HYPOTHYROIDISM Flashcards
What endocrine disorder can present with symptoms such as
- weakness
- cold intolerance
- constipation
- depression
- menorrhagia
- hoarseness
- dry skin
- bradycardia
Hypothyroidism
In what thyroid condition may you see delayed return of deep tendon reflexes?
Hypothyroidism
In what condition will serum free tetraiodothyronine (aka thyroxine (T4) low and TSH elevation?
Hypothyroidism
Primary Hypothyroidism is due to what?
thyroid gland disease
Secondary Hypothyroidism is due to a lack of what?
Pituitary TSH
True or False
Maternal hypothyroidism during pregnancy results in cognitive impairment in the child
True
generally need to increase doses of thyroid replacement hormone (levothyroxine) by 30%
These can all be causes of what?
- autoimmune:
a. Hashimoto’s Disease
b. Thyroiditis - Subacute (de Quervain’s thyroiditis)(after initial hyperthyroidism)
- Iodine deficiency (seen in developing countries)
- Genetic thyroid enzyme defects
Hypothyroidism with goiter
These can all be causes of what?
- Hepatitis
- Drugs:
a. lithium
b. amiodarone
c. propylthiouracil
d. methimazole
e. phenylbutazone
f. sulfonamides
g. interferon - food goitrogens in idodine-deficient areas
- Peripheral resistance in thyroid hormone
- infiltrating diseases
Hypothyroidism with goiter
These can all be causes of what?
- thyroid surgery, irradiation, radioiodine treatment
- deficiency pituitary TSH
- Severe illness
- drugs:
a. lithium
b. amiodarone
c. propylthiouracil
d. methimazole
e. phenylbutazone
f. sulfonamides
g. Interferon a & b
h. iodine
Hypothyroidism WITHOUT goiter
True or False
Radiation therapy to the head-neck-chest-shoulder region can cause hypothyroidism with or without goiter or thyroid cancer many years later
True
“Subclinical” hypothyroidism, i.e., clinically euthyroid individual with high TSH, normal t4, occurs commonly in who?
Elderly women (10% incidence)
Amiodarone, due to high iodine content, causes clinical hypothyroidism in what percentage of patients?
8%
True or False
High iodine intake from other sources may also cause hypothyroidism, especially in those with underlying lymphocytic thyroiditis
True
What is caused by interstitial accumulation of the hydrophilic mucopolysacchardies, leading to fluid retention and lymphedema?
Myxedema
These can all be early symptoms of what?
- fatigue, lethargy, weakness
- arthralgias, myalgias, muscle cramps
- cold intolerance
- difficulty concentrating
- constipation
- dry skin
- headache
- weight gain
- menorrhagia
Hypothyroidism
These can all be late symptoms of what?
- slow speech
- peripheral edema
- pallor
- hoarseness
- decreased sense of taste, smell, hearing
- dyspnea
- adsent sweating
- amenorrhea or menorrhagia
- galactorrhea
Hypothyroidism
These can be early signs of what thyroid disorder?
- thin, brittle nails
- thinning of the hair
- pallor
- poor turgor of mucosa
- delayed return of deep tendon reflexes
Hypothyroidism
These can be late signs of what thyroid disorder?
- goiter
- puffiness in face and eyelids
- thinning of outer eyebrows
- tongue thickening
- hard pitting edema
- pleural, peritoneal, pericardial, and joint effusions
Hypothyroidism
True or False
Serum TSH is increased in primary hypothyroidism but low or normal in secondary hypothyroidism (pituitary insufficiency)
True
Is serum triiodothyronine (T3) a good test for routine hypothyroidism?
Nope
These are lab findings associated with what?
- Free T4 may be low or low normal
- Serum cholesterol, troglycerides, liver enzymes, creatine kinase, prolactin increased
- hyponatremia occurs due to imparied renal tubular sodium reabsorption
- hypoglycemia
- anemia
Hypothyroidism
What is the treatment for adult hypothyroidism?
Levothyroxine 25-75 mcg/day PO
How often should thyroid function tests be repeated for medication titration until TSH is at goal?
4-6 weeks
What is the disposition of a hypothyroidism patient?
MEDEVAC depending on signs and symptoms
may retain if no major issues
Long term untreated hypothyroidism can lead to what condition characterized by
- hypothermia
- hypotension
- hypoventilation
- hypoxia
- hypercapnia
- hyponatremia
- convulsions
- abnormal CNS signs
Myxedema Coma
True or False
Angina pectoris, congestive heart failure, and cardiac dysrhythmias may be participated by too rapid thyroid replacement
True
