Thyroid Flashcards
Thyrotoxicosis
any condition resulting in excess thyroid hormone–graves, toxic goiter, thyroiditis, med ingestion
Hyperthyroidism
ONLY hyper-functioning of gland itself–graves in young people or toxic nodular goiter in elderly
Graves disease
autoimmune–usually antibodies against TSH receptor
Graves disease physical exam findings
proptosis, pre-tibial myxedema, lid lag
Lab findings in hyperthyroidism
Low TSH, increase T3/T4
Treatment for hyperthyroid
Propylthiouracil/methimazole–block new hormone synthesis
What beta blocker can be used in hyperthyroidism and why?
Propranolol–only BB that doesn’t convert T4 to T3
What other drug can be used to prevent the conversion of T4 to T3?
glucocorticoids
How do you prevent decompenasation in hyperthyroidism?
- 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)
Most common cause of hypothyroidism in US?
Hashimoto’s–autoimmune
Most common cause of hypothyroidism world wide?
Iodine deficiency
Subacute thyroiditis
de Quervain’s–viral and self-limited–can cause pain that radiates towards ear
What does infectious thyroiditis present with?
fever, chills, dysphagia, red/hot–bacterial–antibiotics
What is pre-tibial myxedema?
NON-pitting edema
Labs in hypothyroidism
high TSH, low T3/T4
Treatment of hypothyroidism
synthroid–if iodine deficient, then iodine
If you feel a thyroid nodule what do you refer for?
fine needle aspiration–if cancerous usually papillary
What happens to calcium level in hyperparathyroidism?
increase Ca
What signs are present in hyperparathyroidism/hypercalcemia?
“bones, stones (kidney stones), groans (abdominal pain/constipation), psychic overtones (depression/confusion)”
Treatment for hyperparathyroidism?
treat hypercalcemia–IV fluids, lasix (after fluids), bisphosphonates, calcitonin, steriods–EVENTUALLY surgery
Calcium levels in hypoparathyroidism?
low calcium
What is a common cause for hypoparathyroidism?
Thyroid surgery
What is DiGeorge syndrome?
born w/o parathyroid glands
What are two signs of hypocalcemia?
Chvostek-tapping on facial nerve causes spasm
Trousseau-use blood pressure cuff and fingers and wrist will flex
What is the treatment for hypocalcemia from hypoparathyroid?
calcium and vitamin d
Where is T4 converted to T3?
peripheral tissues
Where is thyroid releasing hormone from and what does it do?
release from hypothalamus which tells the pituitary to release TSH
