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NUR 326 Exam 3 > Thyroid Disorders > Flashcards

Thyroid Disorders Flashcards

1
Q

Thyroid: Shape and Location

A

a 2” butterfly-shaped gland
located in the neck

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2
Q

Thyroid: Secretes what? (2)

A

triiodothyronine (T3)
thyroxine (T4)

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3
Q

Thyroxine (T4): Function

A

regulator of body metabolism that influences almost every body system

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4
Q

_______ is a necessary component in the synthesis of thyroid hormone

A

iodine

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5
Q

Secretion of T4/T3

A

hypothalamus releases TRH–> stimulates anterior pituitary gland to release TSH–> stimulates thyroid gland to release thyroxine—> thyroxine (T4) is converted to T3, which is the active form in the body

Once we have enough to get to ideal metabolism, our body tells the hypothalamus to turn down

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6
Q

Thyroid Dysfunctions

A

-Are either HYPOthyroidism or HYPERthyroidism
-Primary thyroid disorders are the MOST common
-Thyroid problems are more likely in women than men
-An enlargement can occur with both types of disorders

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7
Q

Goiter: Definition

A

An enlargement of the thyroid gland with OR without symptoms of thyroid dysfunction

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8
Q

Goiter: Causes (3)

A

excess pituitary TSH
low iodine levels
goitrogens (ex: meds)

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9
Q

Hypothyroidism

A

insufficient levels of the thyroid hormones T3 and T4
Can be:
-primary: thyroid isn’t
secreting T3 and T4
(MOST common)
-secondary: pituitary gland
is not secreting enough
TSH

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10
Q

Hashimoto’s thyroiditis

A

an autoimmune disorder
MOST common cause of hypothyroidism

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11
Q

Hashimoto’s: antibody

A

Antithyroperoxidase antibody
hallmark of the disorder

antithyroglobulin antibody as well

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12
Q

Hypothyroidism: Risk Factors

A

-female
-age > 50
-Caucasian
-pregnancy
-history of other autoimmune disorders
-family history
-medications
-treatments for hyperthyroidism

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13
Q

Hypothyroidism: EARLY CM (14)

A

cold intolerance
weight gain
lethargy
fatigue
memory deficits
poor attention span
increased cholesterol
muscle cramps
raised carotene levels
constipation
decreased fertility
puffy face
hair loss
brittle nails

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14
Q

Hypothyroidism: LATE CM (6)

A

-below normal body temperature
-bradycardia
-weight gain
-decreased LOC
-thickened skin
-cardiac complications (cardiomegaly)

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15
Q

Hypothyroidism: Affects?

A

ALL body organs
-raises cholesterol;
hyperlipidemia
-raises carotene levels
(yellows skin)
-causes anemia
-decreases filtration by
kidney (risk of
medication toxicity)
-can cause hoarse voice

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16
Q

Myxedema

A

severe hypothyroidism that has gone undiagnosed for a long time
can result in myxedema coma
results in loss of brain function
life-threatening
term is also used to describe dermatological changes that occur with hypothyroidism

17
Q

Hypothyroidism: Diagnosis (Labs)

A

High TSH level
Low free T3
Low free T4
Antithyroglobulin (anti-Tg)
Antithyroperoxidase (anti-TPO) antibodies

18
Q

Hypothyroidism: Diagnosis

A

In primary hypothyroidism, there is low hormone secretion by the thyroid gland, which constantly signals the pituitary to secrete TSH

In secondary hypothyroidism, both TSH and T4 will be low

19
Q

Hypothyroidism: Treatment

A

Replacement hormone therapy with levothyroxine (T4-synthetic thyroid hormone)
-MOA: converted to T3 in
the body
-drug half life= 7 days
-levothyroxine and
warfarin taken together:
be cautious, increased
risk of bleeding
Surgical intervention if necessary

20
Q

Hyperthyroidism (Thyrotoxicosis)

