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PC1-Exam 2 > Endrocrine (thyroid, Precocious Puberty) > Flashcards

Endrocrine (thyroid, Precocious Puberty) Flashcards

1
Q

Primary disorders of the thyroid involve what?

A

Primary disorder caused by abnormal function of the thyroid gland.

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2
Q

Secondary disorders for thyroid disorders are caused by abnormalities of what?

A

Second disorders result of abnormalities at the level pituitary.

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3
Q

Tertiary thyroid disorders are result of a malfunction at the level of what?

A

Teritary result from malfunction at the level of the hypothalamus

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4
Q

What is the first step in investigating a thyroid nodule?

A

Determine if it’s benign or malignant

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5
Q

What is the second step of investigation of a thyroid nodule?

A

Determine association with thyroid dysfunction

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6
Q

Goiter is caused by what?

A

In the US—Are more often the cause of over or under production of the thyroid stimulating hormone, causing hypertrophy.
In other countries it is caused by a lack of iodine in the diet.

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7
Q

If a thyroid nodule is present in children what is this most likely mean?

A

Most likely malignant 

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8
Q

Firm, hard/fixed, or a irregular, nontender nodules without signs or symptoms of thyroid dysfunction are more likely to be what?

A

More likely to be malignant

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9
Q

Malignancy causes what type of thyroid state?

A

A euthyroid state

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10
Q

A single thyroid nodule with cervical Adenopathy highly suggest what?

A

Thyroid cancer

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11
Q

Multiple enlarged large lymph nodes with adenopathy outside the neck could be what?

A

Lymphoma

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12
Q

A pt with a low TSH is suggestive of what?

A

Hyperthyroidism

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13
Q

A Patient with a high TSH a suggestive of what?

A

Hypothyroidism, Hashimoto’s thyroiditis

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14
Q

What tests are involved in a thyroid nodule work up?

List 5

A

A TSH, radioactive iodine uptake scan, ultrasound, fine needle aspiration, thyroid antibody testing.

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15
Q

If a TSH is low in a thyroid work up, what is the next diagnostic step?

A

A radioactive iodine uptake scan

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16
Q

For a radioactive iodine uptake scan, if there is high uptake what does this mean?

A

Hot Nodule , hyper functioning. Rarely malignant, no further work up needed

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17
Q

For a radioactive iodine uptake scan, if there is non-functioning and has low uptake what does this mean?

A

Cold nodule, not diagnostic of malignancy but further tests are required.

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18
Q

What is the best test to rule out a benign versus malignant thyroid nodule? 

A

Fine needle aspiration

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19
Q

If a thyroid nodule is less than 8 to 10 mm, do they need a fine needle aspiration?

A

No they do not. They just need long-term monitoring

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20
Q

What are some drugs that can cause hypothyroidism?

A

Lithium, sulfonamides, amiodarone, Thioureas, phentlbutazone. 

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21
Q

What are the age related changes with thyroid in regards to hypothyroidism?

A

Changes include decrease iodine uptake, and increase half-life on T4 which means it takes longer to break down to convert to T3 which is the active form of thyroid hormone in the tissue

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22
Q

What are the symptoms of hypothyroidism?

A

Lethergy, weight gain, swelling up hands and feet, macroglossia which is enlarged tongue, Periorbital edema, cold intolerance, constipation, irregular menses, infertility, depression, muscle cramp, stiffness, arthralgia, coarse dry skin, hair loss from body and scalp, brittle nails, bradycardia low systolic blood pressure, high diastolic blood pressure low sodium, increase lipids

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23
Q

In central hypothyroidism what type of labs may you see?

Tsh and t3, free t4

A

TSH levels may be low, normal or mildly elevated.

Low levels of T3 and free T4

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24
Q

For subclinical hypothyroidism you can expect for TSH to be what?

A

Elevated TSH, normal T4

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25
Q

What is the preferred test for the diagnosis of autoimmune thyroid disease?

A

Anti-thyroid peroxidase antibody testing

26
Q

Anti-thyroid antibodies that are elevated in patients means what?

A

Autoimmune thyroiditis

27
Q

Patients that have low and anti thyroid antibodies can mean what? 

A

Subacute thyroiditis

28
Q

For a patient who has a high TSH, a low free T4, and a low total T3 What is the diagnosis?

A

Primary hypothyroidism

29
Q

For a patient who has a high TSH, a normal total T3 and free T4 what does this mean?

A

Subclinical hypothyroidism

30
Q

For a patient who has a low TSH, a low free T4, and a low total T3 what does this mean?

