Thyroid Disorders

Question 1

What is the test of choice to screen for abnormal thyroid function?

Answer 1

TSH

Question 2

THyroid hormone effects

Answer 2

• Fetal development
• Oxygen consumption and heat production
• CV effects
• Sympathetic effects
• Pulmonary effects
• GI effects
• Skeletal effects
• Lipid and carbs
• Endocrine effects

KNOW THE CHART YOU MADE

Question 3

Symptoms of hypothyroidism

Answer 3

• Fatigue, weakness
• Dry Skin
• Feeling Cold
• Hair Loss
• Memory
• Constipation
• Wt gain with poor appetite
• Menorhaggia–long periods
  (Think of Leslie)

Question 4

Signs of hypothyroidism

Answer 4

• Dry skin
• Puffy face
• allopecia
• bradycardia
• carpal tunnel
• serous effusions
• delayed tendon reflex

Question 5

Signs and symptoms of hyperthyroidism

Answer 5

know

Question 6

Know the signs and symptoms of both hypo and hyper

Answer 6

ok

Question 7

Inappropriate TSH levels are generally caused by what in hyperthyroidism

Answer 7

• TSH secreting pituitary adenoma (Remember TSH comes from the pituitary and TRH comes from the Hypothalamus)
• isolated pituitary resistance to thyroid hormone (prevents it from recognizing that levels are high in the bloodstream)

Question 8

TSH levels are generally caused by what in hypothyroidism?

Answer 8

Central hypothyroidism

Question 9

Inappropriate TSH levels when there is no thyroid problem is usually caused by

Answer 9

• systemic illlness
• generalized resistance to thyroid hormone
• assay interference

Question 10

Adding Pathoma Notes to this:

Answer 10

ok

Question 11

How does the Thyroid descend?

Answer 11

Thyroid starts at the base of the tongue and then travels along the thyroglossal duct to the anterior neck. Thyroglossal duct usually goes away, if it doesn/t you may get a thyroglossal duct cyst which just presents as an ANTERIOR NECK MASS

Question 12

Most common ectopic thyroid location

Answer 12

Persistence of the thyroid at the base of the tongue

Question 13

How does Hyperthyroidism increase Basal Metabolic Rate?

Answer 13

Increased synthesis of Na/K ATPase

Question 14

Increased sympathetic nervous system activity due to what?

Answer 14

Increases Beta 1 adrenergic receptor

Question 15

Hyperthyroidism Clinical Pres

Answer 15

WHAT DO The Happy Hefty Sluts Bring for Dinner
W-weight loss
H-heat intolerance
Arrhythmia
T- tacchycardia
D- Diarrhea
O- Oligomenorrhea
T- tremor, anxiety, insomnia
H- HYPOCHOLESTEROLEMIA
H- Hyperglycemia
S- staring gaze/lid lag
B-Bone resorption (osteoporosis risk)
D- Decreased muscle mass

Question 16

Most common cause of hyperthyroidism

Answer 16

Graves Disease

Question 17

Graves disease is

Answer 17

autoanitbody that stimulates TSH receptor in the THyroid (Type II Hypersensitivity)

Question 18

Graves is most common in what sex?

Answer 18

Females

Question 19

Clinical features of graves disease

Answer 19

hyperthyroidism of course
Diffuse goiter- constant TSH stimulation leads to Thyroid Hyperplasia and hypertrophy
Exopthalmos and Pretibial myxedema

Question 20

Whats the deal with exopthalmos and pretibial myxedema,

Answer 20

Fibroblasts overlying the shin and behind the orbit express TSH receptors

Question 21

TSH activation results in glycosaminoglycan buildup , inflammation and fibrosis leading to the exopthalmos and pretibial myxedema/

Answer 21

ok

Question 22

What are glycosaminoglycans?

Answer 22

Chondroitin Sulfate and Hyaluronic Acid.

Question 23

Lab findings in Graves disease?

Answer 23

High total and free T4. (Free T4 downregulates TRH receptors in the anterior pituitary. )

• Low Cholesterol
• Increased serum Glucose