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47 Cards in this Set
- Front
- Back
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What is the best marker of iodine intake?
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Urinary iodine excretion
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What is organification?
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Attachment of iodide to tyrosine to form MIT and DIT (catalyzed by thyroid peroxidase)
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What is the minimum daily intake of iodine required to prevent an iodine-deficiency goiter?
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50 micrograms daily
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What is the recommended minimum daily intake of iodine?
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150 micrograms
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Urinary iodine excretion in the US averages what?
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150 micrograms/L
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What are the target TSH values recommended by the AACE?
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0.3 to 3.0
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What is the recommendation of the American Thyroid Association in regards to who should be screened for thyroid disease?
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All adults at 35, every five years after, more often in high risk/symptomatic pts
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The American Academy of Family Physicians recommends against routine screening in patients under what age?
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60
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What is the normal range for T3?
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75-195 ng/dL
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What is the normal range for T4?
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4.6 - 11.2 mcg/dL
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What is the normal range for FT4?
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0.8-2.7 ng/dL
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Thyroglobulin is elevated by what conditions?
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Those that increase thyroid hormone production or release
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What are the natural goitrogens?
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Cruciferous vegetables
Soy products Millet Peanuts Peaches Strawberries Radishes |
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What chemical competes with iodine for uptake into the thryoid?
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Perchlorite
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Bradycardia, atherosclerosis, HTN, and reduced exercise capacity can be caused by what thyroid disease?
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Hypothyroidism
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Reduced taste sensation, hoarseness, and constipation are associated with what thyroid disease?
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Hypothyroidism
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Hypoventilation, CNS depression, and reproductive abnormalities can be caused by what thyroid disease?
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Hypothyroidism
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Hyponatremia, increase in serum creatinine, increased plasma homocysteine, and low lipid clearance with increased free fatty acids can be caused by what thyroid disease?
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Hypothyroidism
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What thyroid medication must be refrigerated?
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Liotrix (Thyrolar)
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Liothyronine (Cytomel) is what?
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Synthetic T3 product
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What thyroid drug causes wide fluctuations in T3 levels due to rapid GI absorption and short half-life?
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Liothyronine (Cytomel)
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What is the drug of choice for hypothyroidism?
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Levothyroxine
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What is the GI absorption % of levothyroxine?
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40 - 80%
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Untreated adrenal insufficiency and MI are contraindications of what thyroid drug?
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Levothyroxine
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What is the usual maintenance dose for adult LT4 drugs?
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75-100 mcg/daily for women
100 - 150 mcg/daily for men |
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What dosage of LT4 should you start with for a patient over 50-60 years of age?
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50 mcg/daily
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How do you calculate the average dose for LT4?
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1.6 - 1.8 mcg/kg/d
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How do you calculate IBW?
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Males = 50 + (2.3 x Height in inches >5 feet)
Females = 45.5 + (2.3 x height in inches > 5 feet) |
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For elderly patients, what should the initial dose of LT4 be?
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12.5 - 25 mcg/daily
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What drugs decrease TSH secretion?
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Dopamine
Glucocorticoids Octreotide |
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What drugs can increase TSH secretion?
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Metoclopramide
Domperidone |
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What drugs can decrease thyroid hormone secretion?
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Lithium
Iodide Amiodarone PTU Methimazole |
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What drugs can increase thyroid hormone secretion?
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Iodide
Amiodarone |
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What drugs can decrease T4 5'deiodinase activity?
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PTU
Amidarone Beta blockers Glucocorticoids |
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What drugs can increase serum TBG?
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Estrogens
Tamoxifen Heroin Methadone Mitotane Fluouracil |
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Calcium carbonate inhibits the absorption of what and by what percentage?
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LT4
70% |
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What drugs increase the hepatic metabolism of LT4?
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Phenytoin
Carbamazepine Rifampin Phenobarbital |
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What are the concerns of long-term over-treatment for hypothyroidism?
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Osteoporosis
Heart failure Atrial fibrillation |
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Patients on LT4 or with uncontrolled hyperthyroidism should receive what?
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Calcium
Vitamin D |
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What is the last resort for patients who are noncompliant with their thyroid meds?
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Weekly dosing
unless cardiac disease |
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What is the mortality rate for untreated myxedema coma?
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50-80%
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What is the traditional drug of choice in pregnancy and thyroid storm?
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PTU
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What is the DOC in non-pregnant patients not in thyroid storm for hyperthryoidism?
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Methimazole
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What is the most common major adverse effect of thionamides?
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Benign leukopenia 12%
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What is the MOA of radioactive iodine?
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Sodium iodine taken up into thyroid gland, causing necrosis/fibrosis and edema of thyroid
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What are the initial side effects of radioactive iodine?
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Sore throat
Salivary gland swelling Mild nausea |
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What are the AACE recommendations for treatment of subclinical hypothyroidism?
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TSH over 10 or
TSH between 5 & 10 in conjunction with goiter or positive TPO antibodies |
