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Patho 1 > Thyroid and parathyroid > Flashcards

Thyroid and parathyroid Flashcards

1
Q

Thyroid gland

A

2” butterfly shaped gland in the neck that secretes T3 and T4 and regulates the body’s metabolism

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2
Q

T3

A

active form of thyroid hormone

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3
Q

T4

A

bound and unbound hormone; becomes unbound and activates T3 when senses needing more thyroid hor in the body

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4
Q

thyroid hormone patho

A

hypothalamus releases TRH when it senses more thyroid hor is needed, and TRH triggers the anterior pit to release TSH which triggers the thyroid gland to release thyroxine (T4) which is converted into T3

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5
Q

Negative feedback in the thyroid

A

T4 levels tell the ant pit when there is enough TSH and T3 levels tell the hypo when there is enough T3

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6
Q

Which mineral is necessary in the synthesis of thyroid hor

A

iodine

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7
Q

Thyroid dysfxn

A
  • common
  • primary thr dx most common - occurs at the gland level
  • more likely in women
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8
Q

Goiter

A
  • can occur with hypo or hyperT
  • enlarged thy gland with or w/o sx of thy dysfxn
  • if no sx, goiter is considered nontoxic
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9
Q

Causes of goiter

A
  • excess pit TSH which causes excess stim of thy
  • low iodine levels which causes low thyroid prod (compensate w/ inc TSH)
  • goitrogens - fluid/meds that inc levels (LITHIUM)
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10
Q

Hypothyroidism

A

Insufficient T3 and T4

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11
Q

Primary hypo

A

thyroid does not secrete T3 and T4 (knows the body needs more but can’t make it)
- inc TSH sec
- Hashimoto’s is most common

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12
Q

Secondary hypo

A

Pit not sec enough TSH causing dec TSH levels
- dysfxn on brain level

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13
Q

Hashimoto’s

A

autoimmune destruction of the thyroid; have thy rec antibodies incl antithyroglobulin antibody and anti-thryoperoxidase antibody

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14
Q

Risk fx for hypothyroidism

A

female, over 50, white, pregnant, hx autoimmune dx like Lupus, family, meds like amio, tx for hyperthy

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15
Q

early CM of hypothy

A

DEC METABOLIC ACTIVITY - cold intolerance, wt gain, fatigue, men def, dec attn, inc chol, cramps, constipation, inc carotene level (yellow)
- nonspecific, poor dx

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16
Q

Later signs of hypo?

A

Puffy face, hair loss, brittle nails

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17
Q

Late CM of hypo

A

dec temp, brady, wt gain, dec LOC, thick skin, cardiomegaly, HLD, anemia, yellow, hoarse varcies, dec kidney filtration (drug tox), MYXEDEMA

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18
Q

myxedema

A

severe undiagnosed cases
- life threatening SE incl coma and loss of brain fxn
- derm chx too

19
Q

Dx of hypo

A

inc TSH, dec T3/T4, Hash antibodies (anti-Tg, anti-TPO antibodies)

20
Q

Hyperthyroidism (thyrotoxicosis)

A
  • excess T3 and T4
21
Q

Primary hyperT

A

gland overproduces (Graves)

22
Q

Secondary hyperT

A

brain prob; pit oversecretes TSH

23
Q

Tertiary hyperT

A

brain prob; hypo oversecretes hypo thyrotropic (TRH)

24
Q

Most common cause of hyperthy

A

Graves

25
Q

Causes of hyperT

A

toxic goiter, adenoma, excess iodine ingestion, subacute thyroid

26
Q

Risks for hyperT

A

family hx, Graves, over 40, women, white, meds (amio), preg, excess iodine intake

27
Q

Graves

A
  • autoimmune disorder of excess T3 and T4 by thyroid-stimulating antibodies that bind to receptors to tell T4 to turn on T3, glands enlarge, and more
28
Q

Graves sx

A

heat sensation, wt loss, nerves, insomnia, glands enlarge and palpable, audible bruit, a-fib, heart fail, myxedema, exophthalmos (bulging eyes), periorbital edema

29
Q

Hyperthy diagnosis

A
  • test for antithyglobulin, antithy receptor antibodies
  • US with color - Doppler with thy gland BP
  • radioactive iodine scan and measure iodine uptake (inc with Graves and diffuse over whole gland)
29
Q

Why does hyperT cause a bruit

A

inc glandular BF

30
Q

Why does hyperT cause a fib

A

increase catcholamine release

31
Q

CM of hypopara

A

muscle cramp, irritable, tetany, convulsions, Trousseau, Chvestok, inc phos

31
Q

Hypopara causes

A

often trauma or damage from thy surg

31
Q

Parathyroid gland

A
  • 4 pea size glands nestled w/i thyroid tissue that secrete parathy hor (PTH) when Ca levels are low (also promotes vit D prod by kidney)
31
Q

HyperT tx

A
  • propylthiouracil
  • radioactive iodine tx to suppress activity
  • surgery
  • levo for life
31
Q

Thyrotoxic storm

A
  • overwhelming release of thy hor that exerts intense stim of met
  • life-threatening crisis often precipitated by surg, trauma, infx
  • CAN DIE W/I 48 HOURS
32
Q

hypopara tx

A
  • replace PTH
  • normalize Ca and vit D levels
  • is para removed, replacement tx is lifelong
33
Q

Hyperpara

A

inc sec of PTH, hyperCa

34
Q

Hyperpara CM

A

bone b/d, weak, dec conc, neuropathies, HTN, stones, acidosis, osteopenia, fractures, depression, confusion, subtle cog changes, constipation

35
Q

Tx for hyperpara

A

dec Ca levels, diuretics, calcitonin, biphosphonates, vit D or surg (if tumor releasing PTH)

36
Q

Levothyroxine MOA and indications

A

Synthetic T4 that converts to T3 in the body; hypothyroidism

37
Q

Levothyroxine SE and NC

A
  • Hyperthyroid or hypothyroid sx
    • half life 7d (need to dose regularly)
  • takes 1 month to see results
  • drug intx and food - take on empty stomach and 30 min before eating (often pt eat first thing when awaken)
  • inc risk of bleeding with Warfarin
  • take for life
38
Q

Propylthiouracil (PTU) MOA and indications

A
  • Blocks thyroid hor synthesis, suppress conversion of T4 to T3
  • hyperthyroidism
39
Q

Propylthiouracil (PTU) NC

A
  • Black box - hepatotox
  • can be used in 1st tri with caution (not 2nd or 3rd bc hepatotox tho)

Patho 1 (37 decks)

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