Thyroid Disease Flashcards
Therapy Thyroid Storm?
- PTU
- ß-blockers
- Lugols (Lithium if iodine allergy): stops release of T3/4
- Steroids (Dexamethasone or Hydrocortisone)
Lab Results Thyroid Storm?
low TSH and high free T4 and/or T3 concentrations.
Symptoms Thyroid Storm?
1- hyperpyrexia,
2- cardiovascular dysfunction,
3- altered mentation
What are the maternal risks of untreated hyperthyroidism?
1- CHF
2- Thyroid Storm
3- Preeclampsia
What are the fetal risks of untreated hyperthyroidism?
1- SAB 2- IUGR 3- IUFD 4- PTD 5- Abruption 6- Goiter 7- Hydrops
Therapy for Hyperthyroidism in pregnancy?
PTU until week 20 (due to risk of aplasia cutis)
Methimazole week 20-delivery (due to risk of agranulocytosis)
How long does it take to reach steady T4 state after changing med dose?
6 weeks
DD Hyperthyroidism etiologies?
1- Transient Hyperthyroidism of hyperemesis 2- Graves 3- Hyperfunctioning Nodule 4- GTD 5- Exogenous ingestion
Do thyroid hormones cross the placenta?
All cross except TSH
When should synthroid be taken?
Take PNV in a.m. and Synthroid in p.m.
Subclinical hyperthyroidism
treatment of pregnant women with subclinical hyperthyroidism is not warranted.
Who should be tested?
A) personal history of thyroid disease or
B) symptoms of thyroid disease.
Should pregnant women with a mildly enlarged Thyroid be tested?
In women who have a mildly enlarged thyroid, testing is not warranted because up to a 30% enlargement of the thyroid gland is typical during pregnancy
In a pregnant woman with a significant goiter or with distinct nodules, thyroid function studies are appropriate, as they would be outside of pregnancy.
Mortality rate in thyroid storm?
10 - 30%
Thyroid Storm is usually preceded by what?
A stressor (pregnancy, sepsis, surgery, manic episode, etc.)
