1|Pag e
NR565 FINAL EXAM|| ALL QUESTIONS AND 100%
CORRECT ANSWERS ALREADY GRADED A+||
LATEST AND COMPLETE UPDATE 2024-2025 WITH
VERIFIED SOLUTIONS|| ASSURED PASS!!
What labs are used to diagnose 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 should you re-check labs after initiating Levothyroxine? - ANSWER: TSH
6-8 weeks after initiation or dose changes.
S/S of Thyrotoxic Crisis (Thyroid Storm) - ANSWER: 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)
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Treatment of thyroid storm - ANSWER: *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? - ANSWER:
permanent neuropsychological deficits in the child
Treatment of hyperthyroidism - ANSWER: 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 - ANSWER: Histamine 2 (H2)
receptor blockers (e.g., cimetidine [Tagamet])
Proton pump inhibitors (e.g., lansoprazole [Prevacid])
Sucralfate (Carafate)
Cholestyramine (Questran)
Colestipol (Colestid)
, 3|Pag e
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 - 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 laboratory tests should be completed before prescribing methimazole? -
ANSWER: free triiodothyronine (T3)
free thyroxine (T4)
LFTs
NR565 FINAL EXAM|| ALL QUESTIONS AND 100%
CORRECT ANSWERS ALREADY GRADED A+||
LATEST AND COMPLETE UPDATE 2024-2025 WITH
VERIFIED SOLUTIONS|| ASSURED PASS!!
What labs are used to diagnose 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 should you re-check labs after initiating Levothyroxine? - ANSWER: TSH
6-8 weeks after initiation or dose changes.
S/S of Thyrotoxic Crisis (Thyroid Storm) - ANSWER: 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)
,2|Pag e
Treatment of thyroid storm - ANSWER: *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? - ANSWER:
permanent neuropsychological deficits in the child
Treatment of hyperthyroidism - ANSWER: 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 - ANSWER: Histamine 2 (H2)
receptor blockers (e.g., cimetidine [Tagamet])
Proton pump inhibitors (e.g., lansoprazole [Prevacid])
Sucralfate (Carafate)
Cholestyramine (Questran)
Colestipol (Colestid)
, 3|Pag e
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 - 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 laboratory tests should be completed before prescribing methimazole? -
ANSWER: free triiodothyronine (T3)
free thyroxine (T4)
LFTs
