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Endo II Exam 2 > Hyperthyroidism - Darrow > Flashcards

Hyperthyroidism - Darrow Flashcards

1
Q

hyperreflexia

A

hyperthyroid

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2
Q

heat intolerance, palpitations, tachy, irritable, loose stool, tremor, warm skin, hyperreflexia

A

hypermetabolic state

  • anxiety
  • pheochromocytoma
  • hyperthyroid
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3
Q

goiter, exopthalmos, pretibial myxedema

A

graves disease

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4
Q

type of hypersensitivity in graves?

A

type 2

  • Ab dependent cytoxicity
  • Abs to cell surface receptors
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5
Q

HLA type in graves?

A

HLA-DRB1

HLA DR8

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6
Q

HLA DR

A

MHC Class II cell surface repceotor

-in graves disease

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7
Q

T cell in pretibial myxedema and graves orbitopathy?

A

CD4 Th1 cells

fibrosis and infiltration

macrophages, cytotoxic T cells, NK cells
-produce GAGs

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8
Q

T cell in graves disease on thyroid?

A

CD4 Th2 cells

-anti-TSH receptor Abs

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9
Q

TSI

A

TSH receptor Abs
-in graves

CD4 Th2 cells**

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10
Q

type II hypersensitivity

A

Abs that attach to cell surface components

in autoimmune hemolytic anemia or blood transfusion rxn

also in graves and myasthenia gravis - abnormal physiologic response

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11
Q

strabismus

A

misaligned eyes
-seen in graves

fibroblast proliferation, GAG deposits, lymphocyte infiltration in muscles around eye

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12
Q

clubbing of fingers

A

hyperthyroid

hypertrophic osteoarthopathy

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13
Q

thyrotoxic cardiomyopathy

A

tachycardia
atrial fib
high output failure
pulmonary HTN

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14
Q

calcium elevation with hyperthyroid?

A

T3 increases bone turnover

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15
Q

factitial thyrotoxicosis

A

would see NO thyroglobulin present

factitial - induced by human action - ie/ patient takes thyroid pills - gets hyperthyroid

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16
Q

TSH receptor pathway

A

GPCR

Gs - cAMP - PKA transduction

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17
Q

tx of graves

A

radioactive iodine - unless pregnant

or antithyroid drugs - PTU and methimazole

or iodine (wolff chaikoff)

or surgery

18
Q

wolf chaikoff effect

A

reduction in thyroid levels with ingestion of large amount of iodine

19
Q

PTU

A

tx for graves

ok in pregnancy 1st trimester

20
Q

methimazole

A

tx for graves

less hepatic necrosis than PTU

21
Q

causes of low TSH

A

steroid use
dopamine use
severe non-thyroid illness - ILs and TNF

22
Q

pansystolic murmur and S3 in hyperthyroid patient

A

CHF

23
Q

hyperthyroid sx with no TSI Abs?

A

apathetic hyperthyroid

-with autonomous functioning thyroid nodule or toxic multinodular goiter

24
Q

apathetic hyperthyroidism

A

hyperthyroid due to AFTN or TMNG

mutations of TSH receptor

25
Q

iodine induced hypethyroid

A

with amiodarone

excess iodine can cause autonomous thyroid nodules to become toxic MN goiter

26
Q

jod basedow phenomenon

A

iodine induced thyrotoxicosis

27
Q

type I amiodarone thyrotoxicosis

A

jod basedown
-high iodine induces hyperthyroid

with graves or TMNG

28
Q

type II amiodarone thyrotoxicosis

A

thyroiditis

29
Q

increased I-123 uptake?

A

GAIT2

graves
adenoma - plummer
inappropriate TSH (pituitary adenoma)
toxic multinodular goiter
trophoblastic
30
Q

tx for AFTN or TMNG

A

radioactive iodine or surgery

31
Q

subclinical hyperthyroidism

A

low TSH but normal T4

risk of osteoporosis and atrial fib

tx with RAI or antithyroid drugs

32
Q

thyrotoxicosis crisis

A

or storm

caused by acute illness, thyroid surgery, or RAI therapy in undertreated thyrotoxicosis patient

33
Q

high fever, tachy, tachypnea, hypothension, V/D, irritable, delirium, coma, death

A

thyroid storm

34
Q

tx for thyroid storm

A

thiourea - methamizole or PTU

iodides started 1 hour after thiourea

also - metoprolol and hydrocortisone

plasmapharesis

35
Q

muscle pain weakness, ate two pizzas night before, gynecomastia, proximal muscle weakness

A

thyrotoxic periodic paralysis

36
Q

thyrotoxic periodic paralysis

A

channelopathy with muscle weakness

thyroid hormone - increased Na/K ATPase activity - results in hypopolarization and hypokalemia**

after heavy meal or exercise in asian men

37
Q

after heavy meal or exercise in asian men

A

look for thyrotoxic periodic paralysis

thyroid hormone increases Na/K ATPase activity

38
Q

wide pulse pressure

A

with thyrotoxicosis

39
Q

tremor

A

hyperthyroid

hypoglycemia

40
Q

hyperthyroid with decreased radioiodine uptake?

A

amiodarone type 1 - jod basedow

ectopic - stuma ovarii (teratoma)

thyroiditis
-de quervains - post viral infection - painful

painless - reidels fibrosis, postpartum, subacute autoimmune

41
Q

most thyroiditis

A

produce transient hyperthyroid over few months followed by hypothyroid

42
Q

high ESR, following upper resp infection

A

subacute granulomatous hyroiditis

de-quervains

painful

Endo II Exam 2 (16 decks)

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