Nur200 Exam With Complete Solution
HyperThyroid aka - Answer thyrotoxicosis
Hyperthyroidism - Answer Thyroid gland makes too much thyroid hormone
hyperthyroidism results in INC or DEC sympathetic NS, BMR, CO? - Answer INC
Hyperthyroid etiology - Answer -Graves disease
-excess TSH
-toxic multinodular goiter
Hyperthyroid risk factors - Answer female, family Hx of Graves, inc iodine intake, 20-40
years of age
Hyperthyroid Clinical Manifestations - Answer -heat intolerance
-emotional lability
-fine/loss of hair
-bulging eyes
-facial flushing
-enlarged thyroid
-tachycardia
-increased SBP
-finger clubbing
-breast enlargement
-weight loss
,-tremors
-diarrhea
-menstrual changes
-muscle wasting
-localized edema
Graves disease - Autoimmune disorder caused by hyperthyroidism with symptoms
including: goiter and/or exophthalmos
Symptoms of Graves disease - Anxiety, irritability, fatigue, rapid or irregular heartbeat,
fine tremor, sensitivity to heat, enlargement of thyroid, weight loss, change in menstrual
cycle, ED, reduced libido, frequent BM, bulging eyes, pretibial myxedema (red, shiny
shins)
Toxic multinodular goiter (Plummer Disease) - Answer One+ nodules in a multinodular
goiter become TSH-secreting
-develops slowly
-most common in postmenopausal women
Distinction from Graves: no exophthalmos or pretibial myxedema
May present as hyper or hypo*
Excess TSH is a rare cause of hyperthyroidism caused by - Answer pituitary adenomas
thyroiditis - Answer inflammation of the thyroid gland, usually viral infection. acutely,
leads to inc TH (hyperthyroid). chronically, leads to dec TH (hypothyroid).
euthyroid - Answer normal thyroid function
Thyroid antibody test - Answer Diagnostic test used to measure levels of thyroid
antibodies that are diagnostic for autoimmune thyroid disease. NR- none- 1:20
,INC --->Graves (hyperthyroid)
However, NR in hypothyroid
TSH test - Answer Diagnostic test to measure the level of thyroid-stimulating hormone in
the blood. NR- 0.35-5.5mu/mL
DEC - primary hyperthyroidism
INC - secondary hyperthyroidism
INC - primary hypothyroid
Thyroxine (T4) test - Answer NR- 4.5-11.5 mcg/dL
INC - hyperthyroid
DEC - hypothyroid
T3 (triiodothyronine) test - Answer NR- 70-205ng/dL
INC - hyperthyroid
DEC - hypothyroid
(T3 and T4) Thyroid Hormones - Answer Graves disease results in a chronic excess
production of what?
T3 uptake - Answer 25-35% is normal, INC in hyperthyroidism, DEC in hypothyroidism
RAI uptake - Answer Radioactive iodide uptake - measures how much iodide goes into
the thyroid gland. INC - Graves
antithyroid drugs - Answer Methimazole (Tapazole)
Propylthiouracil (PTU)
**treat with beta-blockers (-olol drugs) until the antithyroid drugs start to work in about
2 weeks***
, Antithyroid drugs adverse effects - Answer most dangerous is liver and bone marrow
toxicity
-monitor CBC for low values, leukopenia, thrombocytopenia, hepatotoxicity liver panel
Thrombocytopenia - Answer low platelet count
Leukopenia - Answer Abnormally low white blood cell count
antithyroid drug teaching - Answer -give w food at same time of day
-don't stop abruptly
-may need to INC anticoagulants
-avoid high iodine food-(seafood, tofu, soy sauce, iodized salt)
-may take several wks (up to 2) to work
RAI therapy - Answer -destroys thyroid cells
-one dose may be sufficient w/results in 6-8 wks
-usually not hospitalized
-contraindicated in pregnancy
-may develop hypothyroidism
-adverse reactions: cardiac instability, thyroiditis
Thyroid storm - Answer increased temp, pulse and HTN
agitation, tremors, confusion, psychosis, seizures
Thyroid storm treatment? - ANS beta-blockers, PTU, cooling agents, NO ASPIRIN, IV
