Hyperthyroid

Question 1

what are two endogenous causes of hyperthyroid from excess T4/3 prdxn?

Answer 1

graves disease and toxic multinodular goiter

Question 2

what are two endogenous causes of hyperthyroid from excess T4/3 release?

Answer 2

thyroidits

subacute granulomatous

Question 3

what are constitutional signs of hyperthyroid?

Answer 3

fatigue
weight loss
heat intolerance

Question 4

what are cardio sx of hyperthyroid?

Answer 4

increase HR and CO

decrease SVR

Question 5

what happens to cholesterol in hyperthyroid?

Answer 5

decreased

Question 6

what are GI sx of hyperthyroid?

Answer 6

increased appetite

hyperdefecation

Question 7

are reflexes delayed or hyper in hyperthyroid?

Answer 7

hyper

Question 8

what are are findings in hyperthyroid?

Answer 8

lid retraction and lagopthalmos

Question 9

what is mechanism of graves disease?

Answer 9

Thyroid stimulating IGs stimulate prdxn of T4/3

Question 10

what is unique finding in graves disease?

Answer 10

opthalmopathy

Question 11

what is opthalmopathy?

Answer 11

eyeballs bulging due to retro orbital smooth muscle and fibroblast proliferation

Question 12

what can happen to skin in graves disease?

Answer 12

draves dermopathy..pretibial myxedema

Question 13

what causes graves dermopathy?

Answer 13

excess secretion of glycosaminoglycans

Question 14

what is pathophys of toxic multinodular goiter?

Answer 14

nodules grow and eventually become autonomous

Question 15

who gets toxic multinodular goiters?

Answer 15

mainly elderly..more females than males

Question 16

how do you know if multinodular goiter is toxic or non toxic?

Answer 16

measure T4/T3…if high it is toxic

Question 17

what are TSH, T4/T3 levels in primary hyperthyroid?

Answer 17

decrease TSH and high T4/3

Question 18

what are TSH, T4/T3 levels in secondary hyperthyroid?

Answer 18

high TSH and high T4/3

Question 19

what is the main (very rare) cause of secondary hyperthyroid?

Answer 19

TSH secreting adenoma

Question 20

how does thyroiditis appear on a thyroid scan?

Answer 20

will be gray…no hot areas because the thyroid is just dumping out stored hormone, not making any

Question 21

what is non specific lymphocytic thyroiditis?

Answer 21

increased release of T3/4 from thyroid

Question 22

explain clinical course of non specific lymphocytic thyroiditis?

Answer 22

transient hyperthyroid followed by hypo then normal

Question 23

what is granulomatos thyroiditis ?

Answer 23

subacute thyroiditis that leads to release in T3/4

Question 24

what is usual cause of granulomatous subacute thyroidits?

Answer 24

often follows an URI of viral etiology

Question 25

what is thyroid like in granulomatous thyroiditis?

Answer 25

painful and tender and swollen

Question 26

is non specific lymphocytic thyroiditis usually painful?

Answer 26

no

Question 27

what is a common cause of non specific lymphocytic thyroiditis?

Answer 27

postpartum thyroiditis

Question 28

what lab value will be high in thyroiditis?

Answer 28

thyroglobulin

Question 29

what are the two anti thyroid drugs?

Answer 29

methimazole

propylthiouracil

Question 30

what are three options for hyperthyroid rx?

Answer 30

anti thyroid drugs
radioactive iodine
surgery

Question 31

what are the two serious SEs of methimazole and propylthiouracil?

Answer 31

agranulocytosis and liver damage

Question 32

what is major drawback of radioactive iodine?

Answer 32

hypothyroidism

Question 33

what is a counterintuitive treatment for hyperthyroid?

Answer 33

give iodine and induce wolff checkoff effect