Exam #3: Thyroid/Parathyroid Flashcards
Where does conversion of T4 → T3 occur?
LIVER
What two thyroid Abs are indicative of Hashimoto’s?
+TPO Ab
+TgAb
What condition involves:
+TPO Ab
+TgAb
Hashimoto’s
What thyroid Ab is indicative of Graves’ Disease?
+TRAb
What condition involves:
+TRAb
Graves’ Disease
What condition are each of these tests used to evaluate:
- RAIU?
- US?
- FNA?
- RAIU = hyperthyroidism
- US = nodules
- FNA = thyroid CA
What are four possible causes of ENDOgenous hyperthyroidism?
- Graves’ Disease
- Toxic MNG
- Toxic Adenoma
- Thyroiditis
What are two possible causes of EXOgenous hyperthyroidism?
Iatrogenic
- Overreplacement for hypothyroidism
- Suppressive = Thyroid CA
What condition involves heat tolerance, anxiety, tremor, diarrhea, heart palpitations?
Hyperthyroidism
On RAIU, diffuse and HIGH is indicative of?
Graves’ Disease
On RAIU, diffuse and LOW is indicative of (2)?
- Thyroiditis
- T3 Thyrotoxicosis
On RAIU, focal is indicative of (2)?
- Toxic MNG
- Toxic adenoma
If Subacute Thyroiditis is suspected, what test should be obtained?
ESR/CRP
For all Hyperthyroidism etiologies, TSH levels are?
TSH = LOW
On RAIU, focal, hyperfunctioning/hot is indicative of?
Benign
On RAIU, focal, hypofunctioning/cold is indicative of?
Possible malignancy
What are the four recommended treatments for Hyperthyroidism?
- BB
- Methimazole (vs. PTU)
- Radioactive iodine ablation
- Surgery
If Central Hypothyroidism is suspected, what test should be ordered?
Pituitary MRI
What condition presents with fatigue, depression, weight gain?
Hypothyroidism
What is the recommended treatment for Hypothyroidism?
Levothyroxine (Synthroid)
What four things should be considered with use of Levothyroxine (Synthroid)?
- Weight-based
- Lower dose if 60+ years OR cardiac concerns
- Take on empty stomach one hour before breakfast
- Caution that meds can interfere with absorption
What two tests should be obtained for Thyroid Nodule?
- TSH
- Thyroid US
What are the four steps involved in diagnosis of a Thyroid Nodule?
- TSH and US
- IF TSH low, order RAIU
- Hot = nodule, Cold = possible malignancy
- If Cold, order FNA
Low TSH + high Free T4 indicates?
Primary Hyperthyroidism
High TSH + low Free T4 indicates?
Primary Hypothyroidism
If TSH and Free T4 in same direction, what might this indicate?
Another cause
- Central (secondary vs. tertiary)
If low TSH + low Free T4, what test should be obtained?
Pituitary MRI