fluids
HyperThyroid aka - Answer thyrotoxicosis
Hyperthyroidism - Answer Thyroid gland makes too much thyroid hormone
hyperthyroidism results in INC or DEC sympathetic NS, BMR, CO? - Answer INC
Hyperthyroid etiology - Answer -Graves disease
-excess TSH
-toxic multinodular goiter
Hyperthyroid risk factors - Answer female, family Hx of Graves, inc iodine intake, 20-40
years of age
Hyperthyroid Clinical Manifestations - Answer -heat intolerance
-emotional lability
-fine/loss of hair
-bulging eyes
-facial flushing
-enlarged thyroid
-tachycardia
-increased SBP
-finger clubbing
-breast enlargement
-weight loss
,-tremors
-diarrhea
-menstrual changes
-muscle wasting
-localized edema
Graves disease - Autoimmune disorder caused by hyperthyroidism with symptoms
including: goiter and/or exophthalmos
Symptoms of Graves disease - Anxiety, irritability, fatigue, rapid or irregular heartbeat,
fine tremor, sensitivity to heat, enlargement of thyroid, weight loss, change in menstrual
cycle, ED, reduced libido, frequent BM, bulging eyes, pretibial myxedema (red, shiny
shins)
Toxic multinodular goiter (Plummer Disease) - Answer One+ nodules in a multinodular
goiter become TSH-secreting
-develops slowly
-most common in postmenopausal women
Distinction from Graves: no exophthalmos or pretibial myxedema
May present as hyper or hypo*
Excess TSH is a rare cause of hyperthyroidism caused by - Answer pituitary adenomas
thyroiditis - Answer inflammation of the thyroid gland, usually viral infection. acutely,
leads to inc TH (hyperthyroid). chronically, leads to dec TH (hypothyroid).
euthyroid - Answer normal thyroid function
Thyroid antibody test - Answer Diagnostic test used to measure levels of thyroid
antibodies that are diagnostic for autoimmune thyroid disease. NR- none- 1:20
,INC --->Graves (hyperthyroid)
However, NR in hypothyroid
TSH test - Answer Diagnostic test to measure the level of thyroid-stimulating hormone in
the blood. NR- 0.35-5.5mu/mL
DEC - primary hyperthyroidism
INC - secondary hyperthyroidism
INC - primary hypothyroid
Thyroxine (T4) test - Answer NR- 4.5-11.5 mcg/dL
INC - hyperthyroid
DEC - hypothyroid
T3 (triiodothyronine) test - Answer NR- 70-205ng/dL
INC - hyperthyroid
DEC - hypothyroid
(T3 and T4) Thyroid Hormones - Answer Graves disease results in a chronic excess
production of what?
T3 uptake - Answer 25-35% is normal, INC in hyperthyroidism, DEC in hypothyroidism
RAI uptake - Answer Radioactive iodide uptake - measures how much iodide goes into
the thyroid gland. INC - Graves
antithyroid drugs - Answer Methimazole (Tapazole)
Propylthiouracil (PTU)
**treat with beta-blockers (-olol drugs) until the antithyroid drugs start to work in about
2 weeks***
, Antithyroid drugs adverse effects - Answer most dangerous is liver and bone marrow
toxicity
-monitor CBC for low values, leukopenia, thrombocytopenia, hepatotoxicity liver panel
Thrombocytopenia - Answer low platelet count
Leukopenia - Answer Abnormally low white blood cell count
antithyroid drug teaching - Answer -give w food at same time of day
-don't stop abruptly
-may need to INC anticoagulants
-avoid high iodine food-(seafood, tofu, soy sauce, iodized salt)
-may take several wks (up to 2) to work
RAI therapy - Answer -destroys thyroid cells
-one dose may be sufficient w/results in 6-8 wks
-usually not hospitalized
-contraindicated in pregnancy
-may develop hypothyroidism
-adverse reactions: cardiac instability, thyroiditis
Thyroid storm - Answer increased temp, pulse and HTN
agitation, tremors, confusion, psychosis, seizures
Thyroid storm treatment? - ANS beta-blockers, PTU, cooling agents, NO ASPIRIN, IV
fluids
