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Nursing II > Thyroid > Flashcards

Thyroid Flashcards

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0
Q

What shape is thyroid and location

A

Butterfly shape. Located in middle of neck

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1
Q

Any protein bound to a hormone is

A

Inactive

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2
Q

Parathyroid location

A

Embedded in the posterior aspect of the thyroid

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3
Q

Parathyroid gland secretes which hormone

A

PTH. Parathyroid hormone

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4
Q

PTH regulates what

A

Calcium & phosphate levels

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5
Q

What is necessary for PTH function

A

Vitamin D

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6
Q

Hormones are what kinds of messengers & how are they transported?

A

chemical; transported by the blood stream

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7
Q

thyroid c-cells produce

A

calcitonin

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8
Q

thyroid follicles (sac structures) function

A

remove iodine from blood to make thyroid hormones

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9
Q

If the serum calcium level drops….PTH will increase or decrease

A

PTH will increase to get more circulating calcium

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10
Q

Regulation of Thyroid in order

A

Body stimulus–>Hypothalamus:TRH–>Anterior Pituitary:TSH–>Thyroid Glad:Thyroid Hormone

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11
Q

Thyroid Hormone

A

T3 & T4

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12
Q

Things that will make us have an increase in thyroid hormone

A

Cold environment, Hypoglycemia, high altitude, pregnancy

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13
Q

Anterior pituitary gland produces?

A

TSH

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14
Q

Thyroid Hormone regulates

A

metabolic rate

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15
Q

Thyroid Hormone increases?

A

protein synthesis, carb & fat metabolism, oxygen consumption, bone growth

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16
Q

Thyroid Hormone is necessary for

A

growth & mental & sexual development

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17
Q

Difference between T3 &T4

A

T4 has 4 atoms, T3 has 3 atoms. T3 is more powerful, T4 is more prevalent

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18
Q

TSH normal values

A

2-10 mU/ml

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19
Q

Secondary hypothyroidism is related to

A

pituitary problems

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20
Q

FT value

A

1.0-2.3 ng/dL

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21
Q

T4 value

A

5-12 mcg/dL

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22
Q

FT what kind of hormone

A

unbound to protein, active hormone

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23
Q

hyperthyroidism = High or Low TSH

A

Low TSH

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24
Q

T3 Values

A

80-200 ng/dL

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25
Q

When people develop thyroid antibodies they can develop

A

graves disease, Hashimoto’s thyroiditis, chronic thyroiditis

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26
Q

Who can get thyroid antibodies?

A

people with viral infections

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27
Q

An RIA ( radioactive iodine uptake) test

A

They inject or give this PO & look to see how the thyroid takes it up. Any iodine in the system the thyroid will take

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28
Q

warm spots taking up less radiation

A

benign lesions

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29
Q

cold spots taking up less radiation

A

Malignant tumor

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30
Q

What is the DR looking for if he does a thyroid biopsy?

A

cancer

31
Q

3 alterations in thyroid function

A

hyperthyroidism (excess thyroid hormone); hypothyroidism (low thyroid hormone); Goiter (increase in thyroid size)

32
Q

euthyroid

A

normally functioning thyroid

33
Q

Hyperthyroid signs

A

everything is going to speed up. Tachycardia, anxiety, restlessness, fatigue (bc their working so hard), menstrual changes, negative nitrogen balance, weight loss

34
Q

Exophthalmos

A

forward protrusion of eyeball; sclera visible above iris (might need surgery to fix this)

35
Q

Ophthalmopathy

A

related to hyperthyroidism; TSA interacts with orbital tissue behind the eyeball & the extraoccular muscles that move the eyeball (bulging of eye), they can get blurred vision, eye pain, exophthalmos

36
Q

Effects of Exopthalmos

A

eye dryness, irritation, infection& ulceration bc eyelids can not close over protruding eye

37
Q

Pretibial myxedema

A

form of graves disease which is a form of hyperthyroidism. Plaques & nodules forming over legs & feet.

38
Q

hyperthyroidism lab values

A

TSH decreased everything else increased

39
Q

causes of hyperthyroidism?

A

Graves Disease, Toxic multinodular goiter, pituitary neoplasm, Thyroiditis, Tyroid Storm, Increased iodine ingestion

40
Q

Graves disease

A

most common hyperthyroidism, autoimmune disorder, increase in iodine intake can contribute to this. TSA binds to TSH which increases thyroid production

41
Q

Toxic Multinodular goiter

A

They have little nodules on the thyroid which secrete thyroid hormone, gradual onset, no opthalmopathy,

42
Q

Pituitary neoplasm

A

Pituitary tumor stimulates thyroid to synthesize thyroid hormone.

43
Q

who is at risk for toxic multinodular goiters?

A

elderly females c a history of goiters get this

44
Q

What form of hyperthyroidism is pituitary neoplasm?

A

Secondary

45
Q

Thyroiditis

A

inflammation of thyroid gland, can happen with any viral infection, acute disorder with increased TH secretion

46
Q

If a person has thyroiditis chronically, they can develop a

A

hypothyroid state

47
Q

Thyroid crisis/storm

A

extreme state of hyperthyroidism. When a person already has hyperthyroidism & they don’t know it & they get a viral infection or have stress

48
Q

What things can cause thyroid crisis/storm in People who have hyperthyroidism

A

Stress: trauma, infection, pregnancy, co-morbidities or meds, not being treated, manipulation of thyroid gland surgery

49
Q

s/s of thyroid crisis/storm

A

tachycardia, CHF, angina, MI, atrial fib, systolic hypertension c wide pulse pressure, agitation, restlessness & tremors, confusion, psychosis, delirium, sezures, coma, abdominal pain, vomiting, bone loss fracture, life threatening

50
Q

Thyroid crisis/storm treatment

A

supportive therapy, respiratory support, treat hyperthermia by using cooling blankets & acetaminophen, IV fluids, hemodynamic support by vassopressors to restore or maintain bp & digoxin & diuretics to treat CHF

51
Q

Adrenergic blockers- propranolol (Inderal)is given to a patient with thyroid crisis/storm in order to?

A

to slow the hr down, its not to correct hyperthyroidism. it is given to prevent any cardiac problems

52
Q

Anti-thyroid medication is started for a patient with thyroid crisis/storm because it?

A

inhibits hormone synthesis but doesn’t block any thyroid hormone that’s already in the gland &partially inhibit conversion of T4 to T3

53
Q

Why do we do plasmapheresis or peritoneal dialysis on a patient with thyroid crisis/storm?

A

to remove circulating antibodies

54
Q

Treatment of hyperthyroidism depends on what

A

patient age & physical state, & the case of the hyperthyroidism

55
Q

Treatment of hyperthyroidism

A

medications, Radioactive iodine therapy or surgery

56
Q

Medications to treat hyperthyroidism

A

iodine solutions, Antithyroid agents (thioamides); Beta-blocker: Inderal

57
Q

Iodine Solutions: Lugols solution, Potassium Iodine (SSKI)

A

prevent the synthesis & release of TH. Its a short term effect

58
Q

When are Iodine Solutions: Lugols solution, Potassium Iodine (SSKI) used & why?

A

Used in thyroid crisis/storm hastens effect of antithyroid meds, the iodine decreases vascularity of the thyroid gland which decreases the release of TH. Its used prior to surgery

59
Q

Antithyroid agents (thioamides) examples & are given when?

A

Propylthiouracil (PTU) & Methimazole (Tapazole); given during thyroid crisis/storm

60
Q

Propylthiouracil (PTU) effects

A

N&V, crosses placenta & breast milk in low concentrations, onset 10-21 days c peak effect 6-10 weeks

61
Q

Methimazole (Tapazole) effects

A

Bone marrow suppression, agranulocytosis, anemia, leukopenia, crosses placenta & breast milk

62
Q

Radioiodine Therapy

A

Thyroid takes up radioactive iodine which will kill follicle cells in the thyroid gland which will then cause the thyroid gland to produce less TH, can be given orally, no hospitalization & no radiation precautions, Cant do if pregnant

63
Q

Why would radioiodine therapy cause a patient to go on thyroid hormone replacement?

A

because you could send them into a hypothyroid state because you don’t know how much radioiodine they need

64
Q

Dr will do Thyroidectomy if

A

drug therapy fails, Radiation therapy contraindicated, or patient has thyroid cancer

65
Q

With a Partial thyroidectomy, does patient need Thyroid replacement therapy?

A

no thyroid replacement is necessary. A partial thyroid can supply adequate TH

66
Q

thyroid follicles function

A

remove iodine from blood to synthesize thyroid hormones

67
Q

Lithium & Potassium can cause

A

secondary hypothyroidism

68
Q

Secondary hypothyroidism

A

something is wrong with the pituitary

69
Q

Primary hypothyroidism

A

something is wrong with the thyroid

70
Q

Aspirin, steroids, dopamine, heparin & antithyroid therapy can cause

A

primary hypothyroidism

71
Q

cortisone, thorazine, Dilantin, heparin, sulfonamides, reserpine, testosterone, Inderal, orinase & high doses of salicylates may increase or decrease TH

A

decrease

72
Q

What do you want to avoid prior to thyroid test

A

shellfish, no fluid restrictions

73
Q

oral contraceptives, estrogen, clofibrate & trilafon may increase or decrease TH

A

increase

74
Q

Graves disease, Hasimotos thyroiditis, chronic thyroiditis all have what?

A

thyroid antibodies

Nursing II (16 decks)

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