NU 578 Pharm
1. What test is used to diagnose hyperthyroidism <Ans> TSH. Small drops in T3 & T4
cause big increases in TSH
2. What happens when T3 & T4 fall <Ans> TSH increases
3. How do you diagnose primary hypothyroidism <Ans> High TSH levels
4. What is the difference between primary and secondary hypothyroidism <Ans> -
Normal or low-normal TSH levels + low T3 & T4 levels. Primary has high TSH levels.
5. Benefits of levothyroxine + liothyronine (T3) vs levothyroxine alone <Ans> None.
Both work equally well.
6. When should pregnant women initially be screened for hypothyroidism
<Ans> As soon as pregnancy is confirmed. Begin levothyroxine immediately
7. When can you expect to have to increase the levothyroxine dose during
pregnancy <Ans> Between weeks 4-8. Level off by week 16 and stays steady.
8. What is a strategy for managing T4 dose during pregnancy <Ans> Empirically
increase by 30% as soon as pregnancy is confirmed.
9. What causes creatinism in newborns <Ans> Failure of thyroid to develop = congen-
ital hypothyroidism.
10. 5 week old comes in with large, tongue, potbelly, dwarfish looking. What is long
term prognosis <Ans> Hypothyroidism. Cretinism. Permanent mental retardation but no
physical impairment.
11. How do you differentiate between transient & permanent hypothryoidism in
infants <Ans> Treat for 3 years then stop for 4 weeks. If TSH increases = permanent
hypothyroidism = continue treatment.
12. #1 cause of hyperthyroidism: Graves' disease
13. Preferred treatment for adults with hyperthyroidism <Ans> Radioactive iodine
1/7
, 14. What is the treatment of choice in young patients with hyperthyroidism?-
: Methimazole or PTU
15. How do you treat tachycardia associated with hyperthyroidism <Ans> -
Propanolol (beta blockers)
16. What good is non-radioactive iodine <Ans> Block production & release of thyroid
hormones in hyperthyroidism
17. How do you treat exophthalmos <Ans> Eye surgery or high dose PO glucocorti-
coids
18. Thyrotoxic crisis treatment <Ans> High dose of potassium iodide, PTU to block
thyroid hormone synthesis & conversion of T4 to T3. Beta blockers, sedation, cooling,
glucocorticoids & IV fluid
19. Free T4: Normal: 4.5-12.5
20. Serum TSH: Most sensitive method of diagnosing hypothyroid and monitoring
replacement therap. Normal 0.3-6
21. Serum T3: T3 rises faster than T4. Normal: 230-620
2/7
1. What test is used to diagnose hyperthyroidism <Ans> TSH. Small drops in T3 & T4
cause big increases in TSH
2. What happens when T3 & T4 fall <Ans> TSH increases
3. How do you diagnose primary hypothyroidism <Ans> High TSH levels
4. What is the difference between primary and secondary hypothyroidism <Ans> -
Normal or low-normal TSH levels + low T3 & T4 levels. Primary has high TSH levels.
5. Benefits of levothyroxine + liothyronine (T3) vs levothyroxine alone <Ans> None.
Both work equally well.
6. When should pregnant women initially be screened for hypothyroidism
<Ans> As soon as pregnancy is confirmed. Begin levothyroxine immediately
7. When can you expect to have to increase the levothyroxine dose during
pregnancy <Ans> Between weeks 4-8. Level off by week 16 and stays steady.
8. What is a strategy for managing T4 dose during pregnancy <Ans> Empirically
increase by 30% as soon as pregnancy is confirmed.
9. What causes creatinism in newborns <Ans> Failure of thyroid to develop = congen-
ital hypothyroidism.
10. 5 week old comes in with large, tongue, potbelly, dwarfish looking. What is long
term prognosis <Ans> Hypothyroidism. Cretinism. Permanent mental retardation but no
physical impairment.
11. How do you differentiate between transient & permanent hypothryoidism in
infants <Ans> Treat for 3 years then stop for 4 weeks. If TSH increases = permanent
hypothyroidism = continue treatment.
12. #1 cause of hyperthyroidism: Graves' disease
13. Preferred treatment for adults with hyperthyroidism <Ans> Radioactive iodine
1/7
, 14. What is the treatment of choice in young patients with hyperthyroidism?-
: Methimazole or PTU
15. How do you treat tachycardia associated with hyperthyroidism <Ans> -
Propanolol (beta blockers)
16. What good is non-radioactive iodine <Ans> Block production & release of thyroid
hormones in hyperthyroidism
17. How do you treat exophthalmos <Ans> Eye surgery or high dose PO glucocorti-
coids
18. Thyrotoxic crisis treatment <Ans> High dose of potassium iodide, PTU to block
thyroid hormone synthesis & conversion of T4 to T3. Beta blockers, sedation, cooling,
glucocorticoids & IV fluid
19. Free T4: Normal: 4.5-12.5
20. Serum TSH: Most sensitive method of diagnosing hypothyroid and monitoring
replacement therap. Normal 0.3-6
21. Serum T3: T3 rises faster than T4. Normal: 230-620
2/7
