Question 1

Goals of treatment when treating hypothyroidism with thyroid replacement include:&#10;A) Normal TSH and free T4 levels&#10;B) Resolution of fatigue&#10;C) Weight loss to baseline&#10;D) All of the above

Accepted Answer

All of the listed goals are included in the treatment of hypothyroidism with thyroid replacement.

Question 2

A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with:&#10;A) Methimazole&#10;B) Propylthiouracil (PTU)&#10;C) Radioactive iodine&#10;D) Nothing,treatment is best delayed until after her pregnancy ends

Accepted Answer

Propylthiouracil (PTU) is the preferred treatment for hyperthyroidism in pregnancy because it has a lower risk of birth defects compared to Methimazole. Radioactive iodine is contraindicated in pregnancy as it can harm the developing fetus. Delaying treatment is also not recommended as uncontrolled hyperthyroidism can lead to complications for both the mother and baby.

Question 3

When methimazole is started for hyperthyroidism it may take to see total reversal of hyperthyroid symptoms.&#10;A) 2 to 4 weeks&#10;B) 1 to 2 months&#10;C) 3 to 4 months&#10;D) 6 to 12 months

Accepted Answer

6 to 12 months

Question 4

Treatment of a patient with hypothyroidism and cardiovascular disease consists of:&#10;A) Levothyroxine&#10;B) Liothyronine&#10;C) Liotrix&#10;D) Methimazole

Accepted Answer

Levothyroxine is the treatment of choice for hypothyroidism and is safe to use in patients with cardiovascular disease. Liothyronine and liotrix are not preferred as they have a shorter half-life and may lead to fluctuations in thyroid hormone levels. Methimazole is used to treat hyperthyroidism, not hypothyroidism.

Question 5

When starting a patient on levothyroxine for hypothyroidism the patient will need follow-up measurement of thyroid function in:&#10;A) 2 weeks&#10;B) 4 weeks&#10;C) 2 months&#10;D) 6 months

Accepted Answer

Follow-up measurement of thyroid function should occur approximately 4 weeks after initiating levothyroxine therapy to ensure adequate dosing and adjust as necessary.

Question 6

Once a patient who is being treated for hypothyroidism returns to euthyroid with normal TSH levels,he or she should be monitored with TSH and free T4 levels every:&#10;A) 2 weeks&#10;B) 4 weeks&#10;C) 2 months&#10;D) 6 months

Accepted Answer

Once a patient with hypothyroidism is euthyroid with normal TSH levels, they should be monitored with TSH and free T4 levels every 6 months. This is because it takes time for the thyroid medication to reach a steady state and for the effects to be fully realized, and the stability of the patient's condition can be assessed over this time period. Exceptions to this monitoring frequency may be made for certain patients with comorbid conditions or for pregnant or elderly patients.

Question 7

When starting a patient with hypothyroidism on thyroid replacement hormones patient education would include:&#10;A) They should feel symptomatic improvement in 1 to 2 weeks&#10;B) Drug adverse effects such as lethargy and dry skin may occur&#10;C) It may take 4 to 8 weeks to get to euthyroid symptomatically and by lab testing&#10;D) Due to its short half-life,levothyroxine doses should not be missed

Accepted Answer

It takes time for thyroid hormone replacement therapy to become effective, and it may take from 4 to 8 weeks to see improvement in both symptoms and laboratory results. Patients should be counseled on the importance of continued medication use, even if symptoms persist.

Question 8

After starting a patient with Grave's disease on an antithyroid agent such as methimazole,patient monitoring includes TSH and free T4 every:&#10;A) 1 to 2 weeks&#10;B) 3 to 4 weeks&#10;C) 2 to 3 months&#10;D) 6 to 9 months

Accepted Answer

After starting a patient with Grave's disease on an antithyroid agent such as methimazole, patient monitoring includes TSH and free T4 every 3 to 4 weeks. This is to ensure that the medication is effectively managing the overactive thyroid and to adjust the dosage if necessary. Once the thyroid levels have stabilized, monitoring can be done less frequently.

Question 9

Infants with congenital hypothyroidism are treated with:&#10;A) Levothyroxine&#10;B) Liothyronine&#10;C) Liotrix&#10;D) Methimazole

Accepted Answer

Infants with congenital hypothyroidism are typically treated with levothyroxine, which is a synthetic form of the thyroid hormone thyroxine (T4). This is because T4 is the primary hormone produced by the thyroid gland and plays a crucial role in the development and function of various body systems, especially the brain and nervous system. Liothyronine (T3) and liotrix (combination of T3 and T4) are not typically used in infants with congenital hypothyroidism, as they can cause potential adverse effects on growth and development. Methimazole is used to treat hyperthyroidism, which is the opposite of hypothyroidism, and is not indicated for use in treating congenital hypothyroidism.

Question 10

In addition to methimazole,a symptomatic patient with hyperthyroidism may need a prescription for:&#10;A) A calcium channel blocker&#10;B) A beta blocker&#10;C) Liothyronine&#10;D) An alpha blocker

Accepted Answer

A beta blocker, such as propranolol or metoprolol, can be prescribed to manage the cardiovascular symptoms of hyperthyroidism, such as tachycardia, palpitations, and tremors. It does not directly affect thyroid hormone levels but can provide relief from the symptoms. Calcium channel blockers and alpha blockers are not typically used in the management of hyperthyroidism. Liothyronine is a thyroid hormone replacement medication and would not be appropriate for a patient with hyperthyroidism as it would worsen the condition.

Deck 41: Hyperthyroidism and Hypothyroidism