Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENDO > Thyroid > Flashcards

Thyroid Flashcards

1
Q

What does the thyroid make more of, T3 or T4?

A

T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is T3 & T4 transported?

A

Protein bound & freely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Does the protein bound hormone exhibit biologic effects?

A

No, only the free hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the role of thyroid hormone, especially at birth?

A

Crucial for cell differentiation – if absent at birth can cause severe mental retardation = “creatinism”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the role of thyroid hormone as an adult?

A

Helps maintain thermogenic and metabolic homeostasis in the adult. Also essential for normal metabolism, protein synthesis and organ function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How much iodine do we need on a daily basis?

A

0.2mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most commonly, thyroid disorders are what type of disorder?

A

Autoimmune process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of history questions should you ask someone who you suspect has a thyroid disorder?

A

visual changes, skin/hair, mood changes, energy level, palpitations, constipation/diarrhea, weight changes, fluid retention, heat/cold intolerance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What must you always check on PE in someone you suspect with a thyroid disorder?

A

visual/eyes, weight, scalp/hair, neck, skin, heart, abdomen, extremities, reflexes and thyroid exam neuro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the most informative test for thyroid function?

A

Thyroid stimulating hormone (TSH) and free T4, sometimes free T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which test is an extremely sensitive indicator for thyroid function?

A

TSH – almost always abnormal with hyper/hypothyroid states

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What controls the secretion of TSH?

A

Negative feedback from thyroid hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What’s the normal range for TSH?

A

0.27-4.2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If TSH is low, what does that usually indicate?

A

Primary hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If TSH is high, what does that usually indicate?

A

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If the TSH is normal does it always rule-out hypo/hyperthyroidism?

A

No - on very rare exceptions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What if a patient’s TSH is in the 3-6 range?

A

Should follow for the development of hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What’s the goal TSH level is someone with hypothyroidism?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

So, in what type of patients should we always check TSH levels?

A

Prenatal, mood disorder, Afib, weight changes, dementia/delirium, and dyslipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If TSH, is such a good test, why would we check T4?

A

Occasionally needed to confirm hypo/hyperthyroidism, and useful in management of thyrotoxicosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What’s the normal ranges of Free T4?

A

9-24

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When would we check a T3?

A

If TSH is low, but Free T4 is normal and patient presents clinically with hyperthyroid → check T3 (total & free)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

You said, that many thyroid diseases are autoimmune based… so then what tests would you do to confirm autoimmune thyroid disease?

A

Anti-thyroid antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When would the anti-thyroid antibodies be elevated?

A

Hashimoto’s thyroiditis and Graves disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What do TSH-receptor antibodies detect, what is it also known as, and what does it do?

A

Detects – IgG AKA – TSI (thyroid stimulating immunoglobulin)

It stimulates hormone production and is elevated in Graves disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

If a patient presents with increasing fatigue, weight gain, with dry skin, and losing hair, what diagnosis do you think?

A

Hypothyroidism

27
Q

What is hypothyroidism?

A

Autoimmune, AKA Hashimoto’s Thyroiditis

28
Q

What causes Hypothyroidism?

A

Idiopathic, can occur post radioactive iodine, congenital (screen newborns), or drug induced

Lymphocytic infiltration of the gland – early phase may be hyperthyroidism (from stored hormone) but end results is hypothyroidism

29
Q

What are some early symptoms of hypothyroidism?

A

Fatigue, lethargy, weakness, cold intolerance, constipation, dry skin, hair loss, HA, and menorrhagia

30
Q

What are some late symptoms of hypothyroidism?

A

Slow speech, muscle cramps, hoarse voice, weight gain, amenorrhea

31
Q

What are some PE findings of early hypothyroidism?

A

Thin, brittle nails; thin, dry hair; delayed deep tendon reflex

32
Q

What are some PE findings of late hypothyroidism?

A

Goiter, facial/eyelid puffiness, alopecia, bradycardia, edema (non-pitting!), pleural/pericardial effusions

33
Q

If the PE finding shows abnormal interstitial accumulation in skin giving it a waxy/coarsened appearance – what is this known as?

A

Myxedema

34
Q

What might you see on labs with hypothyroidism?

A

Increased TSH, decreased FT4, elevated triglycerides, low HDL, anti-thyroid antibodies

35
Q

What would be a late lab finding of Hypothyroidism?

A

Anemia & Elevated LFT’s

36
Q

How do you treat hypothyroidism?

A

Levothyroxine – Initiate 50-100ug/day and titrate towards full dose over time

37
Q

What must we do when we start a patient on Levothyroxine treatment?

A

Follow their TSH levels – every 2-3 months, until normal (0.5-2.5)

38
Q

What is our goal when treating a patient with hypothyroidism?

A

Symptoms improve slowly (months)

39
Q

Will the lipids improve with levothyroxine in a patient with hypothyroidism?

A

They will improve a little but lipid meds usually needed

40
Q

How do we prevent and treat congenital hypothyroidism?

A

Early detection! Replacement therapy (10-15)

41
Q

If a patient presents with unexplained weight loss, fatigue, who often feels hot and anxious – what diagnosis are you thinking?

A

Hyperthyroidism

42
Q

What else is hyperthyroidism known as?

A

Thyrotoxicosis

43
Q

What is the most common etiology of hyperthyroidism?

A

Graves disease

44
Q

What are other etiologies for hyperthyroidism?

A

Toxic (“hot”) adenomas, early phase hasimoto’s (from stored hormone), factitious (excessive thyroid hormone intake), TSH adenoma, or amiodarone

45
Q

What is Graves disease?

A

Autoimmune disease, caused by TSH-receptor antibody (IgG) causes hypersecretion, hypertrophy, and hyperplasia of the thyroid (goiter)

46
Q

What are some of the symptoms associated with hyperthyroidism?

A

Hyperactivity, irritability, heat intolerance, sweating, palpitations, fatigue, weakness, increased appetite, weight loss, diarrhea, oligomenorrhea

47
Q

What might you find on PE with hyperthyroidism?

A

Tachycardia, arrhythmias, fine tremor, goiter/bruit, oily fine hair, proximal muscle weakness, opthalmopathy, dermopathy, and hyperreflexia

48
Q

What would the labs show with hyperthyroidism?

A

Very low TSH (often

49
Q

What type of hyperthyroidism that occurs in 2-5% of patients do we need to remember?

A

T3 thyrotoxicosis

50
Q

What 2 signs & symptoms are unique to Graves disease?

A

Opthalmopathy – Proptosis with lid-lag, conjunctival inflammation and corneal drying

Dermopathy – pre-tibial areas leading to edema, thickened skin (pre-tibial myxedema)

51
Q

What are some complications of Graves disease?

A

Cardiac arrhythmias – Afib! Thyroid storm

52
Q

How can we treat Graves disease?

A

MUST have an endocrinologist consult

Propranolol (heart)
Thiourea drugs = Propylthiouricil (PTU) or Methimazole – inhibits thyroid peroxidase and block organification of iodine.

53
Q

What are some of the side effects of Thiourea drugs?

A

Agranulocytosis and pruritis. Must follow WBC & Free T4

Must monitor for liver injury!

Cannot use in 1st tri of pregnancy (due to birth defects)

54
Q

If a patient with Graves disease stops returns to normal levels and then stops treatment, what can occur?

A

Recurrent thyrotoxicosis in 50%

55
Q

What is the definitive treatment of choice for Grave’s disease in the US?

A

Radioactive iodine (131I) – destroy overactive thyroid tissue

56
Q

What must we monitor when giving RAI for grave’s disease? Why?

A

Follow free T4.

Permanent hypothyroidism often develops within one year, thus thyroid replacement therapy needed for life. Can’t use in pregnancy!

57
Q

What may worsen after giving RAI for grave’s disease?

A

Opthalmopathy; especially in smokers

58
Q

When would thyroid surgery be indicated?

A

Graves in children or hyperthyroidism during pregnancy that can’t be control with thiourea drugs.

For patients with Grave’s that have failed 131I

59
Q

What must you do if you notice a nodule on a patient’s thyroid?

A

Must do a fine needle aspiration to R/O cancer

60
Q

A thyroid nodule may be benign, but what can it cause?

A

Thyrotoxicosis (Toxic thyroid nodule)

61
Q

How do you treat a toxic thyroid nodule?

A

RAI if >40

Surgery or RAI if

62
Q

If a fine needle aspiration is done on a nodule and thyroid cancer is determined, what type of thyroid dysfunction would they have?

A

None!

63
Q

What does thyroid cancer feel like?

A

A firm, non-tender nodule

64
Q

How do you treat thyroid cancer?

A

Near total thyroidectomy, post-op suppress TSH, follow-up with total body RAI

ENDO (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions