Thyroid CIS Flashcards by Amanda Beach

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

thyroid hormone

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What is the result or endemic iodine deficiency

cretinism

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

mental retardation

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What is the cause of graves disease

hyperthyroidism, continuous production because not under control

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What are the facial characteristics of hypothyroidism

swelling
gain weight
decrease in metabolic rate

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What influences amount of T4

amount of hormone and TBG

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

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What is the most valid and useful assessment of thyroid function

serum TSH

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Which part of pituitary is TSH indicative of

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what is thyrotoxicosis

hyperthyroidism

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What forms of thyroid hormone are increased in hyperthyroidism

increased T3 and T4

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The autoAb in Graves cause what

stimulate TSH–>secretion of thyroid hormone

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what is factitious thyrotoxicosis

low thyroglobulin with exogenous thyroid hormone

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What is toxic adenoma

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

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What is characteristic of viral subacute thyroiditis

painful gland

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Describe silent thyroiditis

subacute lymphocytic, non tender gland, transient

seen post-partum

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When do you see elevated TSH and T4

adenoma of ant pituitary

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describe distribution of radioactive iodine in someone with hyperthyroidism

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

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What happens to distribution of radioactive iodine in hypothyroidism

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

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

low TSH levels because of negative feedback

What is the demographic of Graves disease

more common in women age 20-40

What is the triad of graves disease

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

What is Tx for Graves

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

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

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

What is the most common primary hypothyroidism

Hashimotos (T cell mediated) | or radioactive ablation of thyroid (surgery)

What causes secondary hypothyroidism

pituitary insufficiency

What causes tertiary hypothyroidism

hypothalamic disease

What is the demographic of hashimotos thyroiditis

women 45-65 | clusters in families

Describe hashimotos mechanism

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

What is the classical presentation of hashimotos

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

Describe lab values of hashimotos

increased TSH and TRH | decreased T3 and T4

What is the Tx of hashimotos

replacement therapy with levothyroxine T4

Where is TGB synthesized

in follicular cells

Where is thyroid hormone stored

in the colloid part of the gland

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

decreased T3 T4 | increased TSH because of feedback from no T3 T4

Administration of thyroid hormone to patient with hypothyroidism has what effect

decrease TSH levels

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

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

What is the main use for radioactive iodine scan helpful for

differentiate hyper vs hypothyroidism

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

secondary hypothyroidism

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

hypothryroidism

What would you see in thyroid levels with median eminence laceration

high prolactin because loss of dopamine | also have loss of TSH because no TRH communication

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

Euthyroid sick syndrome

What is TSH levels in primary hypothryoidism

high

What is TSH in secondary hypothyroidism

low

What are the thyroid levels in someone with thyroid hormone Resistance

low TSH T3 and T4

What happens in the severe phase of euthyroid sick syndrome

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

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

normal thyroid function because TSH in normal range

how does the thyroid hormone R work

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

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

reverse T3 has little biological effect