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NR565 Final Exam Questions And Accurate Answers Graded A+
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NR565 Final Exam Questions And Accurate AnswersGraded A+
What laboratories are used in the diagnosis of thyroid function? - Answer 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 - Answer 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 - Answer 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 do you re-check labs after initiating Levothyroxine? - TSH 6-8 wks 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 inhibit the
release of thyroid hormone.
,2. Methimazole is given to inhibit the synthesis of thyroid hormone. 3. A β-blocker is
given to decrease heart rate.
Other measures include sedation, cooling, and giving glucocorticoids and IV fluids.
What is the consequence if hypothyroidism is left untreated during pregnancy? - Answ
permanent neuropsychological deficits in the child
Hyperthyroidism treatment - Answ 1. surgical ablation 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 decrease absorption of levothyroxine - Answer Histamine 2 (H2) receptor
blockers eg, cimetidine Tagamet
Proton pump inhibitors eg, lansoprazole Prevacid
Sucralfate Carafate
Cholestyramine Questran
Colestipol Colestid
Aluminum-containing antacids eg, Maalox, Mylanta
Calcium supplements eg, Tums, Os-Cal
Iron supplements (e.g., ferrous sulfate)
Magnesium salts
Orlistat (Xenical)
/administer 4 hours apart from levothyroxine/
Food interactions with levothyroxine - Answer Food decreases absorption. Should be
taken on an empty stomach 30-60 minutes prior to breakfast
, Drugs that accelerate levothyroxine metabolism - Answer phenytoin (Dilantin)
carbamazepine (Tegretol, Carbatrol)
rifampin (Rifadin)
sertraline (Zoloft)
phenobarbital.
*To maintain adequate levothyroxine levels, patients taking these drugs may need to
increase their levothyroxine dosage.
*Digoxin and Insulin may have more requirements when taking levothyroxine
Which of the following laboratory tests should be finished before starting methimazole
therapy? Free T3
Free T4
LFTs
TSH
CBC
Which of the following is the drug of choice to treat thyroid storm? PTU
(propylthiouracil)
Which of the following is the first line of therapy for hyperthyroidism/ Grave's disease?
Methimazole
How is Diabetes Mellitus diagnosed? Fasting plasma glucose ≥126 mg/dLa
Or
Random plasma glucose ≥ 200 mg/dL plus symptoms of diabetesb
Or
Oral glucose tolerance test (OGTT): 2-h plasma glucose ≥200 mg/dLc
or
Hemoglobin A1c 6.5% or higher (STANDARD TEST)
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