Hyperthyroidism Management Quiz
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Questions and Answers

What is the starting dose of Levothyroxine, according to the table provided?

  • 20-30mg OD
  • 100mcg
  • 12.5 mcg/day (correct)
  • 30-40mg OD

    • Which of these are side effects of Levothyroxine?

  • Permanent hypothyroidism
  • High peak in T3
  • Hyperthyroidism symptoms (correct)
  • Fluctuates serum levels

    • Which drugs are used to treat beta-blockers associated with cardiac overstimulation?

  • Liothyronine
  • Desiccated thyroid
  • All beta blockers (correct)
  • Levothyroxine

    • What is the recommended starting dose of radioactive Iodine?

    <p>Not mentioned in the text (D)</p> Signup and view all the answers

    Which of the following medications can increase the cardiac risk of Levothyroxine?

    <p>All of the above (D)</p> Signup and view all the answers

    What are the facts/uses of Desiccated thyroid?

    <p>First agent, from thyroid of animals, contains T3&amp;4, lifelong drug, causes high peak in T3, not well standardized (D)</p> Signup and view all the answers

    Which of the following options correctly describes the effect of Radioactive Iodine on the thyroid?

    <p>It cures hyperthyroidism permanently, causing temporary thyroiditis and worsening symptoms before leading to hypothyroidism. (C)</p> Signup and view all the answers

    What type of drug is Liothyronine?

    <p>Synthetic thyroid hormone (B)</p> Signup and view all the answers

    What is the half-life of Levothyroxine?

    <p>7 days (A)</p> Signup and view all the answers

    What is the average replacement dose of Levothyroxine?

    <p>100 mcg empirically (D)</p> Signup and view all the answers

    Which of the following is a serious side effect associated with Propylthiouracil and Methimazole?

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

    How does Propylthiouracil and Methimazole work to treat hyperthyroidism?

    <p>Inhibit the production of thyroid hormone (D)</p> Signup and view all the answers

    Which class of drugs is Propylthiouracil and Methimazole a part of?

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

    What is the mechanism of action of Propylthiouracil and Methimazole in relation to the production of thyroid hormone?

    <p>They inhibit the synthesis of thyroid hormone (B)</p> Signup and view all the answers

    What is the most common side effect experienced by patients taking Propylthiouracil and Methimazole?

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

    Study Notes

    Hyperthyroidism

    • Thioamides (e.g., Propylthiouracil, Methimazole):

      • Mechanism of Action (MOA): Inhibit thyroid hormone production by preventing iodine from binding to tyrosine residues, inhibiting coupling of MIT and DIT.
      • Side Effects: Common: gastrointestinal upset, rash, joint pain; Serious: agranulocytosis (0.4% of patients, with a higher risk in the first 90 days), neutropenia.
      • Propylthiouracil: Not commonly used for long-term treatment; has a role in the treatment of pregnant patients, but is less effective and carries risks.
      • Methimazole: More commonly used for long-term treatment.
      • Dosing: Varies by severity (mild, moderate, severe), with initial and maintenance doses adjusted accordingly.

    • Beta-Blockers:

      • MOA: Reduce symptoms related to cardiac overstimulation, do not directly influence thyroid hormones.
      • Use: Many beta-blockers are suitable except for those with intrinsic sympathomimetic activity.
      • Side Effects: Not typically directly related to thyroid function; some may worsen underlying cardiovascular conditions.
      • Note: Beta-blockers do not directly treat the underlying hyperthyroidism; they just treat symptoms.

    • Surgery:

      • Use: Used as a curative treatment due to permanent hypothyroidism in some cases. May be accompanied by temporary thyroiditis or a return to worsened hyperthyroidism symptoms, then eventual hypothyroidism.

    • Radioactive Iodine:

      • Use: Curative treatment for hyperthyroidism, leading to temporary thyroiditis then eventual restoration of thyroid function or hypothyroidism.

    Hypothyroidism

    • Desiccated Thyroid:

      • Use: First agent, derived from animal thyroids. Contains T3 and T4; considered a potentially less stable preparation with less predictable pharmacokinetics.

    • Liothyronine:

      • Use: Analog of T4; quicker action, primarily for use in cases with conversion issues from T4 to T3.

    • Levothyroxine:

      • Average Dose: 1.6 mcg/kg/day, with varying initial dosages (12.5 mcg upward); titrated based on TSH levels. Higher TSH correlates to higher T4 dosage.
      • Starting Dosage Recommendation: Cautious increases based on age, pre-existing cardiac conditions, severity of hypothyroidism, and other factors. Start low, up to 12.5 -50mcg, and advance as tolerated and monitored.
      • Considerations: Administer on an empty stomach; avoid concurrent use with certain medications/nutrients.
      • Side Effects: Relatively few if the medication is dosed correctly, and monitoring is conducted; common side effects include hyperthyroidism symptoms and cardiac issues if dosages are too high.

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    Description

    Test your knowledge on the management of hyperthyroidism, focusing on thioamides and beta-blockers. This quiz covers their mechanisms of action, side effects, and appropriate dosing strategies. Ideal for medical students and healthcare professionals.

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