A

Excessive secretion of T3 and T4
-primary (thyroid)
-secondary (pituitary)
-tertiary (hypothalamus)

21
Q

Hyperthyroidism: Causes

A

-Graves’ disease: MOST common
-Thyroid adenoma
-Subacute thyroiditis
-Toxic multinodular goiter
-Excessive iodine ingestion (Jod-Basedow Syndrome)
-Excessive thyroid hormone replacement

22
Q

Graves’ Disease

A

autoimmune stimulation of the thyroid gland
excess levels of T3 and T4
thyroid-stimulating antibodies

23
Q

Hyperthyroidism: Risk Factors

A

family history of Graves
age > 40
women
Caucasian
Medications
Excessive iodine intake
Pregnancy

24
Q

Graves Disease (Hyperthyroidism): CM (9)

A

-nervousness
-insomnia
-sensitivity to heat
-weight loss
-gland is usually enlarged and palpable
-an audible bruit may be heard because of high glandular blood flow
-atrial fibrillation
-myxedema (dermatologic manifestations)
-exophthalmos

25
Q

Exophthalmos

A

periorbital edema and bulging of the eyes
termed Graves’ ophthalmopathy

women are more affected with this than men

26
Q

Graves’ Disease: Diagnosis

A

-Low TSH
-High T3
-High T4
-Antithyroglobulin
-Antithyrotropin receptor antibody
-Ultrasound with color-Doppler evaluation
-Radioactive iodine scanning and measurements of iodine uptake
-In Graves’, the
radioactive iodine uptake
is increased and the
uptake is diffusely
distributed over the
entire gland

27
Q

Hyperthyroidism: Treatment

A

-antithyroid hormone medication
-propylthiouracil (PTU)
-radioactive iodine* treatment
-radioactive iodine is taken up by the gland and suppresses its activity
-surgery
-replacement thyroid
hormone (levothyroxine)
is needed for life

28
Q

propylthiouracil (PTU)

A

treatment of hyperthyroidism
blocks thyroid hormone synthesis, suppresses conversion of T4 to T3

hepatotoxicity
can be used in 1st trimester with caution

29
Q

Thyrotoxic Crisis (Thyroid Storm)

A

overwhelming release of thyroid hormones that exerts an intense stimulus on the metabolism
this is a life-threatening condition most commonly precipitated by surgery, trauma, or infection

30
Q

Parathyroid Gland: Shape and Location

A

four pea-sized glands nestled within the thyroid tissue of the neck

31
Q

Parathyroid Gland: Function (3)

A

-produce and secrete parathyroid hormone (PTH)
-controls Ca levels in the body
-promotes vitamin D production by the kidney

32
Q

Hypoparathyroidism: Symptoms (6)

A

Muscle cramps
Irritability
Tetany
Convulsion
Hypocalcemia causes carpal spasm known as Trousseau’s sign; and facial muscle twitch known as Chvostek’s sign
*The symptoms associated with hypoparathyroidism are the result of insufficient PTH secretion and the resultant hypocalcemia

33
Q

Hypoparathyroidism: Treatment

A

-Replace PTH
-Normalize serum Ca and Vitamin D levels
-If parathyroid has been removed- replacement treatments are life long

34
Q

Hyperparathyroidism: Definition

A

excessive secretion of PTH

35
Q

Hyperparathyroidism: Symptoms (10)

A

muscle weakness
poor concentration
neuropathies
HTN
kidney stones
metabolic acidosis
osteopenia
pathological fractures
constipation
depression, confusion, or subtle cognitive deficits
*symptoms are caused by excessive secretion of PTH with resulting hypercalcemia and bone breakdown

36
Q

Hyperparathyroidism: Treatment

A

reduce levels of calcium
diuretics: decrease Ca
calcitonin: regulates Ca levels
biphosphonates: decrease bone breakdown
vitamin D: helps absorb Ca
surgical intervention

NUR 326 Exam 3 (11 decks)

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