Thyroid 2

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Author:
jdonaldson
ID:
98950
Filename:
Thyroid 2
Updated:
2011-09-08 22:19:49
Tags:
usp USP thyroid Thyroid james James donaldson Donaldson
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Depression... there's an app for that
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  1. When treating hyperthyroidism, what is/are the target goals for TSH levels?
    • 0.5-4.5 mIU/L
    • aggressive treatment: 0.5 - 2 mIU/L
    • *No specific standard exists
  2. When treating hyperthyroidism, what are the three general goals of therapy?
    • 1. Reach target TSH
    • 2. Relieve symptoms
    • 3. Minimize long term consequences
  3. What are the long-term consequences of hyperthyroidism?
    • 1. arrhythmia
    • 2. osteoporosis
    • 3. thyroid storm
  4. When should surgical removal of the thyroid be considered in cases of hyperthyroidism?
    • Large thyroid (>80 grams)
    • Failure with antithyroid medications
    • First-line for multinodular goiter
  5. What are the two possible preparations that should be made before surgical removal of the thyroid?
    • 1. Antithyroid medication for 6-8 weeks
    • 2. Iodides for 7-14 days
    • *get patient euthyroid (hyperthyroid states are not favorable for surgery)
  6. Which type of hyperthyroidism involves
    1. inflammation
    2. is due to a viral infection
    3. is associated with severe thyroid pain, fever, and a firm and tender gland
    4. triphasic disease course
    5. self-limiting (2-6 months)
    Subacute thyroiditis
  7. What treatment may be given to a patient with subacute thyroiditis?
    • Symptomatic relief with:
    • 1. beta-blockers (to stop heart palpitations and jitteriness)
    • 2. ASA
    • 3. Prednisone
  8. Which type of hyperthyroidism involves
    1. inflammation
    2. is due to autoimmunity
    3. is painless
    4. triphasic disease course
    5. self-limiting
    6. Frequently occurs post-partum
    Painless thyroiditis
  9. What treatment may be given to a patient with painless thyroiditis?
    Symptomatic treatment (probably same as subacute thyroiditis).
  10. What medications are associated with causing hyperthyroidism?
    • 1. excessive exogenous thyroid hormone
    • 2. amiodarone (can cause hyper and hypothyroidism, causes thyroid dysfunction in roughly 15% of pts)
  11. How should amiodarone be monitored to avoid hyper/hypothyroidism?
    TSH measurements at baseline and every 6 months.

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