Final Exam Review: Week 5, 6, 7 & 8
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WEEK 5: ...
1. Thyroid
o Diagnosis & Evaluation
What labs are used to diagnose?: -TSH - used primarily for screening and diag-
nosing hypothyroid and for monitoring replacement therapy in hypothyroid patients
-T4 - Used to monitor thyroid hormone replacement therapy and to screen for thyroid
dysfunction
-T3 - Useful in the diagnosis of hyperthyroidism; can also be used to monitor hormone
replacement therapy
-TSH low
-T4 normal
,-T3 is high = hyperthyroidism
2. Thyroid
o Diagnosis & Evaluation
Timeframe for re-check of labs after starting levothyroxine?: Recheck TSH 6-8
weeks after initiating therapy and after any dosage change; Check TSH at least once a
year after serum TSH is stabilized
3. Thyroid
o Diagnosis & Evaluation
Signs and symptoms of hypothyroidism?: Hypothyroidism: Depend on severity. o
Mild: subtle and may go unrecognized
o Moderate to severe:
-Face is pale, puffy, and expressionless.
-Skin cold and dry.
-Hair is brittle and hair loss occurs.
-Slowed Heart rate.
-Patient may complain of lethargy, fatigue, and
-Temperature is lowered & intolerant to cold.
-Thyroid Enlargement may occur if reduced levels of T3 and
T4
,Mentation may be impaired.
4. Thyroid
o Diagnosis & Evaluation
, Signs and symptoms of hyperthyroidism?: o Elevated Heart rate and strong, and dysr
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hythmias and angina may develop X4 X4 X4 X4
o TheCNSisstimulated,resultingisnervousness,insomnia,rapidthought flow,and rapid s
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peech, hyperreflexia, tremors X4 X4
o Skeletal muscles may weaken and atrophy X4 X4 X4 X4 X4
o Metabolic rate is raised, resulting in health and skin that is warm and moist o Fe X4 X4 X4 X4 X4 X4 X4 X4 X4 X4 X4 X4 X4 X 4 X4
eling Hot + Heat intolerance X4 X4 X4 X4
o Appetit is increased but fails to match metabolic rate resulting in weight loss o Al
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l of these signs are referred to as thyrotoxicosis
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o Also usually present with exophthalmos - bulging of the eyes
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5. Thyroid o X 4 X
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Treatment
Treatment of thyroid storm?: Characterized by profound hyperthermia (105 de- X4 X4 X4 X4 X4 X4 X4 X4 X4
X4 grees F or higher), severe tachycardia, restlessness, agitation, and tremor.
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Unconsciousness, coma, hypotension, and heart failure may ensure. These sym X4 X4 X4 X4 X4 X4 X4 X 4 X4
ptoms are produced by excessive levels of thyroid hormone Thyroid crisis can
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be life threatening and requires immediate treatment.
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o High doses of potassium iodide or strong iodine solution are given to suppress thyr
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oid hormone release. X4 X4
o Methimazole is given to suppress thyroid hormone synthesis o X4 X4 X4 X4 X4 X4 X4 X 4 X4
A beta blocker is given to reduce heart rate
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o Additional measures include sedation, cooling, and giving glu X4 X4 X4 X4 X4 X4 X4