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Endocrinology - year 2 > Hyperthyroidism > Flashcards

Hyperthyroidism Flashcards

1
Q

Common chief complain of patient with thyrotoxicosis?

A
  • hyper but tired
  • difficulty concentrating
  • slightly agitated, thinner than usual
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2
Q

What type of drugs would make a patient describe feeling “hyper”?

A
  • decongestants
  • amphetamines
  • cocaine
  • SSRIs
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3
Q

What key lab tests would you order if you’re suspecting thyrotoxicosis?

A
  • sTSH, T3, T4
  • serum K+
  • ECG
  • B-HCG
  • CBC
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4
Q

what is used for symptom relief of thyrotoxicosis?

A

propanolol - Beta blocker (asthma a contraindication)

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5
Q

Classic blood pressure of a patient with thyrotoxicosis?

A

Systolic hypertension

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6
Q

If the thyroid is tender what do you think about?

A

Subacute thyroiditis

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7
Q

Ddx for thyrotoxicosis?

A
  • graves’ disease
  • toxic adenoma, or multinodular goiter
  • subacute thyroiditis
  • molar pregnancy
  • Excess TSH
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8
Q

What is the pathologic mechanism of thyrotoxicosis in multinodular goiter?

A
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9
Q

What is the pathologic mechanism of thyrotoxicosis in SUBACTUTE thyroiditis?

A

destruction of colloid containing thyroid follicles

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10
Q

What is the pathologic mechanism of thyrotoxicosis in graves’ disease?

A

Activation of TSH- receptor

- cell proliferation

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11
Q

3 ways in which the TSH receptor gets activated

A
  • autoantibodies - graves
  • beta HCG related
  • activating gene mutation
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12
Q

3 types of suprephysiologic levels of hormone that stimulate the TSH receptor

A
  • pregnancy 1st 4 months
  • trophoblastic tumors- choriocarcinomas
  • testicular neoplasms
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13
Q

Causes of multi nodular disease -

A
  • impaired synthesis of hormone
  • iodine deficiency
  • biosynthetic defects
  • sporadic - women early adult
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14
Q

Mutations in multiple nodular disease

A

in TSHR

  • gnas - Gprotein alpha
  • mutations in PKA
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15
Q

Pathologically a toxic multi nodular goitre is characterized by

A

papillary growths

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16
Q

When can you get destructive thyroiditis

A
  • subacute
  • hashitoxicosis - mid-phase
  • post partum
  • type 2 amiodarone
17
Q

When can you get mechanical destruction

A
  • metastatic tumors

- high grade lymphomas

18
Q

which diseases do you have low RAI uptake?

A
  • subacute thyroiditis
  • exogenous hormone
  • struma ovarii - thyroid tissue in ovary
19
Q

You only measure T3 levels in patients with

A

thyrotoxicosis

20
Q

Treatment for thyrotoxicosis

A
  • beta blocker
  • thiouracil (methimazole, PTU)
  • radioactive iodine
  • surgery
21
Q

Treatment for subacute thyroiditis

A
  • use beta blocker but NOT
    RAI
    or Thiouracils
22
Q

Key things to watch for with methimazole

A
  • agranulocytosis
  • sore joints
  • fever, rash
23
Q

Key things to watch for with PTU

A
  • liver enzyme elevation

Endocrinology - year 2 (10 decks)

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