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D&T test 6 - endocrine, dermatology, MSK > Thyroid disorders > Flashcards

Thyroid disorders Flashcards

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Dermatology Board Prep flashcards
1
Q

Thyroid is derived from what? Parathyroid?

A

(4th and 5th pharygeal pouches)

PT = 3rd and 4th

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2
Q

What week does the ability to concentrate iodine occur?

A

12 weeks

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3
Q

What week does HPT axis funcitonal

A

18 weeks:

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4
Q

“Total T4/T3” = free or bound

A

bound

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5
Q

What is the active form of thyroid called

A

Free (FT3/FT4)

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6
Q

If unspecified, it is referring to which form of thyroid homo

A

the bound, “Total” form

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7
Q

4 Bs of thyroid function

A

i. Brain maturation
ii. Bone maturation
iii. β-adrenergic effects (myocardial contractility)
Basal Mtb rate increase - thermogenesis

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8
Q

thyroid relationship with catecholamines

A

increases sensitivity to catecholamines

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9
Q

Which thyroid homo is essential for growth and dev

A

T4

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10
Q

When is the normal surge in T4

A

~day after birth

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11
Q

MC cause of congenital hypothyroidism

A

Thyroid agenesis/dysgenesis

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12
Q

2nd MC cause of congenital hypothyroidism

A

Dyshormonogenesis = organification enzyme defect

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13
Q

If normal Tc99 scan in congenital hypothyroidism, what is cause

A

Dyshormonogenesis

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14
Q

Labs (TSH, T3/T4) : primary and central/secondary/pituitary hypothryroidism

A 
Primary = high TSH ( normal pituitary), low T4/T3
central/secondary/pituitary= low/inappropriately normal TSH, low T3/T4
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15
Q

2 medication causes of acquired hypothyroidism

A

Amiodarone, lithium

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16
Q

define myxedema

A

Hypothyroidism in older kids and adults

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17
Q

Sx of myxedema

A

goiter

Fatigue, constipation, cold intolerance, dry skin, brittle hair, puberty delay

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18
Q

What is the MC cause of enlarged Thyroid?

A

hashimotos thyroiditis

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19
Q

2 mechanisms of hashimotos

A

CD4, CD8, and antithyroid antibodies

→ destruction of thyroid

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20
Q

2 Dx lab findings for hashimotos

A

Anti-Thyroid Peroxidase Ab (Anti-TPO)

Anti-Thyroglobulin Ab (Anti-TG).

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21
Q

tx for hashimotos

A

levothyroxine

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22
Q

T4 = what drug?

A

levothyroxine

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23
Q

T3 = what drg

A

triiodothyronine

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24
Q

Which has longer half life? T3 or T4

A

T4

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25
Q

Administration instructions for levothyroxine and why

A

Take on empty stomach

Food, PPIs, antacids all decrease absorption

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26
Q

What is T3 ix for

A

Indicated for acute emergencies only

27
Q

ADE of T3

A

adverse cardiac effects

28
Q

what drug increases both T4 and T3 ?

A

levothyroxine

29
Q

Diagnosis and Cause of Graves dz:

A

Thyroid Receptor Stimulating Antibodies (TRS-Ab) aka TSI

30
Q

pretibial myxedema cuased by

A

GAG deposition

31
Q

What antibodies are found in graves?

A
  1. Anti-Thyroid Peroxidase Ab (present in hashimotos too)
  2. Anti-Thyroglobulin Ab (present in hashimotos too)
  3. TSI
32
Q

RAI findings in Graves

A

Diffuse uptake on radioactive iodine scan.

33
Q

Tx for Graves (3)

A

Methimazole, B-blockers, radioactive ablation

34
Q

Methimazole MOA

A

inhibits peroxidase

35
Q

SX of neonatal graves (6)

A

Tachy, cardiomegaly/CHF, SGA/preemie, microcephaly, stare, hepatosplenomegaly

36
Q

Carbimazole MOA

A

blocks peroxidase

37
Q

PTU MOA

A

blocks thyroid-peroxidase and 5’-deiodinase (conversion of T4–> T3)

38
Q

What biochemical structure is essential for Methamizole and PTU to work

A

Thiocarbamide groups

39
Q

Why isn’t Carbimazole used much?

A

Carbimazole is converted to Methimazole quickly so it isn’t used very much

40
Q

Which Thyroid drug crosses the pacenta less?

A

PTU

41
Q

How soon will thryoid drugs show effects and why?

A

1) Blocks synthesis but not release:
a) Stored TG not affected
Effects take weeks (until stores are depleted)

42
Q

Most dangerous ADE of thiamides

A

Agranulocytosis (BM suppression) = most dangerous

43
Q

Methimazole ADE:

A

Aplasia cutis congenital = lack of scalp skin

44
Q

all thiamides show this ADE and which one especially?

A

PTU especially shows hepatotoxicity

45
Q

PTU is Cix in what situations?

A
  1. kids unless no other option available

after 1st trimester of pregnancy

46
Q

Unique use of Iodine salts

A

Blocks RAI (radioactive iodine) uptake in event of nuclear reactor accident, etc

47
Q

RAI is absolutely cix in what pop?

A

absolutely cix in pregnancy and nursing mothers.

48
Q

B-blocker MOA on thyroid homo

A

Decreases conversion of T4–>T3.

49
Q

etiology of Subacute Thyroiditis (de Quervain Thyroiditis)

A

Viral etiology:

Measles, mumps, adenovirus, coxsackie

50
Q

CP and course of Subacute Thyroiditis (de Quervain Thyroiditis)

A

Tender thyroid - only disorder with tender thyroid!

Self-limiting

51
Q

Sick Euthyroid lab and why?

A 
↑↑rT3 (reverse T3) = inert form of T3 
decreased T3 (bc T4 is converted in to rT3 instead of T3)
52
Q

What does the Swallow testtell you?

A

if it move up and down = thyroid related

53
Q

FNA is recommended for all thyroid nodules that show what (2)?

A

> 1cm

solid, mixed components

54
Q

Most thyroid adenomas functioning or not?

A

non = “cold”

55
Q

Which thyroid nodule is more likely to become malignant: hot or cold?

A

cold

56
Q

MC and 2nd MC thyroid CA

A
  1. = Papillary

2. Follicular

57
Q

How to dx follicular CA

A

invasion through capsule (if not = adenoma)

58
Q

What thyroid CA is seen in Seen in iodine deficient regions

A

Follicular

59
Q

Inheritance of Medullary CA

A

AD

60
Q

MEN2A has what conditions

A

2A: Medullary CA, parathyroid hyperplasia, Pheochromocytoma

61
Q

MEN2B has what conditions

A

2B: Medullary CA, Pheochromocytoma, mucosal neuromas, marfanoid body habitus

62
Q

Anaplastic CA of thyroid

population, px, mutation

A

older pop
100% lethal
p53

63
Q

Thyrotropin alpha: MOA and use

A

= synthetic TSH

Give before RAI ablation in thyroid cancer to beef up the thyriod

D&T test 6 - endocrine, dermatology, MSK (22 decks)

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