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WorksheetsThyroid Replacement Therapy
Total questions: 18
Worksheet time: 11mins
All of the following are clinical presentations of Myxedema Coma, except:
Hyperthermia
Hypoglycemia
Hypoxia
Paranoid
Puffy Face
& Eye Lids
Which of the following medications and/or supplements may have drug-interaction with Levothyroxine? (SATA)
Cholestyramine
(Questran®)
Sevelamer (Renagel®)
Magnesium
Ferrous Sulfate
Aluminum Hydroxide
Antacids
T/F:
Thyroid hormone therapy should be initiated as partial replacement with gradual incremented dosing by using serum thyrotropin as the goal:
False
True
Low-quality evidence recommended while using levothyroxine, serum thyrotropin monitoring is advisable with which of the following medications? (SATA)
Phenobarbital (Luminal®)
Phenytoin (Dilantin®)
Rifampin (Rifadin®)
Sertraline (Zoloft®)
Oxy-CBZ
(Trileptal®)
Strong recommendation with low-quality evidence advises to alternate brand and generic of levothyroxine for which of the following patients? (SATA)
General populations
Frail patients
Early-Childhood hypothyroidism
Pregnant patients
High-risk thyroid cancer patients
Select all that apply: which of the following statements is true?
Majority of women with primary hypothyroidism require 30-50% increase in pre-pregnancy T4
The loading dose of Levothyroxine IV is 200-400mg
For Myxedema Coma, a daily replacement dose of 1.6 mcg/kg BW is reduced to 75% as long as it is being IV administered
For Myxedema Coma, thyroid hormones should be measured every 1-2 weeks to ensure a favorable biochem. parameters
Levothyroxine replacement at a dose of
10-15 mcg/kg per day should be initiated once newborn screening is positive
T/F:
Hyperthyroidism occurs when FT4 and TSH are high.
True
False
Which of the following is least likely be the cause of hyperthyroidism?
Excess iodine in diet
Currently taking amiodarone and antidepressant
Inflammation of the thyroid
Exposure to radiographic contrast media
Antibodies stimulate the thyroid to produce more T3 and T4
Which of the following is least likely to be a laboratory findings of hyperthyroidism?
↑ T4
↑ T3
↓ TSH
↑ TPA
↓ RAIU
Select all that apply:
Which of the following is most likely be the physical finding of hyperthyroidism?
Brisk DTRs
Proptosis
Narrow pulse pressure
Periorbital edema
Plummer nails
Which of the following is least likely be the treatment for hyperthyroidism?
Surgery
RAI-131
Pentathiouracil
Lugol's Solution
Thyrosafe®
T/F:
Methimazole is 1st-line because it is reserved for
those who are contraindicated for other antithyroid therapies.
True
False
Which of the following is least likely be the side effect of Thioamides?
Acolic stools
Pharyngitis
Dark urine
Jaundice
Myalgia
All of the following may be caused by Methimazole and PTU, except:
GI Upset
Lympha-denopathy
Agranulocytosis
Diarrhea
DILE
Which of the following is least likely be true about Methimazole (Tapazole®)? (SATA)
For moderate or severe symptoms,
30-40 mg PO TID until euthyroid
It is preferred in thyroid storm
increased risk of fetal abnormalities if used in 2nd-trimester
Have less hepatotoxic
CBC including WBC w/differential is required prior to therapy
Which of the following is least likely be the S/S of thyroid storm?
Tachypnea
Agitation
Delirium
Dehydration
Fever ( >100 oF)
T/F:
Measurement of TRAb levels is suggested prior to the stopping of ATD therapy.
True
False
T/F:
For Grave's Disease, Methimazole should be continued for approx. 12-18 mo., then discontinued if TSH and TRAb are within normal range.
True
False
