Chapter 6: Thyroid Disorders Flashcards
What is the mnemonic for hypothyroidism clinical presentation
M- Memory loss
O- Obesity
M- Menorrhagia
S- Slowness
S- skin and hair dryness
O- onset gradual
T- tiredness
I- intolerance to cold
R- raised BP
E- energy levels fall
D- depression/ delayed relaxation phase of all reflexes
Etiology of Hashimoto thyroiditis
most common cause of hypothyroidism; autoimmune in origin, discovered once thyroid is largely destroyed and non-functional
Etiology of post-radioactive iodine treatment
Status post Graves’ disease treatment, SP thyroid cancer treatment
What is the mnemonic for hyperthyroidism clinical presentation
S- Sweating
W- Weight loss
E- emotional lability “mind racing”, memory alteration
A- Appetite increased, but losing weight
T- tremor/ tachycardia
I- intolerance of heat, irregular menstruation, irritability
N- nervousness
G- goiter
G- GI problems
Etiology of Graves disease
Most common; autoimmune in nature. exophthalmos, goiter
Etiology of toxic adenoma
Benign (nonmalignant), metabolically-active thyroid nodule. palpable mass but no exopthalmos
Etiology of toxic adenoma
benign, palpable unilateral mass without exophthalmos
Etiology of thyroiditis
Usually transient. Viral, autoimmune, postpartum, drug-induced. Thyroid tenderness
Clinical presentation: hypo/hyper/both
dry skin
hypo
Clinical presentation: hypo/hyper/both
fine tremor
hyper
Clinical presentation: hypo/hyper/both
hypoactive deep tendon reflexes
hypor
Clinical presentation: hypo/hyper/both
hypoactive DTR
hypo
Clinical presentation: hypo/hyper/both
mood or mentation change
both
Clinical presentation: hypo/hyper/both
menorrhagi
hypo
Clinical presentation: hypo/hyper/both
menorrhagia
hypo
Clinical presentation: hypo/hyper/both
exophthalmos
hyper
Normal range/ purpose of thyroid stimulating hormone (TSH)
0.4-4.0
evaluates the amount of TSH released by pituitary’s anterior lobe
Single most reliable test to diagnose all forms of thyroid disease
Normal range/ purpose of Free T4
10-27
Follow up test to confirm, support the diagnosis of thyroid disease in the face of an abnormal TSH
Normal range/ purpose of TPO Ab
NL <35
measures an antibody against peroxidase, an enzyme held within the thyroid.
A test to help detect autoimmune thyroid disease
Lab results expected for hypothyroidism
T4= low
TSH= high
What is the intervention for hypothyroidism
levothyroxine
When to do you recheck TSH after starting levothyroxine
Check TSH after 8 weeks. If it remains elevated, consider how it is being taken.
if TSH > 4; increase by 12.5-25 –> recheck in 8 weeks
if TSH < 0.5; decrease by 12.5-25 –> recheck in 8 weeks
Lab results expected for hyperthyroidism
T4= high
TSH= low
What is the intervention of hyperthyroidism
Beta blockers to counteract tachycardia
Methimazole or PTU
RAI
Consult endocrine
Lab results expected for subclinical hypothyroidism
TSH= high
T4= normal
What is the treatment for subclinical hypothyroidism?
Levothyroxine if TSH >5 and with symptoms
What is a thyroid nodule
palpable thyroid mass
What is the risk of a palpable thyroid nodule being a malignant lesion
5%; present the same
What are the findings most consistent with a malignant thyroid nodule
history of head or neck irradiation
size larger than 4 cm
firmness, nontender on palpation
relatively fixed position
persistent nontender cervical lymphadenopathy
dysphonia
hemoptysis
