Hypothyroid

Question 1

what is the autoimmune hypothyroid disease called

Answer 1

hashimotos

Question 2

what is a marker of hashimotos hypothyroid ?

Answer 2

increased thyroid peroxidase antibodies

Question 3

do patients with hashimotos have a goiter?

Answer 3

at start of disease, then gets small later on

Question 4

what cells are abundant in thyroid in hashimotos?

Answer 4

lymphocytes/plasma cells

Question 5

what is formed in thyroid in hashimotos?

Answer 5

germinal center

Question 6

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

Answer 6

Hurthle cell

Question 7

what are patients with hashimotos at increased risk for?

Answer 7

B cell lymphoma

Question 8

does weight go up or down in hypothyroid ?

Answer 8

up

Question 9

what are constitutional sx of hypothyroid ?

Answer 9

fatigue/lethargy/weight gain/cold intolerance

Question 10

what happens to heart with hypothyroid ?

Answer 10

decreased HR and CO

increased SVR

Question 11

does cholesterol go up or down in hypothyroid ?

Answer 11

up

Question 12

are reflexes hyper or delayed in hypothyroid ?

Answer 12

delayed reflexes

Question 13

what happens to integument in hypothyroid ?

Answer 13

dry skin/hair
brittle nails
NON pitting edema

Question 14

what two tests help determine hypothyroid ?

Answer 14

TSH and free or total T4

Question 15

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

Answer 15

increased TSH

T4/3 low

Question 16

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

Answer 16

all decreased

Question 17

what is NTI in hypothyroid?

Answer 17

non-thyroidal illness hypothyroidism

Question 18

explain NTI

Answer 18

abnormal thyroif fxn tests in seriously ill patients

Question 19

what are lab findings in NTI?

Answer 19

usually low TSH T4/3

Question 20

what is mainstay of rx for hypothyroid?

Answer 20

levothyroxine

Question 21

what is goal of rx for hypothyroid?

Answer 21

get TSH into normal range

Question 22

does TSH quickly correct with start of levothyroxine?

Answer 22

no…will take a couple weeks

Question 23

what happens to thyroid demand during pregnancy?

Answer 23

gets super high

Question 24

why is thyroid demand high during pregnancy?

Answer 24

metabolism from bby and TBG increase from estrogen load

Question 25

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

Answer 25

she is able to compensate just fine

Question 26

how does woman increase thyroid levels during pregnancy?

Answer 26

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

Question 27

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

Answer 27

TSH normal total T4 high free T4 normal

Question 28

what does hypothyroid during pregnancy cause in newborn?

Answer 28

brain development issues

Question 29

what are two possible causes of congenital hypothyroid?

Answer 29

absent thyroid | defect in thyroid hormone synthesis (enzyme)

Question 30

what are the four Ps of congen hypothyroid?

Answer 30

poor brain dvlpment protruding tongue pot belly puffy face

Question 31

what are features of hypothyroid in children?

Answer 31

increased weight for height short stature delayed bone age

Question 32

what is myxedema coma?

Answer 32

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

Question 33

what is classic inciting event for myxedema coma?

Answer 33

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

Question 34

what medications can cause decreased thyroid hormone prdxn?

Answer 34

lithium, amiodarone, checkpoint inhibitors

Question 35

why does amiodarone cause low thyroid hormone prdxn?

Answer 35

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

Question 36

wht is the wolff checkoff effect?

Answer 36

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

Question 37

explain amiodarone and hypothyroidism

Answer 37

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