Thyroid Disorders Flashcards
what is the thyroid?
2” butterfly-shaped gland located in the neck
what does the thyroid secrete?
secretes triiodothyronine (T3) and thyroxine (T4)
what is thyroxine?
regulator of body metabolism that influences almost every body system
role of iodine with thyroid
necessary component in the synthesis of thyroid hormone
thyroid dysfunctions
–primary thyroid disorders are most common
–more likely in women than men
–enlargement can occur with both types
goiter
enlargement of the thyroid gland with or without symptoms of thyroid dysfunction
chemicals and goiter
–excess pituitary TSH
–low iodine levels
–enlargement of thyroid gland can also occur from goitrogens
hypothyroidism
insufficient levels of thyroid hormones T3 and T4
primary hypothyroidism
increase in release of TSH from pituitary
Hashimoto’s
autoimmune; most common cause of hypothyroidism
patho of Hashimoto’s
–thyroid receptor antibodies
–antithyroglobulin antibody
–antithyroperoxidase antibody (hallmark)
risk factors for hypothyroidism
–female
–age > 50
–Caucasian
–pregnancy
–history of other autoimmune disorders
–family hx
–meds
–treatment for hyperthyroidism
early symptoms of hypothyroidism
–cold intolerance
–weight gain
–lethargy
–fatigue
–memory deficits
–poor attention span
–increased cholesterol
–muscle cramps
–raises carotene levels
–constipation
–decreased fertility
–puffy face
–hair loss
–brittle nails
late symptoms of hypothyroidism
–below normal temp
–bradycardia
–weight gain
–decreased LOC
–thickened skin
–cardiac complications (cardiomegaly)
how does hypothyroidism affect all body organs?
–raises cholesterol (HLD)
–raises carotene levels
–causes anemia
–decreases filtration by kidney
–can cause hoarse voice
myxedema
–severe hypothyroidism (coma)
–describes dermatological change that occurs with hypothyroidism
symptoms of hyperthyroidism
–anxiety
–tremor
–tachycardia
–feeling warm
–loss of weight
–exophthalmos
–a fib
–decreased fertility
diagnosis of hypothyroidism
—high TSH
–low free T3
–low free T4
–antithyroglobulin
–antithyroperoxidase antibodies
diagnostic for primary hypothyroidism
low hormone secretion by the thyroid gland, which constantly signals the pituitary to secrete TSH
what do you treat hypothyroidism with?
synthryoid
MOA of synthryoid
converted to T3 in the body
synthryoid
replacement hormone therapy with levothyroxine
half life of synthryoid
7 days
hyperthyroidism
excessive secretion of T3 and T4
primary hyperthyroidism
thyroid
secondary hyperthyroidism
pituitary
tertiary hyperthyroidism
hypothalamus
Graves disease
most common cause; autoimmune stimulation of thyroid gland
other causes of hyperthyroidism
–thyroid adenoma
–subacute thyroiditis
–toxic multinodular goiter
–excessive iodine ingestion
–excessive thyroid hormone replacement
risk factors for hyperthyroidism
–family hx of Graves
–age > 40
–women
–Caucasian
–meds
–excessive iodine intake
–pregnancy
components of Graves disease
–autoimmune disorders
–excess levels of T3 and T4
–thyroid-stimulating antibodies
symptoms of Graves disease
–nervousness
–insomnia
–sensitivity to heat
–weight loss
–enlarged and palpable gland
–audible bruit (high glandular blood flow)
–a fib
–myxedema
–exophthalmos
exophthalmos
periorbital edema and bulging of the eyes
women
diagnosis of Graves Disease
–low TSH
–high T3
–high T4
–antithyroglobulin
–antithyrotropin receptor antibody
–ultrasound with color-Doppler evaluation
–radioactive iodine scanning and measurement of iodine uptake
treatment of hyperthyroidism
–antithyroid hormone medication –> propylthiouracil (PTU)
propylthiouracil
–blocks thyroid hormone synthesis
–suppresses conversion of T4 to T3
notes about propylthiouracil
–hepatotoxicity
–can be used in 1st trimester with caution
–radioactive iodine treatment
treatment of propylthiouracil
–surgery
–replacement thyroid hormone needed for life (levothyroxine)
thyrotoxic crisis (thyroid storm)
–overwhelming release of thyroid hormones that exerts an intense stimulus on the metabolism
life threatening condition
-precipitated by surgery, trauma, or infection
parathyroid gland
–four pea-sized glands nestled within thyroid tissue of the neck
–produce and secrete parathyroid hormone
–controls calcium levels in the body
–promotes vitamin D production by the kidney
hypoparathyroidism symptoms
–result of insufficient PTH secretion and resultant hypocalcemia
–muscle cramps
–irritability
–tetany
–convulsion
–Trousseau’s and Chvostek’s
treatment for hypoparathyroidism
–replace PTH
–normalize serum Ca and Vitamin D levels
–replacement treatment lifelong if parathyroid removed
symptoms of hyperparathyroidism
–muscle weakness
–poor concentration
–neuropathies
–HTN
–kidney stones
–metabolic acidosis
–osteopenia
–pathological factors
–constipation
–depression, confusion, or subtle cognitive deficits
what are hyperparathyroidism symptoms caused by?
excessive secretion of PTH with resulting hypercalcemia and bone breakdown
treatment for hyperparathyroidism
–reduce levels of calcium
–diuretics
–calcitonin
–biphosphonates
–vitamin D
–surgical intervention
