Thyroid Clinical Aspects Flashcards
What is the most common symptom of hypothyroidism?
Bradycardia
What is the most common symptom of hyperthyroidism?
Tachycardia
What four things are tested in thyroid functional tests?
T4, T3, FT3, FT4
What is the most powerful thyroxine releaser and most important in measuring levels of thyroxine?
TSH
Which substances tested for in thyroid functional tests are able to bind directly in the blood?
FT4 and FT3
What hormone secreted by the pituitary gland stimulates the production of T3 and T4?
Thyroid stimulating hormone (TSH)
TSH production is influenced by what hormones?
Thyroid hormones
An increase in thyroid hormones has what effect on TSH production?
Inhibition
Increased levels of TSH can be indicative of what thyroid disorder?
Hypothyroidism
If there is too little TSH in the system, what thyroid disorder could be present?
Hyperthyroidism
Raised thyroid antibody concentration in the blood can indicate what hormonal conditions?
Hashimoto’s or Grave’s
Low levels of thyroid antibodies can be indicative of what conditions?
Inflammation, diabetes, rheumatoid arthritis
An increase or decrease in thyroxine can lead to what condition?
Toxic goiter
What is goiter?
Enlarged thyroid due to hormonal imbalance
What characteristics can be indicative of goiter?
Decreased iodine, too much or too little thyroid production
Issues with what areas of the brain could be causes of goiter?
Anterior pituitary or hypothalamus (tumor on the thyroid, as well)
Cretinism and myxedema are seem along side what type of thyroid disorder?
Hypothyroidism
At what age can cretinism occur?
Prior to birth or during the first two years
When is myxedema present?
After first two years of hypothyroidism
What kind of disease is chronic-Hashimoto’s thyroditis?
Autoimmune
Which thyroid disorder characteristically has wildly varying levels of thyroxine?
Chronic-Hashimoto’s thyroditis
What are some signs and symptoms of Grave’s disease?
Increased thyroxine Decreased TSH Pretibial myxedema Exopthalmosis Eyelid lag/drooping of eyelid Diffuse toxic goiter
What are the two forms of toxic goiter?
Diffuse (evenly distributed) nodular (unevenly distributed)
What type of disease is Grave’s disease?
Autoimmune
What is the term used for a thyroid crisis when there is too much thyroxine in the system?
Thyroid storm
What procedure is used to analyze enlargement of the thyroid?
Ultrasound
What procedure is used to test for cancer of the thyroid gland?
Needle aspiration
What is the radioactive detector used to detect metabolism of the thyroid?
Scintigrapher
What is the second most common endocrine disorder?
Thyroid disorder
What gender is more likely to develop thyroid issues?
Females (autoimmune factor)
At what age can thyroid issues occur?
At any age
What is Hashimoto’s disease?
Autoimmune inflammatory attack on the thyroid tissue
Blood tests measuring what substance are used to diagnosis Hashimoto’s disease?
Measuring antibodies against thyroglobulin and thryoid peroxidase
What condition can arise following Hashimoto’s disease due to the thyroid’s eventual inability to produce enough thyroxine?
Hypothyroidism
What is the usual age and gender range of Hashimoto’s disease?
Females 30-50 years old
What is the female to male ratio for Hashimoto’s disease?
20:1
What is the frequency of Hashimoto’s disease?
1:10,000
How can Hashimoto’s affect hair?
Becomes dry and coarse
How can Hashimoto’s affect the GI tract?
Slows it down (constipation)
How can Hashimoto’s affect the muscular system?
Muscle cramps/spasms, vague aches
How does Hashimoto’s disease affect cholesterol levels?
Increase
Where can swelling and puffiness be seen in patients with Hashimoto’s disease?
Swelling in legs, puffiness around eyes
What are some of the general symptoms for Hashimoto’s disease?
Fatigue, depression, weight gain, cold intolerance, excessive sleepiness
In advanced stages, how can Hashimoto’s disease affect heart rate?
Decreases it
In advanced stages, how can Hashimoto’s disease affect body temperature?
Decreases it
Failure of what organ can arise in advanced stages of Hashimoto’s disease?
Heart
What two other autoimmune conditions can be associated with Hashimoto’s disease?
Diabetes and celiac disease
How is Hashimoto’s disease treated?
Thyroid hormone replacement
How can hypothyroidism affect the skin?
Dry appearance
What other clinical condition presents similar symptoms to Hashimoto’s disease?
Hypothyroidism
What signs of hypothryoidism can be seen in infants?
