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Endocrine Pathophys > Thyroid Clinical Application > Flashcards

Thyroid Clinical Application Flashcards

1
Q

What is the initial screening test for suspected thyroid disorders?

A

TSH test

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2
Q

What is the most useful test for hypothyroidism?

A

Free T4 test

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3
Q

What does a total T4 test measure?

A

Total free T4 and TBG-T4

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4
Q

Which is more accurate, free T4 test or a total T4 test?

A

Free T4 test

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5
Q

What is the most useful test for hyperthyroidism?

A

Total T3 test

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6
Q

What does a total T3 test measure?

A

Total free T3 and TBG-T3

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7
Q

Which is more accurate, a free T3 test or a total T3 test?

A

Total T3 test

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8
Q

What is the common order of tests for suspected thyroid disorder?

A

TSH and free T4 tests ordered together
Total T3 test ordered as needed after

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9
Q

What are thyroid antibody tests helpful to diagnose?

A

Thyroid autoimmune disorders and/or cancer

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10
Q

What test is used as a “tumor marker” after a thyroid cancer dx and what does it assess?

A

Thyroglobulin test
Assesses effects of thyroid cancer treatment

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11
Q

What does a T3 Uptake test measure?

A

Binding capacity of TBG
Indirectly measures amount of plasma TBG

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12
Q

High rT3 is associated with?

A

Acute crisis or severe chronic illness

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13
Q

If TSH is high what disorder does that indicate?

A

Primary Hypothyroidism

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14
Q

What happens in early/less severe hypothyroidism?

A

Thyroid gland doesn’t release enough T3/T4
Liver/kidneys convert T4 into T3 which causes T3 values to remain normal but T4 values decrease
**This is why free T4 test is most useful

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15
Q

Why is a free T4 test most useful in early diagnosis of primary hypothyroidism

A

T3 values may be normal but T4 will be the first value to decrease as hypothyroidism develops

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16
Q

What are lab findings for late/progressed hypothyroidism?

A

T4 shortage means liver/kidneys can no longer convert T4 to T3
T3 values are now also low

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17
Q

If TSH is low what disorder does that indicate?

A

Primary hyperthyroidism

18
Q

What happens in primary hyperthyroidism?

A

Thyroid releases too much T3/T4

19
Q

Why is a total T3 test most useful in early diagnosis of primary hyperthyroidism?

A

Liver/kidneys is converting T4 into T3, so T4 levels remain normal but T3 levels increase

20
Q

What are lab findings for late/progressed hyperthyroidism?

A

T3 and T4 levels are now elevated

21
Q

What are S/S of hyperthyroidism?

A

Increased CV symptoms (HTN, tachycardia)
Elevated RR
Increased BMs
Hyperactive CNS (tremors, irritable)
Negative effect on diabetes or increased risk of diabetes

22
Q

What disease can cause primary hyperthyroidism?

A

Grave’s Disease

23
Q

What is Grave’s Disease?

A

Autoimmune disease that causes excess secretion of T3/T4
Immune systems releases thyroid antibodies that stimulate release of T3/T4

24
Q

What is another cause of primary hyperthyroidism?

A

Iatrogenic
Too much synthetic thyroxine

25
Q

What are TSH, Free T4, and total T3 values for primary hyperthyroidism?

A

Decreased TSH
Elevated or normal Free T4
Elevated Total T3

26
Q

What lab finding would differentiate between Grave’s disease or iatrogenic hyperthyroidism?

A

If thyroid antibodies are present, it would indicate Grave’s over iatrogenic cause

27
Q

What is the difference between primary and secondary hyperthyroidism?

A

Primary is autoimmune disorder (TSH is decreased)
Secondary is due to TSH secreting adenomas (TSH will be elevated and antibodies will not be present)

28
Q

What are the TSH, free T4, and total T3 values for secondary hyperthyroidism?

A

Elevated TSH
Elevated free T4
Elevated total T3

29
Q

What is thyroid storm?

A

Rare but potentially fatal form of hyperthyroidism

30
Q

What is the hallmark symptom of thyroid storm?

A

Marked increase in body temperature

31
Q

What triggers thyroid storm?

A

Acute event (infection, surgery, medications)

32
Q

What is the most common cause of primary hypothyroidism?

A

Hashimoto’s disease (autoimmune disorder)

33
Q

What are other causes of primary hypothyroidism?

A

Iodide deficiency
Thyroidectomy
Radiation damage

34
Q

What is myxedema?

A

Very severe hypothyroidism that can be potentially fatal
Sometimes used to describe skin changes seen in hypothyroidism

35
Q

What can hypothyroidism cause?

A

Cretinism (impaired congenital development)
Gross Dwarfism
Cognitive impairment

36
Q

What are the TSH, free T4, and total T3 findings of Primary Hypothyroidism?

A

Elevated TSH
Decreased free T4
Decreased total T3

37
Q

What lab finding would indicate Hashimoto’s over other causes of hypothyroidism?

A

Presence of thyroid antibodies

38
Q

What is the difference between primary and secondary hypothyroidism?

A

Primary has elevated TSH
Secondary has decreased TSH

39
Q

What causes secondary hypothyroidism?

A

Pituitary gland pathology/
Hypopituitarism

40
Q

What are other lab findings of Secondary Hypothyroidism?

A

Decreased levels of other pituitary hormones
(GH, FSH, LH, ADH, ACTH, prolactin)

41
Q

What causes goiter to form in Grave’s disease?

A

Increased thyroglobulin and T3/T4 are stored in the colloid

42
Q

What causes goiter to form in Hashimoto’s disease and iodide deficiency?

A

Increased thyroglobulin stored in colloid

Endocrine Pathophys (12 decks)

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