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Flashcards in Thyroid disorders Deck (51)
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1
Q

which has a longer half life ? t4 or t 3?

A

T4

2
Q

which can have a negative feedback w/ TSH to decrease its production? t4 or t3?

A

T4

3
Q

in hyperthyroidism, levels of T4 vs TSH? (diagnosis)

A

t4 is high, tsh is low due to negative feedback

4
Q

in hypothyroidism, levels of t4 vs tsh? (diagnosis)

A

t4 is low, tsh is high

5
Q

sx of hypothyroidism ?

A
fatigue
weight gain  (slow metabolism
dry skin
hoarsness
coarse or loss of hair 
memory and mental impairment 
myalgias
HLD
depression
6
Q

what is the most common type of hypothyroidism?

A

Hashimoto’s: autominue attack of the thyroid gland

7
Q

what are the two most common agents that can cause hypothyroidism?

A

lithium and amiodarone

8
Q

what is a typical dose for starting levothyroxine in an elderly patient?

A

12.5 to 25 mcg daily

9
Q

what are the consequences of overdosing the levothyroxine?

A

causes atrial fibrillation and fractures

10
Q

when you start levothyroxine, how often should you mx levels?

A

q 6-8 weeks until normal levels, then in 6 mod, then every year

11
Q

about how much should you increase the dose of levothyroxine if a women becomes pregnant?

A

30-50% throughout the pregnancy. Even several months after birth of the child

12
Q

cytomel

A

liothyronine

13
Q

triostat

A

liothyronine

14
Q

armour thyroid

A

t3 and t4

15
Q

how should patients take their thyroid hormone?

A

in the AM on an empty stomach 30 minutes before eating because its absorption is decrease w/ fiber, calcium , iron or other supplements

16
Q

synthorid

A

t4

17
Q

levothroid

A

t4

18
Q

levoxyl

A

t4

19
Q

what do you do if a patient switches brands of thyroid hormone?

A

make sure to tell about signs and symptoms and check levels in 6-8 weeks

20
Q

what dose to start patients for t4 <50 years old?

A

1.7 mcg/kg/day

21
Q

what dose to start in elderly adults > 50 years old for t4?

A

0.5 mcg/kg/day usually 12.5 or 25mcg

22
Q

pregnancy category for levothyroxine?

A

A!!!

23
Q

levothyroxine ratio IV to PO?

A

1: 2

24
Q

typical dose for armour thyroid?

A

60-120mg daily

25
Q

usual t3 dose

A

25-75 mcg

26
Q

liotrix

A

t3 and t 4

27
Q

how should you separate meds that interact w/ levothryoxine?

A

take the other medicines 2 hours before or 4 hours after the levothyroxine

28
Q

meds that interact w/ levo

A
calcium, mag, aluminum, iron
sucralfate
orlistat
SPS
cholestyramine
--Beta blovkers, estrogen and hepatic inducers
29
Q

counseling for levothyroxine

A
  • for energy and metabolism
  • take on empty stomach in the 30 minuts before BF
  • it can take up to 1 or two months for the full effect of the medicine to take effect
  • side effects of the medication
30
Q

symptoms of hyperthyroidism?

A

sudden wight loss, sweating , fast HR, nervous, irritable, diarrhea, insomnia

31
Q

most common cause of hyperthyroidism?

A

grave’s disease: immune system stimulates the thyroid gland to produce too much T4

32
Q

most common medications that can cause hyperthyroidism?

A

iodide
amiodarone
interferons

33
Q

what is the DOC for Grave’s disease?

A

RAI-131 : radicactive iodine

34
Q

what can you use only for symptomatic treatment of hyperthyroidism?

A

beta blockers

35
Q

two treatment medications for hyperthyroidism? med names?

A

PTU: propylthiouracil

Methimazole

36
Q

Propyl-thyracil

A

PTU

37
Q

Tapazole

A

methimazole

38
Q

typicl dose of PTU

A

50mg TID or higher (higher doses until euthyroid, then dose reduction)

39
Q

BBW PTU

A

can cause liver damage and acute liver failure

40
Q

typical dose for methimazole

A

5-15 mg daily (maintenance dose) : initial doses are higher

41
Q

two main side effects of PTU and methimzole

A

GI upset and hepatitis , agrunolocytosis (rare)

42
Q

how to toake both PTU and methimazole?

A

w/ food to decrease GI upset

43
Q

which put or methimazole is safe for pregnancy ?

A

methimzole, PTU is pregnancy category D. PTU ok for women trying to conceive or if they are still in the first trimester but should switch to methimazole in 2nd or 3rd trimester

44
Q

what is the DOC for thyroid storm?

A

PTU

45
Q

two iodide solutions for hyperthyroidism?

A

Lugol’s solution ( potassium iodide and iodine solution)

Saturated solution of potassium iodide (SSKI)

46
Q

how should you take your iodide solutions?

A

w/ food to reduce GI upset

47
Q

can you use iodide solutions in pregnancy?

A

no = because category D. Nor in breastfeeding

48
Q

typical dose for the iodide solutions in hyperthyroidism?

A

4-8 drops po Q8h

49
Q

what are symptoms of thyroid storm?

A
fever > 103 F
HR > 140
inc RR
profuse sweating 
agitation 
psychosis 
coma
50
Q

Treatment for thyroid storm

A
PTU 900-1200 po daily divided q 4-6 hours  (30 min before iodide) PLUS 
SSKI  or lugos PLUS
Propranolol PLUS 
dexamethasone
Supportive care
51
Q

dose thyroid storpe SSKI and Lugols

A

sski 3-5 drops q 8h

luglos 5-10 dropps po q 8h