Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med I - Endocrine > Thyroid Disease > Flashcards

Thyroid Disease Flashcards

1
Q

What do the follicular cells of the thyroid gland produce?

A
  • thyroid hormone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do the C cells or parafollicular cells of the thyroid gland produce?

A
  • calcitonin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the function of the thyroid gland?

A
  • produce thyroid hormones that control the rates of metabolism throughout the body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In the ______ tissues, ____ is converted to _____.

A
  • body
  • T4
  • T3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Between T4 & T3, which has the greater metabolic effect/is stronger, more potent?

A
  • T3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is essential to maintain euthyroid function?

A
  • iodine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is the thyroid gland regulated?

A
  • neg. feedback
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is thyroid function assessed?

A

LABS:

  • TSH (thyroid stimulating hormone)
  • T4 (thyroxine)
  • T3 (triiodothyronine)
  • anti-thyroid antibodies
  • anti-thyroid peroxidase (antiTPO)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is goiter?

A
  • increased size of thyroid

- usually palpable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When does goiter occur?

A
  • hypothyroid
  • euthyroid
  • hyperthyroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What causes a goiter?

A
  • hypertrophy of tissue from thyroid hormone output malfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What complications can occur as a result of goiter?

A
  • compression of esophagus, trachea, jugular v, and superior vena cava
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define Pemberton’s Sign

A
  • facial erythema and jugular v. distention that progresses to cyanosis and facial erythema when both arms are raised over the head
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most preventable cause of mental retardation?

A
  • congenital hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the etiology of congenital hypothyroidism?

A
  • thyroid gland dysgenesis or agenesis

- inborn error of thyroid hormone synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What do the S&S of congenital hypothyroidism result in?

A
  • cretinism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the S&S of congenital hypothyroidism?

A
  • mental retardation
  • growth impairment (most noticeable)
  • poor psychomotor development
  • permanent neurologic damage (occurs if tx is delayed)
  • infants may appear normal at first d/t maternal hormones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the treatment/prevention of congenital hypothyroidism?

A
  • screening at birth

- tx with hormone supplement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the types of hypothyroidism?

A
  • primary
  • transient
  • secondary/central
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the etiologies of primary hypothyroidism?

A
  • autoimmune
  • drugs
  • congenital
  • iodine deficiency
  • acquired (s/p thyroidectomy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the etiologies of transient hypothyroidism?

A
  • subacute thyroiditis

- withdrawal of thyroxine tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the etiologies of secondary/central hypothyroidism?

A
  • hypopituitarism

- hypothalamic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the most common form of thyroiditis & most common cause of thyroid disease in the US?

A
  • Hashimoto’s thyroiditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the cause of Hashimoto’s thyroiditis?

A
  • autoimmune

- lymphocytic infiltration of the thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the symptoms of hypothyroidism?

A
  • wt gain
  • fatigue/lethargy
  • depression
  • constipation
  • dry skin
  • cold intolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the signs of hypothyroidism?

A
  • bradycardia
  • thin brittle nails
  • thinning hair
  • thinning lateral 1/2 eyebrows
  • non-pitting pretibial edema
  • puffy face & eyelids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the name for the constellation of hypothyroid symptoms?

A
  • myxedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the S&S unique to Hashimoto’s?

A
  • initial transient hyperthyroidism d/t release of T3/T4 from damaged cells
  • eventually develops into a hypothyroid state d/t destruction of gland
  • non-tender goiter initially then common S&S of hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What labs should be drawn for hypothyroidism?

A
  • serum TSH
  • FT4 (free T4)
  • anti-thyroid antibodies
  • anti-thyroid peroxidase (antiTPO)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What will the TSH level be in primary hypothyroidism?

A
  • elevated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What will the FT4 level be hypothyroidism?

A
  • low or low-normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the anti-thyroid antibody levels in hypothyrodism?

A
  • high
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What other lab abnormalities are common in chronic hypothyroidism?

A
  • increased LDL, cholesterol, triglycerides, liver enzymes, & creatine kinase
  • hyponatremia
  • hypoglycemia
  • anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the lab values for subclinical hypothyroidism?

A
  • normal FT4

- mildly elevated TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the tx for subtle symptoms of subclinical hypothyroidism?

A
  • thyroid replacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the tx for asymptomatic subclinical hypothyroidism?

A
  • close monitoring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

T/F: Imaging is always necessary for hypothyroidism dx.

A
  • false
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

When is imaging necessary for hypothyroidism?

A
  • asymmetric goiter = US

- solitary lesion/focal nodule = FNA (fine needle aspiration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are complications of hypothyroidism?

A
  • myxedma crisis (rare)
  • infertility
  • miscarriages
  • sellar enlargement/TSH secreting tumors
  • cardiac complications
  • megacolon
  • increased risk of bacterial PNA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the tx for hypothyroidism?

A
  • daily levothyroxine
41
Q

When should labs be redrawn s/p hypothyroid tx?

A
  • 6wks
42
Q

How fast are TSH response?

A
  • gradual
43
Q

How are levothyroxine doses adjusted?

A
  • small increments (12.5-25mcg/d)
44
Q

What is the starting dose in elderly patients?

A
  • low (12.5-25mcg qd)
45
Q

What is the risk of untreated preggers with hypothyroidism?

A
  • adverse fetal neural development

- preterm labor

46
Q

What is the dose of levothyroxine in preggers?

A
  • increased by 50%
47
Q

Define myxedema crisis

A
  • severe, life-threatening hypothyroidism
48
Q

What pt pop is myxedema crisis seen in?

A
  • elderly women who have had a stroke or stopped thyroid replacement
49
Q

What causes myxedema crisis?

A
  • underlying infx
  • cold exposure
  • drug use
50
Q

What is the tx goal of myxedema crisis?

A
  • rapid thyroid hormone replacement

- supportive therapy to correct other metabolic conditions

51
Q

Define hyperthyroidism

A
  • overactive thyroid making too much thyroid hormone
52
Q

What are the causes of hyperthyroidism?

A
  • primary
  • transient
  • secondary
53
Q

What are the etiologies of primary hyperthyroidism?

A
  • graves
  • toxic multinodular goiter or toxic adenoma
  • struma ovarii
  • drugs
54
Q

What are the etiologies of transient hyperthyroidism?

A
  • subacute thyroiditis, Hashimotos
  • thyroid destruction
  • thyrotoxicosis factita
55
Q

What are the etiologies of secondary hyperthyroidism?

A
  • TSH secreting pituitary adenoma
  • thyroid hormone resistance syndrome
  • molar pregnancy
  • gestational thyrotoxicosis
  • metastatic follicular thyroid cancer
56
Q

Define Graves Disease

A
  • autoimmune disorder affecting the thyroid gland

- characterized by an increase in synthesis and release of thyroid hormone

57
Q

What is the most common cause of hyperthyroidism?

A
  • Graves
58
Q

What are the risk factors of Graves?

A
  • high iodine intake as well as medication use

- genetic/family hx

59
Q

What is the pathogenesis of Graves?

A
  • antibodies to the thyroid gland’s TSH receptors
60
Q

Define toxic single/multinodular goiter?

A
  • nodules that produce thyroid hormone w/o the TSH receptor stimulation
61
Q

What are the types of subacute thyroiditis?

A
  • granulomatous thyroiditis (de Quervains or painful)

- lymphocytic thyroiditis (painless or silent)

62
Q

Define granulomatous thyroiditis

A
  • initial inflam causes thyroid follicle destruction and release of thyroid hormones followed by hypothyroidism then euthyroid
63
Q

Define lymphocytic thyroditiis

A
  • brief thyrotoxic state followed by hypothyroisim then resolution
64
Q

What is the pt pop of lymphocytic thyroiditis?

A
  • postpartum
65
Q

What are the etiologies of hyperthyroidism?

A
  • ectopic thyroid hormone production
  • pituitary tumor
  • iodine-induced hyperthyroidism
  • amiodarone-induced thyrotoxicosis
66
Q

What are the symptoms of hyperthyroidism?

A
  • hyperactivity/irritability/dysphoric, anxiety
  • heat intolerance & sweating
  • palpitations
  • fatigue & weakness
  • wt loss w/ increased appetite
  • diarrhea
  • polyuria
  • oligomennorhea, loss of libido
  • insomnia, impaired concentration
67
Q

What are the signs of hyperthyroidism?

A
  • tachycardia, atrial fib in elderly
  • tremor
  • goiter
  • warm. moist skin
68
Q

What are signs specific to Graves?

A
  • diffusely enlarged thyroid
  • graves opthalmopathy
  • thyroid dermopathy (pretibial myxedema)
69
Q

What are the lab findings of Graves?

A
  • low TSH
  • elevated FT4
  • (+) anti-thyroid & anti-thyroid peroxidase Abs
70
Q

What imaging should be done for Graves?

A
  • thyroid US
  • thyroid scan (RAI uptake)
  • MRI & CT scan for graves opthalmopathy
  • EKG (not diagnostic)
71
Q

What is the tx for Graves?

A
  • symptomatic
  • reduce T4 production via RAI, ATD, iodinated contrast agents, surgery
  • beta blockers
72
Q

When is RAI contraindicated?

A
  • preggers
73
Q

What are the ATD drugs used to tx Graves/hyperthyroidism?

A
  • methimazole

- propylthiouracil (PTU)

74
Q

How is iodinated contrast agents a tx for hyperthyroidism?

A
  • temporary tx for thyrotoxicosis of any cause

- not used for definitive tx or long term

75
Q

Who is treated with surgery for hyperthyroidism?

A
  • pts who fail rx & RAI

- large goiters causing difficulty swallowing or airway compromise

76
Q

What are potential complications of thyroidectomy?

A
  • recurrent laryngeal n. paralysis

- hypoparathyroidism

77
Q

What is the tx for single toxic adenoma?

A
  • RAI ablation
78
Q

What is the tx for toxic multinodular goiter?

A
  • surgery
79
Q

What is the tx for lymphocytic thyroiditis (painless, autoimmune)?

A
  • symptomatic w/ beta blocker
80
Q

What is the tx for De Quervains thyroiditis (painful, s/p virus)?

A
  • short course NSAIDs or steroids

- ATD are ineffective

81
Q

What are the S&S of thyroid storm?

A
  • marked delirium
  • severe tachycardia
  • vomiting
  • diarrhea
  • dehydration
  • very high fever
82
Q

What is the tx of thyroid storm?

A
  • induce euthyroid state (ATD, ipodate sodium, iodide, propranolol, & hyrdocortisone) followed by RAI or surgery
83
Q

What does non-toxic mean in relation to thyroid disorder?

A
  • normal hormone levels
84
Q

What are the S&S of non-toxic thyroid adenomas & multinodular goiters?

A
  • large nodule can cause discomfort, hoarsness, & dysphagia
  • Pemberton sign
  • most small are asymptomatic
85
Q

What do all nodules & goiters require?

A
  • labs & initial diagnostic imaging
86
Q

What imaging is obtained for nodules/goiter?

A
  • US
  • RAI scan
  • CT
  • FNA bx
87
Q

What is the best method to assess a nodule/goiter for malignancy?

A
  • FNA bx w/ US guidance
88
Q

What is the tx for non-toxic thyroid adenomas & multinodular goiters?

A
  • monitoring w/ regular periodic palpation & US q6m
  • rebx if growth occurs
  • levothyroxine suppression therapy (>2cm nodules)
  • surgery
89
Q

What is the most common malignancy of the endocrine system?

A
  • thyroid CA
90
Q

What are the types of thyroid CA?

A
  • papillary
  • follicular
  • medullary
  • anaplastic
  • other
91
Q

Describe papillary thyroid CA

A
  • most common

- least aggressive

92
Q

What is the most aggressive type of thyroid CA?

A
  • anaplastic
93
Q

What are the S&S of thyroid CA?

A
  • palpable
  • firm
  • non-tender
  • fixed
  • large
94
Q

What is the definitive diagnostic test of choice for thyroid CA?

A
  • FNA bx w/ cytology
95
Q

What are the TFT (thyroid function test) for thyroid CA?

A
  • generally normal
96
Q

What (& why) imaging is done for thyroid CA?

A
  • US: helps localize, measure, & asses for metastaitc dz
  • RAI: used s/p thyroidectomy
  • CT/MRI/PET: locates metastasis
97
Q

What is the tx for thyroid CA?

A
  • surgery
  • RAI (131 I)
  • radiation
  • levothyroxine s/p thyroidectomy
98
Q

What are the complications of thyroid CA?

A
  • metastasis to lungs, bone, brain, adrenals, or LN
99
Q

What are the complications of thyroid CA secondary to surgery?

A
  • hypothyroidism
  • hypoparathyroidism
  • vocal cord paralysis

Clin Med I - Endocrine (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions