NR565 / NR 565 Final
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1. Signs And Symptoms Of Hypothyroidism
Face Is Pale, Puffy, And Expressionless.
Skin Is Cold And Dry.
Hair Is Brittle, And Hair Loss Occurs.
Heart Rate And Temperature Are Lowered. The Patient Lethargy, Fatigue, And Intolerance To Cold.
Mentation May Be Impaired.
, 2. Signs And Symptoms Of Hyperthyroidism
Heart Rate Is Rapid; Possible Arrhythmia/Angina
Nervousness, Insomnia, Rapid Thought Flow, And 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
Weight Loss Occurs If Caloric Intake Fails To Match The Increase In Metabolic Rate
3. Severe Hypothyroidism
Myxedema
4. Hypothyroid Treatment
Levothyroxine Is The Drug Of Choice For Most Patients Who Require Thyroid Hormone Replacement.
5. Levothyroxine (Synthroid) Therapeutic Goal
Resolution Of Signs And Symptoms Of Hypothyroidism And Restoration Of Normal Laboratory Values For
Serum Thyroid-Stimulating Hormone (TSH) And Free Thyroxine (T4).
6. Major Forms Of Hyperthyroidism
Graves Disease And Toxic Nodular Goiter (Also Known As Plummer Disease).
7. Graves Disease
Most Common Cause Of Excessive Thyroid Hormone Secretion
, 8. What Adjunctive Therapy Is Good To Prescribe To Control Symptoms Of Hyperthyroidism Other
Than Thyroid Specific Medications?
Β-Blockers And Nonradioactive Iodine May Be Used As Adjunctive Therapy.
Β-Blockers Suppress Tachycardia By Blocking Β-Receptors On The Heart.
Nonradioactive Iodine Inhibits Synthesis And Release Of Thyroid Hormones.
9. Monitoring Needs And Intervals For Levothyroxine
Check TSH 6-8 Weeks After Initiating Therapy And After Any Dosage Change.
Check TSH At Least Once A Year After Serum TSH Is Stabilized.
10. Hyperthyroid Treatment
Thionamide Drugs—Methimazole And Propylthiouracil (PTU)—Suppress Synthesis Of Thyroid Hormones.
11. Methimazole Therapeutic Goal
(1) Reduction Of Thyroid Hormone Production In Graves' Disease, (2) Control Of Hyperthyroidism Until
The Effects Of Radiation On The Thyroid Become Manifest, (3) Suppression Of Thyroid Hormone
Production Before Subtotal Thyroidectomy, (4) Treatment Of Thyrotoxic Crisis.
12. Monitoring Needs And Intervals For Methimazole
Check CBC With Differential If Signs Or Symptoms Of Infection. Check Lfts If Signs Or Symptoms Of Liver
Dysfunction.
13. High Risk Patients For Methimazole
Should Be Avoided In The First Trimester Of Pregnancy.
, 14. Methimazole Toxicity
Agranulocytosis Is The Most Dangerous Toxicity.
15. PTU High Risk Warning
Carries A Risk For Liver Toxicity. Although Rare, The FDA Recommends Against Using As A First-Line
Treatment Due To Potential For Hepatic Toxicity.
16. Effects Of Maternal Hypothyroidism On Offspring And Appropriate Patient Teaching Related To
Need For Treatment.
Can Cause Delay In Mental Development And Derangement Of Growth. In The Absence Of Thyroid
Hormones, The Child Develops A Large And Protruding Tongue, Potbelly, And Dwarfish Stature.
Development Of The Nervous System, Bones, Teeth, And Muscles Is Impaired.
17. Congenital Hypothyroidism Treatment
Requires Replacement Therapy With Thyroid Hormones. If Treatment Is Initiated Within A Few Days Of
Birth, Physical And Mental Development Will Be Normal.
Replacement Therapy Should Continue For 3 Years, After Which It Should Be Stopped For 4 Weeks To
Determine Whether Thyroid Deficiency Is Permanent Or Transient.
18. Patient Teaching For Methimazole
Tell Your Healthcare Providers That You Are Taking This Drug.
Check Blood Work As Directed.
Taking This Drug May Cause Harm To The Unborn Baby If You Are Pregnant, Especially In The First
Trimester.
