1
NR 565 FINAL STUDY GUIDE [WEEK 5]
NEWLY FORMATTED DOCUMENT
-TSH - used primarily for screening and
diagnosing hypothyroid and for monitoring
replacement therapy in hypothyroid patients
Thyroid
-T4 - Used to monitor thyroid hormone
o Diagnosis & Evaluation
replacement therapy and to screen for
What labs are thyroid dysfunction
used to
diagnose? -T3 - Useful in the diagnosis of
hyperthyroidism; can also be used to
monitor hormone replacement therapy
-TSH low
-T4 normal
-T3 is high = hyperthyroidism
Thyroid Recheck TSH 6-8 weeks after initiating
o Diagnosis & Evaluation therapy and after any dosage change; Check
TSH at least once a year after serum TSH is
Timeframe for re-check
stabilized
of labs after starting
levothyroxine?
,2
Hypothyroidism: Depend on severity.
o Mild: subtle and may go unrecognized
o Moderate to severe:
-Face is pale, puffy, and expressionless.
Thyroid
-Skin cold and dry.
o Diagnosis & Evaluation
-Hair is brittle and hair loss occurs.
-Slowed Heart rate.
Signs and symptoms of
-Patient may complain of lethargy, fatigue, and
hypothyroidism? -Temperature is lowered & intolerant to cold.
-Thyroid Enlargement may occur if
reduced levels of T3 and T4
Mentation may be impaired.
,3
o Elevated Heart rate and strong, and
dysrhythmias and angina may develop
o The CNS is stimulated, resulting is
Thyroid nervousness, insomnia, rapid thought flow,
o Diagnosis & Evaluation and rapid speech, hyperreflexia, tremors
o Skeletal muscles may weaken and atrophy
o Metabolic rate is raised, resulting in
Signs and symptoms of
health and skin that is warm and moist
hyperthyroidism?
o Feeling Hot + Heat intolerance
o Appetit is increased but fails to match
metabolic rate resulting in weight loss
o All of these signs are referred to as thyrotoxicosis
o Also usually present with exophthalmos - bulging of
the eyes
Characterized by profound hyperthermia
(105 degrees F or higher), severe tachycardia,
restlessness, agitation, and tremor.
Unconsciousness, coma, hypotension, and
heart failure may ensure.
Thyroid These symptoms are produced by excessive
o Treatment
levels of thyroid hormone
Thyroid crisis can be life threatening and
Treatment of thyroid
storm? requires immediate treatment.
o High doses of potassium iodide or strong
iodine solution are given to suppress
thyroid hormone release.
o Methimazole is given to suppress thyroid hormone
synthesis
o A beta blocker is given to reduce heart rate
o Additional measures include sedation,
cooling, and giving glucocorticoids and
IVF
, 4
Can result in permanent neuropsychological
deficits in the child - decrease child's IQ
Thyroid The effect of hypothyroidism is limited
o Treatment largely to the first trimester, a time
during which the fetus is unable to
Result of not
produce thyroid hormone of its own
treating
Some authorities currently recommend routine
hypothyroidism
screening for hypothyroidism as soon as pregnancy
during
is confirmed
pregnancy?
Women already taking thyroid hormone
replacement will need to increase dose by
50% max between weeks 4-8 of gestation
and the levels will level out by week 16
Methimazole - first line drug of choice (not
Thyroid given to women who are pregnant or
o Treatment breastfeeding)
o Methimazole blocks synthesis of thyroid hormone.
Medication to treat 1) Prevents the oxidation of iodine,
symptoms of therefore inhibiting incorporation of
hyperthyroidism iodine into tyrosine.
(notice this is treating 2) prevents iodinated tyrosine from
symptoms and not coupling Propylthiouracil - preferred
the hyperthyroidism treatment for thyroid storm Beta
itself) blockers - help with tachycardia
experienced with hyperthyroidism
NR 565 FINAL STUDY GUIDE [WEEK 5]
NEWLY FORMATTED DOCUMENT
-TSH - used primarily for screening and
diagnosing hypothyroid and for monitoring
replacement therapy in hypothyroid patients
Thyroid
-T4 - Used to monitor thyroid hormone
o Diagnosis & Evaluation
replacement therapy and to screen for
What labs are thyroid dysfunction
used to
diagnose? -T3 - Useful in the diagnosis of
hyperthyroidism; can also be used to
monitor hormone replacement therapy
-TSH low
-T4 normal
-T3 is high = hyperthyroidism
Thyroid Recheck TSH 6-8 weeks after initiating
o Diagnosis & Evaluation therapy and after any dosage change; Check
TSH at least once a year after serum TSH is
Timeframe for re-check
stabilized
of labs after starting
levothyroxine?
,2
Hypothyroidism: Depend on severity.
o Mild: subtle and may go unrecognized
o Moderate to severe:
-Face is pale, puffy, and expressionless.
Thyroid
-Skin cold and dry.
o Diagnosis & Evaluation
-Hair is brittle and hair loss occurs.
-Slowed Heart rate.
Signs and symptoms of
-Patient may complain of lethargy, fatigue, and
hypothyroidism? -Temperature is lowered & intolerant to cold.
-Thyroid Enlargement may occur if
reduced levels of T3 and T4
Mentation may be impaired.
,3
o Elevated Heart rate and strong, and
dysrhythmias and angina may develop
o The CNS is stimulated, resulting is
Thyroid nervousness, insomnia, rapid thought flow,
o Diagnosis & Evaluation and rapid speech, hyperreflexia, tremors
o Skeletal muscles may weaken and atrophy
o Metabolic rate is raised, resulting in
Signs and symptoms of
health and skin that is warm and moist
hyperthyroidism?
o Feeling Hot + Heat intolerance
o Appetit is increased but fails to match
metabolic rate resulting in weight loss
o All of these signs are referred to as thyrotoxicosis
o Also usually present with exophthalmos - bulging of
the eyes
Characterized by profound hyperthermia
(105 degrees F or higher), severe tachycardia,
restlessness, agitation, and tremor.
Unconsciousness, coma, hypotension, and
heart failure may ensure.
Thyroid These symptoms are produced by excessive
o Treatment
levels of thyroid hormone
Thyroid crisis can be life threatening and
Treatment of thyroid
storm? requires immediate treatment.
o High doses of potassium iodide or strong
iodine solution are given to suppress
thyroid hormone release.
o Methimazole is given to suppress thyroid hormone
synthesis
o A beta blocker is given to reduce heart rate
o Additional measures include sedation,
cooling, and giving glucocorticoids and
IVF
, 4
Can result in permanent neuropsychological
deficits in the child - decrease child's IQ
Thyroid The effect of hypothyroidism is limited
o Treatment largely to the first trimester, a time
during which the fetus is unable to
Result of not
produce thyroid hormone of its own
treating
Some authorities currently recommend routine
hypothyroidism
screening for hypothyroidism as soon as pregnancy
during
is confirmed
pregnancy?
Women already taking thyroid hormone
replacement will need to increase dose by
50% max between weeks 4-8 of gestation
and the levels will level out by week 16
Methimazole - first line drug of choice (not
Thyroid given to women who are pregnant or
o Treatment breastfeeding)
o Methimazole blocks synthesis of thyroid hormone.
Medication to treat 1) Prevents the oxidation of iodine,
symptoms of therefore inhibiting incorporation of
hyperthyroidism iodine into tyrosine.
(notice this is treating 2) prevents iodinated tyrosine from
symptoms and not coupling Propylthiouracil - preferred
the hyperthyroidism treatment for thyroid storm Beta
itself) blockers - help with tachycardia
experienced with hyperthyroidism
