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Thyroid Disorders Flashcards

1
Q

Describe the etiology of goiter

A
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2
Q

Describe the presentation of goiter

A
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3
Q

Describe the diagnostics for goiter

A
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4
Q

Describe the treatment of goiter

A
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5
Q

What are the actions of T3 & T4

A
  • increase basal metabolic rate & metabolism
  • stimulate bone maturation & growth
  • ensure proper fetal growth & development (esp CNS)
  • increase cardiac output
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6
Q

What meds can suppress TSH

A

high dose steroids, dopamine

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7
Q

What meds can increase TSH

A

metoclopramide & amiodarone

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8
Q

Describe when to do thyroid screening

A
  • newborn (screen for congenital hypothyroidism ( cretinism, intellectual disability))
  • sometimes in pregnancy
  • high index of suspicion in elderly pts
  • if symptomatic
  • when titrating certain meds (or when using amiodarone, Li, metoclopramide)
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9
Q

Describe the screening for thyroid conditions

A

TSH first (if normal, no further testing)
- if high: free T4, maybe T3 (if sus for hyperthyroidism)
- if low: free T4 & T3

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10
Q

Describe the difference between total vs free T3 & T4

A

Total: highly protein bound, many factors influence binding

Free: corresponds to biologically available hormone pool, unpound

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11
Q

Describe the consideration for biotin (Vit H, B7) in thyroid testing

A
  • can impact TSH results
  • stop at least 18 hrs prior to blood draw
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12
Q

Dx for high TSH & low Free T4

A

primary hypothyroidism (thyroid failure)

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13
Q

Dx if TSH is high but FT4 is normal

A

subclinical hypothyroidism

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14
Q

Dx if TSH is low & FT3/FT4 are high

A

primary hyperthyroidism (thyroid overproducing)

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15
Q

Dx if TSH is low and FT3/FT4 are normal

A

subclinical hyperthyroidism

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16
Q

Dx if TSH is low and FT4 is low

A

Central/Secondary hypothyroidism (pituitary failure)

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17
Q

Dx if TSH is high and FT3/FT4 are high

A

Central/Secondary hyperthyroidism (TSH producing tumor)

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18
Q

Which labs test for Hashimoto’s

A
  • Anti-Tg
  • Anti-TPO (also Graves
  • TSH receptor antibody (blocking in hashimoto’s)
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19
Q

Which labs test for Grave’s disease

A
  • Anti-TPO (also hashimoto’s)
  • Antimicrosomal antibody
  • TSH receptor antibody (stimulating in Grave’s)
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20
Q

Describe radioactive iodine uptake scans

A
  • done in hyperthyroidism or nodule workup
  • iodine collects in thyroid gland
  • overactive/nodule takes up more iodine
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21
Q

Describe the appearance of the thyroid in a radioactive iodine uptake scan in Grave’s

A

symmetrical high uptake

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22
Q

Describe the appearance of the thyroid in a radioactive iodine uptake scan in thyroiditis

A

symmetrical low uptake (underfunctioning, usually not ordered for this)

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23
Q

Describe the appearance of the thyroid in a radioactive iodine uptake scan in Toxic MNG or Toxic adenoma

A

irregular/uneven increased uptake

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24
Q

Describe thyrotoxicosis

A

state of excess thyroid hormone (from gland, meds, etc?)

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25
Q

When is it important to include a T3 in workup of the thyroid?

A

when HYPERthyroidism is suspected

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26
Q

Describe the course of postpartum thyroid conditions

A
  • hyper or hypo
  • 2-4 weeks of thyrotoxicosis
  • 4-12 weeks of hypothyroidism
  • spontaneously resolves
  • can treat symptomatically or with short term levo when in hypothyroid phase
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27
Q

Describe the thyroid considerations prior to surgery

A
  • if hyperthyroidism: achieve euthyroid prior
  • if hypothyroidism: proceed if taking meds regularly
28
Q

Describe the etiology of goiter

29
Q

Describe the etiology of hyperthyroidism

30
Q

Describe the presentation of hyperthyroidism

31
Q

Describe the labs for hyperthyroidism

32
Q

Describe the etiology of Grave’s disease

33
Q

Describe the triad presentation of hyperthyroidism

34
Q

Describe the diagnostics for grave’s

35
Q

What is this a typical presentation of

A

Graves disease

36
Q

Describe the etiology of a thyroid storm

37
Q

Describe the presentation of a thyroid storm

38
Q

Describe the labs for a thyroid storm

39
Q

Describe the treatment of a thyroid storm

40
Q

Describe the etiology of toxic MNG

41
Q

Describe the presentation of toxic MNG

42
Q

Describe the etiology of toxic adenoma

43
Q

Describe the workup for toxic MNG & toxic adenoma

44
Q

Describe the treatment for toxic MNG

45
Q

Describe the etiology of hypothyroidism

46
Q

Describe the presentation of hypothyroidism

47
Q

Describe the treatment of hypothyroidism

48
Q

Describe the workup of hypothyroidism

49
Q

Describe the etiology of thyroiditis

50
Q

Describe the presentation of viral thyroiditis

51
Q

Describe the labs for viral thyroiditis

52
Q

Describe the treatment for viral thyroiditis

53
Q

Describe the etiology of hashimoto’s thyroiditis

54
Q

Describe the labs for hashimoto’s thyroiditis

55
Q

Describe the etiology of myxedema coma

56
Q

Describe the presentation of myxedema coma

57
Q

Describe the treatment of myxedema coma

58
Q

Describe the etiology & presentation of euthyroid sick syndrome

59
Q

What is important to check in euthyroid sick syndrome

A

reverse T3

60
Q

What is the most common endocrine cancer

A

thyroid cancer

61
Q

What are the worst and chillest thyroid neoplasms

A

Worst: anaplastic carcinoma

Chillest: papillary or follicular carcinoma

62
Q

What is this characteristic of

A

Hypothyroidism

63
Q

What is this characteristic of

A

hyperthyroidism

64
Q

Describe the treatment of toxic adenoma

A

may develop hypothyroidism after tx

65
Q

Describe the treatment for hyperthyroidism

66
Q

Describe the workup of goiter

67
Q

Describe the treatment of goiter

Cumulative (188 decks)

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