Exam Question With
Correct Answers 100%
Verified
1. Signs And Symptoms Of Hypothyroidism
Face Is Pale, Puffy, And Expressionless.
Skin Is Cold And Dry.
Hair Is Brittle, And Hair Loss Occurs.
Heart Rate And Temperature Are Lowered. The Patient Lethargy, Fatigue, And Intolerance To Cold.
Mentation May Be Impaired.
, 2. Signs And Symptoms Of Hyperthyroidism
Heart Rate Is Rapid; Possible Arrhythmia/Angina
Nervousness, Insomnia, Rapid Thought Flow, And 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
Weight Loss Occurs If Caloric Intake Fails To Match The Increase In Metabolic Rate
3. Severe Hypothyroidism
Myxedema
4. Hypothyroid Treatment
Levothyroxine Is The Drug Of Choice For Most Patients Who Require Thyroid Hormone Replacement.
5. Levothyroxine (Synthroid) Therapeutic Goal
Resolution Of Signs And Symptoms Of Hypothyroidism And Restoration Of Normal Laboratory Values For
Serum Thyroid-Stimulating Hormone (TSH) And Free Thyroxine (T4).
6. Major Forms Of Hyperthyroidism
Graves Disease And Toxic Nodular Goiter (Also Known As Plummer Disease).
7. Graves Disease
Most Common Cause Of Excessive Thyroid Hormone Secretion
, 8. What Adjunctive Therapy Is Good To Prescribe To Control Symptoms Of Hyperthyroidism Other
Than Thyroid Specific Medications?
Β-Blockers And Nonradioactive Iodine May Be Used As Adjunctive Therapy.
Β-Blockers Suppress Tachycardia By Blocking Β-Receptors On The Heart.
Nonradioactive Iodine Inhibits Synthesis And Release Of Thyroid Hormones.
9. Monitoring Needs And Intervals For Levothyroxine
Check TSH 6-8 Weeks After Initiating Therapy And After Any Dosage Change.
Check TSH At Least Once A Year After Serum TSH Is Stabilized.
10. Hyperthyroid Treatment
Thionamide Drugs—Methimazole And Propylthiouracil (PTU)—Suppress Synthesis Of Thyroid Hormones.
11. Methimazole Therapeutic Goal
(1) Reduction Of Thyroid Hormone Production In Graves' Disease, (2) Control Of Hyperthyroidism Until
The Effects Of Radiation On The Thyroid Become Manifest, (3) Suppression Of Thyroid Hormone
Production Before Subtotal Thyroidectomy, (4) Treatment Of Thyrotoxic Crisis.
12. Monitoring Needs And Intervals For Methimazole
Check CBC With Differential If Signs Or Symptoms Of Infection. Check Lfts If Signs Or Symptoms Of Liver
Dysfunction.
13. High Risk Patients For Methimazole
Should Be Avoided In The First Trimester Of Pregnancy.
, 14. Methimazole Toxicity
Agranulocytosis Is The Most Dangerous Toxicity.
15. PTU High Risk Warning
Carries A Risk For Liver Toxicity. Although Rare, The FDA Recommends Against Using As A First-Line
Treatment Due To Potential For Hepatic Toxicity.
16. Effects Of Maternal Hypothyroidism On Offspring And Appropriate Patient Teaching Related To
Need For Treatment.
Can Cause Delay In Mental Development And Derangement Of Growth. In The Absence Of Thyroid
Hormones, The Child Develops A Large And Protruding Tongue, Potbelly, And Dwarfish Stature.
Development Of The Nervous System, Bones, Teeth, And Muscles Is Impaired.
17. Congenital Hypothyroidism Treatment
Requires Replacement Therapy With Thyroid Hormones. If Treatment Is Initiated Within A Few Days Of
Birth, Physical And Mental Development Will Be Normal.
Replacement Therapy Should Continue For 3 Years, After Which It Should Be Stopped For 4 Weeks To
Determine Whether Thyroid Deficiency Is Permanent Or Transient.
18. Patient Teaching For Methimazole
Tell Your Healthcare Providers That You Are Taking This Drug.
Check Blood Work As Directed.
Taking This Drug May Cause Harm To The Unborn Baby If You Are Pregnant, Especially In The First
Trimester.
