Pharmacology- Endocrine -thyroid Treatment
.
- 1.Hypothyroidism usually requires a lifelong hormone replacement, what is the drug of choice for this condition?
- A.
Radioactive iodine
- B.
Levothyroxine
- C.
Thioamides
- D.
Iodides
- 2.What is Myxedema?
- A.
Irreversible mental retardation and dwarfism caused by congenital hypothyroidism
- B.
Severe hypothyroidism
- C.
Enlargement of the thyroid gland
- D.
Autoimmune disorder that results in hyperthyroidism
- 3.You as the NP is having a follow-up visit with a patient that you started on Levothyroxine approximately 1 month ago and you review the patients labs, the labs reveal elevated TSH. What could the elevated TSH indicate, what should you do FIRST?
- A.
Assess for malabsoprtion, diarrhea
- B.
Decrease dosage
- C.
Assess for Angina
- D.
Increase dosage
- 4.You know your patient understood the teaching about his medication Levothyroxine when the patient states...
- A.
"It's okay to switch brands, there is no difference in absorption"
- B.
"I should avoid taking my Iron and calcium supplements at the same time as I take my Levothyroxine"
- C.
"After one year of taking my Levothyroxine, my thyroid will be back to normal"
- D.
" I should take my medication on an empty stomach in the morning or at bedtime"
- 5.What is the recommendation for Thyroid function monitoring with any changes in preparations?
- A.
4- 6 weeks
- B.
6-8 weeks
- C.
2-3 weeks
- D.
8-10 weeks
- 6.What are some causes of Hypothyroidism with Goiter?
- A.
Peripheral resistance to thyroid hormone
- B.
Drugs like Lithium & amiodarone
- C.
Iodine elevated
- D.
Toxic adenoma
- E.
Hashimoto thyroiditis
- F.
Hepatitis C
- G.
Autoimmune disorder
- 7.Select all that apply: As a NP, you know the the clinical signs of Hypothyroidism are
- A.
Bradycardia
- B.
Nervousness, irritability,
- C.
Palpably enlarged thyroid (goiter)
- D.
Skin pallor or yellowing (carotenemia)
- E.
Peripheral edema, puffy face and eyelids
- F.
Tremor, hyperreflexia
- G.
Dry, pale skin
- 8.What lab values would be consistent with the diagnosis of HYPOthyroidism?
- A.
T4- Low T3- Low TSH- High
- B.
T4- High T3- High TSH- Low
- C.
T4- Low T3- High TSH- Normal
- 9.What are some causes of HYPERthyroidism?
- A.
Hashimoto thyroiditis
- B.
Toxic diffuse goiter (Graves disease)
- C.
Toxic adenoma
- D.
Peripheral resistance to thyroid hormone
- E.
Genetic thyroid enzyme defects
- 10.True or False: Hyperthyroidism is a hypermetabolic state resulting from excess thyroid hormone and affects 2% of women and 0.2% of men in their lifetimes.
- A.
True
- B.
False
- 11.What are some clinical features in Thyrotoxicosis (hyperthyroidism)?
- A.
Nervousness, irritability
- B.
Cool dry skin
- C.
Tachycardia, arrhythmias
- D.
Heat intolerance, increased perspiration
- E.
Decreased appetite
- F.
Goiter
- 12.What would the lab values look like in Hyperthyroidism?
- A.
Suppressed TSH and elevated T3 & T4
- B.
Elevated TSH and suppressed T3 & T4
- 13.Select all: What medications are used in a patient with HYPERthyroidism?
- A.
Thioamides
- B.
Levothyroxine
- C.
Somostatin Analogs
- D.
Iodides
- E.
Propanolol
- 14.True or false: Methimazole is the first-line Rx in children, adolescents, and pregnancy with HYPERthyroidism.
- A.
True
- B.
False
- 15.What is the MOA of Thioamides (Methimazole and PTU)?
- A.
Inhibits iodine organification & hormone release
- B.
Inhibit cell-mediated immunologic functions
- C.
Inhibit thyroid peroxidase reactions, iodine organification, and peripheral conversion of T4 to T3 (prevent hormone synthesis)
- 16.Select all: What are some ADE's of Thioamides (Methimazole & PTU)?
- A.
GI symptoms, Nausea,
- B.
Rash
- C.
Agranulocytosis
- D.
Hypothyroidism
- E.
Edema
- F.
Hepatitis
- 17.What medication class is used in hyperthyroidism as a supportive therapy?
- A.
Ace inhibitors
- B.
Beta blockers
- C.
Calcium channel blockers
- D.
Alpha Blockers
- 18.Your patient is in the first trimester of her pregnancy, what treatment is best for her to start for HYPERthyroidism?
- A.
Methimazole
- B.
Radioiodine
- C.
Propylthiouracil (PTU)
- D.
Subtotal thyroidectomy
- 19.This Thioamide is the drug of choice during thyroid storm
- A.
Propylthiouracil (PTU)
- B.
Methimazole
- C.
Propanolol
- D.
Iodine
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