Thyroid Disorders

Question 1

Hypothyroidism

Answer 1

M O M S S O T I R E D
MC cause = hashimotos (autoimmune)
post radiation
causal meds = lithium, amio, interferon

tx: levothyroxine, check TSH 8 weeks after initial start
Pregnancy = increase up to 50%

LOW free T4, HIGH TSH

Question 2

Hyperthyroidism

Answer 2

S W E A T I N G

MC CAUSE = Grave’s disease (autoimmune), can be seen with lupus or RA, goiter may be present
Other causes = toxic adenoma, thyroiditis

TSH LOW, Free T4 HIGH

At diagnosis may be Beta adrenergic antagonists PROPANOLOL
TX W/ PTU or Tapazole
Radioactive iodine ACTIVE GRAVES

Question 3

WHAT IS THE NORMAL LEVEL OF TSH?

Answer 3

0.4-4.0

This hormone is released by anterior pituitary to tell thyroid how much T4 to release

Question 4

What is the normal level of Free T4?

Answer 4

10-27

Question 5

Primary Hyperparathyroidism

Answer 5

ELEVATED PTH
role of PTH = calcium levels in the body
Excess PTH = hypercalcemia
“moans, groans, stones and bones”

s/s loss of energy, osteopenia, insomnia, aches, kidney stones

surgery for lesion, refer, biphosphonates to prevent bone loss
Avoid thiazide diuretics

Question 6

Secondary hyperparathyroidism

Answer 6

results from secondary disease that lowers calcium levels causing PTH to be overproduced

similar as primary presentation

Tx- vitamin d analogs, phosphate binders, surgery if medical therapy fails

Refer to endo

Question 7

How often does the American Thyroid association recommend people be screened for thyroid dysfunction?

Answer 7

women and men >35 years of age screened every 5 YEARS

Question 8

What does the Us preventative task force recommend for thyroid dysfunction screening?

Answer 8

state that evidence is insufficient to recommend for or against routine screening for thyroid disease in adults