Lecture 2 - Hyperthyroid Flashcards
most thyroid hormone in the blood is (unbound/bound) and (active/inactive)
bound (99.9%), inactive
OCPs, estrogens, and pregnancy all increase ___ T4, and have normal ___ T4 by ______ TBG.
total;
free;
increasing
Glucocorticoids, cirrhosis, and nephrotic syndrome are examples where there is ____ TBG, ____ total T4, and ____ free T4
decreased, decreased, normal
hyperthyroidism:
tachycardia, arrythmias due to increased ____;
weight loss, increased appetite, and sweating due to increased _____, which increases the _____
B1 receptors;
Na-K+ pumps, BMR
hyperthyroidism:
____ hair;
_____ myxedema in graves disease;
stare and lid lag due to _____
fine;
pretibial;
increased symp firing
name 2 common medications that affect thyroid function
amiodarone, lithium
grave’s disease and toxic multinodular goiter show ____ uptake of radioiodine. subacute thyroiditis and hashimotos show ____ uptake of radioiodine
increased;
decreased
hyperthyroidism in the elderly:
usually present with ____ problems such as _____. ____ is often a prominent feature
cardiac, AFib;
myopathy
clinical triad in Grave’s disease:
goiter, pretibial myxedema, exopthalmus
graves: proliferation of _____ and secretion of ______ leading to edema cause the symptoms of exopthalmus
fibroblasts, GAGs
grave’s patients often have limited ability to look ____ due to ____ and _____ _____ rectus muscles
superiorly;
thickened, shortened inferior
toxic multinodular goiter is characterized by ______ follicular cells that (do or do not) respond to TSH
autonomous/hyperactive
do not
ie “Hot nodule”
in addition to thiomides, what 2 drugs are used in management of graves disease?
both do what
beta blockers, corticosteroids;
decrease T4 to T3 conversion
in a pregnant woman with graves:
____ should be used in the first trimester to avoid the risk of ____ when ____ is used
PTU;
aplasia cutis, methimazole
PTU has a black box warning for ____
liver toxicity
radiation in hyperthyroidism:
can worsen pre-existing ____;
_____ in thyroid hormone levels 1-2 weeks after treatment, which can cause a ______
exopthalmus in graves;
increase;
thyroid storm (if v high levels)
thyroid storm:
usually occurs when hyperthyroidism is incompletely treated and worsens in the setting of ____ such as ____, trauma, or surgery
acute stress;
infection
thyroid storm:
very high ____;
diarrhea, coma;
cause of death is usually ____
fever;
tachyarrhythmia
the 4 P’s of treating thyroid storm
propanolol (a beta blocker);
propylthiouracil;
Prednisolone (corticosteroids);
Potassium iodide (administer after PTU)
Dequarvains/Granulomatous thyroiditis:
painful or painless?
usually occurs following _____;
self limited or no?
PAINFUL AF;
infection (virus);
yes; give patient NSAIDs
thyroiditis (silent/lymphocytic):
initially ____, progresses to ____
hyperthyroidism, hypothyroid
thyroid surgery:
can damage ______ causing hoarsness,
can remove Parathyroid glands causing ____
recurrent laryngeal;
hypocalcemia
hyper vs hypothyroid:
osteoporosis =
hypercholesterolemia =
hyperglycemia =
hyper;
hypo;
hyper
