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Endocrinology > Hypothyroidism > Flashcards

Hypothyroidism Flashcards

1
Q

In general, hypothyroidism is d/t what?

A

Deficiency of thyroid hormones

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2
Q

What is the MCC worldwide of primary hypothyroidism?

A

Iodine deficiency

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3
Q

Aside from the MCC, what are some other causes of hypothyroidism?

A
  • Autoimmune Diseases
  • Iatrogenic Causes
  • Congenital
  • Infiltrative Disorders
  • Medications
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4
Q

What are the 2 autoimmune diseases that can cause hypothyroidism?

A
  • Hashimoto’s Thyroiditis

- Atrophic Thyroiditis

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5
Q

What are the iatrogenic causes that can cause hypothyroidism?

A

Tx of Hyperthyroidism

- Iodine Tx, Partial/Total Thyroidectomy

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6
Q

What are the 2 congenital causes that can cause hypothyroidism?

A
  • Absent or Ectopic Thyroid Gland

- TSH-R mutation

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7
Q

What are the 4 infiltrative disorders that can cause hypothyroidism?

A
  • Amyloidosis
  • Sarcoidosis
  • Hemochromatosis
  • Scleroderma
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8
Q

What are the medications that can cause hypothyroidism?

A
  • Iodine Excess
  • Lithium
  • Antithyroid
  • Interferon-a
  • Amiodarone
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9
Q

High iodine intake may increase the risk of what?

A

Autoimmune hypothyroidism by immunologic effects or direct thyroid toxicity

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10
Q

Secondary causes of hypothyroidism is d/t what deficiency?

A

TSH

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11
Q

What are 4 examples of secondary causes of hypothyroidism?

A
  • Injury to the pituitary gland
  • Tumor
  • Pituitary surgery
  • Irradiation
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12
Q

Tertiary causes of hypothyroidism is d/t what deficiency?

A

TRH

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13
Q

What are 4 examples of tertiary causes of hypothyroidism?

A
  • Disorders that injure the hypothalamus
  • Tumor
  • Trauma
  • Infiltrative disorders
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14
Q

What are some sxs of hypothyroidism?

MOMS SO TIRED

A
  • Memory loss
  • Obesity w/poor appetite
  • Menorrhagia
  • Slowness (mentally and physically-constipation)
  • Skin and hair dryness
  • Onset gradual
  • Tiredness
  • Intolerance to cold
  • Raised BP
  • Energy levels fall
  • Depression/Delayed relaxation of reflexes
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15
Q

What are the primary and secondary lab findings for hypothyroidism?

A

Primary: ↑TSH, ↓TH (T4 = dx)
Secondary:↓-normal TSH, ↓TH (T4 = dx)

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16
Q

Secondary and tertiary cannot be monitored using what lab study?

A

TSH

17
Q

Hypothyroidism can be caused by an autoimmune disease and can possibly be associated with what?

A

Goiter

18
Q

What does the term “Goiter” mean?

A

Enlargement of the thyroid gland

19
Q

In later stages of the autoimmune disease, minimal residual thyroid tissue is known as what?

A

Atrophic Thyroiditis

20
Q

D/t an autoimmune process what occurs to the thyroid function?

A

Gradual reduction

21
Q

What occurs during the state called Subclinical Hypothyroidism?

A

There is a phase of compensation when normal TH levels are maintained by a rise of TSH

22
Q

What occurs later in the subclinical hypothyroidism phase?

A

Unbound T4 levels fall and TSH levels rise further

23
Q

At what stage do sxs become apparent in a pt with hypothyroidism d/t autoimmune disease?

A

Clinical Hypothyroidism or Overt Hypothyroidism

24
Q

What thyroid antibodies confirm an autoimmune disease?

A

TPOAb + and/or TgAb+

25
Q

What is the tx for hypothyroidism in a <60 yo pt w/o evidence of CAD?

A

Levothyroxine (T4): 50-100 mg daily

26
Q

What is the tx for hypothyroidism in an elderly pt or a pt known to have CAD?

A

Levothyroxine 12.5-25 mg daily
- Should adjust in 12.5-25 mg increments q 6-8 wks.
(based on TSH Level)

27
Q

What is the tx for hypothyroidism in a pt who is pregnant?

A

Usually Replacement Dose Increased 30-50% During Pregnancy

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