Thyrod Gland: Clinical Disorders

Question 1

Clinical Disorders
• Screening is recommended when a person reaches____ years old and every____ years thereafter.

Answer 1

35

5

Question 2

Thyroid Disorders (3 types)

Answer 2

• Hyperthyroidism
• Hypothyroidism
• Euthyroidism

Question 3

• s/sx: heat intolerance
  tachycardia
  weight loss
  weakness
  emotional lability
  tremor

Answer 3

Hyperthyroidism

Question 4

Hyperthyroidism
- most common clinical syndrome associated with this is_______

Answer 4

Graves’ disease

Question 5

• most common clinical syndrome associated with this is Graves’ disease

Answer 5

Hyperthyroidism

Question 6

Thyroid Disorders
• Hyperthyroidism

2 types

Answer 6

• primary hyperthyroidism
• secondary hyperthyroidism

Question 7

Thyroid Disorders
Hyperthyroidism

4

Answer 7

• Thyrotoxicosis
• Graves’ disease (diffuse toxic goiter)
• Subclinical hyperthyroidism
• Subacute granulomatous / Subacute nonsuppurative thyroiditis (De Quervain’s thyroiditis)

Question 8

• group of syndromes caused by high levels of free thyroid hormones in the circulation

Answer 8

Thyrotoxicosis

Question 9

Thyroid Disorders
Hyperthyroidism
•_______ (toxic diffuse goiter)
- most common cause of thyrotoxicosis
- autoimmune disease
- 6x more common in women than in men

Answer 9

Graves’ disease

Question 10

Graves’ disease (_____) and shrew

Cause:

Answer 10

toxic diffuse goiter
- cause: circulating antibodies to the TSH receptor (TRAbs)

Question 11

Graves’s decease

features:

• dx test:

Answer 11

• pretibial myxedema
• goiter
• exophthalmos / opthalmopathy
• dermopathy.

TSH receptor Ab test

Question 12

Clinical Findings in Graves Disease.
Symptoms & Signs:

Answer 12

• Heat intolerance, excessive sweating.
• Anxiety, “hyperkinesis.”
• Sleep disturbances.
• Weight loss despite increased appetite.
• Hyperdefecation (not diarrhea).

Question 13

Signs:
(3).
goiter.
• Fine tremor of outstretched hands.
• Brisk reflexes.

Answer 13

• Tachycardia, wide pulse pressure.
• Warm, moist skin.
: Eyeila, maybe present

Question 14

• no clinical s/sx
• FT, and FT, normal; TSH is low

Answer 14

Subclinical hyperthyroidism

Question 15

• neck pain, low-grade fever, thyroid fxn swings
• TPO Ab absent; ESR and Tg levels are high

Answer 15

Subacute granulomatous / Subacute nonsuppurative thyroiditis (De Quervain’s thyroiditis)

Question 16

• s/sx: hoarseness, cold sensitivity, dry skin, constipation, bradycardia, and muscle weakness

Hypothyroidism
- s/sx: _______, cold sensitivity, dry skin, constipation, bradycardia, and muscle weakness

Answer 16

Hypothyroidism

Question 17

Hypothyroidism
3 types

Answer 17

• primary hypothyroidism
• secondary (central) hypothyroidism
• tertiary hypothyroidism

Question 18

Primary hypothyroidism

Answer 18

• Hashimoto’s disease
• Myxedema

Question 19

• Hashimoto’s disease
• Myxedema

Answer 19

Primary hypothyroidism

Question 20

• primarily due to deficiency of elemental iodine (low T3 and T4; high TSH)
• also caused by destruction or ablation

• surgical removal; use of radioactive iodine (RAI) for hyperthyroidism treatment; radiation exposure; drugs such as Li

Answer 20

• Primary hypothyroidism

Question 21

Hypothyroidism

• most common cause of primary hypothyroidism
• sensitized T lymphocytes / autoAb bind to cell membrane causing cell lysis and inflammatory reaction
• assoc. with enlargement of the thyroid gland (goiter)

Answer 21

Hashimoto’s disease (chronic autoimmune thyroiditis)

Question 22

Hypothyroidism
- TPO Ab: +
- TSH increased

Answer 22

• Hashimoto’s disease (chronic autoimmune thyroiditis)

Question 23

• describes the peculiar nonpitting swelling of the skin

Answer 23

Myxedema

Question 24

Hypothyroidism
• Secondary hypothyroidism

Answer 24

• due to pituitary destruction or pituitary adenoma
• low T3 and T4
• low TSH

Question 25

Hypothyroidism
•
- hypothalamic disease
- low T3 and T4
- low TSH

Answer 25

Tertiary hypothyroidism

Question 26

Hypothyroidism

•
- defects in the development or function of the gland
- Develops in infancy or early childhood
- retarded physical and mental development
- screening test: T4 (decreased)
- confirmatory test: TSH (increased)

Answer 26

Congenital hypothyroidism (cretinism)

Question 27

•
SYMPTOMS
• Patient is dwarf with severe mental defect.
Coarse dry skin
Deficient hair & teeth.
Retarded skeletal growth.
Reduced BMR

Answer 27

Condition of severely stunted physical and mental growth.

CRETINISM

Question 28

• no clinical s/sx
• T3 and T4 normal; TSH is slightly high

Answer 28

Subclinical hypothyroidism

Question 29

•
- refers to normal thyroid hormone levels (clinically and biochemically)

Answer 29

Euthyroidism

Question 30

• Euthyroidism

(normal T3 and T4, low TSH)

(normal T3 and T4, high TSH)

Answer 30

• subclinical hyperthyroidism
• subclinical hypothyroidism

Question 31

• tend to have low TSH results during their acute illness
- severe NTl is associated with low T4 and T3 syndrome (euthyroid sick syndrome)

Answer 31

Nonthyroidal Illness (NTI)

Question 32

• TSH rises to within or above the reference range with resolution of the underlying illness, ultimately returning to normal once the acute illness has resolved

Answer 32

Nonthyroidal Illness (NTI)

Question 33

• T3 thyrotoxicosis (______)

Answer 33

Plummer’s disease

Question 34

• e.g. TSH is low, FT4 is normal, FT3 is high

Answer 34

Thyrotoxicosis

Question 35

TRAbs
TSI

Answer 35

Thyroid Stimulating Hormone Receptor Antibodies

TS Immunoglobulin

Question 36

Graves’ disease (toxic diffuse goiter)
- cause: circulating antibodies to the TSH receptor (_____)

Answer 36

TRAbs

Question 37

Other name for subacute granulomatous thyroiditis

Answer 37

De Quervain’ thyroiditis

Question 38

• clinical features
  • puffy face, weight gain, slow speech, eyebrows thinned, dry and yellow skin, anemia

Answer 38

Myxedema