thyroid Flashcards
(30 cards)
Hypothyroidism
Deficiency in thyroid hormone T3 and T4
Decreases metabolic rate
LOW AND SLOW
Primary hypothyroidism vs secondary hypothryroidism
Primary- problem is within the thyroid gland itself
Secondary- problem with pit. or hypothalamus
Hypothyroidism is Often associated with what other lab values?
High cholesterol
High triglycerides
Anemia
Decreased folate
who is affected?
Women > men
commonly dx 40-50 year olds
Which medications can cause hypothyroidism?
lithium
Iodine compounds
Why is iodine important in hypothyroidism
It is required to synthesize TH
Hashimoto
low and slow
Autoimmune disorder that attacks the thyroid itself causing thyroid to be unable to produce thyroid hormones…can lead to goiter
s/s of hypothyroidism
Low energy= fatigue, muscle weakness, clumsy, lethargy
Low metabolism= weight gain, water gain= eye edema
Low libido, menstrual cycle changes
Low mood= depression, confusion, slow mental processes
Alopecia, thinning hair
Dry, rough skin; brittle nails
LOW body temp= cold
Low BP and RR…. c/o…
Myxedema ..
Decompensated state of extreme hypothyroidism
Very low BP, hypotension
Very low body temp, hypothermia, 75>
Very low respirations, hypoventilation 10>
fatigue –> weakness –> stupor –> coma –> death
Myxedema treatment
IV levothyroxine & hydrocortisone
- endotracheal tube @ bedside!!
Hypothyroidism dx
clinical s/s TSH levels Primary= low TH, high TSH secondary= low TH, low TSH increased cholesterol
Hypothyroidism Tx
Levothyroxine (synthetic thyroid) Synthroid
Gives T4 to body to be converted to T3
c/o hypermetabolic state= s/s hyperthyroidism c/o thyroid storm
L
E
V
O
Life long treatment! low and slow onset, will take time to get to therapeutic levels
Early AM, empty stomach! Same time everyday and do not dbl dose
Very hyper! report s/s of hyperthyroidism c/o thyroid storm
OK w/ baby- okay during preganancy
Causes of myxedema
Thyroidectomy
abrupt stopping of levothyroxine
stressors such as trauma, infection, surgery, stress
cold
Hyperthyroidism
Excessive levels of thyroid hormone in the blood which leads to a hypermetabolic state
Think excessive, HYPER, HIGH
Different causes of hyperthyroidism
Graves disease- most common Toxic adenoma- 2nd most common subacute thyroiditis- virus Pit or Hypothalamus tumor Thyrotoxicosis facitia- ingestion of excessive thyroid hormone
Graves disease
Most common hyperthyroidism cause
autoimmune disease
IgG activate surface receptors on thyroid cells which leads to excess TH production (T4 & T3)
The IgG acts as the pituitary gland however there is no increased release of TSH
Toxic Adenoma
2nd most common
Nodule which increased thyroid production leading to hyperthyroidism and increases thyroid size (goiter)
s/s of hyperthyroidism
Remember HIGH!
High metabolism= weight loss w/ increased appetite
High HR, palpations possible w AFIB
High BP c/o HTN crisis
High GI motility- diarrhea
High temp- heat intolerance, hot and sweaty, flushed with salmon skin color
High irritability, extreme NERVOUSNESS
High eyeball size- grape eyes, exophthalmos
Thyroid storm (thyroid toxicosis)
Uncontrolled and potentially life threatening hyperthyroidism cause by sudden and excessive release of thyroid into blood stream
S/S thyroid storm
Apprehension, restlessness, confusion (first signs)
^^^^ BP
^^^^ Temp 106<
^^^^ HR
leads to..
CNF > resp distress > delirium > Coma > Death
Causes thyroid storm
Stress- such as trauma, DKA, stress
Surgery on unprepared hyperthyroid person
Untreated thyrotoxicosis
Treatment of thyroid crisis
Anti thyroid drugs- get rid of excess thyroid hormone
Beta blockers- help cardiac situation, lower BP/HR
Corticosteroids - block thyroid
Treatment for hyperthyroidism
Antithyroid drugs
Beta blockers
radioactive iodide
Thyroidectomy
