Thyroid Disorders

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Author:
giddyupp
ID:
70615
Filename:
Thyroid Disorders
Updated:
2011-03-04 00:39:27
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Thyroid Disorders PHPR523 Test4
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Thyroid Disorders
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  1. What are the sx of hypothyroidism?
    • Cold intolerance
    • Constipation
    • Lethargy
    • Brittle hair
    • Facial puffiness
    • Wt gain (despite decreased appetite)
    • Impaired memory
    • Confusion
    • Increased cholesterol and TG
    • Decreased deep tendon reflexes
  2. What are the sx of hyperthyroidism?
    • Heat intolerance
    • Increased bowel movements
    • Warm skin, excess sweating
    • Nervousness, emotional lability
    • Fine, thin hair
    • Wt loss (despite increased appetite)
    • Palpitations, tachycardia
    • Dyspnea
  3. What are the trends for lab values in hyperthyroid disease?
    • TSH
    • Total T4
    • Free T4
    • Total T3
  4. What are the trends for lab values in hypothyroid disease?
    • TSH
    • Total T4
    • Free T4
    • Total T3
  5. What is the normal range of TSH?
    0.5-4.7 mIU/mL
  6. What is the normal range for Free T4?
    0.8-1.8 ng/dL
  7. What is the normal range for Total T4?
    4.5-10.9 mcg/dL
  8. What is the normal range for Total T3?
    60-181 ng/dL
  9. What is the dosing for Levothyroxine?
    • 50mcg x 1mo, then 100mcg
    • 25mcg x 1mo, titrate by 25mcg (Elderly)
    • Normal maintenance dose = 1.7 mcg/kg/d
  10. How should Levothyroxine be administered?
    • On an empty stomach 30min before or 1h after the 1st meal of the day
    • separate from calcium, iron, and caffeine by 2hrs
  11. How should Levothyroxine be monitored?
    • TSH and T4 q 6wks after initiation
    • Goal TSH is 0.5-3.5 mIU/mL
  12. What are the disadvantages of T3?
    • Short half-life
    • Cost
    • Higher risk of cardiotoxicity
  13. What are the SE of Levothyroxine?
    • Cardiac issues
    • Osteoporosis
    • Increased fracture risk
  14. What is subclinical hypothyroidism?
    • Normal T4 with elevated TSH
    • Treat if TSH > 10 mIU/mL
  15. What medications might interact with levothyroxine or thyroid disorder?
    • Warfarin:
    • disorder causes slower clotting factor metabolism (need more warfarin)
    • levothyroxine causes decreased drug metabolism (need less warfarin)
    • Digoxin
    • Insulin
  16. What medications can cause hypothyroidism?
    • Lithium
    • Amiodarone
  17. What are the sx of a myxedema coma?
    • hypothermia
    • delerium
    • coma
    • bradycardia
    • large tongue
    • puffy face
  18. How do you treat myxedema?
    • T3 or Combo
    • Hydrocortisone
  19. What is the tx for hyperthyroidism?
    • Surgery
    • Radioactive Iodine
    • Methimazole (MMI)
    • Propylthiouracil (PTU)
  20. What are the SE of MMI and PTU?
    • Rash
    • GI
    • Fevers
    • Altered smell (MMI)
    • Hepatitis (PTU)
    • Agranulocytosis
  21. What is the adjunct therapy for hyperthyroidism sx?
    • Propranolol (blocks T4 conversion to T3)
    • Clonidine
    • Diltiazem

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