Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Endocrine II Final > Parrot DSA Chapter 26 CMDT > Flashcards

Parrot DSA Chapter 26 CMDT Flashcards

(54 cards)

Start Studying
1
Q

What is the most sensitive test for screening for primary hypo or hyperthyroidism?

A
  • TSH

- free thryoxin (T4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is TSH in hypothyroidism?

A

-high in primary, low in secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How are the antithyroglobulin and antithyroperoxidase antibodies in Hashimoto thyroiditis?

A

elevated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

TSh in hyperthyroidism?

A

-suppressed except in TSH-secreting pituitary tumor or pituitary hyperplasia (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T3 and free T3 in hyperthyroidism?

A

-elevated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

I 123 uptake and scan in hyperthyroidism?

A

-increased uptake; diffuse versus “hot” foci on scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Anti TPO and Anti TG antibodies in Graves Disease?

A

-Elevated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

TSI and TSH receptor antibody in Graves?

A

-usually positive (65%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the best diagnostic method for thyroid cancer if you see thyroid nodules?

A

-fine-needle aspiration (FNA) bioposy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is cancer on a 123 I uptake scan?

A

-“cold”; less reliable than FNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how does thyroid nodules look like on 99mTc scan?

A

-Vascular vs. Avascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Thyroid nodule and ultrasonography

A
  • assist FNA biopsy
  • assessing risk of malignancy
  • monitoring nodules and patients after thyroid surgery for carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some common manifestations of Hypothyroidism?

A
  • weight gain, lethargy…. general hypo stuff

- palpably enlarged thyroid… b/c elevated serum TSH levels (Hashimoto’s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lab findings for hypothyroidism

A

-best is TSH (incrased in primary, decreased in secondary)
-FT4 will be low
-hyponatremia/glycemia
-abnormal sperm morphology
-if autoimmune, there will be antibodies (TPO, TG)
-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is subclinical hypothyroidism?

A
  • having normal serum FT4 w/ TSH that is above reference range
  • 65 y/o
  • transient… it’s fine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tx for hypothyroidism?

A

-levothyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where do we want to keep the TSH level at when treating hypothyroidism?

A

-0.4-2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What would require a larger initial dose of levothyroxine ?

A

Myxedema crisis

-can interfere with intestinal absorption of oral levo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What do we have to do before we start thyroid hormone therapy?

A

-look for adrenal insufficiency and angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When would we need to increase the levothyroxine doseage?

A

-if there are other drugs that increase the hepatic metabolism of levo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If there is elevated serum TSH, what does that mean about the amount of thyroxine that we are giving them?

A
  • it’s not enough

- but make sure that they’re actually taking it…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If they have a normal TSH level, what do you do?

Study These Flashcards
A
  • carefully assess them for other conditions…. like adverse drug rxn or something like that
  • if they have CAD, make it so that their TSH levels are a little more elevated
23
Q

If they have a low or suppressed serum TSH level, what do we do?

Study These Flashcards
A
  • < .4
  • reduce it if it looks like hyperthyroidism
  • increased risk of A fib and osteoporosis if they have primary hypothyroidism and take levothyroxine…so lower the dose of levothyroxine
24
Q

