uta 5335 endrocrine and neuro with 100% correct answers(verified for accuracy)

hypothyroidism clinical state resulting from a reduction in the amount of circulating free thyroid hormone, or from resistance to the action of thyroid hormone hypothyroidism risk factors increasing age family hx postpartum hypothalmic ds autoimmune ds hx of head and neck irradiation txment of hyperthyroidism surgical removal of thyroid gland txment w/ lithium, interferon, amiodarone Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:00 / 0:15 Full screen Brainpower Read More hypothyroidism presentation lethargy wt gain swelling of hands and feet periorbital edema intolerance to cold constipation menstrual irregularities, decreased libido, infertility memory loss depression, dull facial expression muscle cramps, arthralgias, paresthesias lethargy, delayed DTRs coarse dry skin, hair loss from body and scalp, brittle nails bradycardia, enlarged hrt, reduced BP anemia, hyponatremia, hyperlipidemia decreased sweating hypothyroidism labs High TSH Low T4 Low or normal T3 subclinical hypothyroidism labs high TSH, normal T4 Levothyroixine drug of choice for hypothyroidism plant based replaces T4 levoxyl, synthroid, levothyroid levothyroxine dosing -dose w/ 1.6-1.8 mcg/kg/day -for patients over 65 or patients over 50 with cardiac disease dose is 25 mcg - adults maintenance: 50-200 mcg daily - infants: 6-15 mcg/kg/day based on age - children: 4-6 mcg/kg/day based on age <12 2-3 mcg/kg/d, >12 adult dose - check levels in 6 wks then Q 6wks until goal and then annually - TSH determines drug adjustment drugs that interfere a/ levothyroixine questran, ferrous sulfate carafate, calcium antacids anticonvulsants rifampin sertaline levothyroixine adverse effects palpitations appetite increasing tachycardia nervousness tremor wt loss diarrhea abdominal cramps fever N/V levothyroxine precautions MI adrenal insufficiency cardiovascular ds DM elderly levothyroxine in pregnancy -dose requires 25-50% increase in first trimester starting at 8 wks - assess every 4 wks during first 1/2 of preg - TSH goals trimester 1: 0.1-2.5, trimester 2: .2-3, trimester 3 =: .3-3 - reduce to prepreg dose immediately after birth What lab do you check in a patient with new onset afib? check thyroid level Thyroid Labs TSH .35-5 T4 4-12 Subclinical hypothyroidism - treat w/ low dose if symptomatic - otherwise check every 3 months - if symptomatic or TSH>10 then start with 25 mcg too much thyroid can cause what cardiac issue? atrial fibrillation hyperthyroidism - clinical state that results when the bodys tissues are exposed to an increased level of circulating thyroid hormone Most common cause of hyperthyroidism Graves disease painless or transient thyroiditis toxic adenoma toxic multinodular goiter E less common cause of hyperthyroidism drug induced thyroiditis (amiodarone) hyperemesis gravidarum post partum thyroiditis subacute granulomatous thyroiditis hyperthyroidism risk factors family hx female thyroid replacement other autoimmune ds down syndrome iodine def viral illness, stress, smoking palpitations, tachycardia, heat intolerance, afib, onycholysis, hyperpigmentation, weight loss, brisk reflexes, anxiety, rapid speech, insomnia, eye irritation, exopthalamos, periorbital edema, reduced color perception are all symptoms of__________________ hyperthyroidism what type of tests are performed prior to giving any thyroid medication? CBC and LFTs what beta blockers are given with the management of hyperthyroidism? -atenolol 25-100 mg daily - propanolol 10-40 mg Q 8 hours or extended release 80-160 daily what antithyroid medications are given? methmizole 5-120 mg d in divided doses - cannot be given in first trimester of preg propylthiouracil 50-300 mg Q8h - high risk of liver failure but is best choice w/ preg radioactive iodine - contraindicated in severe Graves orbitopathy and preg What are the side effects for methmizole? severe: agranulocytosis, leukopenia, thrombocytopenia, nephritis common: rash, urticaria, N/V, dyspepsia, alopecia, HA, drowsiness what are the side effects for proplythyuracil? severe: hepatotoxicity, aplastic anemia, thrombocytopenia common: rash, pruritus, urticaria, fever, taste disturbance N/V thyroid nodules mass that is discrete and may fxn w/o influence from pituitary gland - hot rarely malignant so can be watched - cold need bx iodine deficiency, exposure to radiation, hx of radiation to head, neck or chest, family hx, use of iodine containing drugs or supplements are all risk fcts for? thyroid nodule