Choking, protruding tongue, puffy face, poor growth, delay of permanent teeth and/or puberty, poor mental development
What age range and gender are risks for hypothyroidism?
Women over the age of 60
What are risks for hypothyroidism?
Autoimmune disease, radioactive iodine treatment, upper body radiation, partial thyroidectomy, pregnancy and delivery of baby in past 6 months
What is the condition that develops with hypothyroidism where the thyroid becomes enlarged?
Goiter
Why do heart problems arise with hypothyroidism?
High levels of low-density lipoproteins
What kinds of mental health issues can arise with hypothyroidism?
Slowed mental functioning, depression
What are some of the peripheral neuropathies involved with hypothyroidism?
Damage to peripheral nerves, pain, numbness and tingling, muscle weakness
What signs and symptoms can result from myxedema seen in severe cases of hypothyroidism?
Intense cold intolerance, drowsiness, unconsciousness
How can hypothyroidism affect fertility?
Interferes with ovulation leading to possible infertility
How can a mother’s hypothyroidism have an effect on a fetus?
Increased birth defects, intellectual and developmental problems
How is vision affected by hyperthyroidism?
Bulging eyes, red or swollen inflamed eyes, sensitivity to light, blurred or double vision
How can hyperthyroidism affect the heart?
Rapid heart rate, atrial fibrillation, congestive heart failure
How can hyperthyroidism affect bones?
Osteoporosis, decrease of calcium in bones (osteoclasts activity in adults)
What kinds of signs and symptoms occur in a thyrotoxic crisis?
Intensification of symptoms, fever, rapid pulse, delirium
Red and swollen skin is seen among which thyroid condition?
Hyperthyroidism (Grave’s dermopathy)
What is the treatment for hyperthyroidism?
Radioactive iodine (destroys part of the thyroid), surgery, antithyroid medications for mild cases
What is the most common disease of hyperthyroidism?
Grave’s disease
What is a thyroid storm?
Too much thyroid hormone in the body (medical emergency) leading to multiple organ dysfunction
What condition can be a trigger for a thyroid storm?
Diabetic ketoacidosis
When is thyroid storm more common and among what gender?
Females in their third through sixth decades of life
What kinds of people and situations are associated with a greater risk for a thyroid storm?
Stressful events, untreated Grave’s disease, people with serious health problems
What are symptoms of thyroid storm?
Feeling confused or sleepy, yellowing of the skin, breathing problems, coma/heart failure or death
What is Grave’s disease?
Condition where the immune system makes antibodies that act like TSH and therefore makes more TSH than the body needs
What can cause Grave’s disease?
Genes, sex hormones, emotional stress or trauma, pregnancy, infection
What other autoimmune diseases are associated with Grave’s disease?
Vitiligo, rheumatoid arthritis, Addison’s, Type I diabetes, pernicious anemia, lupus
What is the term for congenital hypothyroidism?
Cretinism
What is a condition of deficiency of iodine at birth?
Endemic cretinism
What are symptoms of cretinism?
Choking episodes, large anterior fontanelle, protruding tongue and abdomen (also, puffy face, dry and brittle hair, decreased activity, constipation, jaundice, hoarseness, hypotonia, poor coordination, poor feeding, low hairline, short stature)
What is a common location for myxedema seen in cases of Grave’s disease?
Pretibial swelling
What is the adult counterpart of cretinism?
Myxedema
What kinds of foods can help the thyroid gland?
Iodine rich: kelp, seaweed, potatoes, shrimp, cod, eggs
What kind of disorders constitute one of the major endocrine problems in pregnancy?
Thyroid disorders
What serious issues can result as maternal outcomes from thyroid conditions?
Abortion, preeclampsia, preterm labor, placental abruption, hemorrhage
What are signs and symptoms of preeclampsia?
Sudden onset of increased blood pressure, persistent headache, edema, protein in the urine, blurred vision, nausea, upper abdominal pain, changes in vision
What are fetal complications resulting from thyroid issues?
Low birth weight, APGAR score
What method is used to assess a newborn’s health immediately after birth?
APGAR
What are the five criteria of the APGAR test?
Apperance-skin color Pulse-heart rate Grimace-reflex irritability Activity-muscle tone Respiration
What APGAR score is considered generally normal? Fairly low? Critically low?
7-10 Generally normal
4-6 Fairly low
3 and below are considered critically low
Preeclampsia is most commonly seen in mothers with what condition?
Thyroid disorders