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Endocrino :D > Thyroid Disorders > Flashcards

Thyroid Disorders Flashcards

1
Q

Hypothyroidism main Etiology

A

almost always from a single cause: failure of the thyroid

gland from burnt-out Hashimoto thyroiditis.

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2
Q

Hypothyroidism less common Etiology

A

Dietary deficiency of iodine

AmIODArone

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3
Q

Hypothyroidism cx fx

A

almost all bodily processes being slowed

down—except menstrual flow, which is increased.

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4
Q

Hypothyroidism management if TSH is very high (more than double the upper limit of normal) with
normal T4,

A

replace hormone. thyroxine (Synthroid)

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5
Q

Hypothyroidism management if TSH is less than double the normal
… wait old note that sounded weird..

here is a new one
Remaking the question:
You have low T4 and T3, High TSH. How would you confirm primary hypothyroidism?

A

get antithyroid peroxidase/antithyroglobulin antibodies. If antibodies are positive, replace thyroid hormone.

they are typical for Hashimoto’s thyroiditis= the classic one (but may also be present in Graves’ disease).

Think of Hashimoto as jaPanese Tyrona de Globos

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6
Q

Hypothyroidism intestinal transit

A

Constipation

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7
Q

Hypothyroidism refelxes

A

Decreased reflexes

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8
Q

Hypothyroidism cold or hot

A

Cold intolerance

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9
Q

Hyperthyroidism intestinal transit

A

Diarrhea (hyperdefecation)

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10
Q

Euthyroid Sick Syndrome patho

A

nonthyroidal systemic illness + low serum levels of thyroid hormones

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11
Q

Euthyroid Sick Syndrome Dx

A

t3 low
reverseT3 high
+- t4 low (t4 is converted into rT3)
TSH NO HIGH!

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12
Q

Euthyroid Sick Syndrome tx

A

treat the underlying cause. NO hormone replacement

Euthyroid is written with E like the number 3= the only affected hormone is T3. This is all because a non-thyroidal disease

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13
Q

Don’t order thyroid function tests in
patients with ____________. The results will not be
accurate.

A

nonthyroid critical

illness

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14
Q

What Is the Most Likely Diagnosis?” Eye (proptosis) (20%–40%) and skin (5%)
findings

A

Graves disease

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15
Q

What Is the Most Likely Diagnosis? Tender thyroid

A

Subacute thyroiditis

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16
Q

Painless “silent” thyroiditis cxfx

A

Nontender, normal exam results

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17
Q

What Is the Most Likely Diagnosis? Involuted gland is not palpable

I guess + High t3t4

A

Exogenous thyroid hormone

use

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18
Q

Etiology/“What Is the Most Likely Diagnosis?” high tsh level

A

Pituitary adenoma

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19
Q

Hyperthyroidism dx

A

All forms of hyperthyroidism have an elevated T4 (thyroxine) level.

20
Q

Graves disease dx

A

only kind of hpth that has TSH receptor antibodies.

Indication: if Graves disease is suspected but classic clinical features are absent

21
Q

Thyroglobulin Significance

A

Detects recurrence of thyroid cancer

22
Q

Thyroid-stimulating immunoglobulin TSI) Significance

A

Confirms Graves disease

Not positive in toxic multinodular goiter

23
Q

Thyroperoxidase antibody (TPO) Significance

A

Confirms presence of Hashimoto

thyroiditis

24
Q

Graves disease

labs: TSH, RAIU, Confirmatory

A

TSH low, RAIU ↑, Confirmatory: positive antibody test (TSI)

[TSH receptor antibody =TRAb]

25
Q

Subacute thyroiditis

labs: TSH, RAIU, Confirmatory

A

TSH low, RAIU ↓, Confirmatory: tenderness

26
Q

Painless “silent” thyroiditis

labs: TSH, RAIU, Confirmatory

A

TSH low, RAIU ↓, Confirmatory:none

27
Q

Exogenous thyroid
hormone use
labs: TSH, RAIU, Confirmatory

A

TSH low, RAIU ↓, Confirmatory: History and involuted, nonpalpable gland

28
Q

Pituitary adenoma

labs: TSH, RAIU, Confirmatory

A

TSH ↑, RAIU not done, Confirmatory MRI oh head

29
Q

Radioactive iodine uptake measurement (RAIU test):

A

a test that quantifies the percentage of the administered amount of radioactive iodine taken up by the thyroid gland

30
Q

Toxic nodule:

labs: TSH, RAIU, Confirmatory

A 
↓ TSH
↑ RAIU
Focal uptake of radioactive
iodine
Graves is diffuse
31
Q

Graves disease Tx

A

Radioactive iodine. thioamides: PTU or methimazol

32
Q

Subacute thyroiditis tx

A

Aspirin

33
Q

Painless “silent” thyroiditis tx

A

None

34
Q

Exogenous thyroid hormone use tx

A

Stop use

35
Q

Pituitary adenoma tx

A

Surgery

36
Q

Treatment of Acute Hyperthyroidism and “ Thyroid Storm

A

cold IV fluids

1 Propranolol: blocks target organ effect, inhibits peripheral conversion of
T4→T3
2 Thiourea drugs (methimazole or propylthiouracil): blocks hormone
production
3 Iodinated contrast material (iopanoic acid and ipodate): blocks the peripheral
conversion of T4 to the more active T3; also blocks the release of existing
hormone
4 Steroids (hydrocortisone)
5 Radioactive iodine: ablates the gland for a permanent cure for all …qx resection for Graves is rarely done alternative!

37
Q

Graves Ophthalmopathy tx

A

Steroids are the best initial therapy. Radiation is used in those not responding to
steroids. Severe cases may need decompressive surgery.

38
Q

Graves disease important cxfx

A

esophtalmos

pretibial myxedema

39
Q

hashimoto’s tyroditis patho

A

after inflamated, it dies

40
Q

multiondular goiter

toxic adenoma

A

tons of t4.

41
Q

factitious disorder hyperthyroidism

A

someone who intentoinaly takes t4

42
Q

struma ovarii

A

ovarian lesion produciong t4

43
Q

struma ovarii and factitious disorder hyperthyroidism

A

both have cold tyroid

44
Q

when to treat a subclinical hypothyroidisim

A

only if tsh>=10 OR

if there arre symptoms

45
Q

myxedema coma

A

coma+hypothermica+hypotensjon dur to too low t4.

46
Q

myxedema coma tx

A

IVF
blankets
give t4. not working? t3

amboss:IV combination of levothyroxine and liothyronine plus IV hydrocortisone
o sea t4+t3

Endocrino :D (14 decks)

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