NR 565 EXAM 2 2025– 2026 (Combined) EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS GRADED
D A+
O
N
O
T
C
Hypothyroidism - ANSWER-underproduction of the hormone thyroxine
(T4) (yellow)
O
Too little thyroxine=slower metabolism
PY
fatigue, depressed mood, slow heart rate, constipation, weight gain,
and irregular menstrual periods.
MC in >60 women
What active hormones are produced by the thyroid? -
ANSWERtriiodothyronine (T3) and thyroxine (T4, tetraiodothyronine)
,4 steps to synthesis of thyroid hormoness - ANSWER-1. Uptake
2. Activation (Oxidation by peroxidase)
3. Iodination of Tyrosine
4. Coupling of Iodinated Tyrosine
3 Principle Actions of Thyroid Hormones - ANSWER-(1) stimulation of
energy use
D
(2) stimulation of the heart
O
(3) promotion of growth and development
N
Most sensitive method for diagnosing hypothyroidism - ANSWER-Serum
O
TSH
T
Levothyroxine Dosage in adults - ANSWER-100-125ug for 70kg adult
C
ORAL
O
Older adults- start at 25-50ug daily
PY
Levothyroxine dose in Myxedema Coma - ANSWER-200-500 ug once
INJECTION
Addition dose of 100-300 ug can be given a day later
Levothyroxine dose for Congenital Hypothyroidism - ANSWER-<3mo:
10-15mg/kg
,3-5mo: 8-10mg/kg
6-11mo: 6-8mg/kg
1-5yrs: 5-6mg/kg
6-12 yrs: 4-5mg/kg
ORAL
Dose DECREASES with age.
Dose adjusted to normalize TSH and free T4
D
O
Levothyroxine dose for simple goiter - ANSWER-100-200ug
N
ORAL
O
Baseline data for levothyroxine - ANSWER-Serum levels of TSH and free
T
T4
C
O
What are thionamide drugs - ANSWER-For hyperthyroidism
PY
ex. methimazole and propylthiouracil (PTU) Suppresses
synthesis of thyroid hormones long term-hyperthyroidism
short-term- subtotal thyroidectomy or tx with radioactive iodine
Frequency of therapy for Methimazole and Propylthiouracil -
ANSWERMethimazole: Initial therapy-3 times a day
Maintenance therapy- Once a day
, Propyltiouracil:
Initial therapy- 3 or 4 times a day
Maintenance therapy- 2 or 3 times a day
What is a first-line drug for hyperthyroidism - ANSWER-Methimazole
(Tapazole)
D
Hyperthyroidism - ANSWER-overproduction of thyroid hormones:
triiodothyronine (T3) (green), and thyroxine (T4) (yellow)
O
N
Methimazole - ANSWER-inhibits thyroid hormone synthesis--> DOES
O
NOT DESTROY EXISTING STORES OF THYROID HORMONE
T
SAFER and more convenient than PTU and preferred more
C
EXCEPT in those who are pregnant or breastfeeding and those who are
O
in thyrotoxic crisis
PY
May take 3-12 weeks to produce euthyroid state
Baseline data for methimazole - ANSWER-Obtain serum levels of
thyroid-stimulating hormone (TSH), free triiodothyronine (T3), and free
thyroxine (T4). Check baseline CBC and LFTs prior to initiation.
QUESTIONS AND CORRECT VERIFIED ANSWERS GRADED
D A+
O
N
O
T
C
Hypothyroidism - ANSWER-underproduction of the hormone thyroxine
(T4) (yellow)
O
Too little thyroxine=slower metabolism
PY
fatigue, depressed mood, slow heart rate, constipation, weight gain,
and irregular menstrual periods.
MC in >60 women
What active hormones are produced by the thyroid? -
ANSWERtriiodothyronine (T3) and thyroxine (T4, tetraiodothyronine)
,4 steps to synthesis of thyroid hormoness - ANSWER-1. Uptake
2. Activation (Oxidation by peroxidase)
3. Iodination of Tyrosine
4. Coupling of Iodinated Tyrosine
3 Principle Actions of Thyroid Hormones - ANSWER-(1) stimulation of
energy use
D
(2) stimulation of the heart
O
(3) promotion of growth and development
N
Most sensitive method for diagnosing hypothyroidism - ANSWER-Serum
O
TSH
T
Levothyroxine Dosage in adults - ANSWER-100-125ug for 70kg adult
C
ORAL
O
Older adults- start at 25-50ug daily
PY
Levothyroxine dose in Myxedema Coma - ANSWER-200-500 ug once
INJECTION
Addition dose of 100-300 ug can be given a day later
Levothyroxine dose for Congenital Hypothyroidism - ANSWER-<3mo:
10-15mg/kg
,3-5mo: 8-10mg/kg
6-11mo: 6-8mg/kg
1-5yrs: 5-6mg/kg
6-12 yrs: 4-5mg/kg
ORAL
Dose DECREASES with age.
Dose adjusted to normalize TSH and free T4
D
O
Levothyroxine dose for simple goiter - ANSWER-100-200ug
N
ORAL
O
Baseline data for levothyroxine - ANSWER-Serum levels of TSH and free
T
T4
C
O
What are thionamide drugs - ANSWER-For hyperthyroidism
PY
ex. methimazole and propylthiouracil (PTU) Suppresses
synthesis of thyroid hormones long term-hyperthyroidism
short-term- subtotal thyroidectomy or tx with radioactive iodine
Frequency of therapy for Methimazole and Propylthiouracil -
ANSWERMethimazole: Initial therapy-3 times a day
Maintenance therapy- Once a day
, Propyltiouracil:
Initial therapy- 3 or 4 times a day
Maintenance therapy- 2 or 3 times a day
What is a first-line drug for hyperthyroidism - ANSWER-Methimazole
(Tapazole)
D
Hyperthyroidism - ANSWER-overproduction of thyroid hormones:
triiodothyronine (T3) (green), and thyroxine (T4) (yellow)
O
N
Methimazole - ANSWER-inhibits thyroid hormone synthesis--> DOES
O
NOT DESTROY EXISTING STORES OF THYROID HORMONE
T
SAFER and more convenient than PTU and preferred more
C
EXCEPT in those who are pregnant or breastfeeding and those who are
O
in thyrotoxic crisis
PY
May take 3-12 weeks to produce euthyroid state
Baseline data for methimazole - ANSWER-Obtain serum levels of
thyroid-stimulating hormone (TSH), free triiodothyronine (T3), and free
thyroxine (T4). Check baseline CBC and LFTs prior to initiation.
