Pharmacology for Advanced Practice |\ |\ |\ |\
Nurses Exam 4 questions with answers |\ |\ |\ |\ |\
Role of thyroid gland
|\ |\ |\
Controls the metabolic rate of the body
|\ |\ |\ |\ |\ |\
Thyroid gland feedback |\ |\
Hypothalamus produces TRH which stimulates the anterior |\ |\ |\ |\ |\ |\ |\
pituitary to produce TSH
|\ |\ |\
TSH induces the thyroid to produce and secrete T3 and T4
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Follicular cells within the thyroid produce T3 and T4
|\ |\ |\ |\ |\ |\ |\ |\
Parafollicular cells produce calcitonin |\ |\ |\
Thyroid hormones regulate basal metabolic rate and impact the
|\ |\ |\ |\ |\ |\ |\ |\ |\
function of almost ALL major organ systems
|\ |\ |\ |\ |\ |\
Autoimmune disorders of thyroid gland |\ |\ |\ |\
Can stimulate overproduction of thyroid hormones
|\ |\ |\ |\ |\ |\
(thyrotoxicosis) or cause glandular destruction and hormone |\ |\ |\ |\ |\ |\ |\
deficiency (hypothyroidism) |\
Thyroid Gland produces two hormones
|\ |\ |\ |\
Thyroxine (T4) |\
Triiodothyronine (T3) |\
Iodine and thyroid function
|\ |\ |\
Essential for thyroid hormone production (T3 and T4).
|\ |\ |\ |\ |\ |\ |\
Hormones contain about 60-65% of iodine.
|\ |\ |\ |\ |\
,No iodine = no thyroid hormone production
|\ |\ |\ |\ |\ |\
Nontoxic goiter |\ |\
There is a large presence of nontoxic goiter global prevalence
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
related to iodine deficiency.
|\ |\ |\
To treat, iodine supplementation is used because it is well
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
absorbed.
Hypothyroidism: Incidence and Prevalence |\ |\ |\
Affects over 1% of the general population and about 5% of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
individuals > age 60 |\ |\ |\
More common in women than men
|\ |\ |\ |\ |\
Affects almost all body systems and functions
|\ |\ |\ |\ |\ |\
Degree of severity ranges from mild and unrecognized to severe
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
myxedema.
Primary Hypothyroidism |\
DUE TO THYROID GLAND DISEASE
|\ |\ |\ |\
Abnormality in the thyroid gland itself/due to thyroid disease. |\ |\ |\ |\ |\ |\ |\ |\ |\
Elevated TSH |\
Decrease Free T4 |\ |\
Primary hypothyroidism feedback |\ |\
Increased TSH because the pituitary is needing more hormone
|\ |\ |\ |\ |\ |\ |\ |\ |\
from the thyroid. Thyroid stimulating hormone is being pumped
|\ |\ |\ |\ |\ |\ |\ |\ |\
out, but the gland is not responding to it. Leading to increased
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
TSH and decreased free T4.
|\ |\ |\ |\
Secondary Hypothyroidism |\
,DUE TO LACK OF PITUITARY TSH
|\ |\ |\ |\ |\
Thyroid isn't being stimulated by pituitary to produce
|\ |\ |\ |\ |\ |\ |\
hormones/lack of pituitary TSH
|\ |\ |\ |\
Decreased TSH |\
Descreased Free T4 |\ |\
Secondary hypothyroidism feedback |\ |\
Due to a lack of pituitary TSH because the pituitary is not doing
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
its job by not producing the thyroid stimulating hormone leading
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
to a low TSH and also a low free T4.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Causes of Hypothyroidism with Goiter |\ |\ |\ |\
-Hashimoto thyroiditis |\
-Other types thyroiditis
|\ |\
-Iodine deficiency |\
-Peripheral resistance to thyroid hormone |\ |\ |\ |\
-Genetic thyroid enzyme defects |\ |\ |\
-Hepatitis C |\
Medications that cause hypothyroidism with goiter? |\ |\ |\ |\ |\
Lithium and Amiodarone |\ |\
Symptoms of Hypothyroidism |\ |\
EVERYTHING IS SLOWED DOWN |\ |\ |\
Weight gain |\
Fatigue
Depression
Cold intolerance|\
Constipation
Weakness
Dyspnea on exertion |\ |\
, Arthralgias
Muscle cramps |\
Paresthesias
Dry skin
|\
Headache
Carpal tunnel |\
Menorrhagia
Physical findings of Hypothyroidism |\ |\ |\
Bradycardia
Diastolic hypertension |\
Thin, brittle nails
|\ |\
Thinning hair |\
Peripheral edema, puffy face/eyes |\ |\ |\
Pale or yellow skin
|\ |\ |\
Delayed relaxation of DTRs |\ |\ |\
Possible goiter |\
Thin eye brows
|\ |\
Dull, expressionless face
|\ |\
Labs for Hypothyroidism
|\ |\
Decreased T4 |\
Normal or decreased T3 |\ |\ |\
Increased TSH |\
Treatment of Hypothyroidism |\ |\
Lifelong hormone replacement therapy with synthetic
|\ |\ |\ |\ |\ |\
levothyroxine
Levothyroxine (T4) |\
Nurses Exam 4 questions with answers |\ |\ |\ |\ |\
Role of thyroid gland
|\ |\ |\
Controls the metabolic rate of the body
|\ |\ |\ |\ |\ |\
Thyroid gland feedback |\ |\
Hypothalamus produces TRH which stimulates the anterior |\ |\ |\ |\ |\ |\ |\
pituitary to produce TSH
|\ |\ |\
TSH induces the thyroid to produce and secrete T3 and T4
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Follicular cells within the thyroid produce T3 and T4
|\ |\ |\ |\ |\ |\ |\ |\
Parafollicular cells produce calcitonin |\ |\ |\
Thyroid hormones regulate basal metabolic rate and impact the
|\ |\ |\ |\ |\ |\ |\ |\ |\
function of almost ALL major organ systems
|\ |\ |\ |\ |\ |\
Autoimmune disorders of thyroid gland |\ |\ |\ |\
Can stimulate overproduction of thyroid hormones
|\ |\ |\ |\ |\ |\
(thyrotoxicosis) or cause glandular destruction and hormone |\ |\ |\ |\ |\ |\ |\
deficiency (hypothyroidism) |\
Thyroid Gland produces two hormones
|\ |\ |\ |\
Thyroxine (T4) |\
Triiodothyronine (T3) |\
Iodine and thyroid function
|\ |\ |\
Essential for thyroid hormone production (T3 and T4).
