Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrinology 🧪 > Thyroid > Flashcards

Thyroid Flashcards

1
Q

Name a side effect of TSH being too low because of high Thyroxine dose in old ptn?

A

⬆️ risk of fracture

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

In treating ptn with Graves disease by radioactive Iodine What’s the most common complication?

A

Hypothyroidism

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

What’s the management for thyroid crisis?

A

Supportive ttt with: saline & glucose, hydration, glucocorticoids, oxygen, cooling blanket

⬇️ thyroid hormone by : propylthiouracil ( ⬇️ synthesis) & iodine ( block secretion )

adrenergic antagonist ( B-adrenergic blockers )

manage stress & Adrenal insufficiency by Hydrocortisone

Finally dexamethasone is given to inhibit hormone release

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

Q-Name few conditions that can cause thyrotoxicosis?

A

( stress, infection, surgery, trauma )

Graves disease

Choriocarcinoma

Jodbasedow effect ( in person with toxic nodular goiter)

Overian teratoma

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

In ptn with Hashimoto thyroiditis, what do you expect to be elevated?

A

Anti-thyroid peroxidase or Antithyroglobulin antibodies

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

In medullary carcinoma of thethyroid, what do you expect to be elevated?

A

Calcitonin due to proliferation of parafolicular C cells

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

Where do you expect to find psammoma bodies?

A

In papillary carcinoma of thyroid

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

What’s de Quervain thyroiditis ( subacute thyroiditis ) ?

A

Self-limited multi-phase disease : first hyperthyroidism then euthyroid then hypothyroidism often following viral infection, thyroid is very tender and resolves by itself

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

What is the next step in ptn with suspicious FNA results?

A

Radio active Iodine uptake scan is done to determine if the nodule is hot or cold

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

Ptn who has current infection with high TSH and normal other tests, would it be right to give them Thyroxine?

A

No, repeat the test in the follow up then decide upon the new results because the TSH elevation could be temporary because of infection

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

In ptn with Graves disease who chose Radioactive Iodine as treatment, what’s the most common side effects to expect?

A

Hypothyroidism in 70%

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

A- How to manage thyroid crises?

A

Cooling blankets ( to ⬇️ hyperpyrexia )

Hydrocortisone ( stress )

Iodide ( block thyroid hormone secretion)

propylthouracil ( inhibit synthesis of thyroid hormone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Q- ptn on total parentral nutrition developes glucose intolerance. What is the most likely deficiency?

A

Chromium

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

Note: name a condition where TGB level & Total T4 are ⬆️ but free or active T4 is normal ?

A

pregnancy & oral contraceptives pills

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

Note: name a condition where TGB & Total T4 are ⬇️ but the free and active T4 is normal?

A

nephrotic syndrome

androgen use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Note: What’s the preferred age group for subacute thyroiditis?

A

Occur at any age but > in 40-50s

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

Note: What are the expected lab findings in subacute thyroiditis?

A

⬆️ ESR

⬇️ RAIU

initial ⬆️ Of T3-T4, then ⬇️

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

Note: how to treat subacute thyroiditis?

A

is only symptomatic 💊 with :
NSAIDS
prednisone
propranolol

(The disorder takes months but eventually return to normal function )

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

Note from pediatrics: what’s the combination of ( Type1 )Autoimmune polyglandular disease?

A

autoimmune thyroiditis + hypoparathyroidism + Addison disease + mucocutaneous candidiasis

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

Pediatric note: Addison + DM +/- thyroiditis, name the syndrome?

A

Type 2 autoimmune polyglandular disease ( Schmidt syndrome):

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

Note: Name the types of thyroiditis?

A

Subacute (⬆️ then ⬇️ thyroid hormones)

Hashimoto ⬇️

Lymphocytic ⬆️

Riedel ⬇️

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

Note: Name the type of thyroiditis that is associated with postpartum?

A

Lymphocytic thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Note: what are the lab findings in lymphocytic thyroiditis?

A
  • T4-T3 are ⬆️
  • RAIU ⬇️
  • ESR is normal
  • If Antithyroid antibodies are present it will be in low titer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Note: how to treat lymphocytic thyroiditis?

A

Because it’s a self limiting condition ( resolve in 2-5 months)

Only symptomatic treatment as propranolol is needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Note: what’s the cause of Riedel thyroiditis?

A

intense fibrosis of thyroid and surrounding structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Note: When to suspect the nodule to be carcinogenic?

A
  1. Young male
  2. Single nodule, Cold nodule on scan ,Solid mass on sonogram or Calcifications
  3. Recent growth of painless thyroid mass
  4. History of radiation
  5. Production of calcitonin
  6. ⬆️ Density is seen in medullary carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Note: what’s the type of thyroid cancer that spreads via blood and it’s the least common?

