High TSH Approahc

Question 1

High TSH aka ___thyroidism ____ ___ the metabolic process

Answer 1

aka hypothyroidism, slows down the metabolic process

Question 2

how does the relaxation phase on the ECG change in hypothyoidism

Answer 2

there is a delayed relaxation phase relative to the contraction in people with hypothy

Question 3

What would you see on histology with hashimoto’s thyroiditis

Answer 3

Autoimmune lymphocytic thyroiditis. you wold see lymphocytes compared to normal.

Question 4

post ablative causes of hypothyroidism

Answer 4

radio iodine, surgery

Question 5

transient causes of hypothyroidism

Answer 5

thyroiditis, after hyperthyroid phase

Question 6

drug- induced causes of hypothyroidism

Answer 6

amiodorone, lithium, interferon, radioiodine

Question 7

infiltrative causes of hypothyroidism

Answer 7

reidels, amyloid, scleroderma, hemosiderosis

Question 8

secondary causes of hypothyroidism

Answer 8

pituitary or hypothalamic disease

Question 9

generally, hashimoto’s thyroiditis diagnosis, clnical findings and presentation may vary from person to person. what is the natural history of this disease?

Answer 9

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

Question 10

specific pediatric problem seen in hashimotos

Answer 10

stops growing

Question 11

how does hypothyroidism change young women

Answer 11

• causes short, hypermenorrhagic and poly menorrhagic cycles

Question 12

what hypothyroidism symptoms are present in the elderly that may appear as dementia?

Answer 12

Question 13

outline symptoms of hypothyroidism

Answer 13

most are vague and non-specific, but it has many common features of depression.

Question 14

what is Myxedema coma and how do you treat it?

Answer 14

hypothyroidism to the level of organ failure.

• coma
• hypothermia
• cardiac failure
• respiratoyr failure

treatment with IV thyroxine

Question 15

Diagnosing hypothyroidism: lab tests

TSH is ___, free T4 is ___

if free T4 is normal, it’s considered ___ ___

If TSH is normal, it’s considered ___

Answer 15

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

Question 16

main treatment of hypothyroidism. Why should you not overmedicate?

Answer 16

synthetic thyroxin– make you you determine and monitor dose of oral thyroxine

• you sholdnt overmedicate cause you can give them hyperthyroid symptoms

Question 18

What are some reversible causes of subclinical hypothyroid?

Answer 18

• 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

Question 19

how does age and gender affect the prevalence of subclinical hypothydoism

Answer 19

women are more likely to have subAHypo. prevalence increasese with age, in women over 60 and in men over 74

Question 20

T/F it is imperative to treat subclinical hypothyroidism to prevent it from goin to full blown hypothyrod

Answer 20

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

Question 21

T/F TSH is best taken with food

Answer 21

false. do not eat it with food.

Question 23

Note: thyroid failure (thus low thyroid hormone) can affect every body system.