How soon should you follow up with a patient after starting thyroid
medications?
(Ans- 6-8 weeks. Recheck TSH.
if TSH is high, increase dose by 0.1-1.0mcg/kg/day. Then recheck again
in 6-8 weeks.
What should you do if TS
...
How soon should you follow up with a patient after starting thyroid
medications?
(Ans- 6-8 weeks. Recheck TSH.
if TSH is high, increase dose by 0.1-1.0mcg/kg/day. Then recheck again
in 6-8 weeks.
What should you do if TSH is normal 6-8 weeks after you start thyroid
medications?
(Ans- maintain current dose, and then check annually
What would you do is TSH is low 6-8 weeks after starting thyroid
medication?
(Ans- lower the dose, then recheck in 6-8 weeks.
What is the starting dose of levythyroxine for patients 50 and older with
no comorbidities?
(Ans- 50mcgWhat is the starting dose of synthroid for patients 50 and older with
CAD?
(Ans- 25mcg
What is the starting dose of synthroid of a healthy patient over 65?
(Ans- 25mcg
What is the starting dose of synthroid of a patient with CAD and over
65yrs old?
(Ans- 12.5-25mcg
What is an adverse effect of too much synthroid?
(Ans- cardiac arrhythmias, s/s of hyperthyroid
What is an infant dose of Synthroid?
(Ans- 6-15mcg/kg/day
What is a children's dose of synthroid?
(less than age 12)
(Ans- 4-6mcg/kg/dayHow should you instruct patients to take synthroid?
(Ans- on empty stomach in the morning. Take 3-4 hours before zoloft,
antacids, carafate, iron, cholestyramine, and any anticonvulsants
When is a referral to an endocrinologist warranted with
hypothyroidism?
(Ans- congenital, secondary and tertiary hypothyroidism
What is hyperthyroidism?
(Ans- body's tissues are exposed to increased level of circulating
thyroid hormone which causes excessive metabolic activity
What is the most common cause of hyperthyroidism?
(Ans- Graves disease
Explain grave's disease
(Ans- autoimmune process in which antibodies stimulate the TSH
receptors on the thyroid, which causes the thyroid to overproduce T4.
Which drugs can induce hyperthyroidism?
(Ans- amiodarone, lithium, inteferonWhat are some causes of hyperthyroidism aside from grave's disease?
(Ans- hyperemesis gravidarum, post partym thyroiditis, toxic adenoma,
subacute granulomatous thyroiditis, thryoid cancer
What are risk factors for hyperthyroidism?
(Ans- female, patients taking thyroid replacement, patient having other
autoimmune disorders, down syndrome, iodine deficiency, smoking
What are some s/s of hyperthyroidism
(Ans- palpitations, tachycardia, anxiety, heat intolerance, hyper
defecation, A-fib, dyspnea, hyperpigmentation, weight loss, brisk
reflexes, exophthalmos, blurred vision, diplopia
What will the lab values be for hyperthyroid?
(Ans- Low TSH and high T4.
What is your action if you discover hyperthyroid on a patient?
(Ans- depending how severe patient symptoms are, can start on
propranolol to reduce tachycardia and tremors. Refer these patients out
to endocrinologist
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