NU 578 Pharm
What test is used to diagnose hyperthyroidism? – answer TSH. Small drops in T3 & T4
cause big increases in TSH
What happens when T3 & T4 fall? – answer TSH increases
How do you diagnose primary hypothyroidism? - answer High TSH levels
What is the difference between primary and secondary hypothyroidism? - answer
Normal or low-normal TSH levels + low T3 & T4 levels. Primary has high TSH levels.
Benefits of levothyroxine + liothyronine (T3) vs levothyroxine alone? - answer None.
Both work equally well.
When should pregnant women initially be screened for hypothyroidism ? – answer As
soon as pregnancy is confirmed. Begin levothyroxine immediately
When can you expect to have to increase the levothyroxine dose during pregnancy? -
answer Between weeks 4-8. Level off by week 16 and stays steady.
What is a strategy for managing T4 dose during pregnancy? - answer Empirically
increase by 30% as soon as pregnancy is confirmed.
What causes creatinism in newborns? - answerFailure of thyroid to develop = congenital
hypothyroidism.
5 week old comes in with large, tongue, potbelly, dwarfish looking. What is long term
prognosis? - answerHypothyroidism. Cretinism. Permanent mental retardation but no
physical impairment.
How do you differentiate between transient & permanent hypothryoidism in infants? -
answerTreat for 3 years then stop for 4 weeks. If TSH increases = permanent
hypothyroidism = continue treatment.
#1 cause of hyperthyroidism - answerGraves' disease
Preferred treatment for adults with hyperthyroidism? - answerRadioactive iodine
What is the treatment of choice in young patients with hyperthyroidism? -
answerMethimazole or PTU
, How do you treat tachycardia associated with hyperthyroidism? - answerPropanolol
(beta blockers)
What good is non-radioactive iodine? - answerBlock production & release of thyroid
hormones in hyperthyroidism
How do you treat exophthalmos? - answerEye surgery or high dose PO glucocorticoids
Thyrotoxic crisis treatment? - answerHigh dose of potassium iodide, PTU to block
thyroid hormone synthesis & conversion of T4 to T3. Beta blockers, sedation, cooling,
glucocorticoids & IV fluid
Free T4 - answerNormal: 4.5-12.5
Serum TSH - answerMost sensitive method of diagnosing hypothyroid and monitoring
replacement therap. Normal 0.3-6
Serum T3 - answerT3 rises faster than T4. Normal: 230-620
Methimazole - answerSafer than PTU. 30-40 mg once per day PO to start then switch
maintenance to 5-15 mg once per day PO
Methimazole side effects - answerAgranulocytosis, hypothyroidism, creatinism in
neonates.
Signs of agranulocytosis - answerFever and sore throat. Stop methimazole or PTU &
give neupogen to speed up recovery
PTU first line for what? - answerFirst trimester pregnancy
Breast feeding women
During thyroid storm
PTU dose? - answer100-300 mg 3 times/day to start. Then switch to maintenance of 50
mg 3 times per day.
Radioactive Iodine - answerHyperthyroidism: destroy thyroid tissue without causing
complete gland destruction
Who can't use radioactive iodine? - answerPatients younger than 30 - cancer, pregnant,
breastfeeding
Lugol's Solution - answerDecreases iodine uptake by the thyroid, blocks thyroid
hormone production, blocks release of thyroid hormone into blood
What is iodism? - answerbrassy taste, burning in mouth, sore teeth & gums, frontal HA,
coryza. Fades when you stop iodine.
What test is used to diagnose hyperthyroidism? – answer TSH. Small drops in T3 & T4
cause big increases in TSH
What happens when T3 & T4 fall? – answer TSH increases
How do you diagnose primary hypothyroidism? - answer High TSH levels
What is the difference between primary and secondary hypothyroidism? - answer
Normal or low-normal TSH levels + low T3 & T4 levels. Primary has high TSH levels.
Benefits of levothyroxine + liothyronine (T3) vs levothyroxine alone? - answer None.
Both work equally well.
When should pregnant women initially be screened for hypothyroidism ? – answer As
soon as pregnancy is confirmed. Begin levothyroxine immediately
When can you expect to have to increase the levothyroxine dose during pregnancy? -
answer Between weeks 4-8. Level off by week 16 and stays steady.
What is a strategy for managing T4 dose during pregnancy? - answer Empirically
increase by 30% as soon as pregnancy is confirmed.
What causes creatinism in newborns? - answerFailure of thyroid to develop = congenital
hypothyroidism.
5 week old comes in with large, tongue, potbelly, dwarfish looking. What is long term
prognosis? - answerHypothyroidism. Cretinism. Permanent mental retardation but no
physical impairment.
How do you differentiate between transient & permanent hypothryoidism in infants? -
answerTreat for 3 years then stop for 4 weeks. If TSH increases = permanent
hypothyroidism = continue treatment.
#1 cause of hyperthyroidism - answerGraves' disease
Preferred treatment for adults with hyperthyroidism? - answerRadioactive iodine
What is the treatment of choice in young patients with hyperthyroidism? -
answerMethimazole or PTU
, How do you treat tachycardia associated with hyperthyroidism? - answerPropanolol
(beta blockers)
What good is non-radioactive iodine? - answerBlock production & release of thyroid
hormones in hyperthyroidism
How do you treat exophthalmos? - answerEye surgery or high dose PO glucocorticoids
Thyrotoxic crisis treatment? - answerHigh dose of potassium iodide, PTU to block
thyroid hormone synthesis & conversion of T4 to T3. Beta blockers, sedation, cooling,
glucocorticoids & IV fluid
Free T4 - answerNormal: 4.5-12.5
Serum TSH - answerMost sensitive method of diagnosing hypothyroid and monitoring
replacement therap. Normal 0.3-6
Serum T3 - answerT3 rises faster than T4. Normal: 230-620
Methimazole - answerSafer than PTU. 30-40 mg once per day PO to start then switch
maintenance to 5-15 mg once per day PO
Methimazole side effects - answerAgranulocytosis, hypothyroidism, creatinism in
neonates.
Signs of agranulocytosis - answerFever and sore throat. Stop methimazole or PTU &
give neupogen to speed up recovery
PTU first line for what? - answerFirst trimester pregnancy
Breast feeding women
During thyroid storm
PTU dose? - answer100-300 mg 3 times/day to start. Then switch to maintenance of 50
mg 3 times per day.
Radioactive Iodine - answerHyperthyroidism: destroy thyroid tissue without causing
complete gland destruction
Who can't use radioactive iodine? - answerPatients younger than 30 - cancer, pregnant,
breastfeeding
Lugol's Solution - answerDecreases iodine uptake by the thyroid, blocks thyroid
hormone production, blocks release of thyroid hormone into blood
What is iodism? - answerbrassy taste, burning in mouth, sore teeth & gums, frontal HA,
coryza. Fades when you stop iodine.
