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Animal Disease > HypERthyroidism > Flashcards

HypERthyroidism Flashcards

1
Q

Hyperthyroidism

A

an endocrine Dz characterized by excessive circulating amounts of thyroid hormone

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2
Q

Location of thyroid glands

A

mid-cervical region adjacent to the trachea

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3
Q

What is the thyroid gland made up of?

A

follicles

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4
Q

What is inside of the thyroid follicles?

A

colloid

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5
Q

What is colloid made of?

A

thyroglobulin

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6
Q

What is thyroglobulin?l

A

a large protein that contains each of the thyroid hormones

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7
Q

Tyrosine molecules + ______________ = thyroid hormone

A

iodine

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8
Q

What secretes colloid?

A

Epithelial cells that line the follicles

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9
Q

What are thyroid hormones cleaved from? When are they cleaved?

A

cleaved from thyroglobulin prior to release of the hormone into circulatory system

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10
Q

What pathological process in the thyroid gland leads to hyperthyroidism?

A

an overgrowth of thyroid tissue either due to benign or malignant tumor; in either case, the additional tissue is functional

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11
Q

What species is most at risk for hyperthyroid?

A

cats

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12
Q

Common clinical signs of hyperthyroid Dz

A 
Increased cardiovascular func (HR, BP)
Hyperactivity
Muscle wasting 
Vomiting
Occasionally diarrhea
polyphagia
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13
Q

What does increased perfusion to the kidneys result in? What about increased BP?

A
  • increased perfusion to kidneys results in polyuria with compensatory polydipsia
  • increased BP can lead to retinal hemorrhage or detachment resulting in blindness
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14
Q

Why is hyperactivity seen in hyperthyroid cats?

A

secondary due to increased metabolism

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15
Q

Why are muscle wasting and weight loss seen with hyperthyroid cats?

A

increased muscle activity and increased energy expenditure

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16
Q

What causes vomiting in hyperthyroid cats?

A

increased metabolism of liver and GI tract

17
Q

Why are hyperthyroid cats polyphagic?

A

body is constantly burning energy and looking for more energy

18
Q

Abnormalities on PE with hyperthyroidism

A
  • poor body condition due to muscle wasting and weight loss
  • haircoat greasy and unkempt
  • increased size of thyroid gland
19
Q

Abnormalities on bloodwork with hyperthyroidism

A
  • Polycythemia (increased metabolism –> increased demand at tissue lvl for O2 –> RBC production amps up)
  • Elevated liver enzymes (due to increased metabolic demand on liver)
  • Azotemia
  • Elevated T4
20
Q

What hormonal test is most beneficial in hyperthyroid confirmation?

A

Serum T4 concentration test

21
Q

4 Specialized tests that may be beneficial for hyperthyroidism confirmation

A

T3 suppression test
TSH rsponse test
TRH stimulation test
Radionuclid scan of thyroid gland

22
Q

3 Ways to treat hyperthyroidism

A

Methimazole
Thyroidectomy
Radioactive Iodine

23
Q

Methimazole

  • type of Tx
  • what it does
  • pros
  • cons
A
  • tablet, orally SID
  • reduces serum thyroid hormone concentration by blocking synthesis of thyroid hormones by thyroid gland; does not destroy thyroid tissue, so it is not a permanent cure
  • Pro: easy to adjust dose and to give, inexpensive, no anesthesia/hospital stay/special equipment
  • Con: vomiting, anorexia, development of bone marrow disorder
24
Q

Thyroidectomy

  • type of Tx
  • what it does
  • pros
  • cons
A
  • surgery
  • removes one or both glands; curative if not ectopic tissue
  • Pro: can cure Dz
  • Con: requires anesthesia which often isn’t ideal for older patients with increased metabolism of organs, expensive, hypocalcemia may result
25
Q

Radioactive Iodine

  • what it does
  • pros
  • cons
A
  • overactive thyroid tissue takes up cytotoxic radioactive iodine thus destroying abnormal thyroid cells (unilateral or bilateral) and any ectopic tissue that might be present
  • Pro: potential to cure with 1 dose, no anesthesia, reactions are rare
  • Con: may require multiple doses, expensive, limited availability, prolonged hospital stay
26
Q

2 Complications seen with untreated hyperthyroidism

A

Heart
-increased HR and increased pressure in circulatory system increases workload on the heart which leads to thickening of cardiac muscle (usually LV) resulting in secondary hypertrophic cardiomyopathy and heart failure

Eyes
-increased pressure in ocular circulation may lead to retinal hemorrhage and detachment resulting in sudden blindness

27
Q

Potential complication that may occur when starting therapy for hyperthyroidism

A

unmasking kidney failure

  • hyperthyroidisms can help sustain failing kidneys because it increases BP, and increased BP results in increased blood flow (perfusion) to kidneys
  • therapy normalizes BP, so blood flow to kidneys decreases and may reveal kidney failure
28
Q

How to treat if CRF and hyperthyroid?

A

balance methimazole to a level that drops thyroid hormone enough that it lessens risks of hyperthyroidism but also still allows for some increased BP for increased perfusion to kidneys

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