Thyroid dysfunction

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1. lab data requested:

    1. TSH only for screening

    2. TSH, T3, T4

2. Hypothyroidism

    1. actual: high TSH, low T3/T4

    2. subclinical: high TSH, NL T3/T4

    3. Tx:

        1. Tab levothyroxine 50-100 ugr qd

        2. start with 1.6 ugr/kg daily, calculate weekly dose

        3. if PMHx + for HF or age>60 y/o

            1. start with 25 ugr qd

        4. check every 2 month and add or decrease 1/4 to 1/2 of tab

3. Hyperthyroidism ⇒ REFER ALL PT

    1. tab methimazole 5 mg q12h #100

    2. tab propranolol 20 mg q8h #100

    3. side effects of methimazole told written to the pt

        1. urticaria, rash

        2. jaundice, bleeding

        3. fever, chills

        4. headache