Hypothyroidism Flashcards
Essentials of diagnosis for what issue?
(1) Weakness, cold intolerance, constipation, depression, menorrhagia, hoarseness, dry skin, bradycardia
(2) Delayed return of deep tendon reflexes
(3) Serum free tetraiodothyronine aka thyroxine (T4) low
(4) Thyroid-stimulating hormone (TSH) elevated in primary hypothyroidism
Hypothyroidism
Primary hypothyroidism is due to….
thyroid gland disease
Secondary hypothyroidism is due to….
lack of pituitary TSH
Maternal hypothyroidism during pregnancy results in…..
cognitive impairment in child
Maternal hypothyroidism need to increase dose of thyroid replacement hormone by what %?
30
These issues can cause what?
(a) Autoimmune:
—-1) Hashimoto’s Disease
—-2) Thyroiditis
(b) Subacute (de Quervain’s thyroiditis) (after initial hyperthyroidism)
(c) Iodine deficiency (seen in developing countries)
(d) Genetic thyroid enzyme defects
(e) Hepatitis C
(f) Drugs:
—-1) Lithium, amiodarone, propylthiouracil, methimazole, phenylbutazone, sulfonamides, interferon
(g) Food goitrogens in iodide-deficient areas
(h) Peripheral resistance to thyroid hormone
(i) Infiltrating diseases
hypothyroidism with goiter
These issues can cause what?
(a) Thyroid surgery, irradiation, or radioiodine treatment
(b) Deficient pituitary TSH
(c) Severe illness
(d) Drugs
–1) Lithium
–2) Amiodarone
–3) Propylthiouracil
–4) Methimazole
–5) Phenylbutazone
–6) Sulfonamides
–7) Interferon-a & b
–8) Iodine
hypothyroidism without goiter
True/False
Radiation therapy to the head-neck-chest-shoulder region can cause hypothyroidism with or without goiter or thyroid cancer many years later
True
________ is caused by interstitial accumulation of hydrophilic mucopolysaccharides, leading to fluid retention and lymphedema
Myxedema
True/False
Serum triiodothyronine (T3) is a good test for routine hypothyroidism?
FALSE
Treatment for hypothyroidism
-levothyroxine is started at 25 – 75 mcg/day administered
orally
-Thyroid function tests should be repeated every 4 to 6 weeks for medication titration until TSH is at goal.
What issue?
Long term untreated hypothyroidism can leads to this condition characterized by hypothermia, hypotension, hypoventilation, hypoxia, hypercapnia, hyponatremia, convulsions and abnormal CNS sign
Myxedema coma
Complications of hypothyroidism
(1) Myxedema coma
(2) Increased susceptibility to infection
(3) Megacolon in long-standing hypothyroidism
(4) Organic psychoses with paranoid delusions
(5) Angina pectoris, congestive heart failure and cardiac dysrhythmias may be precipitated by too rapid thyroid replacement
(6) Adrenal crisis precipitated by thyroid replacement
What issue?
*signs
(a) Thin, brittle nails
(b) Thinning of hair
(c) Pallor
(d) Poor turgor of mucosa
(e) Delayed return of deep tendon reflexes
*symptoms
(a) Fatigue, lethargy, weakness
(b) Arthralgias, myalgias, muscle cramps
(c) Cold intolerance
(d) Difficulty concentrating
(e) Constipation
(f) Dry skin
(g) Headache
(h) Weight gain
(i) Menorrhagia
Early Hypothyroidism
What issue?
*signs
(a) Goiter
(b) Puffiness of face and eyelids
(c) Thinning of outer eyebrows
(d) Tongue thickening
(e) Hard pitting edema
(f) Pleural, peritoneal, pericardial, and joint effusions
*symptoms
(a) Slow speech
(b) Peripheral edema
(c) Pallor
(d) Hoarseness
(e) Decreased senses of taste, smell, and hearing
(f) Dyspnea
(g) Absent sweating
(h) Amenorrhea or menorrhagia
(i) Galactorrhea
LAte Hypothyroidism