|\ |\ |\ |\ |\ |\ |\
Hormones contain about 60-65% of iodine.
|\ |\ |\ |\ |\
,No iodine = no thyroid hormone production
|\ |\ |\ |\ |\ |\
Nontoxic goiter |\ |\
There is a large presence of nontoxic goiter global prevalence
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
related to iodine deficiency.
|\ |\ |\
To treat, iodine supplementation is used because it is well
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
absorbed.
Hypothyroidism: Incidence and Prevalence |\ |\ |\
Affects over 1% of the general population and about 5% of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
individuals > age 60 |\ |\ |\
More common in women than men
|\ |\ |\ |\ |\
Affects almost all body systems and functions
|\ |\ |\ |\ |\ |\
Degree of severity ranges from mild and unrecognized to severe
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
myxedema.
Primary Hypothyroidism |\
DUE TO THYROID GLAND DISEASE
|\ |\ |\ |\
Abnormality in the thyroid gland itself/due to thyroid disease. |\ |\ |\ |\ |\ |\ |\ |\ |\
Elevated TSH |\
Decrease Free T4 |\ |\
Primary hypothyroidism feedback |\ |\
Increased TSH because the pituitary is needing more hormone
|\ |\ |\ |\ |\ |\ |\ |\ |\
from the thyroid. Thyroid stimulating hormone is being pumped
|\ |\ |\ |\ |\ |\ |\ |\ |\
out, but the gland is not responding to it. Leading to increased
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
TSH and decreased free T4.
|\ |\ |\ |\
Secondary Hypothyroidism |\
,DUE TO LACK OF PITUITARY TSH
|\ |\ |\ |\ |\
Thyroid isn't being stimulated by pituitary to produce
|\ |\ |\ |\ |\ |\ |\
hormones/lack of pituitary TSH
|\ |\ |\ |\
Decreased TSH |\
Descreased Free T4 |\ |\
Secondary hypothyroidism feedback |\ |\
Due to a lack of pituitary TSH because the pituitary is not doing
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
its job by not producing the thyroid stimulating hormone leading
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
to a low TSH and also a low free T4.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Causes of Hypothyroidism with Goiter |\ |\ |\ |\
-Hashimoto thyroiditis |\
-Other types thyroiditis
|\ |\
-Iodine deficiency |\
-Peripheral resistance to thyroid hormone |\ |\ |\ |\
-Genetic thyroid enzyme defects |\ |\ |\
-Hepatitis C |\
Medications that cause hypothyroidism with goiter? |\ |\ |\ |\ |\
Lithium and Amiodarone |\ |\
Symptoms of Hypothyroidism |\ |\
EVERYTHING IS SLOWED DOWN |\ |\ |\
Weight gain |\
Fatigue
Depression
Cold intolerance|\
Constipation
Weakness
Dyspnea on exertion |\ |\
, Arthralgias
Muscle cramps |\
Paresthesias
Dry skin
|\
Headache
Carpal tunnel |\
Menorrhagia
Physical findings of Hypothyroidism |\ |\ |\
Bradycardia
Diastolic hypertension |\
Thin, brittle nails
|\ |\
Thinning hair |\
Peripheral edema, puffy face/eyes |\ |\ |\
Pale or yellow skin
|\ |\ |\
Delayed relaxation of DTRs |\ |\ |\
Possible goiter |\
Thin eye brows
|\ |\
Dull, expressionless face
|\ |\
Labs for Hypothyroidism
|\ |\
Decreased T4 |\
Normal or decreased T3 |\ |\ |\
Increased TSH |\
Treatment of Hypothyroidism |\ |\
Lifelong hormone replacement therapy with synthetic
|\ |\ |\ |\ |\ |\
levothyroxine
Levothyroxine (T4) |\
