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326 Exam 3 (Cardiology,GI,Endocrine) > Thyroid > Flashcards

Thyroid Flashcards

1
Q

Thyroid Gland secretes

A

triiodothyronine (T3) and thyroxine (T4)

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2
Q

Thyroxine

A

Is the regulator of body metabolism that influences almost every body function

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3
Q

Thyroid gland

A

a 2in butterfly-shaped gland located in the neck

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4
Q

What is a necessary component in the synthesis of thyroid hormone?

A

Iodine

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5
Q

Thyroid gland feedback loop

A
  1. Hypothalamus: releasing hormone (TRH)
  2. Anterior pituitary: TSH
  3. Thyroid gland: makes T4
  4. Thyroxine
    - Negative feed back to stop Anterior pituitary and hypothalamus
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6
Q

Most common thyroid disorders

A

Primary thyroid disorders

-Involves the thyroid gland itself

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7
Q

Thyroid dysfunctions are either

A

Hypo or hyperthyroidism

-enlargement can occur in either

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8
Q

Thyroid problems are more likely in who?

A

Women

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9
Q

Goiter

A

an enlargement of the thyroid gland WITH or WITHOUT symptoms of thyroid dysfunction

Excess pituitary TSH

Low iodine levels

If NO symptoms of thyroid disease the goiter is “nontoxic”

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10
Q

Enlargement of the thyroid gland can also occur from

A

Goitrogens

-substances that promote thyroid gland enlargement (lithium)

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11
Q

Hypothyroidism

A

Insufficient levels of T3 + T4

  1. Primary
  2. Secondary
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12
Q

Primary Hypothyroidism

A

Increase in release of TSH from pituitary (Excessive release of TSH indicates hypoactive thyroid)

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13
Q

Most common type of hypothyroidism

A

Hashimoto’s thyroiditis

-an autoimmune disorder

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14
Q

Hypothyroidism: Hashimoto’s

A
  • Thyroid receptor receptor antibodies
  • Antithyroglobulin antibody
  • Antithyroperoxidase antibody: HALLMARK of disorder
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15
Q

Hypothyroidism Risk Factors

A

-Females
-Age >50
-Caucasian
-Pregnancy
-History of other
Autoimmune disorders
-Family Hx
-Medications (amiodarone, lithium)
-Treatment for hyperthyroidism

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16
Q

Hypothyroidism: Manifestations (Early)

A 
Cold intolerance
Weight gain
Lethargy
Fatigue
Memory deficits
Poor attention span
Increased cholesterol
Muscle cramps
Raises carotene levels
Constipation
Decreased fertility
Puffy face
Hair loss
Brittle nails
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17
Q

Hypothyroidism: Manifestations (late)

A 
Below Normal Temp
Bradycardia
Weight gain
Decreased LOC
Thickened skin
Cardiac complications (cardiomegaly)
18
Q

Hypothyroidism Affects all Body Organs:

A
  • Raises cholesterol: hyperlipidemia
  • Raises carotene levels (yellows skin)
  • Causes anemia
  • Decreased filtration by kidney (risk of med toxicity)
  • Can cause hoarse voice
19
Q

Myxedema

A

Severe hypothyroidism (coma)

Describes the dermatological change that occurs with hypothyroidism

Myxedema can be found in hypo and hyperthyroidism

20
Q

Hyperthyroidism: Symptoms

A 
Anxiety 
Tremor
Tachycardia
Feeling warm
Loss of weight
Exophthalmos
Atrial fibrillation
Decreased fertility
21
Q

Diagnosing Hypothyroidism

A

High TSH level

Low free T3
Low Free T4

Antithyroglobulin (anti-Tg)

Antithyroperoxidase (anti-TPO) antibodies

22
Q

In primary hypothyroidism…

A

There is low hormone secretion by the thyroid gland, which constantly signals the pituitary to secrete TSH

23
Q

In secondary Hypothyroidism..

A

Both TSH and T4 will be low (anterior pituitary problem)

24
Q

Treatment of Hypothyroidism

A

Replacement of hormone therapy with Levothyroxine (T4-synthetic thyroid hormone)

MOA: converted to T3 in the body

Half life: 7 days

Surgical intervention if necessary

25
Q

T3 is..

