Corticosteroid and Thyroid Physiology Quiz
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Questions and Answers

What is a known risk associated with long-term corticosteroid therapy?

  • Increased immune response
  • Adrenal atrophy (correct)
  • Improved inflammatory responses
  • Decreased risk of weight gain

Which of the following is NOT a potential adverse effect of chronic corticosteroid use?

  • GI bleeds
  • Osteoporosis
  • Enhanced immune function (correct)
  • Behavioral changes

How does phenytoin interact with levothyroxine therapy?

  • Inhibits its metabolism
  • Accelerates its metabolism (correct)
  • Increases its absorption
  • Has no effect on it

What is the preferred laboratory value for diagnosing thyroid disorders?

<p>TSH (C)</p> Signup and view all the answers

Which of the following statements about live vaccines in patients on corticosteroids is correct?

<p>They should be avoided in all patients on corticosteroids (A)</p> Signup and view all the answers

Which foods are known to interact negatively with pharmacotherapy in hypothyroid disorders?

<p>Soybean flour and walnuts (B)</p> Signup and view all the answers

How might corticosteroids affect a patient's weight?

<p>Result in weight gain of more than 2 lbs in one day (B)</p> Signup and view all the answers

What potential risk do Ginkgo Biloba supplements pose for patients on anticoagulants?

<p>Increased bleeding risk (A)</p> Signup and view all the answers

Which electrolyte imbalance is primarily indicated by serum potassium levels exceeding 5 mEq/L?

<p>Hyperkalemia (A)</p> Signup and view all the answers

What is the most significant adverse effect to monitor for in a patient receiving magnesium therapy?

<p>Respiratory paralysis (D)</p> Signup and view all the answers

What is a common cause of hypokalemia related to pharmacotherapy?

<p>Loop and thiazide diuretics (D)</p> Signup and view all the answers

Which condition is a contraindication for administering calcium supplements?

<p>Hyperparathyroidism (A)</p> Signup and view all the answers

What is a key consideration when administering Levodopa to a patient with Parkinson's disease?

<p>Taking it on an empty stomach (A)</p> Signup and view all the answers

What is the primary action of dopamine agonists in Parkinson's disease treatment?

<p>Increase available dopamine (B)</p> Signup and view all the answers

What is the serum level indicative of hypermagnesemia?

<p>Above 1.05 mmol/L (D)</p> Signup and view all the answers

What is the most common serious adverse effect of cholinesterase inhibitors used in Alzheimer's treatment?

<p>Dysrhythmias (B)</p> Signup and view all the answers

What is one of the main symptoms of hyponatremia in patients?

<p>Confusion (C)</p> Signup and view all the answers

Which condition is characterized by demyelination and considered an autoimmune disorder?

<p>Multiple Sclerosis (B)</p> Signup and view all the answers

What dietary consideration should be made when taking Donepezil for Alzheimer's?

<p>Avoid high-fat meals (D)</p> Signup and view all the answers

Which drug category is associated with the treatment of muscle spasticity?

<p>Skeletal muscle relaxants (D)</p> Signup and view all the answers

What is a serious complication of hypercalcemia that healthcare providers must monitor?

<p>Heart block (C)</p> Signup and view all the answers

What condition occurs due to excessive breakdown of acetylcholine in Alzheimer's treatment?

<p>Cholinergic crisis (B)</p> Signup and view all the answers

Which of the following is NOT an indication for using loop (high-ceiling) diuretics?

<p>Hypotension (D)</p> Signup and view all the answers

What is a common consideration when administering loop diuretics to older adults?

<p>Establish safety precautions and observe them carefully (B)</p> Signup and view all the answers

Which of the following diuretics is most likely to cause significant hearing loss?

<p>Ethacrynic acid (Edecrin) (A)</p> Signup and view all the answers

Which interaction is a concern when using potassium-sparing diuretics?

<p>Hyperkalemia with potassium supplements (B)</p> Signup and view all the answers

What is the primary mechanism of action for loop diuretics?

<p>Block sodium reabsorption at the loop of Henle (C)</p> Signup and view all the answers

Which herb is known to decrease blood pressure while increasing blood flow and memory?

<p>Ginkgo-biloba (C)</p> Signup and view all the answers

What is a significant risk associated with the use of St John's Wort?

<p>Increased appetite (C)</p> Signup and view all the answers

Which vitamin is considered an antidote for warfarin overdose?

<p>Vitamin K (D)</p> Signup and view all the answers

What is the primary role of the kidneys in maintaining homeostasis?

<p>Fluid balance (B)</p> Signup and view all the answers

Which herb can dangerously increase blood pressure if consumed in large amounts over a prolonged period?

<p>Black licorice (C)</p> Signup and view all the answers

Which herb is known for its relaxing effects and is commonly used for sleeping problems?

<p>Kava Kava (C)</p> Signup and view all the answers

What effect does ginger have on anticoagulants?

<p>Increases their effectiveness (C)</p> Signup and view all the answers

Which vitamin is specifically cautioned against for patients on Parkinson's medications due to its potential to decrease efficacy?

<p>Pyridoxine (A)</p> Signup and view all the answers

What is a common adverse effect of diuretic therapy?

<p>Electrolyte imbalances (B)</p> Signup and view all the answers

Which herb is associated with decreased insulin levels in diabetics?

<p>Ginkgo-biloba (A)</p> Signup and view all the answers

Flashcards

Long-term Steroid Therapy: Adrenal Atrophy

Chronic steroid use can lead to adrenal atrophy, where the adrenal glands shrink due to lack of stimulation.

Long-term Steroid Therapy: Live Vaccines

Patients on long-term steroid therapy should avoid live vaccines (e.g., MMR, varicella).

Long-term Steroid Therapy: Weight Gain

Rapid weight gain (over 2 lbs in one day) is a sign of fluid retention and should be reported by patients on long-term steroids.

Hypothyroidism: TSH Levels

TSH (thyroid-stimulating hormone) is the preferred lab value for diagnosing thyroid disorders. A low TSH indicates primary hypothyroidism.

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Hypothyroidism: Hashimoto's Thyroiditis

Hashimoto's thyroiditis, an autoimmune disorder, is characterized by abnormally high levels of antithyroid antibodies.

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Hypothyroid Treatment: Drug Interactions

Certain drugs can interact with thyroid medication. Phenytoin, for example, speeds up the metabolism of levothyroxine.

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Hypothyroid Treatment: Food Interactions

Foods containing soy, iron supplements, and high amounts of fiber can interfere with the absorption of thyroid medication.

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Gingko Biloba: Caution with Anticoagulants

Gingko biloba, a natural supplement, can increase the risk of bleeding in patients taking blood thinners (anticoagulants).

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Loop Diuretics: Action

Loop diuretics, like furosemide (Lasix), block sodium reabsorption in the loop of Henle, increasing urine output and reducing fluid volume.

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Loop Diuretics: Indications

Loop diuretics are used to treat fluid overload, such as edema caused by heart failure, liver disease, or kidney problems.

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Loop Diuretics: Safety Considerations

When using loop diuretics, monitor vital signs closely, especially blood pressure and heart rate, and be mindful of potassium levels, as they can be depleted.

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Thiazide Diuretics: Key Consideration

Thiazide diuretics can cause dehydration; encourage fluid intake, but avoid alcohol and caffeinated drinks.

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Potassium-Sparing Diuretics: Interactions

Potassium-sparing diuretics, like spironolactone, increase potassium levels; avoid potassium supplements and other medications that raise potassium, like ACE inhibitors.

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Ginseng: Impact on Blood Sugar

Ginseng can lower blood sugar levels. This effect could be beneficial for individuals with high blood sugar, but it can also interact with medications like insulin and oral hypoglycemic agents.

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Ginkgo Biloba: Blood Flow & Memory

Ginkgo biloba is a herbal supplement known for its potential to improve blood flow and memory function.

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Black Licorice: Potential Dangers

Excessive consumption of black licorice (more than 4 weeks) can lead to harmful effects, such as headaches, increased blood pressure, and potassium depletion.

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Ginger: Anticoagulant Interaction

Ginger can enhance the effects of anticoagulants, drugs that help prevent blood clotting, potentially increasing the risk of bleeding.

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Garlic: Blood Thinning Effect

Garlic has blood-thinning properties, similar to aspirin. It can interact with other medications that also thin the blood.

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Valerian: CNS Depressant Interactions

Valerian can interact with CNS depressants, such as benzodiazepines, barbiturates, and anticonvulsants, increasing their effects.

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St. John's Wort: Drug Interactions

St. John's Wort can interact with a range of medications, including CNS depressants. It can also increase appetite.

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Melatonin: Sleep Regulation

Melatonin is a natural hormone that regulates sleep-wake cycles. It can interact with medications that affect the brain, such as antidepressants and calcium channel blockers.

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Saw Palmetto: Potential for Drug Interactions

Saw palmetto can interact with certain medications, including finasteride (Proscar), used to treat enlarged prostate.

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Turmeric: Anticoagulant Interactions

Turmeric can enhance the effects of anticoagulants, increasing the risk of bleeding.

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Fluid Imbalance Disorders

Conditions caused by an imbalance between fluid intake and output, leading to problems like dehydration or shock.

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Electrolytes: What are They?

Charged substances (ions) like sodium, potassium, magnesium, and calcium, that are essential for maintaining the body's functions.

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Electrolyte Imbalance: Causes

Imbalances in electrolytes are usually a sign of a medical condition, not a standalone problem.

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Electrolyte Imbalance: Treatment

Addressing the underlying cause of the imbalance is crucial for treatment.

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Hypernatremia: Signs & Symptoms

High sodium levels can cause symptoms like lethargy, confusion, muscle tremors, hypotension, and restlessness.

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Hypokalemia: What is it?

Low potassium levels in the blood, often caused by diuretics.

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Hypokalemia: Treatment

Administering potassium supplements is a common treatment for low potassium levels.

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Hypermagnesemia: Cause

High levels of magnesium are usually associated with advanced kidney failure.

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Hypocalcemia: What causes it?

Low calcium levels can be caused by deficiencies in calcium or vitamin D, hypothyroidism, or certain medications.

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Hypercalcemia: Causes

High calcium levels are usually caused by overactive parathyroid glands.

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Parkinson's Disease: Pharmacotherapy Goal

To balance dopamine and acetylcholine in the brain, aiming to improve motor function.

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Levodopa: Considerations

Take on an empty stomach, avoid B6 supplements and high-protein diets.

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Benztropine: Adverse Effects

Can cause sedation, constipation, blurred vision, dry mouth, and urinary retention.

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Alzheimer's Disease: Pharmacotherapy Goal

To improve cognitive function, behavior, and ability to perform activities of daily living (ADLs).

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Cholinesterase Inhibitors: Mechanism

They prevent the breakdown of acetylcholine, increasing its concentration in the brain.

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Study Notes

Long-Term Corticosteroid Treatment

  • Corticosteroids suppress inflammation and immune responses
  • Prolonged use can lead to adrenal atrophy
  • Avoid live vaccines while on steroids
  • Weight gain of over 2 pounds in a day is a potential indicator
  • Oral route is often preferred for chronic use, while IV is for acute
  • Higher doses lead to faster adrenal atrophy (2-4 weeks)

Adverse Effects of Chronic Steroid Use

  • Compromised immune system
  • Reduced inflammatory responses
  • Gastrointestinal bleeding (peptic ulcers)
  • Osteoporosis
  • Behavioral changes
  • Metabolic changes (fat redistribution, fluid retention)

Steroid Therapy Drug Interactions

  • Some drugs increase potassium loss; others worsen steroid efficacy
  • Avoid live vaccines
  • Insulin and oral agents are affected

Thyroid Gland Physiology

  • Low thyroid hormone levels trigger a negative feedback loop
  • Hypothalamus releases TRH
  • Anterior pituitary releases TSH
  • Thyroid produces T3 and T4 hormones

Thyroid Disorders Diagnosis

  • TSH (thyroid-stimulating hormone) is the preferred lab value for diagnosis
  • Low TSH is generally considered good
  • Primary hypothyroidism is characterized by low T4 and high TSH
  • Hashimoto's thyroiditis is indicated by abnormal anti-thyroid antibodies

Hypothyroid Disorders Treatment - Drug Interactions

  • Phenytoin speeds up the metabolism of levothyroxine
  • Certain foods (soy, walnuts, some fruits and vegetables) can interact with levothyroxine

Herbal Interactions

  • Gingko biloba can pose risks for those on anticoagulants
  • Ginseng potentially reduces blood sugar, blood pressure, and sexual function; but may increase CNS depressants' effects
  • Herbal remedies aren't always safe, some have ingredients similar to prescription drugs

Other Drug Interactions (Specific Examples)

  • Ginger can decrease nausea and inflammation, and increase blood thinning effects/anticoagulants
  • Garlic increases blood thinning
  • Valerian may increase CNS depressant effects
  • St. John's Wort potentially reduces the effectiveness of antidepressants
  • Saw Palmetto may decrease urination and iron absorption

Fluid and Electrolyte Imbalances

  • Body fluids constantly travel between intracellular and extracellular compartments.
  • Fluid imbalances can lead to shock and dehydration.
  • Electrolytes (Na, K, Mg, and Ca) are crucial for homeostasis
  • Imbalances can signal underlying medical conditions.

Specific Electrolytes (Examples)

  • Hypernatremia: Watch neurological status (LOC), assess for lethargy, confusion, and muscle issues.
  • Hypokalemia: Serum levels below 3.5 mEq/L, commonly caused by diuretics; it necessitates administration or prevention.
  • Hyperkalemia: Serum levels above 5 mEq/L, caused by excess intake or impaired kidney function (renal pathology)

Kidney Function and Electrolyte Balance (Kidney Role)

  • Kidneys are major organs for excretion and maintaining homeostasis
  • They control fluid balance, electrolyte balance, and acid-base balance.

Specific Diseases (Examples)

  • Multiple Sclerosis (MS): Exact cause unknown, an inflammatory demyelinating disease.
  • Parkinson's Disease: Loss of dopamine and acetylcholine balance in the brain; goal of treatment is to balance these substances.
  • Alzheimer's Disease: Cholinesterase inhibitors improve cognitive function.

Other Important Considerations

  • Monitor liver function tests
  • Avoid alcohol
  • Nonpharmacological therapies like physical therapy and herbal remedies can assist with treatments.

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Description

Test your knowledge on long-term corticosteroid treatment, its adverse effects, and the physiology of the thyroid gland. This quiz covers important aspects of drug interactions and the hormonal regulation involving the thyroid. Ensure you understand the implications of corticosteroid therapy and thyroid function.

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