NR565 / NR 565 Final Exam Question Bank
(Latest 2025 / 2026):
Advanced Pharmacology Fundamentals - Chamberlain What labs are used to diagnose Thyroid dysfunction? - ANSWER TSH, free T3, total T3, free T4 and total T4.Thyroid function in hypothyroidism? - ANSWER T3 and T4 are lower, TSH is higher.Thyroid function in hyperthyroidism? - ANSWER TSH low, free T4 is normal and T3 is high.What is the timeframe for re-check of labs after starting Levothyroxine? - ANSWER Check TSH 6-8 weeks after initiating therapy and after dosage changes. Check TSH annually once TSH is stablizied.Signs and symptoms of hypothyroidism? - ANSWER Pale, puffy, expressionless face, cold, dry skin, brittle hair, hair loss, low temperature/HR, lethargy, fatigue, constipation, weight gain, intolerance to cold, menstruation impairment, thyroid enlargement. 1 / 3
Signs and symptoms of hyperthyroidism? - ANSWER Rapid strong heartbeat, dysrhythmias, angina, CNS stimulation, nervousness, insomnia, rapid thought process, rapid speech, skeletal muscles weaken, atrophy, metabolic rate increased, increased heat production, increased body temperature, increased appetite, weight loss, exophthalmos.What is the treatment of thyroid storm? - ANSWER High doses of potassium iodide or strong iodine solution, methimazole suppresses hormone synthesis, beta blockers reduce heart rate, sedation, cooling, and giving glucocorticoids and IV fluids can also help.First line treatment for hypothyroidism? - ANSWER Levothyroxine.First line treatment for hyperthyroidism? - ANSWER Methimazole.Why does the FDA recommend against using PTU as first line treatment of Thyroid storm? - ANSWER Hepatic toxicity.What can happen if hypothyroidism is not treated during pregnancy? - ANSWER Permanent neuropsychological deficits in the child, congenital hypothyroidism, decreased IQ (mainly occurs during the 1st trimester and increases up to 50%).What medication is used to treat symptoms associated with hyperthyroidism? - ANSWER Beta blockers to suppress tachycardia. 2 / 3
Medications that accelerate metabolism of Levothyroxine (may need to increase their levothyroxine dosage)? - ANSWER phenytoin (Dilantin), carbamazepine (Tegretol, Carbatrol), rifampin (Rifadin), sertraline (Zoloft).
Think about the CYP450 inducers that increase medication metabolism: CRAP
GPS Medications that reduce Levothyroxine absorption? - ANSWER Histamine 2 receptor blockers (cimetidine [Tagamet], PPIs (lansoprazole [Prevacid], sucralfate [carafate], colestipol [colestid]), aluminum containing antacids (Maalox, Mylanta), calcium supplements (Tums, Os-cal), iron supplements (ferrous sulfate), magnesium salts, Orlistat (Xenical).Medications whose metabolism is altered by Levothyroxine? - ANSWER Warfarin (doses of medication may need to be reduced), catecholamines, insulin, digoxin (may need to be increased).How to confirm a diagnosis of DM prior to beginning treatment? - ANSWER Fasting plasma greater than or equal to 126 (on 2 occasions), random plasma glucose greater than or equal to 200 plus symptoms of DM, oral glucose tolerance test 2 hr. plasma glucose greater than or equal to 200, and hemoglobin A1C 6.5% or higher.General Goals and older adult goals for A1C? - ANSWER General
Goals: less than 7%
Older Adult Goals: less than 8%
When should insulin be considered in DM? - ANSWER After the 3 drug combination is unsuccessful or patients who have A1C 10% or greater, fasting glucose greater than 300 or are markedly symptomatic.
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