Deck 43: Hyperthyroidism and Hypothyroidism

Question 1

When starting a patient on levothyroxine for hypothyroidism the patient will need follow-up measurement of thyroid function in:

A)Two weeks
B)Four weeks
C)Two months
D)Six months

Answer 1

Four weeks

Question 2

When starting a patient with hypothyroidism on thyroid replacement hormones patient education would include:

A)They should feel symptomatic improvement in 1 to 2 weeks.
B)Drug adverse effects such as lethargy and dry skin may occur.
C)It may take 4 to 8 weeks to get to euthyroid symptomatically and by laboratory testing.
D)Because of its short half-life, levothyroxine doses should not be missed.

Answer 2

It may take 4 to 8 weeks to get to euthyroid symptomatically and by laboratory testing.

Question 3

Goals when treating hypothyroidism with thyroid replacement include:

A)Normal TSH and free T4 levels
B)Resolution of fatigue
C)Weight loss to baseline
D)All of the above

Answer 3

All of the above

Question 4

Which body system is most impacted if congenital hypothyroid is not rapidly recognized after birth?

A)Central nervous system
B)CV system
C)Gastrointestinal (GI) system
D)Immune system

Question 5

After decades of thyroid supplementation in a patient with TSH at the low end of the range, the patient has increased risk for what?

A) Cataracts
B) Osteoporosis
C) Cancer
D) Dementia

Question 6

Infants with congenital hypothyroidism are treated with:

A)Levothyroxine
B)Liothyronine
C)Liotrix
D)Methimazole

Question 7

Treatment with radioactive iodine requires which precaution in the first few days of therapy?

A)Keeping 100 ft. distance from all others
B)Not bathing
C)Not sharing dishes, cups, and utensils
D)Wearing a neck brace

Question 8

A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with:

A)Methimazole
B)Propylthiouracil (PTU)
C)Radioactive iodine
D)Nothing, because treatment is best delayed until after her pregnancy ends.

Question 9

Laboratory values are different for TSH when screening for thyroid issues and when used for medication management. Which of the following holds true?

A)Screening TSH has a wider range of normal values (0.02 to 5.0); therapeutic levels need to remain above 5.0.
B)Screening values are much narrow than the acceptable range used to keep a person stable on hormone replacement.
C)Therapeutic values are kept between 0.05 and 3.0 ideally. Screening values are considered acceptable up to 10.
D)Screening values are between 5 and 10, and therapeutic values are greater than 10.

Question 10

Hyperthyroid patients require which specialty consultation even when asymptomatic for that organ system?

A)Hepatology
B)Pulmonary
C)Ophthalmology
D)Rheumatology

Question 11

In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for:

A)A calcium channel blocker
B)A beta blocker
C)Liothyronine
D)An alpha blocker

Question 12

After starting a patient with Grave's disease on an antithyroid agent such as methimazole, patient monitoring includes thyroid-stimulating hormone (TSH) and free thyroxine (T4) every:

A)1 to 2 weeks
B)3 to 4 weeks
C)2 to 3 months
D)6 to 9 months

Question 13

In hyperthyroid states, what, other than the cardiovascular (CV), must be evaluated to establish potential adverse issues?

A)The liver
B)The nails and skin
C)The eyes
D)The ears

Question 14

When methimazole is started for hyperthyroidism it may take ________ to see a total reversal of hyperthyroid symptoms.

A)2 to 4 weeks
B)1 to 2 months
C)3 to 4 months
D)6 to 12 months

Question 15

Treatment of a patient with hypothyroidism and cardiovascular disease consists of:

A)Levothyroxine
B)Liothyronine
C)Liotrix
D)Methimazole

Question 16

Why are some patients unable to achieve stability on generic forms of Synthroid?

A)The U.S. Food and Drug Administration (FDA)-allowed tolerance of 20% variance per tablet is of potential issue even with very small dosage changes in this drug family.
B)Thyroid patients are sensitive to the food coloration used in the tablets.
C)It is a psychosomatic belief that emphasizes the true power of the hypothalamic pituitary adrenal (HPA) axis.
D)This only occurs during pregnancy.

Question 17

What is the desired ratio of T3 to T4 drug levels in newly diagnosed endocrine patients?

A)Ninety-nine percent of T3 and the rest is T4 to get rapid resolution.
B)Most needs to be T4 to mimic natural ratios of hormone.
C)The ratio is unimportant.
D)The mix needs to be 50-50 at first.

Question 18

Why are "natural" thyroid products not readily prescribed for most patients?

A)There is no reliability for the amount of hormone per dose.
B)There is higher incidence of allergic reactions.
C)There is a more reliable dose of triiodothyronine (T3) to T4 per batch lot of preparation.
D)All of the above

Question 19

What happens to the typical hormone replacement dose when a woman becomes pregnant?

A)Most women need less medication.
B)Most women do not require a dose change.
C)The average woman needs more medication during pregnancy.
D)The average woman needs more medication only if carrying multiples.

Question 20

Once a patient who is being treated for hypothyroidism returns to euthyroid with normal TSH levels, he or she should be monitored for TSH and free T4 levels every:

A)Two weeks
B)Four weeks
C)Two months
D)Six months