Hypothyroidism + Goiter Flashcards
a patient presents with weight gain, fatigue, cold intolerance, dry skin, arthralgias/myalgias, depression and poor memory. what are they likely experiencing?
hypothyroidism
what is the problem in a primary etiology of the thyroid?
thyroid failure
what is the problem in a secondary etiology of the thyroid?
pituitary TSH deficiency
what is the problem in a tertiary etiology of the thyroid?
hypothalamic TRH deficiency
what is the most common cause of a primary thyroid problem?
idiopathic
if a patient presents with suspicious hypothyroidism, what labs should we order? (3)
TSH
T3/T4
antithyroperoxidase (anti-TPO)
what should we order for a patient suspicious for hypothyroidism, if we palpate nodules?
thyroid ultrasound
a patient presents with elevated TSH, low T4, hyponatremia, and hyperlipidemia. what are they likely experiencing?
primary hypothyroidism
a patient presents with low TSH, low T4, hyponatremia, and hyperlipidemia. what are they likely experiencing?
secondary hypothyroidism
what is the preferred treatment for hypothyroidism?
synthetic levothyroxine (T4)
in an elderly or cardiac patient with hypothyroidism, how should we dose levothyroxine?
low doses
in a pregnant woman with hypothyroidism, how should we dose levothyroxine?
high doses
in a young, healthy patient with hypothyroidism, how should we dose levothyroxine?
1.6 mcg/kg/day for 6 weeks
in a young healthy patient with hypothyroidism, what should we do if their TSH is still elevated after 6 weeks of taking levothyroxine at 1.6 mcg/kg/day?
increase dose by 12-25 mcg/day
in a confirmed pregnancy, how does levothyroxine T4 increase?
increase by 30%
what is one of the most common preventable causes of intellectual disabilities?
congenital hypothyroidism (cretinism)
what is the problem in congenital hypothyroidism (cretinism)?
baby is born without having the proper amount of thyroid hormone while in the womb
a baby is born with a large anterior fontanel, low hair line, dull puffy face, slow reactions, large tongue, edema of the eyelids, jaundice, hypothermia, and hypotonia. what are they likely experiencing?
cretinism (congenital hypothyroidism)
what is the treatment for cretinism (congenital hypothyroidism)?
levothyroxine
what is the most common cause of a goiter?
iodine deficiency
where are goiters common?
in regions with low iodine diets
what is the treatment for a patient with a goiter that is euthyroid?
add iodine to diet
what is the treatment for a patient with a goiter that is experiencing compression or thyrotoxicosis? (can also be done for cosmetics)
thyroidectomy
what is the treatment for a patient with a goiter that has hyperthyroidism or hypothyroidism?
treat the hyperthyroidism or hypothyroidism
