thyroid primary care I

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Author:
Anonymous
ID:
150918
Filename:
thyroid primary care I
Updated:
2012-04-29 22:19:26
Tags:
thyroid TSH T4 T3 endocrine
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Description:
thyroid lecture primary care I NP
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  1. How does digoxin affect thyroid function?
    • decreases thyroid binding globulin (TBG)
    • this will alter free T4 levels
  2. which lab meausre is the single most important measureent in the evalutiaon of thyroid disease?
    T4
  3. which leel is the last 2 be affected in a hypothyroid person?
    T3
  4. wha is the single most effective lab screen of thyroid function?
    Free T4 index (FTI) (T7) b/c it takes into account the presence and amounts of both T4 and T3
  5. what test is used for snthroid treatment decisions?
    • TSH
    • hihg-hypo
    • low=hyper
  6. high TSH + Low T4=?
    high low = HYPO
  7. if you find a nodule on a thyroid what should you order?
    FNA ( fine needle aspiration)
  8. exopthalmos, what is it/
    • autoimmune "bug eye" seen with Graves
    • findings include: lid retraction, dry eyes, diplopia with upward and lateral extremes of gaze and lid lag
  9. what is the most common cause of hyperthyroidism?
    graves disease:causes include autoimmune, immunilogic, thryroid deficieny and toxic goiter
  10. >age 50, long history of goider now found with multinodular goiter and presents with anorexia, weight loss and cardiac excitation (palpitations) elevated BP, lid lag over last several months what is your dx?
    toxic multinodular goiter, hshimotos thyroiditis, AKA plummers disease
  11. patient on amiodorone what lab should check during first 6 motnhs and with yearly labs/
    TSH b/c it has iodine in it and can cause hyperthyroid
  12. client in thyroidtoxicosis with RAIU increased and TSH not suppressed what should you order?
    MRI r/o pituitary adenoma
  13. what should you order for a person in a thyroidtoxicois (thyroid storm)?
    • thyroid scan (radioactive iodine uptake)
    • hospitalization!
  14. what elevations or depression in labs will you find during thyroid storm?
    elevated T3 and T4
  15. thyrotoxicosis not due to hyperthyroidism , low RAIU what are some causes?
    • subacute thyroditis: inflammatory response causing throxine relase. usullay following a viral syndrome may present with head and nexk pain that radiates to jaw or ear seen 2-6 months postartum.
    • can be caused by exogenous synthroid.
  16. subclinical hypo9throidism start on what does of synthroid?
    25mcg/day
  17. name two common anti thryroid drugs (used for other problems but interfere with thyroid function)?
    lithium, amiodarone
  18. what are some causes of enlarged thyroid (thyrotoxicosis)?
  19. some sort of attack on the thyroid causeing inflammation hashimotos thyroditis
    • postpartum thyroditis
    • subacute thyroiditis
    • acute/infectious thyroiditis
  20. what do you check to dx hashimoto's?
    anti-thyroid peroxidase antibodies and or antithyroidglobulin
  21. what test is best for determining HYPER thyroidism?
    TSH (low means hyper)
  22. with a goiter or thyroid enlargement what should you think, hyper or hypo?
    can be either look at signs especialy cardiac to determine.
  23. amiodoerone causes hyper or hypo thyroid?
    amio =go (HR, BP)=HYPER
  24. "hot nodule" is assoicated with what TSH level?
    low TSH so HYPER thyroid
  25. clinical subacute thryoditis is usually painful, can cause fever and is self limited. TRUE or FALSE?
    TRUE

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