High TSH Approahc Flashcards
High TSH aka ___thyroidism ____ ___ the metabolic process
aka hypothyroidism, slows down the metabolic process
how does the relaxation phase on the ECG change in hypothyoidism
there is a delayed relaxation phase relative to the contraction in people with hypothy
What would you see on histology with hashimoto’s thyroiditis
Autoimmune lymphocytic thyroiditis. you wold see lymphocytes compared to normal.
post ablative causes of hypothyroidism
radio iodine, surgery
transient causes of hypothyroidism
thyroiditis, after hyperthyroid phase
drug- induced causes of hypothyroidism
amiodorone, lithium, interferon, radioiodine
infiltrative causes of hypothyroidism
reidels, amyloid, scleroderma, hemosiderosis
secondary causes of hypothyroidism
pituitary or hypothalamic disease
generally, hashimoto’s thyroiditis diagnosis, clnical findings and presentation may vary from person to person. what is the natural history of this disease?
hashimoto’s thyroiditis NH may stop progression at any stage.
- there is usually a genetic predisposition, combined with enviornmental insult. Causes TPOantibodies to increase, TSH elevation progressiving to hypothyroidism, and then the high TSH and low FT4 can cause overt hypothyroidism progression. there is a 5% increase in progression to overt hypothyroidism per year
specific pediatric problem seen in hashimotos
stops growing
how does hypothyroidism change young women
- causes short, hypermenorrhagic and poly menorrhagic cycles
what hypothyroidism symptoms are present in the elderly that may appear as dementia?
outline symptoms of hypothyroidism
most are vague and non-specific, but it has many common features of depression.
what is Myxedema coma and how do you treat it?
hypothyroidism to the level of organ failure.
- coma
- hypothermia
- cardiac failure
- respiratoyr failure
treatment with IV thyroxine
Diagnosing hypothyroidism: lab tests
TSH is ___, free T4 is ___
if free T4 is normal, it’s considered ___ ___
If TSH is normal, it’s considered ___
TSH is HGIH, free T4 is LOW
if free T4 is normal, it’s considered SUBCLINICAL HYPOTHYROID
If TSH is normal, it’s considered EYTHYROID
main treatment of hypothyroidism. Why should you not overmedicate?
synthetic thyroxin– make you you determine and monitor dose of oral thyroxine
- you sholdnt overmedicate cause you can give them hyperthyroid symptoms
What are some reversible causes of subclinical hypothyroid?
- under- treated hypothyroidism (incerase dose of T4)
- transient disturbances; recovery from acute illness (thyroid hormone changes during acute illness and recovery “sick euthyroid”
- recovery from hyperthyroid phase of thyroiditis
- many subclinical hypothyroid states return to normal with observation
how does age and gender affect the prevalence of subclinical hypothydoism
women are more likely to have subAHypo. prevalence increasese with age, in women over 60 and in men over 74
T/F it is imperative to treat subclinical hypothyroidism to prevent it from goin to full blown hypothyrod
false. untreated studies have not shown any consistent morbidity or mortality. therapy trials have not shown any benefit.
You do not treat it because there is a risk of over treating hypothyroidism. LOW TSH (hyperthyroidism) is more of a problem than high TSH.
– thyroid hormone therapy in OLDER people with sublincila hypothyroidism showd a reduced level of TSH, but there were no difference in tiredness score, no benefit on secondary outcomes, no strength or cognitive function benefits. etc.
- honestly, most people don’t treat hypothyroidism unless there are profound symptoms like depression
T/F TSH is best taken with food
false. do not eat it with food.
Note: thyroid failure (thus low thyroid hormone) can affect every body system.
