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%
