Nur200 UPDATED ACTUAL Questions and CORRECT Answers
HyperThyroid aka thyrotoxicosis
Hyperthyroidism Thyroid gland makes too much thyroid hormone
hyperthyroidism results in INC or DEC sympathetic NS,
INC
BMR, CO?
-Graves disease
Hyperthyroid etiology -excess TSH
-toxic multinodular goiter
female, family Hx of Graves, inc iodine intake, 20-40 years
Hyperthyroid risk factors
of age
-heat intolerance
-emotional lability
-fine/loss of hair
-bulging eyes (exophthalmos)
-facial flushing
-enlarged thyroid
-tachycardia
-increased SBP
Hyperthyroid Clinical Manifestations
-finger clubbing
-breast enlargement
-weight loss
-tremors
-diarrhea
-menstrual changes
-muscle wasting
-localized edema
an autoimmune disorder that is caused by hyperthy-
Graves disease roidism and is characterized by goiter and/or exophthal-
mos
Graves disease symptoms
,anxiety, irritability, fatigue, rapid or irregular heartbeat,
fine tremor, sensitivity to heat, enlargement of thyroid,
weight loss, change in menstrual cycle, ED, reduced li-
bido, frequent BM, bulging eyes, pretibial myxedema
(red, shiny shins)
One+ nodules in a multinodular goiter become TSH-se-
creting
-develops slowly
Toxic multinodular goiter (Plummer Disease) -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 pituitary adenomas
inflammation of the thyroid gland, usually viral infection.
thyroiditis acutely, leads to inc TH (hyperthyroid). chronically, leads
to dec TH (hypothyroid).
euthyroid normal thyroid function
Diagnostic test used to measure levels of thyroid antibod-
ies that are diagnostic for autoimmune thyroid disease.
Thyroid antibody test NR- none- 1:20
INC --->Graves (hyperthyroid)
However, NR in hypothyroid
Diagnostic test to measure the level of thyroid-stimulating
hormone in the blood. NR- 0.35-5.5mu/mL
TSH test DEC - primary hyperthyroidism
INC - secondary hyperthyroidism
INC - primary hypothyroid
Thyroxine (T4) test
, NR- 4.5-11.5 mcg/dL
INC - hyperthyroid
DEC - hypothyroid
NR- 70-205ng/dL
T3 (triiodothyronine) test INC - hyperthyroid
DEC - hypothyroid
Graves disease results in a chronic excess production of
(T3 and T4) Thyroid Hormones
what?
25-35% is normal, INC in hyperthyroidism, DEC in hy-
T3 uptake
pothyroidism
Radioactive iodide uptake - measures how much iodide
RAI uptake
goes into the thyroid gland. INC - Graves
Methimazole (Tapazole)
Propylthiouracil (PTU)
antithyroid drugs
**treat with beta-blockers (-olol drugs) until the antithy-
roid drugs start to work in about 2 weeks***
most dangerous is liver and bone marrow toxicity
Antithyroid drugs adverse effects -monitor CBC for low values, leukopenia, thrombocytope-
nia, hepatotoxicity liver panel
Thrombocytopenia low platelet count
Leukopenia Abnormally low white blood cell count
-give w food at same time of day
-don't stop abruptly
-may need to INC anticoagulants
antithyroid drug teaching
-avoid high iodine food (seafood, tofu, soy sauce, iodized
salt)
-may take several weeks (up to 2) to work
RAI therapy
HyperThyroid aka thyrotoxicosis
Hyperthyroidism Thyroid gland makes too much thyroid hormone
hyperthyroidism results in INC or DEC sympathetic NS,
INC
BMR, CO?
-Graves disease
Hyperthyroid etiology -excess TSH
-toxic multinodular goiter
female, family Hx of Graves, inc iodine intake, 20-40 years
Hyperthyroid risk factors
of age
-heat intolerance
-emotional lability
-fine/loss of hair
-bulging eyes (exophthalmos)
-facial flushing
-enlarged thyroid
-tachycardia
-increased SBP
Hyperthyroid Clinical Manifestations
-finger clubbing
-breast enlargement
-weight loss
-tremors
-diarrhea
-menstrual changes
-muscle wasting
-localized edema
an autoimmune disorder that is caused by hyperthy-
Graves disease roidism and is characterized by goiter and/or exophthal-
mos
Graves disease symptoms
,anxiety, irritability, fatigue, rapid or irregular heartbeat,
fine tremor, sensitivity to heat, enlargement of thyroid,
weight loss, change in menstrual cycle, ED, reduced li-
bido, frequent BM, bulging eyes, pretibial myxedema
(red, shiny shins)
One+ nodules in a multinodular goiter become TSH-se-
creting
-develops slowly
Toxic multinodular goiter (Plummer Disease) -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 pituitary adenomas
inflammation of the thyroid gland, usually viral infection.
thyroiditis acutely, leads to inc TH (hyperthyroid). chronically, leads
to dec TH (hypothyroid).
euthyroid normal thyroid function
Diagnostic test used to measure levels of thyroid antibod-
ies that are diagnostic for autoimmune thyroid disease.
Thyroid antibody test NR- none- 1:20
INC --->Graves (hyperthyroid)
However, NR in hypothyroid
Diagnostic test to measure the level of thyroid-stimulating
hormone in the blood. NR- 0.35-5.5mu/mL
TSH test DEC - primary hyperthyroidism
INC - secondary hyperthyroidism
INC - primary hypothyroid
Thyroxine (T4) test
, NR- 4.5-11.5 mcg/dL
INC - hyperthyroid
DEC - hypothyroid
NR- 70-205ng/dL
T3 (triiodothyronine) test INC - hyperthyroid
DEC - hypothyroid
Graves disease results in a chronic excess production of
(T3 and T4) Thyroid Hormones
what?
25-35% is normal, INC in hyperthyroidism, DEC in hy-
T3 uptake
pothyroidism
Radioactive iodide uptake - measures how much iodide
RAI uptake
goes into the thyroid gland. INC - Graves
Methimazole (Tapazole)
Propylthiouracil (PTU)
antithyroid drugs
**treat with beta-blockers (-olol drugs) until the antithy-
roid drugs start to work in about 2 weeks***
most dangerous is liver and bone marrow toxicity
Antithyroid drugs adverse effects -monitor CBC for low values, leukopenia, thrombocytope-
nia, hepatotoxicity liver panel
Thrombocytopenia low platelet count
Leukopenia Abnormally low white blood cell count
-give w food at same time of day
-don't stop abruptly
-may need to INC anticoagulants
antithyroid drug teaching
-avoid high iodine food (seafood, tofu, soy sauce, iodized
salt)
-may take several weeks (up to 2) to work
RAI therapy
