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SM 408 > Hypothyroidism & Thyroiditis > Flashcards

Hypothyroidism & Thyroiditis Flashcards

1
Q

Primary hypothyroidism

A

It is caused by intrinsic dysfunction of the thyroid gland leading to hormone deficiency.

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2
Q

Definition of overt hypothyroidism

A

Elevated TSH above 10 mIU/L with free T4 below normal.

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3
Q

Definition of subclinical hypothyroidism

A

Modestly elevated TSH with free T4 in the low-normal range.

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4
Q

Most common cause of primary hypothyroidism

A

Autoimmune thyroiditis including Hashimoto’s and atrophic thyroiditis.

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5
Q

Iatrogenic causes of hypothyroidism

A

Radioiodine therapy subtotal or total thyroidectomy and neck irradiation.

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6
Q

Drugs that cause hypothyroidism

A

Amiodarone lithium iodine-containing contrast and antithyroid drugs.

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7
Q

Two types of transient hypothyroidism

A

Silent thyroiditis and subacute thyroiditis.

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8
Q

Common causes of secondary hypothyroidism

A

Pituitary tumors surgery irradiation or infiltrative disorders.

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9
Q

Common causes of hypothalamic hypothyroidism

A

Tumors trauma infiltrative diseases or idiopathic causes.

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10
Q

Definition of autoimmune hypothyroidism

A

Hypothyroidism caused by immune-mediated thyroid destruction.

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11
Q

Goitrous autoimmune hypothyroidism

A

Also called Hashimoto’s thyroiditis.

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12
Q

Atrophic thyroiditis

A

Late stage of autoimmune hypothyroidism with minimal residual thyroid tissue.

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13
Q

Subclinical autoimmune hypothyroidism

A

Normal T4 maintained by elevated TSH with minor symptoms.

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14
Q

Clinical or overt hypothyroidism

A

TSH >10 mU/L with decreased unbound T4 and apparent symptoms.

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15
Q

Histological features of Hashimoto’s thyroiditis

A

Lymphocytic infiltration germinal centers thyroid atrophy and fibrosis.

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16
Q

Histological difference in atrophic thyroiditis

A

More extensive fibrosis with fewer lymphocytes and absent thyroid follicles.

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17
Q

Genetic factors in autoimmune hypothyroidism

A

Increased risk in siblings and linkage with other autoimmune diseases.

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18
Q

Autoimmune diseases linked to hypothyroidism

A

Type 1 diabetes Addison’s disease pernicious anemia and vitiligo.

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19
Q

Common symptoms of hypothyroidism

A

Fatigue cold intolerance dry skin and weight gain.

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20
Q

Neurological symptoms of hypothyroidism

A

Difficulty concentrating poor memory and impaired hearing.

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21
Q

Gastrointestinal symptoms of hypothyroidism

A

Constipation and poor appetite.

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22
Q

Respiratory symptoms of hypothyroidism

A

Dyspnea and hoarse voice.

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23
Q

Menstrual changes in hypothyroidism

A

Menorrhagia followed by oligomenorrhea or amenorrhea.

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24
Q

Common signs of hypothyroidism

A

Puffy face dry skin alopecia bradycardia and peripheral edema.

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25
Q

Neurological sign of hypothyroidism

A

Delayed tendon reflex relaxation.

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26
Q

Hand disorder associated with hypothyroidism

A

Carpal tunnel syndrome.

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27
Q

Laboratory abnormalities in hypothyroidism

A

Anemia hyponatremia hypoglycemia and high cholesterol.

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28
Q

ECG finding in hypothyroidism

A

Sinus bradycardia with low voltage in limb leads.

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29
Q

Imaging finding in hypothyroidism

A

Pericardial effusion on chest X-ray and echocardiography.

30
Q

Primary hypothyroidism diagnosis

A

Elevated TSH with low free T4.

31
Q

Subclinical hypothyroidism diagnosis

A

Elevated TSH with normal free T4.

32
Q

Central hypothyroidism diagnosis

A

Normal or low TSH with low free T4.

33
Q

Treatment goal in hypothyroidism

A

Replace thyroid hormone while avoiding thyrotoxicosis.

34
Q

Drug of choice for hypothyroidism

A

Levothyroxine sodium.

