Thyroid CIS Flashcards
Cretinism
Metal retardardaion and growth delays which results form thyroid hormone deficiency during development
___ is essential for the development of the CNS
TH
Clinical manifestations of Cretinism
- short stature
- potbelly
- enlarged, protruding tongue
- developmentally delayed
The most valid and useful assessment of thyroid function is a ____ test.
Serum TSH
In hyperthyroidism TSH will be ____ and T4 will be ___
- decreased
- increased
Overproduction of thyroid hormone by a nodule with low TSH and gland hypertrophy around the the thyroid gland is ____.
Toxic adenoma or “hot nodule”
A toxic nodular goiter is a ____.
is a mulitnodular toxic andenoma
What pattern is seen in hyperthyroid thyroiditis?
hyperthyroidism –> euthyroidism –> hypothyroidism –> euthyroidism
Thyroiditis with a painful gland is ____ and ____.
Subacute thyroiditis and is viral
Thyroiditis with non-tender glands is ____ and ____. An example is ____
- Silent thyroiditis
- transient
- postpartum thyroiditis
6 Causes of hyperthyroidism
- Autoimmune (graves disease)
- exogenous TH
- Toxic adenoma
- Nodular goiter
- subacute thyroiditis
- silent thyroiditis
Results of a radioactive Iodine test in Hyperthyroidism
Increased uptake of I and less in urine
Results of radioactive Iodine test in Hypothyroidism
Small amounts taken up by thyroid and large amounts excreted in urine
Silent thyroiditis is also know as ______
Subacute lymphocytic
The most common cause of hyperthyroidism is _____.
Graves Disease
What the the Triad of Graves Disease?
- Hyperthyroidism
- Exophthalmos
- Shin Edema
Graves Disease is an ________ disease in which ______ auto-antibodies are directed towards the _____ receptor.
- autoimmune disease
- activating
- TSH
Treatment in graves disease: (4)
- immune suppression
- antibody clearance
- blocking thyroid function
- gland removal
Graves disease occurs commonly in ____ages ____
- women ages 20-40
Eye changes in graves disease is dt ______.
increased volume of retro-orbital connective tissue and extraocular mm from inflammation
Primary hypothyroidism effects the _____
thyroid gland
Secondary Hypothyroidism effects the _____. What lab values would we see?
- anterior pituitary
- low TSH and T4/T3
Tertiary hypothyroidism effects the ___
hypothalamus
Examples of Primary hypothyroidism: (2)
- Hashimoto’s Disease
2. Radioactive ablation of the thyroid
Example of secondary Hypothyroidism: (3)
- Pituitary insufficiency
- TBI
- Sheehan’s
Example of tertiary Hypothyroidism: (1)
- hypothalamic disease
The most common disorder of hypothyroidism in iodine sufficient areas is _____
Hashimoto’s Thyroiditis
Autoimmune antibodies present in Hashimoto’s Thyroiditis (4)
Type?
- Thyroid peroxidase
- TSH receptor
- thyroglobulin
- iodine transporter
type = blocking
Hormone levels in Hashimoto’s Thyroiditis:
- Increased TSH and TRH
Decreased T3 and T4
Classical Presentation of Hashimoto’s / hypothyroidism: (8)
- goiter
- skin changes
- peripheral edema
- constipation
- headache
- fatigue
- anovulation
- brittle hair
Treatment of Hashimoto’s:
T4 replacement therapy with levothyroxine
Hashimoto’s Thyroiditis is more common in ___ ages ____ and is seen in _____.
- women ages 45-65
- clusters in families
In Hashimoto’s Thyroiditis, the thyroid gland is ______ and we see a ______ of the gland.
- inflamed
- gradual failure
The absence of iodine for an extended period of time will result in which changes to thyroid laboratory values?
- High TSH
- Low T3/T4
Administration of thyroid hormone to a patient with hypothyroidism will have what effect?
Decrease in TSH levels
Clinical findings in Hyperthyroidism: (8)
- weight loss
- sweating
- palpitations
- nervousness/ tremors
- exophthalmos
- diarrhea
- hair thinning
- shin edema
Testing shows a suppressed TSH and an increased homogeneous radioactive iodine uptake. Which finding would be likely in the patient?
- elevated thyroid stimulating immunoglobulins
Laboratory findings in hypothyroidism:
- high TSH
- Low T3/T4
What physical exam findings would be present in the case of recurrent hyperthyroidism?
What would the radioactive iodine test show?
- Thyroid gland hypertrophy
2. increase uptake of Iodine
What physical exam finding would be present in the case of over replacement of thyroid hormone?
Thyroid gland atrophy (small gland)
Why do we see amenorrhea/
anovulation and increased prolactin in hypothyroidism?
- lack of T3/T4 = no negative feed on anterior pituitary
- increase in TRH –> increase in TSH and prolactin
Prolactin –> inhibits GnRH causing amenorrhea and anovulation (no LH/FSH)
A 33 y/o male takes L-thyroxine 1 μg orally each day. He asks how the thyroxine works on a cellular levels. Which is the best explanation?
It binds to a cytoplasmic receptor, and the hormone-receptor complex diffuses into the nucleus to affect transcription.
Role of rT3?
rT3 has little biological effect
What is Euthyriod Sick Syndrome? And what value will be elevated? how is it treated?
- mild hypothyroid symptoms are seen in ill patients with normal functioning thyroids
- see an elevation in rT3
- treated by treating the illness
