NURS 642 Thyroid Test Questions and Answers
TSH levels
0.3-4
under 0.3: hyperthyroid
above 4: hypothyroid
iodine isotope scans
can distinguish hot vs cold nodules
cold: most malignant cases are cold nodules
risk factors for nodules in the thyroid
iodine deficiency
exposure to radiation (head, neck, chest)
family history
uterine fibroids
smoking
alcohol use in women
younger than 20, older than 60
hx of multiple endocrine neoplasia II
symptoms of thyroid nodule
asymptomatic: most of the time
identified as a lump during routine examination
anapestic tumor
enlarging, painful mass
hoarseness, dysphonia, dysphagia, dyspnea
, pathologic fracture of the spine or hip
hyperthyroid signs
diagnostics for thyroid nodule
TSH to r/o hyper/hypo thyroid
serum calcitonin
thyroid US
FNA biopsy
management of thyroid nodule when TSH is suppressed:
t3 & t4 are checked
iodine uptake scan
functioning nodules/ thyrotoxicosis: radioiodine/surgery
FNA biopsy on indeterminate or cold nodules
management of thyroid nodule when TSH is elevated:
free t4
start patient on levothyroxine
management of thyroid nodule when TSH is normal:
ultrasound
refer to endo/IR for FNA
management of benign nodules:
annual evaluation with TSH level, PE and US
stable size and US: every 2 years
Complications of thyroidectomy
hoarseness (recurrent laryngeal nerve damage)
hypoparathyroidism
complications of radio iodine uptake:
TSH levels
0.3-4
under 0.3: hyperthyroid
above 4: hypothyroid
iodine isotope scans
can distinguish hot vs cold nodules
cold: most malignant cases are cold nodules
risk factors for nodules in the thyroid
iodine deficiency
exposure to radiation (head, neck, chest)
family history
uterine fibroids
smoking
alcohol use in women
younger than 20, older than 60
hx of multiple endocrine neoplasia II
symptoms of thyroid nodule
asymptomatic: most of the time
identified as a lump during routine examination
anapestic tumor
enlarging, painful mass
hoarseness, dysphonia, dysphagia, dyspnea
, pathologic fracture of the spine or hip
hyperthyroid signs
diagnostics for thyroid nodule
TSH to r/o hyper/hypo thyroid
serum calcitonin
thyroid US
FNA biopsy
management of thyroid nodule when TSH is suppressed:
t3 & t4 are checked
iodine uptake scan
functioning nodules/ thyrotoxicosis: radioiodine/surgery
FNA biopsy on indeterminate or cold nodules
management of thyroid nodule when TSH is elevated:
free t4
start patient on levothyroxine
management of thyroid nodule when TSH is normal:
ultrasound
refer to endo/IR for FNA
management of benign nodules:
annual evaluation with TSH level, PE and US
stable size and US: every 2 years
Complications of thyroidectomy
hoarseness (recurrent laryngeal nerve damage)
hypoparathyroidism
complications of radio iodine uptake:
