Corticosteroids and Thyroid Physiology Quiz
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Questions and Answers

What is a potential adverse effect of long-term corticosteroid use?

  • Stimulation of adrenal functionality
  • Increased appetite leading to rapid weight gain
  • Suppression of the immune system (correct)
  • Improved inflammatory responses

How does long-term steroid therapy affect adrenal function?

  • Enhances adrenal responsiveness
  • Causes adrenal atrophy from lack of stimulation (correct)
  • Leads to adrenal hypertrophy
  • Stimulates adrenal hormone production

Which laboratory value is preferred for diagnosing thyroid disorders?

  • T3 levels
  • T4 levels
  • Thyroid-stimulating hormone (TSH) levels (correct)
  • Thyroid antibodies

Which of the following interactions can accelerate the metabolism of levothyroxine?

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

What dietary item should be avoided when taking levothyroxine due to potential interference?

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

What is a recommended monitoring practice for infants being treated for thyroid deficiency?

<p>Monthly height and weight assessments (D)</p> Signup and view all the answers

Which action should be taken when a patient on anticoagulants uses Ginkgo Biloba?

<p>Educate on potential bleeding risks (B)</p> Signup and view all the answers

Which of these is NOT a common adverse effect of chronic corticosteroids?

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

What is the primary action of loop diuretics at the loop of Henle?

<p>Block Na+ reabsorption (B)</p> Signup and view all the answers

Which drug is known to be particularly useful for patients allergic to sulfonamides?

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

What precautions should be taken when administering loop diuretics to older adults?

<p>Ensure access to a bathroom (A)</p> Signup and view all the answers

Which of the following is a potential side effect of potassium-sparing diuretics?

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

What should be monitored before therapy when using thiazide diuretics?

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

Which herbal supplement is known to decrease blood pressure and increase blood flow to improve memory?

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

What is a potential risk of taking large amounts of black licorice over an extended period?

<p>Decreased potassium levels (A)</p> Signup and view all the answers

Which herb is known to increase the effects of anticoagulants?

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

Which vitamin is known to enhance iron absorption and is used for improving wound healing?

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

Which herb should be avoided in individuals who are pregnant or have hormone-sensitive cancers?

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

What effect does Kava Kava have on the body?

<p>Decreases anxiety and relaxes muscles (B)</p> Signup and view all the answers

Which of the following functions is NOT a role of the kidneys in homeostasis?

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

What is the primary function of Vitamin K in the body?

<p>Assists in RBC production and clotting factor synthesis (C)</p> Signup and view all the answers

What adverse effect is commonly associated with diuretic therapy?

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

Which herbal supplement is beneficial for decreasing nausea and inflammation?

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

What is the most abundant intracellular cation that plays a critical role in maintaining potassium balance?

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

Which serum level indicates hyperkalemia?

<p>Greater than 5 mEq/L (A)</p> Signup and view all the answers

What serious adverse effect should be monitored for in cases of hypermagnesemia?

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

What is the primary treatment goal for pharmacotherapy in Parkinson's Disease?

<p>Balance dopamine and acetylcholine (A)</p> Signup and view all the answers

Which of the following is a contraindication for the use of Benztropine?

<p>Closed-angle glaucoma (A)</p> Signup and view all the answers

What serum level indicates hypocalcemia?

<p>Less than 2.1 mmol/L (B)</p> Signup and view all the answers

Which of these is a common side effect of cholinesterase inhibitors used in Alzheimer's Disease?

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

What is a key consideration when administering Levodopa for Parkinson's Disease?

<p>Avoid alcohol consumption (C)</p> Signup and view all the answers

What is a typical adverse effect of Magnesium supplements due to overdose?

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

Which condition is often a sign of hypercalcemia?

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

What distinguishes muscle spasticity from muscle spasms?

<p>Spasticity involves continuous contraction and greater pain. (A)</p> Signup and view all the answers

What electrolyte imbalance can result from the use of loop and thiazide diuretics?

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

What is a common reason for using anticholinergic drugs in Parkinson's Disease?

<p>To block excitatory actions of acetylcholine (B)</p> Signup and view all the answers

Flashcards

Long-term Steroid Therapy: Adrenal Atrophy

Prolonged steroid use can lead to adrenal gland shrinking due to lack of stimulation. This can occur within 2-4 weeks of high doses.

Long-term Steroid Therapy: Live Vaccines

Patients taking long-term steroids should avoid live vaccines, as their weakened immune system cannot fight off the weakened virus.

Long-term Steroid Therapy: Weight Gain

Report a weight gain of over 2 lbs in a single day while on long-term steroids, as this could indicate fluid retention.

Hypothyroidism Diagnosis: Low TSH

A low TSH level indicates a healthy functioning thyroid gland in the case of primary hypothyroidism.

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Hypothyroidism Drug Interactions: Phenytoin

Phenytoin can accelerate the metabolism of levothyroxine, meaning a higher dose may be needed.

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Hypothyroidism Food Interactions: Soy Products

Soy products, like soybean flour, can hinder the absorption of levothyroxine.

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Ginkgo Biloba and Anticoagulants

Ginkgo Biloba's flavones can interact with blood thinners, potentially causing an increased risk of bleeding.

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Natural Products: Safety vs. Effectiveness

Just because a product is 'natural' doesn't mean it's safe. Some natural chemicals can be as strong as prescription and OTC meds.

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Ginseng Interactions

Ginseng can decrease blood sugar, stress, blood pressure, and sexual dysfunction while increasing energy. Be cautious with insulin and oral hypoglycemics as ginseng could increase their effects.

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Ginkgo Biloba's Benefits

Ginkgo Biloba acts as an antioxidant, improves blood flow and memory, and can lower blood pressure. However, it can increase the effects of anticoagulants.

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Black Licorice: Dangerous Amounts

Consuming large amounts of black licorice (more than four weeks) can lead to headaches, increased blood pressure, and decreased potassium, which can be dangerous.

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Ginger's Impact

Ginger helps reduce nausea, IBS symptoms, stomach issues, and inflammation. However, it can increase the effects of anticoagulants.

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Feverfew: Migraine Relief

Feverfew helps decrease fever, inflammation, migraines and dizziness, nausea and vomiting, tinnitus, and blood pressure. However, it can increase the effects of blood thinners and NSAIDs.

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Garlic: Blood-Thinning Properties

Garlic thins the blood, boosting immunity and increasing the effects of anticoagulants. It also decreases cholesterol levels.

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Valerian: Sleep Aid

Valerian helps with sleep disorders by decreasing anxiety and blood pressure. However, it can increase the effects of CNS depressants like benzodiazepines, barbiturates, anticonvulsants, and sedatives.

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Kava Kava: Stress Relief

Kava Kava helps decrease stress and anxiety, controls convulsions, and relaxes muscles. However, it can increase the effects of CNS depressants like benzodiazepines, barbiturates, anticonvulsants, sedatives, Adderall, and 5-HTPs.

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Turmeric: Anti-Inflammatory Power

Turmeric reduces inflammation, tumors, infections, and stomach problems. It enhances the effects of anticoagulants and can decrease the effectiveness of PPIs and H2 blockers, leading to increased stomach acid.

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Vitamin K's Role

Vitamin K helps in red blood cell production, clotting factor synthesis, and is used to treat neonatal hemorrhagic disease. It acts as an antidote for warfarin overdose and takes 3-8 hours to stop bleeding.

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Loop Diuretics: Mechanism of Action

Loop diuretics block the reabsorption of sodium (Na+) in the loop of Henle, leading to increased urine production and a decrease in blood volume.

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Loop Diuretics: Indications

Loop diuretics are primarily used to treat edema, a condition where fluid builds up in the body. They can also be used for hypertension in some cases.

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Loop Diuretics: Important Considerations

Loop diuretics can cause electrolyte imbalances, particularly potassium depletion. Frequent monitoring of potassium levels and overall health status is essential.

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Potassium-Sparing Diuretics: Drug Interactions

Potassium-sparing diuretics can interact with various medications, including potassium supplements, ACE inhibitors, and ARBs, increasing the risk of hyperkalemia (high potassium levels).

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Fluid Imbalance: Intracellular vs Extracellular Fluids

The body's water is distributed between two compartments: intracellular fluid (ICF), which makes up 2/3, and extracellular fluid (ECF), which makes up 1/3. The balance between these compartments is critical for overall health.

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Electrolytes: Definition

Electrolytes are charged substances, like sodium (Na+) and potassium (K+), that are essential for maintaining the body's balance (homeostasis).

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Electrolyte Imbalance: Cause

An imbalance of electrolytes, either too high or too low, is a sign of an underlying medical condition.

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Electrolyte Imbalance: Treatment

Treating electrolyte imbalance involves identifying and addressing the underlying cause of the imbalance.

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Hypernatremia: Symptoms

Hypernatremia, or high sodium levels, can lead to symptoms like lethargy, confusion, muscle tremors, low blood pressure, restlessness, and even pulmonary edema.

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Hypokalemia: Cause

Low potassium levels, known as hypokalemia, are often caused by medications like loop and thiazide diuretics.

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Hypomagnesemia: Causes

Low magnesium levels, called hypomagnesemia, can happen due to kidney problems or the use of certain diuretics.

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Hypermagnesemia: Cause

High magnesium levels, or hypermagnesemia, are primarily caused by advanced kidney failure.

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Hypercalcemia: Cause

High calcium levels, hypercalcemia, often occur due to overactive parathyroid glands.

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Hypocalcemia: Causes

Low calcium levels, hypocalcemia, can be caused by a lack of calcium or vitamin D, hypothyroidism, or certain medications.

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Neurodegenerative Diseases: Characteristics

Neurodegenerative diseases are progressive and irreversible, leading to a gradual loss of neurons.

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Parkinson's Disease: Treatment Goal

The goal of Parkinson's disease treatment is to restore a balance between dopamine and acetylcholine neurotransmitters.

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Levodopa: Considerations

Levodopa, a Parkinson's medication, should be taken on an empty stomach, avoiding multivitamins with vitamin B6 and high-protein meals.

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Pramipexole: Important Notes

Pramipexole, a Parkinson's medication, requires assessment of vital signs, symptoms, and mental status, and patients and families should be aware that it only manages symptoms, not cures the disease.

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Benztropine: Adverse Effects

Benztropine, an anticholinergic medication for Parkinson's, can cause side effects like sedation, constipation, blurred vision, dry mouth, and confusion.

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Alzheimer's Disease: Treatment

Treatment for Alzheimer's disease aims to improve function and cognition using medications such as cholinesterase inhibitors, but it doesn't stop the disease's progression.

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Study Notes

Long-Term Corticosteroid Treatment

  • Corticosteroids suppress inflammation and immune responses.
  • Long-term use can lead to adrenal atrophy.
  • Patients should avoid live vaccines while on long-term steroids.
  • Rapid weight gain (over 2 lbs in a day) is a potential side effect.
  • Higher doses lead to faster adrenal atrophy (2-4 weeks).
  • Side effects include immune suppression, GI issues (bleeds/ulcers), osteoporosis, behavioral changes, and fluid retention.
  • Drug interactions exist with potassium-wasting drugs and anticholinesterase agents.

Thyroid Gland Physiology

  • Low blood levels trigger negative feedback.
  • The hypothalamus releases TRH.
  • The anterior pituitary releases TSH.
  • The thyroid gland releases T3 and T4 hormones.

Thyroid Disorders Diagnosis

  • TSH is the preferred lab value.
  • Low TSH is a good indicator.
  • Primary hypothyroidism involves low serum T4 and elevated TSH levels.
  • Hashimoto's thyroiditis is associated with abnormal antithyroid antibodies.

Pharmacotherapy of Hypothyroid Disorders

  • Drugs like phenytoin can accelerate the metabolism of levothyroxine.
  • Foods like soybean flour and walnuts can affect levothyroxine absorption.
  • Some herbs, like gingko biloba, can interact with anticoagulants.

Herb-Drug Interactions

  • Ginkgo biloba can be dangerous for patients on anticoagulants.
  • Ginseng can decrease blood sugar, blood pressure, and sexual function.
  • It can also increases levels of CNS depressants and anticoagulants.

Other Herb-Drug Interactions

  • Black licorice can increase blood pressure, decrease potassium, and increase digoxin, aspirin, and steroid effects.
  • Ginger may lower nausea and inflammation but increase anticoagulant effects.
  • Feverfew can decrease fever and inflammation but increase anticoagulant and anti-inflammatory effects.
  • Garlic can thin the blood and increase immunity.
  • Valerian can decrease anxiety and blood pressure but increases the effects of other CNS depressants like benzodiazepines, barbiturates, and anticonvulsants.
  • Kava Kava can decrease stress and anxiety but increase the effects of CNS depressants.
  • St. John's Wort can decrease depression and anxiety but increase the effects of other CNS depressants.
  • Melatonin may decrease the effects of desipramine and fluoxetine.
  • Saw Palmetto can decrease BPH symptoms but decrease iron absorption and interactions exist with oral contraceptives and finasteride.
  • Turmeric may decrease inflammation but enhance the effects of anticoagulants, and may increase stomach acid.

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Description

Test your knowledge on the effects of long-term corticosteroid treatment and the physiology and disorders of the thyroid gland. This quiz covers important concepts such as hormone regulation, potential side effects of corticosteroids, and the diagnosis of thyroid disorders. Ideal for medical students and healthcare professionals.

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