Graves disease

Study These Flashcards
A
  • mos common cause of thyrotoxicosis
  • women»>men
  • auto antibodies bind TSH receptors… thyroid hormone made
  • too much iodine can cause it
25
Postpartum Thyroiditis
-hashimoto thyroiditis that occurs in the first 12 months after delivery
26
Subacute Thyroiditis
- De quervain or granulomatous thyroiditis - viral infection - differentiate from infectious (suppurative bacterial) thyroiditis
27
Silent thyroiditis
- subacute lymphocytic thyroiditis | - drugs can cause it (Lithium, amiodarone)
28
Signs and symptoms of Hyperthyroidism
- heat intolerance - irritability - diffusely enlarged thyroid - forceful heartbeat - exophthalmos - pretibial myxedema
29
Lab findings for hyperthyroidism
- thyroid hormones increased - suppressed TSH - subclinical hyperthyroidism: lowered TSH but normal T4 and 3 - +TSI
30
What drug will give people high levels of T4 and FT4?
amiodarone - type 1: TSI + - Type 2: IL-6+
31
Tx of Grave's disease
- Propranolol - Thiourea drugs: methimazole and PTU.. blocks organification - Iodinated contrast agents: blocks T4-T3 conversion - Radioactive iodine: don't give to preggo or lactating woman - Thyroid surgery: try not to take everything out... leave some behind
32
Which is preferred, methimazol or PTU?
Methimazole unless it's the first trimester of preggo.... then PTU -methimazole is more convenient to use
33
Tx of hyperthyroidism from thyroiditis
- propranolol - Ipodate sodium or Iopanoic acid to correct T3 levels - Thioureas are ineffective
34
Is hashimoto an autoimmune condition?
yes
35
Subacute thyroiditis
- granulomatous... dequervain's - giant cell thyroiditis - relatively common - viral infection... upper resp tract infection - incidence peaks in the summer - middle aged women
36
How does subacute thyroiditis present?
- usually painful enlargement of thyroid gland - w/ dysphagia - if no pain, it's called silent thyroiditis
37
Lab values for Hashimoto's
- anti TPO | - anti TG
38
Lab values for subacute thyroiditis?
- ESR markedly elevated - anithyroid titers are low - in infectious thyroiditis, both the leukocyte count and the ESR are usually elevated
39
Tx for hashimoto thyroiditis?
-levothyroxine
40
Tx for subacute thyroiditis?
- aspirin... relieves pain and inflammation - Thyrotoxic sx are treated with propranolol - Iodinated contrast agents work well
41
Signs and sx of hypoparathyroidism?
- hypocalcemia - can happen with PPI - tetany, cramps, spasm, irritability, tingling,
42
Lab values for hypoparathyroidism
- Ca is low - P is high - PTH is low - hypomagnesemia may exacerbate symptoms and decreased parathyroid function
43
What is the most common cause of hypercalcemia?
- primary hyperparathyroidism - women in 70s - hypersecretion of PTH - adenoma is most common - size of adenoma correlates with PTH level
44
Clinical findings of hyperparathyroidism?
- Skeletal (bones): loss of cortical bone and gain of trabecular bone... so low density... vertebral fractures - Hypercalcemia manifestations: depression, constipation, and bone and joint pain.... diminished DTRs... polyuria and polydipsia
45
Complications with hyperparathyroidism
- long bone fractures - UTI's from stones - clouding of sensorium - kidney disease - peptic ulcer and pnacreatitis - insulinomas or gastrinomas - hypercalcemia during gestation produces neonatal hypocalcemia
46
What drugs are contrindicated in hyperparathyroidism?
- thiazide diuretics - large doses of Vit A - calcium-containing antacids or supplements
47
What are the very basics of bone densitometry?
- DXA= dual energy x-ray absorptiometry - neglible radiation - used to look at osteoporosis and osteomalacia.. but can't tell them apart - Uses "T" score - do 2-3 sites... hip, lumbar spine
48
What are the T score significant values?
->or =1 is norm - -1 to -2.5 is osteopenia (low bone density) -
49
Tx options for osteoporosis?
- Vit D and calcium - Sex hormons - Bisphosphonates
50
What do the Bisphosphonates do?
-indicated for pts with pathologic spine fracture or a low impact hip fracture... and for pts with osteoporosis (
51
Osteomalacia
- painful proximal muscle weakness; bone pain and tenderness - decreased bone density from defective mineralization - Increased alkaline phosphatase, decreased 25-OH vit D, hypocalcemia, hypocalciuria, hypophosphatemia, secondary hyperparathyroidism
52
Vit D deficiency and resistance
- most common cause of osteomalacia - low sunlight - usually asymptomatic at first, then pain comes - hypocalcemia or hypophosphatemia
53
Paget Disease of Bone
- Often asymtomatic - Bone pain may be the first symptom - Kyphosis, bowed tibias, large head, deafness, and frequent fractures - Serum calcium and phosphate normal; alkaline phosphatase elevated; urinary hydroxyproline elevated - dense, expanded bones on radiographs
54
Signs and symptoms of Paget disease of bone?
- mild - pelvis, vertebrae, femur , humerus, skull - doesn't involve additional bones in the course - pain is worse at night - "headaches and an increased hat size" - hearing loss b/c of involvement of petrous temporal bone

Endocrine II Final (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions