NURS 623 - EXAM 2
Anti-thyroid antibodies. Which one is more specific? – answer antimicrosomal (anti-
TPO) antibodies or anti-thyroglobulin antibodies. Anti-TPO is more specific.
T3 – answer Triidothyronine
T4 – answer Thyroxine
How are T3 and T4 related? - answerT3 is more biologically active. T4 is converted to
T3 in peripheral tissues.
TSH - answerthyroid stimulating hormone - produced by pituitary gland
Grave's disease - answeran autoimmune disorder that is caused by hyperthyroidism
and is characterized by goiter and/or exophthalmos
Grave's disease - TSH would be ____ and T3/T4 would be ___ - answerlow, high
Hashimoto's disease - answeran autoimmune disease in which the body's own
antibodies attack and destroy the cells of the thyroid gland
Hashimoto's disease - TSH would be ____ and T3/T4 would be ___ - answerhigh, low
In a pituitary abnormality, you would expect to see the TSH ___ and the T3/T4 ___. -
answerlow, low
What is the test that assesses the functional status (hot and cold spots) of the thyroid
gland? - answerNuclear scintigraphy - 24hr radioactive iodine uptake (RAIU) test.
- Pts with toxic nodular goiter and Grave's disease have a high RAIU, whereas in
subacute thyroiditis, iodine uptake is low.
Anti-thyroid medications - answer-inhibit the synthesis of thyroid hormones.
- They are used as a primary treatment to reduce the level of thyroid hormone on the
initiation of radioactive iodine therapy, as well as before after thyroid surgery.
-Methimazole (MMI)
-PTU (propylthiouracil)
May take 2-8 wks for effect
Drug of choice for pregnant woman with hyperthyroidism - answerpropylthiouracil (PTU)
(less likely to cross the placenta than methimazole (MMI))
, Common adverse reactions to antithyroid medications - answerrash, urticaria,
arthralgias
rare but serious: angranulocytosis, aplastic anemia, and hepatitis
what is an "ablative dose" for Grave's disease? - answerA 24hr radioactive iodine-131
uptake dose of 75-200 mcCi is administered orally, which concentrates in overactive
thyroid cells, where it emits radiation, causing inflammation and the ultimate destruction
of the pathological cells.
Treatment of choice for hyperthyroidism in the US, especially in middle-aged or older
adults - answerRadioactive iodine-131
Treatment for hyperthyroidism contraindicated in pregnancy - answerRadioactive iodine
How long will the pt require thyroid replacement therapy after ablative radioactive
treatment for hyperthyroidism>? - answerIf the treatment regimen has produced a state
of hypothyroidism, the pt should be informed that thyroid hormone replacement therapy
must continue for life.
After radio ablative therapy, how often should thyroid function tests be performed? -
answer4-6 wks, 12 wks, 6 mo, and annually thereafter
Usual dose of Levothyroxine according to the AACE - answer1.6mcg/kg per day for full
replacement. Otherwise healthy patients younger than 60yo may receive 50-100 mcg
daily as a full replacement.
What to avoid when taking levothyroxine - answersome meds and mineral supplements
taken at the same time
When should levothyroxine be taken? - answerin the AM to avoid insomnia
How would you alter the dose for initiating synthetic thyroid replacement with an older pt
with hx of cardiac issues? - answerShould begin with 1/2 of the expected replacement
dose or 25-50 much/day orally, increasing the dose gradually by 25 mcg/day once every
4-6 weeks.
Major symptoms of thyroid cancer - answerlump or nodule in the neck, which is usually
painless. Pts may also c/o a tight or full feeling in the neck, difficulty breathing or
swallowing, hoarseness, hemoptysis (may indicated invasiveness), and swollen lymph
nodes. Neck pain is usually a late symptom.
What is the reliable method of diagnosis of thyroid CA? - answerONLY A BIOPSY can
rule in malignancy
Anti-thyroid antibodies. Which one is more specific? – answer antimicrosomal (anti-
TPO) antibodies or anti-thyroglobulin antibodies. Anti-TPO is more specific.
T3 – answer Triidothyronine
T4 – answer Thyroxine
How are T3 and T4 related? - answerT3 is more biologically active. T4 is converted to
T3 in peripheral tissues.
TSH - answerthyroid stimulating hormone - produced by pituitary gland
Grave's disease - answeran autoimmune disorder that is caused by hyperthyroidism
and is characterized by goiter and/or exophthalmos
Grave's disease - TSH would be ____ and T3/T4 would be ___ - answerlow, high
Hashimoto's disease - answeran autoimmune disease in which the body's own
antibodies attack and destroy the cells of the thyroid gland
Hashimoto's disease - TSH would be ____ and T3/T4 would be ___ - answerhigh, low
In a pituitary abnormality, you would expect to see the TSH ___ and the T3/T4 ___. -
answerlow, low
What is the test that assesses the functional status (hot and cold spots) of the thyroid
gland? - answerNuclear scintigraphy - 24hr radioactive iodine uptake (RAIU) test.
- Pts with toxic nodular goiter and Grave's disease have a high RAIU, whereas in
subacute thyroiditis, iodine uptake is low.
Anti-thyroid medications - answer-inhibit the synthesis of thyroid hormones.
- They are used as a primary treatment to reduce the level of thyroid hormone on the
initiation of radioactive iodine therapy, as well as before after thyroid surgery.
-Methimazole (MMI)
-PTU (propylthiouracil)
May take 2-8 wks for effect
Drug of choice for pregnant woman with hyperthyroidism - answerpropylthiouracil (PTU)
(less likely to cross the placenta than methimazole (MMI))
, Common adverse reactions to antithyroid medications - answerrash, urticaria,
arthralgias
rare but serious: angranulocytosis, aplastic anemia, and hepatitis
what is an "ablative dose" for Grave's disease? - answerA 24hr radioactive iodine-131
uptake dose of 75-200 mcCi is administered orally, which concentrates in overactive
thyroid cells, where it emits radiation, causing inflammation and the ultimate destruction
of the pathological cells.
Treatment of choice for hyperthyroidism in the US, especially in middle-aged or older
adults - answerRadioactive iodine-131
Treatment for hyperthyroidism contraindicated in pregnancy - answerRadioactive iodine
How long will the pt require thyroid replacement therapy after ablative radioactive
treatment for hyperthyroidism>? - answerIf the treatment regimen has produced a state
of hypothyroidism, the pt should be informed that thyroid hormone replacement therapy
must continue for life.
After radio ablative therapy, how often should thyroid function tests be performed? -
answer4-6 wks, 12 wks, 6 mo, and annually thereafter
Usual dose of Levothyroxine according to the AACE - answer1.6mcg/kg per day for full
replacement. Otherwise healthy patients younger than 60yo may receive 50-100 mcg
daily as a full replacement.
What to avoid when taking levothyroxine - answersome meds and mineral supplements
taken at the same time
When should levothyroxine be taken? - answerin the AM to avoid insomnia
How would you alter the dose for initiating synthetic thyroid replacement with an older pt
with hx of cardiac issues? - answerShould begin with 1/2 of the expected replacement
dose or 25-50 much/day orally, increasing the dose gradually by 25 mcg/day once every
4-6 weeks.
Major symptoms of thyroid cancer - answerlump or nodule in the neck, which is usually
painless. Pts may also c/o a tight or full feeling in the neck, difficulty breathing or
swallowing, hoarseness, hemoptysis (may indicated invasiveness), and swollen lymph
nodes. Neck pain is usually a late symptom.
What is the reliable method of diagnosis of thyroid CA? - answerONLY A BIOPSY can
rule in malignancy
