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HRR 2 > Thyroid disorders > Flashcards

Thyroid disorders Flashcards

1
Q

Hypothyroid- Eti

A
  • Low T4, high TSH
  • 1% population
  • W>M
  • Elderly- 4-10%
  • Hep C, chemo, Amiodarone
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2
Q

Hypothyroid- Dx

A
  • High TSH, +/- low T4
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3
Q

Hypothyroid- Sx

A
  • Fatigue
  • Wt gain
  • Dry skin, hair loss
  • Cold sensitivity
  • loss of memory, depression
  • Delayed DTRs
  • Goiter
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4
Q

Myxedema coma- Sx

A
  • Life threatening
  • Decompensated hypothyroidism
  • Mental status change
  • Hypothermia
  • Hypoventilation- biggest risk
  • opioid sensitivity
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5
Q

Hashimoto thyroiditis- Eti

A
  • Autoimmune disorder- B- lymphocytes
  • W 6x > M
  • Most common thyroid disorder
    • family hx
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6
Q

Hypothyroid- Tx

A
  • Levothyroxine- 1.7 micrograms/kg/day

- Recheck within 6 weeks

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7
Q

Hyperthyroid- Eti

A
  • High T4, suppressed TSH
  • W>M
  • Younger, 2%
  • Excess production from gland, autoimmune, goiter
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8
Q

Hyperthyroid- Sx

A
  • Wt loss, increased appetite
  • Sweating
  • Palpitations, restlessness, nervousness
  • Oligoamenorrhea, gynecomastia
  • Tremor
  • Hyperdefecation
  • palpitations
  • Insomnia, irritability, poor concentration
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9
Q

Thyroid crisis/ storm- Eti

A
  • Life threatening, extreme thyrotoxicosis
  • Triggered by stress
  • Rare disorder, high mortality rate
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10
Q

Hyperthyroid- Tx

A 
Acute:
- Beta blockers
- Propylthiouricil or methimazole to block T4 synthesis
Chronic:
Tailored to etiology
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11
Q

Graves disease- Tx

A
  • Symptomatic relief- eye drops, beta blockers
  • Antithyroid meds- long term remission after 12 months tx
  • Radioactive iodine- destroy tissue
  • Surgery- not routinely recommended
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12
Q

Goiter- Eti

A

Enlarged thyroid gland

  • 5% population
  • W>M
  • Painful v painless
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13
Q

Goiter- Dx

A
  • Thyroid fxn tests
  • Radioactive iodine scan (hyperthyroid)
  • US
  • Flow-volume loop, barium swallow (obstruction)
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14
Q

Goiter- Tx

A
  • Tx cause- hyper or hypo

- Surgery if large, substernal or obstruction

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15
Q

Thyroid nodules- Eti

A
  • 4-7% adults
  • Women, older, radiation exposure, iodine deficiency
  • Commonly asymptomatic
  • Hyper or hypothyroid
  • 30-40% have non-palpable nodule
  • 5-10% are malignant
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16
Q

Thyroid nodules- Malignant risks

A
  • Male
  • Hoarseness or dysphagia
  • Rapid growth
  • Hx of radiation
  • Hashimoto’s thyroiditis (lymphoma)
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17
Q

Thyroid nodules- Dx

A
  • Serum TSH
  • Radionuclide scan
  • Ultrasound for defining characteristics
  • Fine needle aspiration if indicated
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18
Q

Myxedema- Eti

A
  • Elderly women

- Hx of stroke, infection, stop med

19
Q

Myxedema- Tx

A
  • IV levothroxine- large dose

- Tx hypoventilation & hypothermia

20
Q

Graves- Eti

A
  • Most common cause of thyrotoxicosis
  • W>M
  • 20-40 yrs old
  • Fam hx
21
Q

Graves- Sx

A
  • Pretibial myxedema
  • exophthalmos
  • Lid lag
  • periorbital edema
22
Q

Subacute thyroiditis- Eti

A
  • Viral infections

- W>M

23
Q

Subacute thyroiditis- Sx

A
  • Tender thyroid
  • Enlarges 3-4 x size
  • Dysphagia- pain radiates to jaw or ear
24
Q

Subacute thyroiditis- Tx

A
  • NSAIDs

- Corticosteroids

25
Q

Thyroid crisis/ storm- Sx

A
  • Severe tachycardia
  • Marked delirium
  • high output heart failure, wide pulse pressure, elevated SBP, fever
  • Vomiting, diarrhea & dehydration
26
Q

Thyroid crisis/ storm- Tx

A
  • Thiourea drug & iodine

- Hydrocortisone

27
Q

Thyroid nodule- Sx

A
  • Palpable nodule
  • Hoarseness, discomfort & dysphagia
  • Dyspnea
  • Superior vena cava syndrome- facial erythema, JVD & facial edema
28
Q

Thyroid nodule- Tx

A
  • Levothyroxine if TSH elevated
  • Surgical excision of hx of radiation, positive cytology
  • Percutaneous ethanol injection
29
Q

Hashimoto Thyroiditis- Sx

A
  • Hypothyroid more common
  • Diffusely enlarged, firm & finely nodular
  • Xerostoma and dry eyes
  • Associated with other autoimmune diseases
30
Q

Hashimoto Thyroiditis- Dx

A
  • Anthithyroglobulin antibodies
  • Antithyroid peroxidase
  • Fine needle aspiration
  • Ultrasound- diffuse heterogeneous
31
Q

Hashimoto Thyroiditis- Tx

A
  • Hypothyroid- Levothyroxine to shrink goiter size
32
Q

Thyroid cancer- Eti

A
  • W>M, increases with age
  • Most microscopic & indolent
  • Papillary thyroid carcinoma most common
33
Q

Thyroid cancer- Sx

A
  • Firm, palpable nontender nodule
  • Asymptomatic
  • Neck discomfort, dysphagia & hoarseness
  • Flushing & diarrhea
34
Q

Thyroid cancer- Dx

A
  • Radioactive iodine scan
  • US, CT or MRI
  • Normal thyroid function test
35
Q

Thyroid cancer- Tx

A
  • Surgical removal

- Thyroxine suppression or Radioactive iodine

36
Q

Endemic goiter- Eti

A
  • Iodine deficiency

- Risk of miscarriage & stillbirth

37
Q

Endemic goiter- Sx

A
  • Large, multinodular goiter
  • Compression of anatomical structures nearby
  • May be hypothyroid or thyrotoxic
38
Q

Endemic goiter- Dx

A
  • See/ feel goiter
39
Q

Endemic goiter- Tx

A
  • Add iodine to diet
40
Q

Toxic multinodular goiter- Eti

A
  • Toxic adenoma
  • Older women
  • Nodules progress to toxic & cause hyperthyroid
41
Q

Toxic multinodular goiter- Sx

A
  • Nodular goiter
  • Nervousness, resetlessness, irritibility
  • Heat intolerance, sweating, wt loss
  • Tachycardia & palpitations
42
Q

Toxic multinodular goiter- Dx

A
  • Hyperthyroid TSH/ free T4
  • US
  • FNA
  • RAI- increased uptake
43
Q

Toxic multinodular goiter- Tx

A
  • Methimazole
  • RAI
  • Surgery

HRR 2 (10 decks)

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