3. Tiroides Flashcards

1
Q

Trm coma mixedematos?

A

Hidrocortisona seguida de levotiroxina (i fluids)

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2
Q

Com trobes TSH , T4 i T3 en:

  • hipotiroidisme subclinic
  • eutiroideu malalt
  • hipertiroidisme primari
  • tirotoxicosi T3 exogena
A
  • hipotiroidisme subclinic: TSH alta , T4 normal i T3 normal
  • eutiroideu malalt: TSH baixa/N, T4 baixa/normal i T3 baixa (rT3 alta)
  • hipertiroidisme primari : TSH baixa , T4 alta i T3 alta
  • tirotoxicosi T3 exogena: TSH baixa , T4 baixa i T3 alta
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3
Q

En un d’aquests casos NO tractes hipoTiroidisme subclinic:

  • embarassada TSH 6
  • cardiopata TSH 12
  • avi TSH 9
  • nen TSH 8
  • adult TSH 10
A
  • avi TSH 9 (ancians i cardiopates nomes si TSH 10 o major)
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4
Q

Amiodarona sonre tiroides

  • hipoT mes freq si deficit iode
  • HiperT mes freq en homes
  • hipoT en qualsevol moment
  • HiperT en 1r any
  • HiperT tipus I es per efecte Wolff Chaikoff
  • tot cert
A
  • HiperT mes freq en homes (en zones amb def de iode, en qualsevol moment del ttm, efecte Jod-Basedow)
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5
Q

Com trobes el reflex aquilinen hiper i hipotiroidisme?

A

Exaltat en hiper i mes lent en hipo

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6
Q

Efecte Job-Basedow

A

Hipertiroidisme per iode captat en nodults autonoms

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7
Q

Efecte wolff-chaikoff

A

Inhibicio sintesi tiroidea transitoria, seguida de fenomen d’escapament que torna a normalitat. Freq en Graves Basedow i amiodarona

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8
Q

En malaltia de Graves es fals

  • oftalmopatia no es correlaciona amb activitat hormonal
  • mixedema pretibial es caracteristic i indolor
  • el tabac protegeix de oftalmopatia
  • hipertiroidisme neonatal es per el pas d’anticossos
A
  • tabac protegeix oftalmopatia. NOOOOO!! S’ha d’abandonar
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9
Q

En oftalmopatia de Graves

  • el millor ttm es radioiode
  • cortis empitjoren la clinica
  • Tiroidectomia subtotal en casos greus
  • retraccio palpebral es signe de progressio
A

-tiroidectomia en greus

Radioiode empitjora, cortis milloren i son primera opcio en greus (ev), retraccio palpebral es el primer signe

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10
Q

Ttm hipertiroidisme Graves en embarassades i lactancia?

A

Embarassades: Propiltiuracil 1rT i Metimazol 2n i 3r T (PTU hepatotoxic). Cirurgia 2n T si no control
Lactancia: metimazol baixes dosis

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11
Q

Durant l’embaras, Graves millora o empitjora?

A

Millora fins a poder desapareixer pero recidiva o empitjora post-part

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12
Q
No tractates amb antitiroideus:
Tiroiditis de Hashimoto
Tiroiditis de Quervain
Tiroiditis limfocitaria
Tiroiditis de Riedel
A

De Quervain

Riedel

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13
Q
Quina s'associa a antiTPO?
Tiroiditis de Hashimoto
Tiroiditis de Quervain
Tiroiditis limfocitaria
Tiroiditis de Riedel
A

Hashimoto (i en baixa titulacio la limfocitaria)

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14
Q
Quina tiroiditis es dolorosa?
Tiroiditis de Hashimoto
Tiroiditis de Quervain
Tiroiditis limfocitaria
Tiroiditis de Riedel
A

De Quervain (tambe ho seria l’aguda bacteriana)

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15
Q

Quina dada histologia es tipica de carcinoma medular tiroides?

A

Teixit amiloideu

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16
Q

Quin cancer tieoideu s’associa amb elevacio de catecolamines o metanefrines?

A

Medular de tiroides

17
Q

Que t’obliga a demanar un carcinoma medular d tiroides?

A

Feoctomocotoma? Metanefrines o catecolamines
Calcotectina i CEA
protooncogen RET.