Associated diseases of the Thyroid

Question 1

Hyperthyroidism

Answer 1

increase T3 and T4, decrease TAG level

Question 2

Hypothyrodism

Answer 2

– decrease T3 and T4, increase TAG level

Question 3

give the S/S for Hyperthyroidism

Answer 3

• Heat intolerance (increase sweating)
• Emotionally labile
• Tachycardia
• Unexplained weight loss
• Tremors, restlessness, hyperkinesis, anxiety,
  irritability
• With diarrhea and increase appetite

Question 4

give the S/S for Hypothyroidism

Answer 4

Cold intolerance (decrease sweating)
- Bradychardia, Fatigue
- Dryness of skin
- Unexplained weight gain, dyspnea, hair loss
- Mental dullness, muscle weakness, constipation
- Yellow discoloration of skin (hypercarotenemia)
- Decrease Na+
, increase CK

Question 5

Severe: Pleural and Peritoneal effusions, irregular mens,
periorbital edema, myopathy, anemia

Answer 5

Hypothyroidism

Question 6

Primary Hyperthyroidism

Answer 6

increase T3,T4, FT4, rT3;
decrease TSH,
normal TBG

Increase: aTPO, ATG, TBII, TSI

Question 7

Secondary Hyperthyroidism

Answer 7

– increase T3, T4, and TSH! (Pituitary problems)
- “TSH” to compare with primary

Question 8

T3 thyrotoxicosis –

Answer 8

increase T3, normal to decrease T4,
normal FT4

Increase T3 uptake
- Suppressed TSH, NO Signs and symptoms

Question 9

T4 thyrotoxicosis

Answer 9

increase T4, normal to decrease T3

Question 10

Grave’s disease

Answer 10

with diffuse toxic goiter
- most common, autoimmune
- 6x more common in girls
- Due to circulating antibodies to TSH receptor

Question 11

Grave’s disease is associated with?

Answer 11

Exophthalmos and Pritibial Myxedema

Question 12

Test for Grave’s disease

Answer 12

TSH receptor antibody test

Question 13

Thyroid is woody/stony hard mass

Answer 13

Riedel’s disease

Question 14

low TSH, normal FT3 & FT4
- without symptoms

Answer 14

Subclinical hyperthyroidism

Question 15

painful thyroiditis
- TPO antibody is absent
- Increase Thyroglobulin and ESR

Answer 15

Subacute granulomatous/Subacute non-suppurative
thyroiditis/ De Quervain’s

Question 16

Primary Hypothyroidism

Answer 16

decrease T3, T4, FT4, rT3; increase TSH, normal
TBG

Normal or increase: aTPO, ATG, TBII
- Normal to decrease: Tg

Question 17

Secondary Hypothyroidism

Answer 17

decrease T4, decrease TSH (Pituitary no TSH!)
- Decrease T3, FT4

Question 18

Tertiary Hypothyroidism

Answer 18

decrease T3 and T4 and TSH

Question 19

Subclinical

Answer 19

normal T3, T4 and FT4; TSH slightly increase
- No signs and symptoms

Question 20

Other names for Hashimoto’s disease

Answer 20

“chronic autoimmune thyroiditis”
- “Chronic lymphocytic thyroiditis”

Question 21

Hashimoto’s disease

Answer 21

Common cause of primary hypothyroidism
- Thyroid is replaced by nest of lymphoid tissue
sensitized T-cells bind to cell membrane causing
cell Lysis and inflammatory reaction
- With Goiter

Question 22

Test for Hashimoto’s disease

Answer 22

Test: TPO antibody = (+) increase TSH
(TPO Ab = tissue destructive disease)

Question 23

peculiar nonpitting swelling of skin. Skin
infiltrated by mucopolysaccharide

Answer 23

Myxedema

Question 24

Myxedema

Answer 24

“puffy face” (moon face)
- Weight gain, slow speech
- Thin eyebrows, dry yellow skin

Question 25

Cretinism

Answer 25

Congenital hypothyroidism

Question 26

Congenital hypothyroidism

Answer 26

• Development/functional defect of gland
• Retarded child

Question 27

Non-thyroidal illness

Answer 27

Euthyroid Sick Syndrome

Question 28

Pregnancy

Answer 28

high Estrogen =
high TBG = i
ncrease binding
capacity =

increase total T4 and T3, normal FT4, T3 and TSH

Question 29

Pregnancy feedback mechanism is due to?

Answer 29

negative feedback of anterior pituitary

Question 30

Nephrotic syndrome, Decrease protein production

Answer 30

low TBG = Low T4, normal FT4 and TSH

Question 31

HCG

Answer 31

After fertility = increase FT4 and T3, Low TSH