A

Follicular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Note: name the tumor that metastasize by direct extension and ptn who has it will die within 1 year?

A

Anaplastic tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Note: hyperplasia or medullary cancer of thyroid + adrenal medullary hyperplasia or pheochromocytoma + parathyroid hyperplasia. Is a combination of what syndrome?

A

MEN 2A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Note: multiple neuromas + medullary thyroid cancer + pheochromocytoma. Is a combination of what syndrome?

A

MEN 2B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Note: name the cancers that can elevate calcitonin?

A
  1. Lung
  2. Breast
  3. Pancreas
  4. Colon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Note: Name the mutations ass. With MEN2 & familial medullary thyroid carcinomas?

A

RET mutations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Note: name the drugs that causes hypothyroidism?

A 
lithium
acetylsalicylic acid 
amiodarone,
interferon 
sulfonamides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Note: What’s Amiodarone side effect on thyroid?

A

Hypothyroidism and sometimes Hyperthyroidism

35
Q

Note: What’s the cause of intrinsic autonomy?

A

hyperfunctioning adenoma ( toxic )

toxic multinodular goiter ( Plummer disease)

( It is a non autoimmune disease )

36
Q

Notes: name the conditions that are ass. With DR3 gene?

A 
DR3-related disorders: 
Graves’ disease 
Addison disease
DM
MG
celiac disease
37
Q

Note: what are the genes ass. With Graves?

A

HLA-B8 & DR3

38
Q

Note: name the antibody against TSH receptors that is specific to Graves’ disease ?

A

thyroid stimulating immunoglobulin TSI

39
Q

Note: what’s the best anti-Graves’s drug during pregnancy? And what’s its famous side effect?

A

Propylthiouracil ( PTU )

Side effect: agranulocytosis

40
Q

Note: what’s the DOC in Gravis’s disease to decrease thyroid hormones? And what’s its famous SE?

A

Methimazole ( because it has less hepatotoxicity )

Side effect: agranulocytosis

41
Q

Note: Subtotal thyroidectomy for ptn with Graves’ disease is only indicated in….?

A

pregnancy 2nd trimester

children

large thyroid with compressive symptoms

fails of medications

42
Q

Note: Thyroid disease with normal or ⬆️ RAIU are………?

A

Graves’ disease

Toxic multinodular goiter / toxic adenoma >2.5cm

Choriocarcinoma

Pituitary tumor

43
Q

Note: hyperthyroidism diseases with ⬇️ RAIU……?

A

Thyroiditis

Struma ovarii

Metastatic follicular cancer

Hashitoxicosis ??

Iodine-induced goiter (jod-basedow)

44
Q

Note: what are the PTH effects on body to increase serum calcium?

A

⬆️ Serum calcium directly from 🦴 by ⬆️ Osteoclasts

from kidney by ⬆️ Distal reabsorption

indirectly from intestines by ⬆️ Absorption ( through activation of Vit. D➡️ ⬆️GI absorption of Calcium)

⬇️ Phosphate reabsorption in the kidney tubule
(which helps Indirectly to ⬆️ Calcium release from the bone)

45
Q

Q. The thyroid cancer with worse prognosis is……?

A

Anaplastic carcinoma

46
Q

N. What’s the precipitating factors for thyroid storm? 5

A

Sever infection, MI, surgery, pregnancy, radio active iodine

47
Q

N. What’s the treatment given for thyroid storm? 4

A

Thionamides, B-blockers, iodine drops & high dose glucocorticoids

48
Q

N. What’s the cardiac clinical picture in gravis disease? 3

A

High Systolic pressure, tachycardia, widening of pulse pressure

49
Q

How to diagnose Graves’ disease?

A

Clinically ( mostly) /
Thyroid function: ⬇️ TSH, ⬆️ T3- T4 / check TSI antibodies (+) /
RAIU and scan : increased uptake with diffuse activity

50
Q

N. What’s the treatment for Graves’ disease?

A

Thionamide ( can be used up to 2 years ) , B-blockers, if the above didn’t work consider surgery or radioactive iodine ablation therapy

51
Q

N. What’s the first line agent in thionamide?

A

Methimazole / the second option is propylthiouracil ( PTU )

52
Q

N. What’s the side effect of propylthiouracil? 2

A

Increase aminotrasferase level , hepatotoxicity

53
Q

N. What’s the contraindication for methimazole?

A

Can not be sued in first trimester in pregnancy ( teratogen )

54
Q

N. ⬆️ Increased TSH, T3-T4. What’s the condition?

A

Pituitary adenoma ( rare ) = 2ry hyperthyroidism

55
Q

N. Decreased ⬇️ TSH, Normal free T4, increased ⬆️ T3. Name the condition?

A

T3 toxicosis

56
Q

N. ⬇️ decreased TSH, Normal T4-T3. What’s the condition?

A

Subclinical hyperthyroidism ( pregnancy or non-thyroid illness )

