Thyroid

Question 1

Thyrotoxicosis

Answer 1

any condition resulting in excess thyroid hormone–graves, toxic goiter, thyroiditis, med ingestion

Question 2

Hyperthyroidism

Answer 2

ONLY hyper-functioning of gland itself–graves in young people or toxic nodular goiter in elderly

Question 3

Graves disease

Answer 3

autoimmune–usually antibodies against TSH receptor

Question 4

Graves disease physical exam findings

Answer 4

proptosis, pre-tibial myxedema, lid lag

Question 5

Lab findings in hyperthyroidism

Answer 5

Low TSH, increase T3/T4

Question 6

Treatment for hyperthyroid

Answer 6

Propylthiouracil/methimazole–block new hormone synthesis

Question 7

What beta blocker can be used in hyperthyroidism and why?

Answer 7

Propranolol–only BB that doesn’t convert T4 to T3

Question 8

What other drug can be used to prevent the conversion of T4 to T3?

Answer 8

glucocorticoids

Question 9

How do you prevent decompenasation in hyperthyroidism?

Answer 9

• aggresive dextrose containing IV fluids (D5 1/2 NS) b/c of high metabolic demand
• cooling blankets/ice packs
• tylenol (not salicylates b/c they promote thyroid hormone from releasing from thyroid binding hormone)

Question 10

Most common cause of hypothyroidism in US?

Answer 10

Hashimoto’s–autoimmune

Question 11

Most common cause of hypothyroidism world wide?

Answer 11

Iodine deficiency

Question 12

Subacute thyroiditis

Answer 12

de Quervain’s–viral and self-limited–can cause pain that radiates towards ear

Question 13

What does infectious thyroiditis present with?

Answer 13

fever, chills, dysphagia, red/hot–bacterial–antibiotics

Question 14

What is pre-tibial myxedema?

Answer 14

NON-pitting edema

Question 15

Labs in hypothyroidism

Answer 15

high TSH, low T3/T4

Question 16

Treatment of hypothyroidism

Answer 16

synthroid–if iodine deficient, then iodine

Question 17

If you feel a thyroid nodule what do you refer for?

Answer 17

fine needle aspiration–if cancerous usually papillary

Question 18

What happens to calcium level in hyperparathyroidism?

Answer 18

increase Ca

Question 19

What signs are present in hyperparathyroidism/hypercalcemia?

Answer 19

“bones, stones (kidney stones), groans (abdominal pain/constipation), psychic overtones (depression/confusion)”

Question 20

Treatment for hyperparathyroidism?

Answer 20

treat hypercalcemia–IV fluids, lasix (after fluids), bisphosphonates, calcitonin, steriods–EVENTUALLY surgery

Question 21

Calcium levels in hypoparathyroidism?

Answer 21

low calcium

Question 22

What is a common cause for hypoparathyroidism?

Answer 22

Thyroid surgery

Question 23

What is DiGeorge syndrome?

Answer 23

born w/o parathyroid glands

Question 24

What are two signs of hypocalcemia?

Answer 24

Chvostek-tapping on facial nerve causes spasm

Trousseau-use blood pressure cuff and fingers and wrist will flex

Question 25

What is the treatment for hypocalcemia from hypoparathyroid?

Answer 25

calcium and vitamin d

Question 26

Where is T4 converted to T3?

Answer 26

peripheral tissues

Question 27

Where is thyroid releasing hormone from and what does it do?

Answer 27

release from hypothalamus which tells the pituitary to release TSH