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Thyroid stuff

QuestionAnswer
What is the thyroid, and what does it do? (who is your daddy, and what does he do?) Thyroid is an endocrine gland that produces T3, T4 and calcitonin. Thyroid hormones effect growth, metabolism.
Thyroid activity is determined by...? TSH. Thyroid stimulating hormone.
What produces TSH? Anterior pituitary
What regulates TSH? TRH. Thyrotropin-releasing hormone secreted by hypothalamus.
What is the negative feedback loop involving TSH and thyroid hormones (T3 and T4)? The more T3 and T4 are produced, less TSH levels are present in the blood. The less T3 and T4 are produced, higher levels of TSH are present.
What is hypothyroidism? Insufficient production of T3 and T4, which indicate abnormally high levels of TSH.
What is secondary hypothyroidism? Due to dysfunction of anterior pituitary. TSH levels are low/normal/slightly elevated.
Hypothyroidism can cause _________ in infants. Cretinism
What are signs and symptoms of hypothyroidism? Pale, puffy, expressionless face. Cold, dry skin. Brittle hair/hair loss. Lowered heart rate and temperature. Lethargy, fatigue, cold, mentation?, goiter. Weight gain.
What can cause hypothyroidism? Thyroid dysfunction. Chronic autoimmune thyroiditis. Insufficient iodine. Removal of thyroid. Destruction of thyroid by radiation. Insufficient TSH (anterior pituitary) or TRH (hypothalamus)
What is used to treat hypothyroidism? Levothyroxine
What is Levothyroxine? T4 analog. Used in hypothyroidism as a thyroid hormone replacement. Also used to treat cretinism, myxedema coma, goiter.
Levothyroxine helps maintain levels of thyroid hormones after...? (3) 1. After thyroid surgery 2. Irraditation 3. Treatment with anti-thyroid drugs
What are the trade names for Levothyroxine? Levothyroid, Synthroid, Levoxyl
Levothyroxine is converted to ___ in the body. T3
What is hyperthyroidism? Too much T3 and T4 is produced by thyroid. Can be caused by autoimmune disease, virus,
What is Graves' disease? Most common type of hyperthyroidism. Caused by thyroid-stimulating immunoglobulins that mimic TSH. Autoimmune process.
What is Plummer's disease? Less common form of hyperthyroidism. Also called toxic nodular goiter. Caused by thyroid adenoma (tumor).
What is thyrotoxic crisis/ thyroid storm? Rise in thyroid hormones after major surgery, or concurrent illness (infection, sepsis).
What are signs/symptoms of hyperthyroidism? Hyperthermia, tachycardia, restlessness, agitation, tremor. Nervousness, weight loss, increased appetite, insomnia, anxiety, heart palpitations or arrhythmia, and fine motor tremors.
Hyperthyroidism can cause...? Coma, hypertension, heart failure.
What agents are used to treat hyperthyroidism? Thionamides
What do thionamides do? Thionamides suppress synthesis of thyroid hormones.
What is a 1st generation thionamide? Propylthiouracil (PTU)
Which thionamide is preferred during pregnancy? Propylthiouracil (PTU)
What is a 2nd generation thionamide? Methimazole
Which thionamide is more commonly recommended due to fewer daily dosage required? Methimazole
Thyroid agents: Contraindications? Known drug allergy, recent MI, adrenal insufficiency, hyperthyroidism
Thyroid agents: SE/AE? Overdose can cause: tachycardia, palpitations, angina, insomnia, nausea, vomiting, diarrhea, menstrual irregularities.
Levothyroxine: SE/AE? Skin reactions, hair loss, cardiac stimulation (hypertension, arrhythmias), CNS- anxiety, insomnia, headache
Levothyroxine: Contraindications? Known allergy, MI, lactation. Use with caution during pregnancy
Levothyroxine: Interactions? Oral anticoagulants should be reduced. Cardiac glycosides, theophylline builds up when synthroid is given
Thionamides: Contraindications? Can be used in pregnancy, but not lactation.
What is important patient education regarding Levothyroxine? Use caution when switching brands (trade to generic, etc). Therapeutic ratio is low, easily reach toxicity. Best to take medication in morning before breakfast on empty stomach. If increasing dose, or changing brands, check TSH at least every 6 weeks.
Created by: kangaloo
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