A

Secondary hypothyroidism

31
Q

For a patient who has a normal TSH, with a low free T4 and a low total T3 and a low TRH what does this mean?

A

Tertiary hypothyroidism

32
Q

What is the medication for hypothyroidism?

A

Levothyroxine

33
Q

After starting a patient on levothyroxine when should you retract a TSH after starting treatment?

A

Recheck TSH after six weeks then every 6 to 8 weeks until normal

34
Q

What is the treatment recommendation for subclinical hypothyroidism?

A

Monitor TSH every three months, starting on medication increases risk of osteopenia and osteoporosis

35
Q

Amiodarone can cause both hyper and hypothyroidism, For hyperthyroidism when can it occur?

A

It can occur from four months to three years after starting the drug it can even develop after it’s discontinued

36
Q

 Hepatitis see patients need what checked if they are on interferon?

A

Tsh

Can cause hyper thyroidism

37
Q

What are some hyperthyroid symptoms?

A

Symptoms-Nervousness, sweating, heat intolerance, palpitations, fatigue, Disney, increase appetite, I irritation, smelling in legs, diarrhea, Emotional lability, Amenorrhea.

Signs-Tachycardia, goiter, warm, moist skin, tremor, hyperreflexia, bruit over thyroid,
Tenderness if I were a gland, exophthalmos (staring, bulging eyes), Fever, weight loss, weight gain did increase appetite, splenomegaly, gynecomastia, soft tissue swelling and fingers and toes with clubbing

38
Q

If a patient has a low TSH, a elevated T3, and elevated T4 what is the diagnosis?

A

Hyper thyroidism

39
Q

An ESR that is elevated is in relation to what thyroid problem?

A

Subacute thyroiditis

40
Q

A normal or elevated I take in a thyroid scan suggest what?

A

Graves’ disease, toxic multinodular and nodular goiter

41
Q

What is radioactive 131 iodine?

A

It is used to treat hyperthyroidism. It is a treatment of choice for pts with hyperthyroidism, Risks associated with this treatment is permanent hypothyroidism and thyroiditis.

42
Q

Theourylenese (methimazole), tapezold, or prophylthiouracil (ptu) is what 

A

Is a medication that inhibits thyroid hormone biosynthesis.
Offers patient a chance of permanent remission, low cost, minor adverse effects, maybe used as monotherapy in patients with mild disease or treat symptoms while patients are waiting for a response to radioactive iodine or surgery.

43
Q

For adjunctive therapy what blood pressure lowering medication is recommended for patients with hyper thyroidism?

A

Propranolol because of its benefits of blocking peripheral conversion of T4 to T3

44
Q

What medication for hyperthyroidism can be given to pediatric patients less than six years old and why?

A

Methimazole

PTU cannot be given because it has not been established

45
Q

What should be monitored in patients on thioureylenes:

A

CBC, thyroid function test, INR, LFTs, renal function (ptu)

46
Q

thioureylenes have what interaction with anticoagulants?

A

Increase effects of anticoagulants

47
Q

thioureylenes have what interaction with beta blockers?

A

Beta blockers decrease levels with methimazole

48
Q

thioureylenes have what interaction with digoxin

A

Increase levels with methimazole

49
Q

thioureylenes have what interaction with theophylline

A

Increase levels with methimazole 

50
Q

How long should women Of childbearing age wait before trying to get pregnant after taking the radio iodine treatment?

A

At least six months, it does not decrease infertility

51
Q

 Hair loss after hyperthyroidism treatment, is this an adverse effect?

A

No it is not this is a result of fluctuating hormone levels

52
Q

If a patient is allergic to thioureylenes, what would be the next step for pts with hyperthyroidism?

A

Radioiodine

53
Q

What medications for hyper thyroidism can be used during pregnancy?

A

PTU or methimazole

54
Q

Name of three tests for diagnosing Cushing syndrome/disease?

A

24 hour in urinary free cortisol, Low-dose dexamethasone suppression test, late night salivary cortisol test

55
Q

Precocious puberty is the onset for girls at what age?

A

Before age 8

56
Q

Precocious puberty onset for boys is at what age

A

Before Age 9 

57
Q

The appearance of secondary sex characteristics without activation of the hypothalamus pituitary Gonadal axis is what?

A

Precocious pseudo puberty

58
Q

If a child has precocious puberty what should you always rule out for?

A

CNS tumors. Even if there’s no neurologic symptoms.

59
Q

In boys if the testes are larger than the penis what type of precocious puberty is this?

A

Central precocious puberty

60
Q

If the penis is larger than the testes which type of puberty is this?

A

Pseudo precocious puberty

PC1-Exam 2 (3 decks)

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