FNP-652 Quiz 2 -Questions with Correct Answers/ Verified/ Latest Update HYPOthyroidism - ✔✔Two types: Congenital (Hashimotos) or Acquired (Iodine Deficiency) Symptoms: Growth Failure, goiter, del ayed puberty, weight gain, fatigue, hyperlipidemia, poor school performance, menorrhagia, positive family history Pediatric Symptoms: Prolonged jaundice, constipation, umbilical hernia, large fontanelle, decreased muscle tone, poor feeder, growth delay, o verweight for age/height Diagnosis: Newborn Screening, if Down Syndrome also test at at 6.5 months then annually) Medications:Referral to endocrine specialist for replacement therapy Synthroid (Levothyroxine) HYPERthyroidism - ✔✔Graves disease is the most common - excessive thyroid hormone production. Most common presenting symptom in >60 is Afib. Symptoms: Palpitations, tremors, hungry, skinny, fatigue, muscle weakness, emotional, poor concentation, hyper def ecation, poor sleep patterns Pediatric Symptoms: Also add tachycardia, thyroid bruit, hyperreflexia, eyelid lag, wide pulse pressure, exophthalmos Diagnosis: free T4, TSh, free T3 Medications/Management: Beta -blockers, anti -thyroid drugs subtotal thyroi dectomy, radioiodine ablation. REFER PEDS Thyroid nodules - ✔✔If palpable order ultrasound and thyroid function tests. Refer to a Endocrinologist for a fine needle biopsy and radioactive iodine studies. Both benign and malignant nodules are often asympt omatic. FIXED, FIRM, Non -tender, and LARGE: likely to be malignant Hashimotos may have multiple. Differences between Type 1 and 2 Diabetes: - ✔✔Type 1: Caused y autoimmune destruction of the pancreatic beta cells. Typically gradual onset, but individua ls may have sudden onset of illness once symptoms manifest (IE new DKA) Type 2: Genetic and Enviromental inluences combine. Obesity is the most important enviromental issue. ^ visceral fat contributes to insulin resistance. Ethnic variations are significa nt Type 1 Diabetes: - ✔✔Medication Management: Insulin pumps are preferred. Insulin is delivered at a basal rate with boluses at mealtimes. Glargine, humalog, novalog. Type 2 Diabetes: - ✔✔Medication management: Start with Metformin and follow the ADA guidelines/ flowchart. Gestational Diabetes - ✔✔Diagnosis: Universal screening at 24 -48 weeks gestation via Glucose Tolerance test. Treatment: send to diabetes educator, self -monitoring QID, Insulin if not controlled with diet. Increases risk for type 2 di abetes later in life. Thyroid Labs - ✔✔TSH normal (0.4 -4.0) with most normal adults will be <3.0 T4 (free T4) most commonly decreased T3 (total triiodothyronin as T3) Check if estrogen levels are elevated
