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