35
Q

Levothyroxine dosage in adults

A

1.8 mcg/kg/day.

36
Q

Levothyroxine dosage in elderly

A

1.0 mcg/kg/day due to reduced clearance.

37
Q

Higher levothyroxine dose required in

A

Postsurgical or postablative hypothyroidism.

38
Q

Definition of myxedema coma

A

Severe hypothyroidism with hypothermia bradycardia hypotension and altered mental status.

39
Q

Risk factors for myxedema coma

A

Advanced age poor healthcare access and major organ diseases.

40
Q

Immediate treatment for myxedema coma

A

IV thyroxine 50-100 mcg every 6-8 hours for 24 hours.

41
Q

Supportive treatment in myxedema coma

A

Intensive care for hypoventilation and hypotension.

42
Q

Additional hormone used in severe cases

A

Triiodothyronine in divided doses.

43
Q

Adrenal support in myxedema coma

A

IV hydrocortisone 50 mg every 8 hours to prevent adrenal crisis.

45
Q

Acute thyroiditis

A

It is caused by bacterial or fungal infections or radiation exposure.

46
Q

Common bacterial causes of thyroiditis

A

Staphylococcus Streptococcus and Enterobacter.

47
Q

Common fungal causes of thyroiditis

A

Aspergillus Candida Coccidioides Histoplasma and Pneumocystis.

48
Q

Cause of radiation thyroiditis

A

131I treatment.

49
Q

Subacute thyroiditis causes

A

Viral infections and silent thyroiditis including postpartum thyroiditis.

50
Q

Chronic thyroiditis causes

A

Autoimmunity and parasitic infections.

51
Q

Autoimmune causes of thyroiditis

A

Hashimoto’s thyroiditis atrophic thyroiditis and focal thyroiditis.

52
Q

Parasitic causes of thyroiditis

A

Echinococcosis strongyloidiasis and cysticercosis.

53
Q

Cause of transient thyrotoxicosis in subacute thyroiditis

A

Uncontrolled leakage of thyroid hormone.

54
Q

Typical duration of thyrotoxicosis in subacute thyroiditis

A

2 to 8 weeks.

55
Q

Outcome after thyrotoxicosis in subacute thyroiditis

A

Transient hypothyroidism followed by recovery.

56
Q

Hallmark symptoms of subacute thyroiditis

A

Painful thyroid enlargement systemic inflammation and transient thyrotoxicosis.

57
Q

Pain location in subacute thyroiditis

A

Thyroid throat ears or jaw.

58
Q

Constitutional symptoms in subacute thyroiditis

A

Fever chills sweats and malaise.

59
Q

Thyroid gland characteristics in subacute thyroiditis

A

Tender enlarged and woody hard.

60
Q

Differential diagnoses for thyroid pain

A

Acute thyroiditis hemorrhage into a nodule and rapidly growing thyroid cancer.

61
Q

Laboratory findings in subacute thyroiditis

A

Overt thyrotoxicosis with high T4 and elevated ESR.

62
Q

First-line treatment for subacute thyroiditis pain

A

High-dose aspirin or naproxen sodium.

63
Q

Second-line treatment for subacute thyroiditis

A

Glucocorticoids tapered over several weeks.

64
Q

Treatment for transient thyrotoxicosis

A

Short-term β-blockers for 1 to 3 weeks.

65
Q

Treatment for symptomatic hypothyroidism in subacute thyroiditis

A

Short-term thyroxine replacement.

66
Q

Most common population affected by lymphocytic thyroiditis

A

Postpartum women.

67
Q

Percentage of postpartum women affected by lymphocytic thyroiditis

68
Q

Predisposing factors for lymphocytic thyroiditis

A

Prior postpartum thyroiditis type 1 diabetes and antithyroid antibodies.

69
Q

Phases of lymphocytic thyroiditis

A

Transient thyrotoxicosis followed by transient or persistent hypothyroidism.

70
Q

Typical duration of thyroid dysfunction in lymphocytic thyroiditis

A

2 to 8 weeks.

71
Q

Management of lymphocytic thyroiditis

A

Observation and reassurance.

72
Q

Symptomatic treatment for thyrotoxicosis in lymphocytic thyroiditis

A

Short-term β-blocker therapy.

SM 408 (15 decks)

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