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Endocrine II > Hypothyroidism Amboss Style > Flashcards

Hypothyroidism Amboss Style Flashcards

1
Q

The most common cause of hypothyroidism in iodine-sufficient regions

A

Primary hypothyroidism Hashimoto thyroiditis

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2
Q

Associated with HLA-DR3 and other autoimmune diseases (e.g., vitiligo, pernicious anemia, type 1 diabetes mellitus, and systemic lupus erythematosus)

A

Hashimoto thyroiditis

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3
Q

A transient and self-resolving patchy inflammation of the thyroid gland that is associated with granuloma formation. Often occurs after a viral upper respiratory infection and is more common among women. The clinical course is typically triphasic, beginning with hyperthyroidism, followed by hypothyroidism, and finally a return to the euthyroid state. Classically presents with tender goiter, elevated ESR, and jaw pain.

A

De Quervain thyroiditis

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4
Q

A lymphocytic thyroiditis that typically occurs 1-12 months after delivery and manifests with a period of transient thyrotoxicosis followed by hypothyroidism without thyroid enlargement or tenderness. Histologically characterized by lymphocytic infiltration and formation of germinal centers. Usually resolves spontaneously.

A

Postpartum thyroiditis

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5
Q

occurs in IgG4-related systemic disease

A

Riedel thyroiditis

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6
Q

Wolff-Chaikoff effect

A

A transient decrease in the production of thyroid hormones following the ingestion of a large amount of iodine.

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7
Q

Secondary hypothyroidism

A

Secondary hypothyroidism: pituitary disorders (e.g., pituitary adenoma) → TSH deficiency

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8
Q

Tertiary hypothyroidism

A

hypothalamic disorders → TRH deficiency

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9
Q

Etiology Hashimoto thyroiditis

A

Autoimmune thyroiditis
Associated with HLA-DR3

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10
Q

Anti-TPO and TgAb

A

Hashimoto thyroiditis

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11
Q

Pathology findings Hashimoto thyroiditis

A

Lymphocytic infiltration with germinal centers and oncocytic-metaplastic cells (Hurthle cells)

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12
Q

Multinucleated giant cells and granuloma formation

A

Pathology findings Subacute granulomatous thyroiditis (De Quervain)

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13
Q

Dense and white fibrotic tissue
Inflammatory infiltrate

A

Riedel thyroiditis

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14
Q

___________peripheral (thyroid) disorders → T3/T4 are not produced (↓ levels) → compensatory ↑ TSH

A

Primary hypothyroidism:

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15
Q

_________pituitary disorders → ↓ TSH levels → ↓ T3/T4 levels

A

Secondary hypothyroidism:

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16
Q

hypothalamic disorders → ↓ TRH levels → ↓ TSH levels → ↓ T3/T4 levels

A

Tertiary hypothyroidism:

17
Q

Effects of hypothyroidism Decreased sympathetic activity leads to:

A

Decreased sweating
Cold skin (due to decreased blood flow)
Constipation (due to decreased gastrointestinal motility)
Bradycardia

18
Q

Hyperprolactinemia

A

↑ prolactin production is stimulated by TRH → suppression of LH, FSH, GnRH, and testosterone and stimulation of breast tissue growth

19
Q

Myxedema: due to accumulation of ________________within the reticular layer of the dermis

A

glycosaminoglycans and hyaluronic acid

20
Q

Subclinical hypothyroidism levels

A

TSH Mildly ↑
FT4 Normal
FT3 Normal

21
Q

Euthyroid sick syndrome levels

A

TSH normal
FT4 dec free T3 and rT3 inc
FT3 dec

22
Q

Hypothyroidism is treated with lifelong hormone substitution____

A

Levothyroxine
Liothyronine

23
Q

First-line choice for the treatment of hypothyroidism

A

Levothyroxine: synthetic form of T4

24
Q

MOA Levothyroxine

A

Peripherally converted to T3 (biologically active metabolite) and rT3 (biologically inactive metabolite)

25
Q

T3
Part of the treatment for myxedema coma

A

Levothyroxine

26
Q

Long-term therapy considerations

A

Side effects: Overtreatment can lead to symptoms of thyrotoxicosis.
Sweating, heat intolerance, tremors
Tachycardia, palpitations, arrhythmias
Weight loss, osteoporosis

27
Q

Exogenous thyrotoxicosis lev3el

A

Low/undetectable TSH
High levels of T4 and/or T3

28
Q

Complications

A

Myxedema coma
CVS risk inc
Carpal tunnel
Primary thyroid lymphoma

29
Q

Congenital hypothyroidism is called

A

Cretinism

30
Q

What are the 7 P’s of congenital hypothyroidism

A

The 7 P’s of congenital hypothyroidism are Pot-bellied, Pale, Puffy-faced, Protruding umbilicus, Protuberant tongue, Poor brain development, and Prolonged neonatal jaundice

Endocrine II (16 decks)

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