A

Active form of T4

26
Q

Hyperthyroidism (Thyrotoxicosis)

A

Excessive secretion of T3 and T4

  • Primary (thyroid)
  • Secondary (pituitary)
  • Tertiary (hypothalamus)
27
Q

Most common cause of Hyperthyroidism

A

Grave’s disease: an autoimmune stimulation of the thyroid gland

28
Q

Other causes of Hyperthyroidism

A
  • Thyroid adenoma
  • subacute thyroiditis
  • Toxic multinodular goiter (benign growth)
  • Excessive iodine ingestion (JOD-Basedow syndrome), -Excessive thyroid hormone replacement
29
Q

Hyperthyroidism Risk Factors

A 
Family Hx of graves
Age >40
Women
Caucasian 
Medications
Excessive iodine intake
Pregnancy
30
Q

Grave’s Disease

A
  1. Autoimmune disorder
  2. Excess levels of T3 + T4
  3. Thyroid-stimulating antibodies (antibodies that stimulate the thyroid gland)
31
Q

Grave’s Disease Symptoms

A
  • nervousness
  • Insomnia
  • Sensitivity to heat
  • Weight loss
  • Gland is usually enlarged and palpable
  • An audible bruit may be heard because high glandular blood flow
  • Atrial fibrillation
  • Myxedema
  • Exophthalmos
32
Q

Exophthalmos

A

Wide-eyes stare associated with increased sympathetic tone and infiltration of the extraocular area with lymphocytes and mucopolysaccharides

Periorbital edema and bulging of the eyes termed Grave’s OPTHALMOPATHY

Women are more often affected with Grave’s Ophthalmopathy than men

33
Q

Diagnosis of Graves Disease

A
  • Low TSH
  • High T3
  • High T4
  • Antithyroglobulin
  • Antithyrotropin receptor antibody
  • Ultrasound with color-doppler evaluation
  • Radioactive iodine scanning and measurement of iodine uptake
34
Q

In graves disease…

A

Radioactive iodine uptake is increased and the uptake is diffusely distributed over the entire glan

35
Q

Treatment of Hyperthyroidism

A

Antithyroid hormone medication
Propylthiouracil (PTU): blocks thyroid hormone synthesis conversion of T4 to T3
-Hepatotoxicity
-Can be used in 1st trimester with caution

Radioactive iodine treatment

Surgery
-Replacement thyroid hormone (levothyroxine) is needed for life

36
Q

Thyrotoxic Crisis (Thyroid Storm)

A

Overwhelming release of thyroid hormones that exerts an intense stimulus on the metabolism

This is life-threatening condition most commonly precipitated by surgery, trauma, or infection

37
Q

Parathyroid gland

A

4 pea-sized glands within the thyroid tissue of the neck

Produce and secrete parathyroid hormone (PTH)

Controls calcium levels

Promotes vitamin D production by the kidney

38
Q

Hypoparathyroidism

A

A results of: insufficient PTH secretion and the resulting HYPOCALCEMIA

Muscle cramps
Irritability
Tetany
Convulsions 
Trousseau's + Chvostek's
39
Q

Hypoparathyroidism Treatment

A

Replace PTH

Normalize serum Ca and Vitamin D levels

If parathyroid has been removed: replacement treatments are life long

40
Q

Hyperparathyroidism

A 
Muscle weakness
Poor concentration
Neuropathies
Hypertension
Kidney stones
Metabolic acidosis 
Osteopenia
Pathological fractures
Constipation
Depression, Confusion, Cognitive defects
41
Q

Symptoms of Hyperparathyroidism are caused by

A

Excessive secretion of PTH with resulting hypercalcemia and bone breakdown

42
Q

Hyperparathyroidism Treatment

A

Reduce levels of calcium

Diuretics

Calcitonin

Bisphosphonates

Vitamin D

Surgical intervention

326 Exam 3 (Cardiology,GI,Endocrine) (19 decks)

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