Question 1

Why are "natural" thyroid products not readily prescribed for most patients?

Accepted Answer

A)  There is no reliability for the amount of hormone per dose. 
B)  There is higher incidence of allergic reactions. 
C)  There is a more reliable dose of T3 to T4 per batch. 
D)  All of the above 
A)  There is no reliability for the amount of hormone per dose. 
B)  There is higher incidence of allergic reactions. 
C)  There is a more reliable dose of T3 to T4 per batch. 
D)  All of the above D

Question 2

Infants with congenital hypothyroidism are treated with:

Accepted Answer

A)  Levothyroxine 
B)  Liothyronine 
C)  Liotrix 
D)  Methimazole 
A)  Levothyroxine 
B)  Liothyronine 
C)  Liotrix 
D)  Methimazole A

Question 3

When methimazole is started for hyperthyroidism it may take ________ to see a total reversal of hyperthyroid symptoms.

Accepted Answer

A)  2 to 4 weeks 
B)  1 to 2 months 
C)  3 to 4 months 
D)  6 to 12 months 
A)  2 to 4 weeks 
B)  1 to 2 months 
C)  3 to 4 months 
D)  6 to 12 months D

Question 4

Once a patient who is being treated for hypothyroidism returns to euthyroid with normal TSH levels, he or she should be monitored with TSH and free T4 levels every:

Accepted Answer

A)  2 weeks 
B)  4 weeks 
C)  2 months 
D)  6 months 
A)  2 weeks 
B)  4 weeks 
C)  2 months 
D)  6 months

Question 5

In hyperthyroid states, what organ system other than CV must be evaluated to establish potential adverse issues?

Accepted Answer

A)  The liver 
B)  The nails and skin 
C)  The eye 
D)  The ear 
A)  The liver 
B)  The nails and skin 
C)  The eye 
D)  The ear

Question 6

In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for:

Accepted Answer

A)  A calcium channel blocker 
B)  A beta blocker 
C)  Liothyronine 
D)  An alpha blocker 
A)  A calcium channel blocker 
B)  A beta blocker 
C)  Liothyronine 
D)  An alpha blocker

Question 7

Laboratory values are actually different for TSH when screening for thyroid issues and when used for medication management. Which of the follow holds true?

Accepted Answer

A)  Screening TSH has a wider range of normal values 0.02-5.0; therapeutic levels need to remain above 5.0. 
B)  Screening values are much narrower than the acceptable range used to keep a person stable on hormone replacement. 
C)  Therapeutic values are kept between 0.05 and 3.0 ideally. Screening values are considered acceptable up to 10. 
D)  Screening values are between 5 and 10, and therapeutic values are greater than 10. 
A)  Screening TSH has a wider range of normal values 0.02-5.0; therapeutic levels need to remain above 5.0. 
B)  Screening values are much narrower than the acceptable range used to keep a person stable on hormone replacement. 
C)  Therapeutic values are kept between 0.05 and 3.0 ideally. Screening values are considered acceptable up to 10. 
D)  Screening values are between 5 and 10, and therapeutic values are greater than 10.

Question 8

After starting a patient with Grave's disease on an antithyroid agent such as methimazole, patient monitoring includes TSH and free T4 every:

Accepted Answer

A)  1 to 2 weeks 
B)  3 to 4 weeks 
C)  2 to 3 months 
D)  6 to 9 months 
A)  1 to 2 weeks 
B)  3 to 4 weeks 
C)  2 to 3 months 
D)  6 to 9 months

Question 9

Treatment of a patient with hypothyroidism and cardiovascular disease consists of:

Accepted Answer

A)  Levothyroxine 
B)  Liothyronine 
C)  Liotrix 
D)  Methimazole 
A)  Levothyroxine 
B)  Liothyronine 
C)  Liotrix 
D)  Methimazole

Question 10

Goals when treating hypothyroidism with thyroid replacement include:

Accepted Answer

A)  Normal TSH and free T4 levels 
B)  Resolution of fatigue 
C)  Weight loss to baseline 
D)  All of the above 
A)  Normal TSH and free T4 levels 
B)  Resolution of fatigue 
C)  Weight loss to baseline 
D)  All of the above

Question 11

What is the desired mixed of T3 to T4 drug levels in newly diagnosed endocrine patients?

Accepted Answer

A)  99% of T3 and the rest is T4 to get rapid resolution. 
B)  Most needs to be T4 to mimic natural ratios of hormone. 
C)  The ratio is unimportant. 
D)  The mix needs to be 50-50 at first. 
A)  99% of T3 and the rest is T4 to get rapid resolution. 
B)  Most needs to be T4 to mimic natural ratios of hormone. 
C)  The ratio is unimportant. 
D)  The mix needs to be 50-50 at first.

Question 12

When starting a patient with hypothyroidism on thyroid replacement hormones patient education would include:

Accepted Answer

A)  They should feel symptomatic improvement in 1 to 2 weeks. 
B)  Drug adverse effects such as lethargy and dry skin may occur. 
C)  It may take 4 to 8 weeks to get to euthyroid symptomatically and by laboratory testing. 
D)  Because of its short half-life, levothyroxine doses should not be missed. 
A)  They should feel symptomatic improvement in 1 to 2 weeks. 
B)  Drug adverse effects such as lethargy and dry skin may occur. 
C)  It may take 4 to 8 weeks to get to euthyroid symptomatically and by laboratory testing. 
D)  Because of its short half-life, levothyroxine doses should not be missed.

Question 13

When starting a patient on levothyroxine for hypothyroidism the patient will need follow-up measurement of thyroid function in:

Accepted Answer

A)  2 weeks 
B)  4 weeks 
C)  2 months 
D)  6 months 
A)  2 weeks 
B)  4 weeks 
C)  2 months 
D)  6 months

Question 14

A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with:

Accepted Answer

A)  Methimazole 
B)  Propylthiouracil (PTU) 
C)  Radioactive iodine 
D)  Nothing, treatment is best delayed until after her pregnancy ends 
A)  Methimazole 
B)  Propylthiouracil (PTU) 
C)  Radioactive iodine 
D)  Nothing, treatment is best delayed until after her pregnancy ends

Question 15

What happens to the typical hormone replacement dose when a woman becomes pregnant?

Accepted Answer

A)  Most women need less medication. 
B)  Most women do not require a dose change. 
C)  The average woman needs more medication during pregnancy. 
D)  The average woman needs more medication only if carrying multiples. 
A)  Most women need less medication. 
B)  Most women do not require a dose change. 
C)  The average woman needs more medication during pregnancy. 
D)  The average woman needs more medication only if carrying multiples.

Exam 41: Hyperthyroidism and Hypothyroidism

Why are "natural" thyroid products not readily prescribed for most patients?

Infants with congenital hypothyroidism are treated with:

When methimazole is started for hyperthyroidism it may take ________ to see a total reversal of hyperthyroid symptoms.

Once a patient who is being treated for hypothyroidism returns to euthyroid with normal TSH levels, he or she should be monitored with TSH and free T4 levels every:

In hyperthyroid states, what organ system other than CV must be evaluated to establish potential adverse issues?

In addition to methimazole, a symptomatic patient with hyperthyroidism may need a prescription for:

Laboratory values are actually different for TSH when screening for thyroid issues and when used for medication management. Which of the follow holds true?

After starting a patient with Grave's disease on an antithyroid agent such as methimazole, patient monitoring includes TSH and free T4 every:

Treatment of a patient with hypothyroidism and cardiovascular disease consists of:

Goals when treating hypothyroidism with thyroid replacement include:

What is the desired mixed of T3 to T4 drug levels in newly diagnosed endocrine patients?

When starting a patient with hypothyroidism on thyroid replacement hormones patient education would include:

When starting a patient on levothyroxine for hypothyroidism the patient will need follow-up measurement of thyroid function in:

A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with:

What happens to the typical hormone replacement dose when a woman becomes pregnant?

The Role of the Nurse Practitioner

Review of Basic Principles of Pharmacology

Rational Drug Selection

Legal and Professional Issues in Prescribing

Adverse Drug Reactions

Factors That Foster Positive Outcomes

Cultural and Ethnic Influences in Pharmacotherapeutics

An Introduction to Pharmacogenomics

Nutrition and Nutraceuticals

Herbal Therapy and Nutritional Supplements

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Over-The-Counter Medications

Drugs Affecting the Autonomic Nervous System

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