Thyroid

Question 1

what is the thyroid

Answer 1

a 2 in butterfly shaped gland in the neck

secretes t3 and t4

Question 2

iodine is a ______ component in the _____ of ________ hormone

Answer 2

necessary, synthesis, thyroid

Question 3

negative feedback loop for thyroid

Answer 3

hypothalamus (releasing hormone TRH)
anterior pituitary (releasing TSH)
thyroid gland
thyroxine
then back to hypothalamus OR anterior pituitary
T4 is released the most

Question 4

two types of thyroid dysfunctions

Answer 4

hypothyroidism and hyperthyroidism

Question 5

which type of thyroid disorder is most common?

Answer 5

primary

Question 6

what is primary thyroid disorder?

Answer 6

involves the gland itself

Question 7

thyroid problems are most common in?

Answer 7

women

Question 8

an enlargement can occur in which thyroid disorders?

Answer 8

hypo and hyper

Question 9

what is a goiter

Answer 9

enlargement of thyroid gland with or without thyroid dysfunction

Question 10

what causes goiters?

Answer 10

excessive pituitary TSH

low iodine levels (decreased TSH manufacturing)

Question 11

what are goitrogens?

Answer 11

foods or substances that promote thyroid gland enlargement
goitrogens promote thyroid gland enlargement
Ex: Lithium

Question 12

which type of goiters are larger?

Answer 12

iodine deficient

Question 13

what is hypothyroidism?

Answer 13

insufficient levels of T3 and T4

2 types primary and secondary

Question 14

what is primary hypothyroidsim?

Answer 14

increase in release of TSH from pituitary
decrease in thyroid level
release of TSH indicates a hypoactive thyroid
low hormone secretion by thyroid gland, constantly signals pituitary to secrete TSH

Question 15

what is secondary hypothyroidism?

Answer 15

pituitary not secreting TSH, T3 and T4

all 3 low

Question 16

hashimotos thyroiditis

Answer 16

autoimmune
most common cause of hypothyroidism
increased TSH
decreased T3 and T4

Question 17

what is the hallmark of hashimotos?

Answer 17

antithyroperoxidase antibody

Question 18

what specific antibodies do you look for in hashimotos?

Answer 18

thyroid receptor antibodies
antithyroglobin antibody
antithyroperoxidase antibody
these antibodies attack the thyroid

Question 19

risk factors for hashimotos

Answer 19

female 
older than 50
Caucasian
pregnancy
hx autoimmune dx
family hx
meds
treatment for hyerthyroidism

Question 20

why can treatment for hyperthyroidism cause hashimotos?

Answer 20

tx goes to far and ends up low, ex: radiation to the neck damaging thyroid

Question 21

early manifestations of hypothyroidism

Answer 21

cold intolerance
weight gain
fatigue
poor attention/memory probs
high cholesterol
yellow skin (carotene)
hair loss
puffy face
brittle nails

Question 22

late manifestations of hypothyroidism

Answer 22

below normal temp
bradycardia
THICK skin
cardiac problems
weight gain 
decreased LOC

Question 23

hypothyroidism causes

Answer 23

raised cholesterol
raised carotene levels
anemia
decreased filtration by kidneys causing medication toxicity
HOARSE VOICE

Question 24

what does severe hypothyroidism cause

Answer 24

myxedema ( loss of brain function, life threatening, dermatological changes, extreme hair loss)

Question 25

hyperthyroidism causes

Answer 25

anxiety
tremor
tachycardia
feeling warm
loss of weight
exophthalmos
afib
decreased fertility

Question 26

hypothyroidism is diagnosed by

Answer 26

High TSH
low free T3
Low free T4
anti-Tg and anti- TPO antibodies

Question 27

tx of hypothyroidism

Answer 27

levothyroxine

caution: increased risk of bleeding with warfarin

Question 28

thyrotoxic crisis

Answer 28

thyroid storm
overwhelming release of thyroid hormones that exerts intense stimulus on metabolism
life threatening commonly caused by surgery, trauma, or infection
death can occur in 48 hrs if not tx
increased release of stress hormones and catecholamines, body gets overwhelmed and cant tolerate

Question 29

parathyroid gland

Answer 29

4 pea sized glands in thyroid gland in neck
secretes PTH
controls calcium levels in body
promotes vitamin D production by kidney

Question 30

hypoparathyroidism

Answer 30

insufficient PTH secretion resulting in hypocalcemia and increased phosphate levels

Question 31

hypoparathyroidism causes

Answer 31

muscle cramps
irritability
tetany
convulsion
hypocalcemia (+ trousseau's and chvosteks)

Question 32

tx of hypoparathyroidism

Answer 32

Replace PTH
normalize serum calcium and Vit D
if parathyroid has been removed, replacement is lifelong

Question 33

hyperparathyroidism

Answer 33

hypercalcemia (bone breakdown)
muscle weakness
neuropathy
HTN
kidney stones
osteopenia
pathological fx
poor concentration

Question 34

symptoms of hyperparathyroidism is caused by

Answer 34

excessive secretion of PTH with resulting hypercalcemia and bone breakdown

Question 35

tx of hyperparathyoidism

Answer 35

reduce calcium levels with diuretics, calcitonin
bisphosphates
vitamin D
surgical intervention