Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine > EXAM #1: HYPERTHYROID > Flashcards

EXAM #1: HYPERTHYROID Flashcards

1
Q

What are the cardiac sequelae of hyperthyroidism?

A

1) A-fib

2) High-output failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Graves’ dermopathy?

A

Thickening of the skin in the setting of hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What changes in the eyes are specific to Graves’ disease?

A

1) Proptosis
2) Ophthalmoplegia*
3) Periorbital edema

*Can’t look in certain directions, can lead to diplopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the three major pathophysiologic mechanisms of hyperthyroidism?

A

1) Increased thyroid hormone synthesis
- Primary (thyroid)
- Secondary (TSH)
2) Inappropriate LEAK of T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the major etiologies of hyperthyroidism?

A

1) Graves’ Disease
2) Autonomous nodules
3) Subacute thyroiditis
4) Iodine-induced
5) TSH-producing adenoma
6) HCG-mediated (pregnancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the TSH and FT4 levels in hyperthyroidism?

A
  • Low TSH

- High FT4 (normal is subclinical)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What antibody test is used in the diagnosis of hyperthyroidism?

A

TSI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most common cause of hyperthyroidism?

A

Graves’ Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes Graves’ Disease?

A

Autoimmune antibodies to TSH receptors

  • TRAb
  • TSIg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the “extra” manifestations of Graves’ disease compared to hyperthyroidism?

A

1) Graves’ Ophthalmopathy
- Inflammation
- GAG
- Edema
- Adipogenesis
- Extraocular muscle hypertrophy
2) Dermopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the direct cause of Graves’ Ophthalmopathy?

A

Antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the main test used to diagnose Graves’ Disease? What is the expected outcome?

A

Radionuclear uptake and scan

  • Uptake will be normal/high
  • Homogenous scan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment for Graves’ Disease?

A

1) Symptomatic: beta-blockers, steroids

2) Specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the MOA of the antithyroid drugs?

A

Inhibits organification and coupling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What drugs are “antithyroid?”

A

PTU

Methimazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What adverse is associated with the antithyroids, especially PTU?

A

Hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How long are the antithyroid medications typically given?

A

2 years

18
Q

What is used for a radioactive ablation in Graves’ Disease?

A

I131 (different from what is used for the diagnostic test)

*Permanent but can take 4 weeks to 6 months

19
Q

What do you do when a patient becomes hypothyroid s/p radioactive thyroid ablation?

A

Levothyroxine

20
Q

Why would you treat a patient with iodine for a week prior to surgery?

A

Decreased T4 and vascularity

*Utilizes the Wolff Chiakoff Phenomenon

21
Q

What is an autonomously functioning thyroid nodule?

A

Hot nodule with hyperplasia of follicular cells

*There is overproduction of T4 INDEPENDENT of TSH

22
Q

How will the uptake and scan appear in autonomously functioning thyroid nodule?

A
  • Normal to high uptake

- Focal hyperactivity i.e. NOT homogenous

23
Q

What is the preferred treatment for autonomously functioning thyroid nodule?

A

Radioactive ablation

*Only the focal hot-spots will uptake the radioactive material

24
Q

How does the outcome of radioablation for autonomously functioning thyroid nodule differ from Graves’ Disease?

A

Much less likely to cause hypothyroid

25
Q

What is the underlying pathology in thyroiditis?

A

Inflammation of thyroid tissue leading to leakage of preformed hormone

26
Q

What will a radionuclear scan appear in thyroiditis?

A

Low uptake

27
Q

What is the treatment for thyroiditis?

A

Supportive care

28
Q

What should you be sure to check after a patient with thyroiditis transitions to euthyroid?

A

TSH/T4 to ensure they don’t develop hypothyroid

29
Q

When is iodine-induced hyperthyroidism commonly seen?

A

Amiodarone*

*Utilizes the Jod Basedow effect

30
Q

What are the types of amiodarone induced hyperthyroid?

A

Type 1 AIH= increased synthesis

Type 2 AIH= thyroiditis

31
Q

How can you diagnose Type 1 vs 2 AIH?

A

Ultrasound will show increased muscularity in Type 1

32
Q

How can AIH be treated?

A

1) Glucocorticoids i.e. prednisone

2) Surgery

33
Q

What labs are seen in a TSH-producing pituitary adenoma? What name is given to this condition?

A
  • Increased T4
  • Increased TSH

This is SECONDARY hyperthyroidism

34
Q

What clinical features are associated with TSH-producing pituitary adenomas?

A

1) Hyperthyroidism
2) Goiter
3) Visual field defects

35
Q

What is the treatment for a TSH-producing pituitary adenoma?

A

1) Octreotide

2) Transphenodial resection

36
Q

Why is hyperthyroid seen in pregnancy?

A

HCG stimulates thyroid

37
Q

What is the treatment for HCG-mediated hyperthyroidism in pregnancy, IF T4 is high?

A

First trimester= PTU
2nd-3rd= Methimazole

*Note if T4 is normal, no treatment necessary

38
Q

What typically triggers Thyroid Storm?

A

1) Omission of anti-thyroid drug
2) Surgery, MI, CVA

*In patient with underlying hyperthyroidism

39
Q

What is the specific treatment algorithm for Thyroid Storm?

A

1) Beta-blocker
2) Glucocorticoids
3) Antithyroids
4) Iodine

40
Q

What is euthyroid sick syndrome?

A

Low serum levels of thyroid hormones in clinically euthyroid patients with nonthyroidal systemic illness

*TSH is also low

41
Q

What is the treatment for euthyroid sick syndrome?

A

None–treatment is not necessary

Endocrine (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions