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Adult Health > Thyriod > Flashcards

Thyriod Flashcards

1
Q

Normal TSH T3 and T4 levels

A 
TSH = .4-5.5
T3 = 80-220
T4 = .7-2.0
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2
Q

Thyroid nodules

A

If visibile - hyperthyroid

Can be uncomfortable

Obstructive sx - sob, hoarness, dyspaghia, sob

Concern if pressing on the laryngeal nerve

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3
Q

Thyroid nodule concerning features

A

Rapid growth, solid nodule, hard and fixed , esophageal or tracheal obstruction , swelling under jaw

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4
Q

Thyroid nodules - what to do with them

A

Assess for thyroid function - TSH and T4

Low TSH - nodule is producing thyroid hormone
High TSH - autoimmune inflammation of the thyroid ( hashimotos)

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5
Q

Thyroid US

A

Can assess # of nodules, location and size

Can tell if it is cystic solid

But not diagnostic

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6
Q

Thyroid scan

A

Uses a radioactive substance to determine the nodule function

Cold = non function and needs biopsy 
Hot = not concern for CA
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7
Q

FNA

A

Biopsy

In office, 5-6 samples, may miss the area

Takes 2-3 weeks to come back

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8
Q

Thyroid Cancer

A

Risks : childhood ca, ages 30-60 M>W, radiation exposure, fam hx

ROS: hoarness and dysphagia

DX; elevated TSH , cold nodules

Management : scans every 3-6 months x 5 years after diagnosis
Scans 6-12 months once cancer free

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9
Q

Goiter

A

Pronounced swelling of neck

Common in hashimotos

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10
Q

Hyperthyroidism

A 
decrease in TSH increase in T3 
- excess thyroid hormone 
May be due to graves 
Inflammation of thyroid gland
Excessive intake of thyroxine mediation 
Excess TSH from pituitary glan
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11
Q

Hyper s/s

A

Increased metabolic rate
Intolerance to heat
Fine, straight hair, bulging eyes, tachy increased BP, tachy, tremors, weight loss, amenorrhea
Agitation, racing HR

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12
Q

Hyper labs

A

Low TSH and increased T3 , t4 , free t5

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13
Q

Hyper TX

A

Radiation , medication , or surgery

  • methimazole - 3 divided doses 8 hour internals
  • PTU - TID good for pregnant women
  • treament may be life long
  • beta blocker to decrease HR
  • metabolism return to normal 1 -2 months
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14
Q

Hypothyroidism

A

Caused by hashimotos

Increased TSH decreased T4

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15
Q

Hypo s/s

A

Early = hair loss, dry skin, contsptiaion , intolerance to cold, thick tongue

Late- Brady, weight gain, decreased loc, thickend skin, cardiac complications

PE: facial puffiness, goiter, enlarged tongue, depression, dementia , diminished reflexes, coarse hair, brittle nail, yellow hue, dryness, weight gain

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16
Q

Hypo labs

A

Increased TSH and Low t 4

Will see low t4 and low TSH which is a = pituatary failure

Check cholesterol - fix and reassess

17
Q

Hypo TX

A

Synthroid - 6 mcg/kg/day : increase by 12.5 - 25 mcg every 6-8 weeks

Young healthy - 100-125 mcg / day
Older w/ cardiac - 75-150 up to 200 mcg/day

Once dose achieve follow up 6-12 months

Look for drug reactions

Should take same time every day on empty stomach 1 hour before meals

18
Q

Hyperparathyroidism

A

High calcium caused by a benign tumor in one of the glands

S/s: loss of energy, feels bad, lack of interest, high BP, palpitations,

May have irregular rate and rhythm

> 10.5 ( 8.5-10.5) PT > 65 (10-65)

Refer to endocrine will need surgery and then calcium replacement

19
Q

Hypoparathyroidism

A

Low calcium - rare - refer to endocrine

S/s - restlessness, agitation, numbness tingling around nose, lips and extremities,

PE: hyperreflexia of deep tendons, tremors, hyotension

< 8.5 PTH < 10
Treat bases on acuity and severeity

Calcium and Vit D

20
Q

Cushing syndrome

A

Adrenal problem
Excessive production of cortisol

S/s: obesity, moon face, water retention, heavy truck, depression

PE: fatty hump on back of neck, HTN, hirtsitism, red/purple striae > 1 cm wide

DX; 24 hour excretion cortisol in urine

Refer to endocrine

21
Q

Addisons

A

Adrenal insufficiency

S/s : weight loss, dehydration, increased skin pigmentation, darkened creased of palms, knees and lip, low BP

PE; look at skin and VS

refer to endocrine

22
Q

PCOS

A

In women of reproduction age causing infertility due to failure to ovulate
- at risk for DM II , CVD, uterine ca , premature menses, 1st degree relative, antileptic drugs

23
Q

PCOS s/s

A 
Appears during teenage years
Irregular or absent menses 
Hirstutism 
Oily skin  and acne 
Skin tag
Scalp hair loss or balding 
Depression, anxiety 
Overweight

Fewer than 9 men’s trail periods in a year = oligomenorrhea

Amenorrhea = no menstrual periods for three or more months

Our role is to identify and refer

24
Q

PCOS Treatment

A

Weight loss / healthy diet exercise

Oral conception to restore menses and protect again uterine cancer - helps with acne

Aldactone - 50-100- a diuretic which acts by blocking the action of testerone at the hair cell level. NOT in PREG

Metformin

Progestin

25
Q

Tanner stage II boys

A

Enlargement of testes and scrotum - scrotal skin reddened and change in texture

26
Q

Tanner II boy

A

Enlargement of penis in length

27
Q

Tanner IV boy

A

Increase size of penis with growth in breadth and development of gains - Scotland skin darker

28
Q

Tanner II girl

A

Breast bud stage with elevation fo breast and papilla - enlargement of areola

29
Q

Tanner stage III

A

Further enlargement fo breast and areaola - no separation of the countour

30
Q

Tanner IV girl

A

Areola and papilla separate form a secondary mound above the level of breast

31
Q

tanner V. Girl

A

Projection of papilla only, ,related to recession of areola

32
Q

Tanner pubic hair 2

A

Sparse grown of long , slightly pigmented hair , at base of penis or along labia

33
Q

tanner pubic III

A

Darker, coarser and more curled hair, speaking sparsely over junction of pubes

34
Q

Tanner pubic IV

A

Hair adult type but covering smaller area an adult , no spread to the medial surface of thighs

35
Q

Tanner pubic stage 5

A

Adult type and quantity with horizontal upper border

Adult Health (12 decks)

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