57
Q

N. What is de quervian thyroiditis?

A

It’s a post viral thyroiditis ( ptn will have hyperthyroidism symptoms following an infection)

58
Q

N. What’s the natural history of de Quervain thyroiditis?

A

It’s a self-limited condition ( hyperthyroidism for 2-6 weeks followed by hypothyroidism for 6-12 week then complete resolution

59
Q

N. What’s the DD for painful thyroiditis with (-) TPO ab? And how to treat?

A

Subacute thyroiditis ( de Quervian ) / post-viral inflammatory process / infectious thyroiditis/ immunocompromised ptn ( staphylococcus, streptococcus)

The treatment is : NSAIDs , or systemic glucocorticoids

60
Q

N. What’s the DD of painless thyroiditis with (+) TPO ab?

A

Hashimoto thyroiditis / postpartum/ drug induced thyroiditis

61
Q

N. Subacute thyroiditis = ……TSH and ……T4 ……RAIU .

A

Low TSH, high T4, Low RAIU

62
Q

N. How can you differentiate Hashimoto from subacute thyroiditis since both have low RAIU?

A

Other than symptoms I can check the TPO ab which is + in Hashimoto while - in subacute thyroiditis

63
Q

Q. At what point a treatment should be initiated in subclinical hyperthyroidism ptn?

A

When TSH is < 0.1

64
Q

N. What’s the next step in diagnosis if you find thyroid nodule with normal or high TSH?

A

Do US➡️ Depends on the size ( if <1cm then follow up after 6 month ) while if >1cm do FNA

65
Q

N. What’s the next step in diagnosis if you find thyroid nodule with low TSH?

A

free T4-T3 , thyroid scan ➡️ if the nodule is hot then No need for FNA , while if it’s cold nodule do FNA

66
Q

N. Papillary carcinoma occurs in ……. Age group, while follicular carcinoma occurs in …….

A

Papillary = young / follicular = old

67
Q

N. Name the thyroid cancer that rarely metastasize to LN ?

A

Follicular carcinoma

68
Q

N. Name the thyroid cancer that is associated with MEN2A & MEN2B and you need to look for RET proto-Oncogene?

A

Medullary ( parafollicular ) carcinoma ( it also can be familial with positive FH )

69
Q

N. What’s the most aggressive thyroid cancer?

A

Anaplastic carcinoma ( 1 year survival rate is 20-30% )

70
Q

N. Thyroid cancer can be 2ry to these original cancers, name them ? 4

A

Breast, colon, melanoma. Renal

71
Q

N. Medullary thyroid cancer accounts for ……% from all thyroid cancer. And ……% are hereditary

A

10% from all thyroid cancers / 25% are ass. With FH /

72
Q

N. Screening for pheochromocytoma ( by plasma fractionated metanephrines ) is essential ( when you find RET mutation ) prior to Thyroidectomy in what cancer?

A

Medullary thyroid cancer

73
Q

N. …….. antibody test is positive in Hashimoto thyroiditis .

A

Positive thyroid peroxidase ( TPO antibody test )

74
Q

B. In Hashimoto thyroiditis ptn might experience hyperthyroidism then progress to be hypothyroidism. True or false ?

A

True

75
Q

N. What’s the most common cause for hypothyroidism?

A

Iodine deficiency, then Hashimoto thyroiditis

76
Q

N. Name the drugs that can cause hypothyroidism? 4

A

Lithium, Amiodarone, interferon, tyrosine-kinase inhibitor

77
Q

N. Diastolic hypertension is associated with what thyroid disease?

A

Hypothyroidism

78
Q

N. What happened to tendon reflexes in hypothyroidism?

A

Delay relaxation phase of tendon reflex is a classic sign

79
Q

N. Myxedema coma ( sever hypothyroidism) presentation resembles ……… , therefore give ………. empirically in the first step of ttt.

A

Hypoadrenalism ( low cortisol ) , hydrocortisone

80
Q

N. In case of 2ry causes of hypothyroidism, T4 is used to measure the treatment effect not the TSH. True or false?

A

True

81
Q

N. Normal or low TSH with low T-3 , normal or low T4, what’s your diagnosis?

A

Eyothyroid sick syndrome

82
Q

High TSH with normal T3-T4 it means?

A

Subclinical hypothyroidism

83
Q

Q. Ptn with thyrotoxicosis present with atrial fibrillation and ventricular rate of 180. What’s the medicine that should be given immediately?

A

Propranolol

Endocrinology 🧪 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions