NUS 111 Test #3 Flashcards
this releases thyroid stimulating hormone
pituitary gland
iodine is needed to synthesize these
T3 and T4
what does the thyroid gland affect
metabolic rate, growth and developement, brain function and metabolism
decreased basal metabolic rate creating weight gain, supresses glucose
hypothyroidism
weight loss, caloric requirement goes up; graves disease causes 75% of this
hyperthyroidism
this is caused by the destruction of the thyroid gland and/or defect in the production of hormones
hypothyroidism
decreased production of ____ leads to the stimulation of the secretion of _____ which stimulates the secretion of T3
T4
TSH
T3 increases the secretion of _____ which leads to the hypertrophy of the thyroid gland
T4
what is transient hypothyroidsm
temporary/reversible
waht is primary hypothyroidism
disfunction of thyroid gland itself; or not enough iodine
this is thyroid deficiency is present at b irth
cretinism
drugs for hypothyroidism
lithium
what is the most common cause of hypothyroidism in the world
iodine deficiency
modifiable risk of hypothyroidism - 2
use of lithium
diet iodine deficiency
Non modifiable risk factors of hypothyroidism - 6
age, 30-60 yrs old
genetics
autoimmune disease
females
hyperthyroidism, part of thyroid removed, meds for hyperthyroid at any point, head or neck radiation
old ppl considerations for hypothyroidism - 6
depression
decreased mobility
presents atypically*
constipation
thyroid replacement therapy
CV & neurologic side effects with thyroid replacement therapy
early symptoms of hypothyroidism - 8
- fatigue
- amenorrhea
- loss of libido
- non pitting edema
- mental sluggishness
- parasthesia and nerve entrapment syndrome
- hair loss, dry skin, brittle nails
- constipation
late symptoms of hypothyroidism - 10
- slow speech
- cold intolerance
- subdued emotional response,
- apathy
- absence of sweating
- constipation
- thickening of skin
- dyspnea
- weight gain (without increase in food consumption)
- thinning of hair, alopecia (Severe)
severe hypothyroidism resulting in decompensated metabolic state and mental status change
myxedema coma
what part of myxedema coma is pt a medical emergency
enlarged tongue
depressed resp drive
advanced stage of hypothyroidism
personality and congnitive changes - looks like dementia
respiratory issues:
-muscle weakness
-pleural effusion
-sleep apnea
severe stage of hypothyroidism
elevated level of serum cholesterol
CAD/ Poor left ventricular function
myxedema coma
-hypothermic
-Lethargy/unconscious /coma
-Non pitting and periorbital edema
-Enlarged tongue (hoarseness)
-Depressed respiratory drive
how do you manage myxedema coma
- supportive (airway, rewarming)
- hydrocortisone
- levothyroxine, T4
- +/- T3 supllementation
what are the laboratory findings for myxedema coma
hypoglycemia
hyponatremia
hypoxemia
prolonged QT, low voltage
pericardial effusion
hypercapnia