hyperthyroidism

Question 1

Wolff-Chaikoff effect.

Answer 1

In normal subjects, the administration of pharmacologic amounts of iodine leads to temporary inhibition of iodine organification in the thyroid gland, thereby diminishing thyroid hormone biosynthesis, a phenomenon called the Wolff-Chaikoff effect [2]. However, within two to four weeks of continued exposure to excess iodine, organification and thyroid hormone biosynthesis resume in a normal fashion. This is called escape from the Wolff-Chaikoff effect.

Question 2

T4

Answer 2

one week

Question 3

Half life

Answer 3

4-6 weeks to stablilize

The half-life of T4 is 5-7 days; the half-life of T3 is only 1 day.

TSH half life of 1 hr

Question 4

Physical Exam

Answer 4

Physical
Dry skin
Hoarseness
Edema
Coarse skin
Puffy facies and loss of eyebrows
Periorbital edema
Enlargement of the tongue
hypertension
Pleural and pericardial effusions
Ascites
Galactorrhea

Question 5

Symptoms

Answer 5

Hypothyroidism
Slowing of metabolic processes
Fatigue and weakness
Cold intolerance
Dyspnea on exertion
Weight gain
Cognitive dysfunction
Mental retardation (infantile onset)
Constipation
Growth failure
Decreased hearing
Myalgia and paresthesia
Depression
Menorrhagia
Arthralgia
Pubertal delay
Dry skin
Hoarseness
Edema

Question 6

GENE Hypothyroidism due to RTSH

Answer 6

PAX8 gene mutations

Question 7

The goal is to maintain TSH in the trimester-specific reference range

Answer 7

(0.1 to 2.5 mU/L, 0.2 to 3 mU/L, and 0.3 to 3 mU/L for the first, second, and third trimesters, respectively)