thyroid storm - ✔✔*MEDICAL EMERGENCY*
1.High doses of potassium iodide or strong iodine solution are given to suppress thyroid hormone
release.
2.Methimazole is given to suppress thyroid hormone synthesis. 3.A β-blocker is given to reduce
heart rate.
Additional measures include sedation, cooling, and giving glucocorticoids and IV fluids.
What can result from not treating hypothyroidism during pregnancy? - ✔✔permanent
neuropsychological deficits in the child
, Treatment of hyperthyroidism - ✔✔1. surgical removal of thyroid tissue
2. destruction of thyroid tissue with radioactive iodine (preferred for adults)
3. antithyroid drug (methimazole or propylthiouracil). (preferred for younger patients)
β-Blockers suppress tachycardia by blocking β-receptors on the heart.
Nonradioactive iodine inhibits synthesis and release of thyroid hormones.
Drugs that reduce absorption of levothyroxine - ✔✔Histamine 2 (H2) receptor blockers (e.g.,
cimetidine [Tagamet])
Proton pump inhibitors (e.g., lansoprazole [Prevacid])
Sucralfate (Carafate)
Cholestyramine (Questran)
Colestipol (Colestid)
Aluminum-containing antacids (e.g., Maalox, Mylanta)
Calcium supplements (e.g., Tums, Os-Cal)
Iron supplements (e.g., ferrous sulfate)
Magnesium salts
Orlistat (Xenical)
*administer 4 hours apart from levothyroxine*
Food interactions with levothyroxine - ✔✔Food decreases absorption. Should be taken on an empty
stomach 30-60 minutes prior to breakfast
Drugs that accelerate levothyroxine metabolism - ✔✔phenytoin (Dilantin)
carbamazepine (Tegretol, Carbatrol)
rifampin (Rifadin)
sertraline (Zoloft)
phenobarbital.
Verified
What labs are used to diagnose thyroid function? - ✔✔1. Serum thyroid-stimulating hormone test
(TSH)
2. Serum thyroxine test (Total or Free T4)
3. Serum triiodothyronine test (Total or Free T3)
s/s hypothyroidism - ✔✔Signs and symptoms of hypothyroidism depend on disease severity. The
face is pale, puffy, and expressionless; skin is cold and dry; hair is brittle; hair loss occurs;Heart rate
and temperature are lowered. The patient may complain of lethargy, fatigue, and intolerance to
cold. Mentation may be impaired.
s/s hyperthyroidism - ✔✔Exophthalmos; Heartbeat is rapid and strong; dysrhythmias and angina
may develop; nervousness; insomnia, rapid thought flow; rapid speech; Skeletal muscles may
weaken and atrophy; Metabolic rate is raised, resulting in increased heat production, increased body
temperature, intolerance to heat, and skin that is warm and moist. Appetite is increased, but weight
loss may still occur.
When should you re-check labs after initiating Levothyroxine? - ✔✔TSH 6-8 weeks after initiation or
dose changes.
S/S of Thyrotoxic Crisis (Thyroid Storm) - ✔✔profound hyperthermia (105°F or even higher), severe
tachycardia, restlessness, agitation, and tremor. Unconsciousness, coma, hypotension, and heart
failure may occur
*Excessive levels of thyroid hormones (occurs after surgery or intercurrent illness (e.g. sepsis)
Treatment of thyroid storm - ✔✔*MEDICAL EMERGENCY*
1.High doses of potassium iodide or strong iodine solution are given to suppress thyroid hormone
release.
2.Methimazole is given to suppress thyroid hormone synthesis. 3.A β-blocker is given to reduce
heart rate.
Additional measures include sedation, cooling, and giving glucocorticoids and IV fluids.
What can result from not treating hypothyroidism during pregnancy? - ✔✔permanent
neuropsychological deficits in the child
, Treatment of hyperthyroidism - ✔✔1. surgical removal of thyroid tissue
2. destruction of thyroid tissue with radioactive iodine (preferred for adults)
3. antithyroid drug (methimazole or propylthiouracil). (preferred for younger patients)
β-Blockers suppress tachycardia by blocking β-receptors on the heart.
Nonradioactive iodine inhibits synthesis and release of thyroid hormones.
Drugs that reduce absorption of levothyroxine - ✔✔Histamine 2 (H2) receptor blockers (e.g.,
cimetidine [Tagamet])
Proton pump inhibitors (e.g., lansoprazole [Prevacid])
Sucralfate (Carafate)
Cholestyramine (Questran)
Colestipol (Colestid)
Aluminum-containing antacids (e.g., Maalox, Mylanta)
Calcium supplements (e.g., Tums, Os-Cal)
Iron supplements (e.g., ferrous sulfate)
Magnesium salts
Orlistat (Xenical)
*administer 4 hours apart from levothyroxine*
Food interactions with levothyroxine - ✔✔Food decreases absorption. Should be taken on an empty
stomach 30-60 minutes prior to breakfast
Drugs that accelerate levothyroxine metabolism - ✔✔phenytoin (Dilantin)
carbamazepine (Tegretol, Carbatrol)
rifampin (Rifadin)
sertraline (Zoloft)
phenobarbital.
