Thyrod Gland: Clinical Disorders Flashcards
Clinical Disorders
• Screening is recommended when a person reaches____ years old and every____ years thereafter.
35
5
Thyroid Disorders (3 types)
• Hyperthyroidism
• Hypothyroidism
• Euthyroidism
- s/sx: heat intolerance
tachycardia
weight loss
weakness
emotional lability
tremor
Hyperthyroidism
Hyperthyroidism
- most common clinical syndrome associated with this is_______
Graves’ disease
- most common clinical syndrome associated with this is Graves’ disease
Hyperthyroidism
Thyroid Disorders
• Hyperthyroidism
2 types
- primary hyperthyroidism
- secondary hyperthyroidism
Thyroid Disorders
Hyperthyroidism
4
• Thyrotoxicosis
• Graves’ disease (diffuse toxic goiter)
• Subclinical hyperthyroidism
• Subacute granulomatous / Subacute nonsuppurative thyroiditis (De Quervain’s thyroiditis)
- group of syndromes caused by high levels of free thyroid hormones in the circulation
Thyrotoxicosis
Thyroid Disorders
Hyperthyroidism
•_______ (toxic diffuse goiter)
- most common cause of thyrotoxicosis
- autoimmune disease
- 6x more common in women than in men
Graves’ disease
Graves’ disease (_____) and shrew
Cause:
toxic diffuse goiter
- cause: circulating antibodies to the TSH receptor (TRAbs)
Graves’s decease
features:
- dx test:
• pretibial myxedema
• goiter
• exophthalmos / opthalmopathy
• dermopathy.
TSH receptor Ab test
Clinical Findings in Graves Disease.
Symptoms & Signs:
• Heat intolerance, excessive sweating.
• Anxiety, “hyperkinesis.”
• Sleep disturbances.
• Weight loss despite increased appetite.
• Hyperdefecation (not diarrhea).
Signs:
(3).
goiter.
• Fine tremor of outstretched hands.
• Brisk reflexes.
• Tachycardia, wide pulse pressure.
• Warm, moist skin.
: Eyeila, maybe present
- no clinical s/sx
- FT, and FT, normal; TSH is low
Subclinical hyperthyroidism
- neck pain, low-grade fever, thyroid fxn swings
- TPO Ab absent; ESR and Tg levels are high
Subacute granulomatous / Subacute nonsuppurative thyroiditis (De Quervain’s thyroiditis)
- s/sx: hoarseness, cold sensitivity, dry skin, constipation, bradycardia, and muscle weakness
Hypothyroidism
- s/sx: _______, cold sensitivity, dry skin, constipation, bradycardia, and muscle weakness
Hypothyroidism
Hypothyroidism
3 types
- primary hypothyroidism
- secondary (central) hypothyroidism
- tertiary hypothyroidism
Primary hypothyroidism
• Hashimoto’s disease
• Myxedema
• Hashimoto’s disease
• Myxedema
Primary hypothyroidism
- 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
- Primary hypothyroidism
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)
Hashimoto’s disease (chronic autoimmune thyroiditis)
Hypothyroidism
- TPO Ab: +
- TSH increased
• Hashimoto’s disease (chronic autoimmune thyroiditis)
- describes the peculiar nonpitting swelling of the skin
Myxedema
Hypothyroidism
• Secondary hypothyroidism
- due to pituitary destruction or pituitary adenoma
- low T3 and T4
- low TSH
Hypothyroidism
•
- hypothalamic disease
- low T3 and T4
- low TSH
Tertiary hypothyroidism
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)
Congenital hypothyroidism (cretinism)
•
SYMPTOMS
• Patient is dwarf with severe mental defect.
Coarse dry skin
Deficient hair & teeth.
Retarded skeletal growth.
Reduced BMR
Condition of severely stunted physical and mental growth.
CRETINISM
- no clinical s/sx
- T3 and T4 normal; TSH is slightly high
Subclinical hypothyroidism
•
- refers to normal thyroid hormone levels (clinically and biochemically)
Euthyroidism
• Euthyroidism
(normal T3 and T4, low TSH)
(normal T3 and T4, high TSH)
- subclinical hyperthyroidism
- subclinical hypothyroidism
• tend to have low TSH results during their acute illness
- severe NTl is associated with low T4 and T3 syndrome (euthyroid sick syndrome)
Nonthyroidal Illness (NTI)
• 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
Nonthyroidal Illness (NTI)
• T3 thyrotoxicosis (______)
Plummer’s disease
- e.g. TSH is low, FT4 is normal, FT3 is high
Thyrotoxicosis
TRAbs
TSI
Thyroid Stimulating Hormone Receptor Antibodies
TS Immunoglobulin
Graves’ disease (toxic diffuse goiter)
- cause: circulating antibodies to the TSH receptor (_____)
TRAbs
Other name for subacute granulomatous thyroiditis
De Quervain’ thyroiditis
- clinical features
• puffy face, weight gain, slow speech, eyebrows thinned, dry and yellow skin, anemia
Myxedema
