UPDATED CORRECT ANSWERS 100%
What labs are used to diagnose Thyroid dysfunction? - correct answer ✔✔TSH, free T3, total T3,
free T4 and total T4.
Thyroid function in hypothyroidism? - correct answer ✔✔T3 and T4 are lower, TSH is higher.
Thyroid function in hyperthyroidism? - correct answer ✔✔TSH low, free T4 is normal and T3 is
high.
What is the timeframe for re-check of labs after starting Levothyroxine? - correct answer
✔✔Check TSH 6-8 weeks after initiating therapy and after dosage changes. Check TSH annually
once TSH is stablizied.
Signs and symptoms of hypothyroidism? - correct answer ✔✔Pale, puffy, expressionless face,
cold, dry skin, brittle hair, hair loss, low temperature/HR, lethargy, fatigue, constipation, weight
gain, intolerance to cold, menstruation impairment, thyroid enlargement.
Signs and symptoms of hyperthyroidism? - correct answer ✔✔Rapid strong heartbeat,
dysrhythmias, angina, CNS stimulation, nervousness, insomnia, rapid thought process, rapid
speech, skeletal muscles weaken, atrophy, metabolic rate increased, increased heat production,
increased body temperature, increased appetite, weight loss, exophthalmos.
What is the treatment of thyroid storm? - correct answer ✔✔High doses of potassium iodide or
strong iodine solution, methimazole suppresses hormone synthesis, beta blockers reduce heart
rate, sedation, cooling, and giving glucocorticoids and IV fluids can also help.
, First line treatment for hypothyroidism? - correct answer ✔✔Levothyroxine.
First line treatment for hyperthyroidism? - correct answer ✔✔Methimazole.
Why does the FDA recommend against using PTU as first line treatment of Thyroid storm? -
correct answer ✔✔Hepatic toxicity.
What can happen if hypothyroidism is not treated during pregnancy? - correct answer
✔✔Permanent neuropsychological deficits in the child, congenital hypothyroidism, decreased
IQ (mainly occurs during the 1st trimester and increases up to 50%).
What medication is used to treat symptoms associated with hyperthyroidism? - correct answer
✔✔Beta blockers to suppress tachycardia.
Medications that accelerate metabolism of Levothyroxine (may need to increase their
levothyroxine dosage)? - correct answer ✔✔phenytoin (Dilantin), carbamazepine (Tegretol,
Carbatrol), rifampin (Rifadin), sertraline (Zoloft).
Think about the CYP450 inducers that increase medication metabolism: CRAP GPS
Medications that reduce Levothyroxine absorption? - correct answer ✔✔Histamine 2 receptor
blockers (cimetidine [Tagamet], PPIs (lansoprazole [Prevacid], sucralfate [carafate], colestipol
[colestid]), aluminum containing antacids (Maalox, Mylanta), calcium supplements (Tums, Os-
cal), iron supplements (ferrous sulfate), magnesium salts, Orlistat (Xenical).
Medications whose metabolism is altered by Levothyroxine? - correct answer ✔✔Warfarin
(doses of medication may need to be reduced), catecholamines, insulin, digoxin (may need to
be increased).