Thyroid

Question 1

Symptoms of hypothyroidism

Answer 1

Lethargy, constipation, dry/coarse skin & hair, parasthesis, slowed DTRs, facial puffiness, cold intolerance, decreased sweating, impaired memory/confusion/dementia, slow speech/motor activity, anemia, growth retardation in children (EVERYTHING SLOWS DOWN)

Question 2

Primary hypothyroidism is due to failure of _____

Answer 2

Thyroid gland to produce thyroid hormones

Question 3

Causes of primary hypothyroidism

Answer 3

Autoimmune (Hashimoto’s thyroiditis), drugs, diet, thyroid ablation (I131 treatment)

Question 4

Secondary hypothyroidism is due to failure of ______

Answer 4

Anterior pituitary to secrete TSH

Question 5

Tertiary hypothyroidism is due to failure of ______

Answer 5

Hypothalamus to produce TRH

Question 6

Hyperthyroidism definition

Answer 6

Overproduction of thyroid hormone

Question 7

Symptoms of hyperthyroidism

Answer 7

Nervousness, fatigue, weight loss, heat intolerance, increased sweating, tachycardia/afib, muscle atrophy, warm/moist skin, exophthalmos (EVERYTHING SPEEDS UP)

Question 8

Causes of hyperthyroidism

Answer 8

Overproduction of thyroid hormone (Grave’s disease, TSH-secreting adenoma, multinodal goiter), “leaking” thyroid hormone due to thyroid destruction, drugs

Question 9

Increased free T4 indicates:

Answer 9

Hyperthyroidism

Question 10

Decreased free T4 indicates:

Answer 10

Hypothyroidism

Question 11

Increased TSH indicates:

Answer 11

Primary hypothyroidism

Question 12

Decreased TSH indication:

Answer 12

Hyperthyroidism

Question 13

Increased total serum T4 indicates:

Answer 13

Hyperthyroidism

Question 14

Decreased total serum T4 indicates:

Answer 14

Hypothyroidism

Question 15

Increased serum T3 resin uptake indicates:

Answer 15

Hyperthyroidism

Question 16

Decreased serum T3 resin uptake indicates:

Answer 16

Hypothyroidism

Question 17

Increased free T4 index indicates:

Answer 17

Hyperthyroidism

Question 18

Decreased free T4 index indicates:

Answer 18

Hypothyroidism

Question 19

Total serum T3 used to indicate:

Answer 19

Hyperthyroidism

Question 20

A significant increase in TRH rules out:

Answer 20

Hyperthyroidism

Question 21

Increase in RAIU indicates:

Answer 21

Hyperthyroidism

Question 22

Decreased RAIU indicates:

Answer 22

Hypothyroidism

Question 23

Causes of Cushing Syndrome

Answer 23

ACTH secreting pituitary tumor, adrenal tumor, long-term use of glucocorticoids

Question 24

Symptoms of Cushing Symdrome

Answer 24

Facial plethora (MOON FACE), fat accumulation (BUFFALO HUMP), HTN, osteopenia, glucose intolerance, myopathy, bruising, depression

Question 25

24-hr urine-free cortisol (UFC) indicates:

Answer 25

Hypercortisolism

Question 26

Midnight plasma cortisol levels > ______ indicates Cushing Syndrome

Answer 26

7.5 mcg/mL

Question 27

Low-dose dexamethasone suppression test (DST) > _____ indicate Cushing Syndrome

Answer 27

5 mcg/mL

Question 28

Tests to identify source of hypersecretion:

Answer 28

Plasma, ACTH, CRH test, overnight high-dose DST

Question 29

Causes of Addison disease (primary adrenal insufficiency)

Answer 29

TB, fungal infections, AIDS, metastatic cancer, lymphomas

Question 30

Symptoms of Addison disease

Answer 30

Weakness, weight loss, increased pigmentation, hypotension, GI symptoms, postural dizziness, vertigo

Question 31

Causes of secondary adrenal insufficiency

Answer 31

High doses of steroids

Question 32

Symptoms of secondary adrenal insufficiency

Answer 32

Patients maintain normal dose aldosterone levels and do NOT have hyperpigmentation

Question 33

Diagnostic test for secondary renal insufficiency:

Answer 33

Cosyntropin stimulation test

Question 34

Hypothyroidism definition

Answer 34

Deficiency of thyroid hormone