NR 565 - FINAL (WEEK 5) EXAM QUESTIONS
WITH CORRECT ANSWERS RATED A+
Thyroid panels - CORRECT ANSWER -diagnosis comes from TSH, total T4 and T3, free T4 and T3
Recheck Thyroid labs - CORRECT ANSWER -6-8 weeks after starting therapy.
Hypothyroidism - CORRECT ANSWER -pale, puffy, expressionless. cold & dry skin, brittle hair
with hair loss, lethargy, fatigue, intolerance to cold. mentation may be impaired. Thyroid
enlargement if decreased levels of T3 and T4 which promote excessive release of TSH.
Hyperthroidism - CORRECT ANSWER -heartbeat is rapid and strong, dysrhythmia and angina
possible. nervousness, insomnia, rapid thought flow and speech, muscle weakness and atrophy.
increase metabolic rate, intolerance to heat, skin warm and moist, increased appetite but
weight loss
thyrotoxicosis - CORRECT ANSWER -condition caused by excessive thyroid hormones - all
symptoms
graves disease - CORRECT ANSWER -exophthalmos.
treatment of thyroid storm - CORRECT ANSWER -high dose potassium iodine or strong iodine
solution to suppress thyroid hormone release., methimazole to suppress thyroid hormone
synthesis, beta blocker to reduce heart rate, sedation cooling glucocorticoids and IV fluids.
not treating hypothyroidism during pregnancy - CORRECT ANSWER -permanent neurological
defects, decreased IQ, large protruding tongue, potbelly dwarfish stature, impaired
development of nervous system, bones, teeth, and muscles.
, medication to treat symptoms of hyperthyroidism - CORRECT ANSWER -*treats symptoms and
not the hyperthyroidism itself.
beta blockers (metoprolol) to treat tachycardia
Absorption of levothyroxine REDUCED by: - CORRECT ANSWER -histamine 2 receptor blockers
(tagamet), proton pump inhibitors (lansoprazole), sucralfate (carafate), Cholestyramine
(Questran), Colestipol (colestid), aluminum containing antacids (mylanta, maalox), calcium
supplements (tums), iron supplements, magnesium salts, orlistat.
*4 hours between levothyroxine and the above meds is recommended as well as food
Metabolism of levothyroxine ACCELERATED by: - CORRECT ANSWER -phenytoin (dilantin),
Carbamazepine (Tegratol, Caratrol), Rifampin (Rifadin), Sertraline (Zoloft), Phenobarbital.
*patients taking these medications will need to have dose of levothyroxine increased.
Warfarin & Levothyroxine - CORRECT ANSWER -levothyroxine accelerates degradation of
vitamin k dependent clotting factors, may need to reduce the dose of warfarin.
Catecholamines - CORRECT ANSWER -increase cardiac responsiveness - at an increased risk of
catecholamine induced dysrhythmia.
Digoxin and insulin - may need to be increased if pt. is taking levothyroxine.
How to confirm diagnosis of diabetes - CORRECT ANSWER -Hemoglobin A1C > 6.5 %
Fasting plasma glucose > 126 mg/dL
Random plasma glucose > 200 mg/dL plus symptoms of diabetes
Oral glucose tolerance test (OGTT): 2-h plasma glucose > 200 mg/dL
A1C - CORRECT ANSWER -goals: less than 7%, less than 8% in patients with severe
hypoglycemia, limited life expectancy, or advanced microvascular or macrovascular
complications.
WITH CORRECT ANSWERS RATED A+
Thyroid panels - CORRECT ANSWER -diagnosis comes from TSH, total T4 and T3, free T4 and T3
Recheck Thyroid labs - CORRECT ANSWER -6-8 weeks after starting therapy.
Hypothyroidism - CORRECT ANSWER -pale, puffy, expressionless. cold & dry skin, brittle hair
with hair loss, lethargy, fatigue, intolerance to cold. mentation may be impaired. Thyroid
enlargement if decreased levels of T3 and T4 which promote excessive release of TSH.
Hyperthroidism - CORRECT ANSWER -heartbeat is rapid and strong, dysrhythmia and angina
possible. nervousness, insomnia, rapid thought flow and speech, muscle weakness and atrophy.
increase metabolic rate, intolerance to heat, skin warm and moist, increased appetite but
weight loss
thyrotoxicosis - CORRECT ANSWER -condition caused by excessive thyroid hormones - all
symptoms
graves disease - CORRECT ANSWER -exophthalmos.
treatment of thyroid storm - CORRECT ANSWER -high dose potassium iodine or strong iodine
solution to suppress thyroid hormone release., methimazole to suppress thyroid hormone
synthesis, beta blocker to reduce heart rate, sedation cooling glucocorticoids and IV fluids.
not treating hypothyroidism during pregnancy - CORRECT ANSWER -permanent neurological
defects, decreased IQ, large protruding tongue, potbelly dwarfish stature, impaired
development of nervous system, bones, teeth, and muscles.
, medication to treat symptoms of hyperthyroidism - CORRECT ANSWER -*treats symptoms and
not the hyperthyroidism itself.
beta blockers (metoprolol) to treat tachycardia
Absorption of levothyroxine REDUCED by: - CORRECT ANSWER -histamine 2 receptor blockers
(tagamet), proton pump inhibitors (lansoprazole), sucralfate (carafate), Cholestyramine
(Questran), Colestipol (colestid), aluminum containing antacids (mylanta, maalox), calcium
supplements (tums), iron supplements, magnesium salts, orlistat.
*4 hours between levothyroxine and the above meds is recommended as well as food
Metabolism of levothyroxine ACCELERATED by: - CORRECT ANSWER -phenytoin (dilantin),
Carbamazepine (Tegratol, Caratrol), Rifampin (Rifadin), Sertraline (Zoloft), Phenobarbital.
*patients taking these medications will need to have dose of levothyroxine increased.
Warfarin & Levothyroxine - CORRECT ANSWER -levothyroxine accelerates degradation of
vitamin k dependent clotting factors, may need to reduce the dose of warfarin.
Catecholamines - CORRECT ANSWER -increase cardiac responsiveness - at an increased risk of
catecholamine induced dysrhythmia.
Digoxin and insulin - may need to be increased if pt. is taking levothyroxine.
How to confirm diagnosis of diabetes - CORRECT ANSWER -Hemoglobin A1C > 6.5 %
Fasting plasma glucose > 126 mg/dL
Random plasma glucose > 200 mg/dL plus symptoms of diabetes
Oral glucose tolerance test (OGTT): 2-h plasma glucose > 200 mg/dL
A1C - CORRECT ANSWER -goals: less than 7%, less than 8% in patients with severe
hypoglycemia, limited life expectancy, or advanced microvascular or macrovascular
complications.
