thyroid

Question 1

thyroid functions

Answer 1

2” butterfly shaped gland in neck

secretes triiodothyronine (T3) and thyroxine (T4)
regulates body metabolism, which influences almost every body system

Question 2

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

Answer 2

iodine

Question 3

thyroid dysfunctions

Answer 3

hyper or hypo
*primary disorders most common
*more likely in women
*thyroid enlargement (goiter) can occur with both

Question 4

goiter

Answer 4

enlargement of thyroid gland with or without symptoms of thyroid dysfunction
*excess pituitary TSH
*low iodine levels
*enlargment can occur from goitrogens (food/substances that promote enlargemnet)

Question 5

hypothyroidism

Answer 5

insufficient levels of the thyroid hormones T3 and T4
(primary + secondary)

Question 6

primary hypothyroidism

Answer 6

increase in release of TSH from pituitary

Question 7

release of TSH indicates a …

Answer 7

hypoactive thyroid

Question 8

what is the most common cause of hypothyroidism?

Answer 8

hasimoto’s thyroiditis, autoimmune disorder
(decrease T3 and T4, increase TSH)

Question 9

Hashimoto’s thyroiditis

Answer 9

hypothyroidism
thyroid receptor antibodies
antithyroglobulin antibody
antithyroperoxidase antibody (hallmark of disorder)

Question 10

risk factors for hypothyroidism

Answer 10

female
>50
white
pregnant
hx of autoimmune disorders
fam hx
meds (lithium, amiodarone)
HYPERthyroidism treatments

Question 11

EARLY s/s of hypothyroidism

Answer 11

intolerant to cold
weight gain
lethargy, fatigue
memory deficit
poor attention span
increased cholesterol
muscle cramps
increased carotene levels
constipation
decreased fertility
puffy face
hair loss
brittle nails

Question 12

LATE s/s of hypothyroidism

Answer 12

below normal temp
bradycardia
weight gain
decreased LOC
thick skin
cardiac complications [cardiomegaly (enlarged heart)]

Question 13

how does hypothyroidism affect the body?

Answer 13

raises cholesterol; HLD
raises carotene; yellows skin
causes anemia
decreased kidney filtration (risk medication toxicity)
hoarse voice

Question 14

myxedema

Answer 14

severe hypothyroidism (COMA)
dermatological change –> thick skin and nails, extreme hair loss, puffy face

Question 15

diagnosing hypothyroidism

Answer 15

high TSH level
low T3 and T4
antithyroglobulin (anti-Tg)
antithyroperoxidase (anti-TPO) ATBs

Question 16

diagnosing primary hypothyroidism

Answer 16

high TSH
low T4

Question 17

diagnosing secondary hypothyroidism

Answer 17

normal TSH
low T4

Question 18

treatment for hypothyroidism

Answer 18

levothyroxine
*replacement hormone therapy (T4)
MOA: converted to T3 in body
half life= 7 days
surgery, if necessary

*watch for bleeding/warfarin

Question 19

hyperthyroidism

Answer 19

aka thyrotoxicosis
excessive secretion of T3 and T4
*primary: thyroid
*secondary: pituitary
*tertiary: hypothalamus

Question 20

most common cause of hyperthyroidism

Answer 20

grave’s disease
autoimmune stimulation of thyroid gland

Question 21

causes of hyperthyroidism

Answer 21

thyroid adenoma
subacute thyroiditis
toxic multinodular goiter
excessive iodine ingestion (jod-besedow syndrome)
excessive thyroid hormone replacement

Question 22

risk factors of hyperthyroidism

Answer 22

female
>40
white
pregnant
fam hx of graves
meds (amirodarone)
excess iodine intake

Question 23

grave’s disease

Answer 23

hyperthyroidism
autoimmune disorder
excess T3 and T4
thyroid stimulation ATBs

Question 24

s/s of graves disease

Answer 24

nervous
insomnia
sensitive to heat
weight loss
enlarged/palpable gland
bruit (d/t high blood flow in gland)
atrial fibrillation
myxedema
exophthalmos

Question 25

exophthalmos

Answer 25

wide-eyed stare w/ increased sympathetic tone and infiltration of extra ocular area with lymphocytes and mucopolysaccharides

Question 26

graves ophthalmopathy

Answer 26

periorbital edema and bulging of the eyes

more common in women

Question 27

diagnosing graves disease

Answer 27

low TSH
high T3 and T4
antithyroglobulin
antithyrotropin receptor ATB
ultrasound with color-doppler eval
radioactive iodine scanning + measurements of iodine uptake

Question 28

treatment of hyperthyroidism

Answer 28

propylthiouracil (PTU)
MOA: blocks thyroid hormone synthesis; suppresses conversion of T4 to T3
*heptatotoxicity

radioactive iodine tx (iodine uptake by gland and suppresses its activity)

surgery – replacement thyroid hormone (levothyroxine) needed for life

Question 29

thyrotoxic crisis (thyroid storm)

Answer 29

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

this is a life-threatening condition most commonly precipitated by surgery, trauma, infection

**can result in death within 48 hours, if left untreated

Question 30

parathyroid gland

Answer 30

4 pea-sized glands within thyroid tissue of neck

produce and secrete parathyroid hormone (PTH)
controls ca levels in body
promotes vitamin D production by kidney

Question 31

hypoparathyroidism

Answer 31

low PTH
low Ca (hypocalcemia - trousseau’s and chvosteks sign)

muscle cramps
tetant
irritability
convulsion

Question 32

treatment of hypoparathyroidism

Answer 32

replace PTH
normalize Ca and vit D levels

if parathyroid has been removed; replacement treatments are life long

Question 33

hyperparathyroidism

Answer 33

high PTH
high Ca (hypercalcemia)
bone breakdown

Question 34

hyperparathyroidism s/s

Answer 34

muscle weakness/breakdown (osteopenia)
pathological fractures
neuropathies
poor concentration
HTN
kidney stones
metabolic acidosis
constipation
depression, confusion or subtle cognitive deficits

Question 35

treatment of hyperparathyroidism

Answer 35

reduce calcium levels
diuretics
calcitonin
biphosphonates
vitamin D
surgery