hyperthyroidism

Question 1

what Ab can you test for hyperthyroidism?

Answer 1

TSI

Question 2

what antibodies would you find in someone with Graves?

Answer 2

TRAb, TSIg

Question 3

graves opthalmopathy is assc’d with which risk factors? (3)

Answer 3

1. smoking
2. high TSI
3. high I131

Question 4

tx of graves that slow conversion of T4?

Answer 4

1. beta blockers

2. steroids

Question 5

tx of graves that fxn as antithyroids? (2)

Answer 5

1. PTU

2. Methimazole

Question 6

SE assc’d with antithyroids

Answer 6

1. liver toxicity

2. agranulocytosis

Question 7

how long can antithyroid meds be used?

Answer 7

under 2 yrs

Question 8

why tx someone with iodine a week before thyroidectomy?

Answer 8

1. decr T4

2. decr vascularity

Question 9

besides iodine, what else to prescribe person before thyroidectomy?

Answer 9

1. antithyroids

2. beta blockers

Question 10

multiple autonomously functioning nodules that form a toxic goiter

Answer 10

Plummer’s disease

Question 11

single autonomously functioning nodule

Answer 11

hot nodule

Question 12

autonomously functioning nodules are typically seen in what patient population?

Answer 12

patients >50

Question 13

uptake and scan with diffuse distribution, normal or high uptake

Answer 13

graves

Question 14

uptake and scan with focal areas of hyperactivity, normal or high uptake

Answer 14

autonomously functioning nodules

Question 15

what is the radioactive tx for hot nodules

Answer 15

radioactive ablation

Question 16

thyroiditis causes thyroid uptake to be ____

Answer 16

low

Question 17

hyperthyroidism with low thyroid uptake

Answer 17

thyroiditis

Question 18

tx of thyroiditis (3)

Answer 18

1. NSAIDS
2. prednisone
3. beta blockers

Question 19

type 1 amiodarone induced hyperthyroidism AKA?

Answer 19

Jod Basedow phenomenon (incr synthesis)

Question 20

mechanisms by which amiodarone causes hyperthyroidism (2)

Answer 20

1. jod basedow phenomenon (type 1 AIH)

2. thyroiditis (type 2)

Question 21

how can you tx type 2 amiodarone hyperthyroidism

Answer 21

steroids

Question 22

what is the only way to decr T4 levels in a person with amiodarone-induced hyperthyroidism?

Answer 22

surgery

Question 23

how to work up TSH producing pit adenoma? (2)

Answer 23

1. high alpha subunit

2. MRI

Question 24

tx of TSH producing pit adenoma (2)

Answer 24

1. surgery via transphenoidal resection

2. octreotide

Question 25

if T4 is elevated in pregnancy, how to tx?

Answer 25

1st trimester: PTU

2nd-3rd trimester: methimazole

Question 26

in euthyroid sick syndrome, TSH is _____, FT4/T3 is ____, rT3 is _____

Answer 26

TSH is low, FT4/T3 is low, rT3 is high

Question 27

tx of euthyroid sick syndrome

Answer 27

none usually