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ENDO I > Thyroid CIS > Flashcards

Thyroid CIS Flashcards

1
Q

in absence of iodine during fetal development, biosynthesis of which hormone is inhibited resulting in a short stature, potbelly and protruding tongue

A

thyroid hormone

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2
Q

What is the result or endemic iodine deficiency

A

cretinism

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3
Q

what occurs if thyroid hormone is not replaced within days of birth

A

mental retardation

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4
Q

What is the cause of graves disease

A

hyperthyroidism, continuous production because not under control

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5
Q

What are the facial characteristics of hypothyroidism

A

swelling
gain weight
decrease in metabolic rate

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6
Q

What influences amount of T4

A

amount of hormone and TBG

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7
Q

If there are changes in TBG are there changes in free T4

A

no

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8
Q

What is the most valid and useful assessment of thyroid function

A

serum TSH

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9
Q

Which part of pituitary is TSH indicative of

A

anterior

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10
Q

what is thyrotoxicosis

A

hyperthyroidism

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11
Q

What forms of thyroid hormone are increased in hyperthyroidism

A

increased T3 and T4

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12
Q

The autoAb in Graves cause what

A

stimulate TSH–>secretion of thyroid hormone

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13
Q

what is factitious thyrotoxicosis

A

low thyroglobulin with exogenous thyroid hormone

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14
Q

What is toxic adenoma

A

overproduction of thyroid hormone by nodule with low TSH and gland atrophy surrounding nodule

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15
Q

What is characteristic of viral subacute thyroiditis

A

painful gland

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16
Q

Describe silent thyroiditis

A

subacute lymphocytic, non tender gland, transient

seen post-partum

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17
Q

When do you see elevated TSH and T4

A

adenoma of ant pituitary

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18
Q

describe distribution of radioactive iodine in someone with hyperthyroidism

A

out of plasma fast and thyroid takes up a lot of it

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19
Q

What happens to distribution of radioactive iodine in hypothyroidism

A

not taken up by thyroid, alot more in urine and takes longer to get out of blood

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20
Q

What are TSH levels like in someone with nodules overproducing thyroid hormone

A

low TSH levels because of negative feedback

21
Q

What is the demographic of Graves disease

A

more common in women age 20-40

22
Q

What is the triad of graves disease

A

hyperthyroidism (dec TSH, inc T3T4 and thyroid size)
infiltrative opthalmyopathy with exophthalmos
localized, infiltrative dermopathy (pretibial myxedmea) swelling of shins

23
Q

What is Tx for Graves

A

immune suppression, Ab clearance, blocking thyroid function, gland removal (radioactive iodine obliteration)

24
Q

What areas can you lose control of that can lead to hypothyroidism

A

thyroid gland- primary
pituitary- secondary
hypothalamus- tertiary
tissue Resistance- rare

25
Q

What is the most common primary hypothyroidism

A

Hashimotos (T cell mediated)

or radioactive ablation of thyroid (surgery)

26
Q

What causes secondary hypothyroidism

A

pituitary insufficiency

27
Q

What causes tertiary hypothyroidism

A

hypothalamic disease

28
Q

What is the demographic of hashimotos thyroiditis

A

women 45-65

clusters in families

29
Q

Describe hashimotos mechanism

A

T cell mediated with presence of Ab against TGB and thyroid peroxidase, TSH Receptor and iodine transporter

30
Q

What is the classical presentation of hashimotos

A

goiter, skin change, peripheral edema, constipation, headache, fatigue and anovulation

31
Q

Describe lab values of hashimotos

A

increased TSH and TRH

decreased T3 and T4

32
Q

What is the Tx of hashimotos

A

replacement therapy with levothyroxine T4

33
Q

Where is TGB synthesized

A

in follicular cells

34
Q

Where is thyroid hormone stored

A

in the colloid part of the gland

35
Q

The absence of iodine for extended period of time results in which changes on TSH, T4 and T3

A

decreased T3 T4

increased TSH because of feedback from no T3 T4

36
Q

Administration of thyroid hormone to patient with hypothyroidism has what effect

A

decrease TSH levels

37
Q

What does pulse, BP and weight look like in someone with hyperthyroidism

A

increase pulse, increase BP and decrease in weight because increased metabolism

38
Q

What is the main use for radioactive iodine scan helpful for

A

differentiate hyper vs hypothyroidism

39
Q

What type of hypothyroid deficiency is caused by Sheehans(ischemia to ant pituitary)

A

secondary hypothyroidism

40
Q

extremely high TSH, low free T4 high prolactin and enlarged pituitary gland
probable diagnosis?

A

hypothryroidism

41
Q

What would you see in thyroid levels with median eminence laceration

A

high prolactin because loss of dopamine

also have loss of TSH because no TRH communication

42
Q

an HIV + male with pneumocytisis carinii has low T4 low T3 and normal TSH
what is the endocrine Dx?

A

Euthyroid sick syndrome

43
Q

What is TSH levels in primary hypothryoidism

A

high

44
Q

What is TSH in secondary hypothyroidism

A

low

45
Q

What are the thyroid levels in someone with thyroid hormone Resistance

A

low TSH T3 and T4

46
Q

What happens in the severe phase of euthyroid sick syndrome

A

T3 drops majorly
T4 and FT4 drop moderately
TSH increases
rT3 increases a bunch

47
Q

If TGB levels are elevated as well as total thyroxine and normal TSH what is the most likely Dx

A

normal thyroid function because TSH in normal range

48
Q

how does the thyroid hormone R work

A

binds cytoplasmic R and the hormone R complex diffuses into nucleus to affect transcription

49
Q

if patient has low BMI
TSH normal
elevated rT3
suspected anorexia, probable?

A

reverse T3 has little biological effect

ENDO I (9 decks)

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