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Endo Week 2 > Hypothyroid > Flashcards

Hypothyroid Flashcards

1
Q

what is the autoimmune hypothyroid disease called

A

hashimotos

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2
Q

what is a marker of hashimotos hypothyroid ?

A

increased thyroid peroxidase antibodies

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3
Q

do patients with hashimotos have a goiter?

A

at start of disease, then gets small later on

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4
Q

what cells are abundant in thyroid in hashimotos?

A

lymphocytes/plasma cells

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5
Q

what is formed in thyroid in hashimotos?

A

germinal center

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6
Q

what is the special cell type seen in thyroid in hashimotos?

A

Hurthle cell

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7
Q

what are patients with hashimotos at increased risk for?

A

B cell lymphoma

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8
Q

does weight go up or down in hypothyroid ?

A

up

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9
Q

what are constitutional sx of hypothyroid ?

A

fatigue/lethargy/weight gain/cold intolerance

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10
Q

what happens to heart with hypothyroid ?

A

decreased HR and CO

increased SVR

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11
Q

does cholesterol go up or down in hypothyroid ?

A

up

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12
Q

are reflexes hyper or delayed in hypothyroid ?

A

delayed reflexes

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13
Q

what happens to integument in hypothyroid ?

A

dry skin/hair
brittle nails
NON pitting edema

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14
Q

what two tests help determine hypothyroid ?

A

TSH and free or total T4

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15
Q

what are levels of TSH, T4 and T3 in primary hypothyroid?

A

increased TSH

T4/3 low

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16
Q

what are levels of TSH, T4 and T3 in secondary hypothyroid?

A

all decreased

17
Q

what is NTI in hypothyroid?

A

non-thyroidal illness hypothyroidism

18
Q

explain NTI

A

abnormal thyroif fxn tests in seriously ill patients

19
Q

what are lab findings in NTI?

A

usually low TSH T4/3

20
Q

what is mainstay of rx for hypothyroid?

A

levothyroxine

21
Q

what is goal of rx for hypothyroid?

A

get TSH into normal range

22
Q

does TSH quickly correct with start of levothyroxine?

A

no…will take a couple weeks

23
Q

what happens to thyroid demand during pregnancy?

A

gets super high

24
Q

why is thyroid demand high during pregnancy?

A

metabolism from bby and TBG increase from estrogen load

25
Q

if woman has normal thyroid, how does she handle the increased thyroid demand during pregnancy

A

she is able to compensate just fine

26
Q

how does woman increase thyroid levels during pregnancy?

A

hcg has same alpha subunit as TSH and stimulates more prdxn from thyroid gland

27
Q

what are TSH, T4 total and free T4 levels in normal pregnancy?

A

TSH normal
total T4 high
free T4 normal

28
Q

what does hypothyroid during pregnancy cause in newborn?

A

brain development issues

29
Q

what are two possible causes of congenital hypothyroid?

A

absent thyroid

defect in thyroid hormone synthesis (enzyme)

30
Q

what are the four Ps of congen hypothyroid?

A

poor brain dvlpment
protruding tongue
pot belly
puffy face

31
Q

what are features of hypothyroid in children?

A

increased weight for height
short stature
delayed bone age

32
Q

what is myxedema coma?

A

super low hypothyroid that is at very end of spectrum and leads to coma…bradycardia, hypotension, hypothermia, hypoventilation

33
Q

what is classic inciting event for myxedema coma?

A

neck scar from prior thyroid surgery with no compliance of thyroid meds

34
Q

what medications can cause decreased thyroid hormone prdxn?

A

lithium, amiodarone, checkpoint inhibitors

35
Q

why does amiodarone cause low thyroid hormone prdxn?

A

has lots of iodine in it and this can shut down body prdxn of thyroid hormone

36
Q

wht is the wolff checkoff effect?

A

when body sees a load of iodine it shuts down thyroid hormone prdxn so it doesnt overproduce

37
Q

explain amiodarone and hypothyroidism

A

failure to escape from wolff checkoff effect due to high iodine conc in drug

Endo Week 2 (8 decks)

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