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Endocrinology > Thyroid Disorders > Flashcards

Thyroid Disorders Flashcards

1
Q

What will TSH look like in primary hypothyroidism?

A

elevated

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2
Q

What will TSH look like in secondary hypothyroidism?

A

depressed

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3
Q

What are the lab values for TSH, T3, and I123 in hyperthyroidism?

A

depressed TSH, elevated T3, increased uptake - “hot” foci

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4
Q

Gold standard for diagnosing thyroid nodule

A

FNA bx. - US guided

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5
Q

How will thyroid nodule look with I123?

A

“cold” foci

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6
Q

Symptoms of hyperthyroidism

A

sweating, weight loss or gain, anxiety, palpitations, loose stool, heat intolerance, irritable, fatigue, weakness, menstural irrgularities, stare, tremor

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7
Q

Cardiac issues seen with hyperthyroidism

A

tachycardia

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8
Q

describe the skin of a hyperthyroid patient

A

warm and moist

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9
Q

Most common cause of thyrotoxicosis

A

Graves Disease

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10
Q

How does Graves Disease cause thyrotoxicosis?

A

increase in synthesis of thyroid hormone - autoantibodies [thyroid-stimulating immunoglobulins or TSH receptor antibodies] bind to TSH receptor in thyroid cell membranes and result in hyperfunction

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11
Q

two symptoms often seen in Graves Disease

A

ophthalmopathy pretibial myxedema

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12
Q

What can trigger Graves Disease?

A

Dietary Iodine Supplements

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13
Q

What are patients with Graves Disease at increased risk for?

A

other systemic autoimmune disorders

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14
Q

Autonomous hyperfunctioning thyroid nodules that produce hyperthyroidism - more prevalent among older adults and in iodine-deficient regions

A

Plummer Disease

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15
Q

Autoimmune thyroiditis that occurs in the first 12 months postpartum and occasionally after miscarriage

A

postpartum thyroiditis

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16
Q

Postpartum thyroiditis has increased incidence in women with

A

preexistent type 1 DM and other autoimmune disorders

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17
Q

Thyroiditis typically caused by viral infection - MC is URI that results in enlarged and painful thyroid

A

Subacute thyroiditis

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18
Q

thyroiditis that occurs spontaneously or due to chemotherapeutic agnts or drugs such as lithium, amiodarone

A

Silent thyroiditis

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19
Q

What must be supressed to diagnose amiodarone-induced thyrotoxicosis?

A

TSH

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20
Q

What can cause hyperthyroidism in pregnancy?

A

high levels of serum hCG binding to TSH receptors

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21
Q

Symptoms of thyrotoxic crisis or “storm”

A

marker agitation or delirium, very high fever, severe tachycardia, vomiting, diarrhea, dehydration

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22
Q

Causes of thyrotoxic crisis or “storm”

A

trigger - stressful illness, thyroid surgery, or RAI administration

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23
Q

Term for asymptomatic individuals with low serum TSH but normal FT4 and FT3

A

Subclinical Hyperthyroidism

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24
Q

Hyperthyroidism can cause what other abnormal lab values

A

hypercalcemia, increased liver enzymes, increased alkaline phosphatase, anemia, decreased neutrophils

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25
Q

When is radioisotope testing contraindicated?

A

pregnancy or breast feeding

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26
Q

Primary treatment for symptomatic relief in Graves Disease

A

propranolol

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27
Q

initial treatment of choice for thyrotoxic crisis

A

propranolol

28
Q

Two most common Thiourea drugs

A

methimazole propylthiouricil

29
Q

What type of patients do thiourea drugs show best results?

A

small goiter, mild hyperthyroidism, those requiring smaller doses

30
Q

What two symptoms must patient on thiourea be on the lookout for?

A

agranulocytosis pancytopenia

31
Q

What would cause a patient to stop their thiourea?

A

onset of any infection

32
Q

Common side effects of thiourea drugs

A

pruritis, allergic dermitits, nausea, dyspepsia

33
Q

In a non-pregnant patient what is the preferred oral therapy for hyperthyroidism?

A

Methimazole

34
Q

Why is propylthiouracil considered second line therapy?

A

acutte liver failure

35
Q

Who is propylthiourcil reseverd for?

A

pregnancy and breast feeding - not known to cause fetal anomalies

36
Q

Effective in temporary treating thyrotoxicosis

A

iodinated contrast agents

37
Q

MOA of iopanoic acid and ipodate sodium

A

inhibit coversion of T4 to T3 in periphery

38
Q

Who are iodinated contrast agents particularly useful for?

A

those who are symptomatically very thyrotoxic

39
Q

How does Radioactive Iodine work?

A

destroys overactive thyroid tissue

40
Q

Can you used RAI in pregnancy or lactation?

A

No

41
Q

After RAI therapy when can men and women safely conceive?

A

women - 4 months men - 6 months

42
Q

While patients are on RAI therapy, what can they take to treat symptoms?

A

propranolol

43
Q

What is a contraindication of 121I therapy?

A

Graves ophthalmopathy

44
Q

Patients with Graves ophthalmopathy who are being treated with radioiodine should also be prophylactically given

A

prednisone

45
Q

After radioiodine therapy, a patients FT4 level drops then rises to toxic levels, should you be concerned?

A

no - does NOT indicated treatment failure. Release of sored thyroid hormone fomr injured thyroid cells

46
Q

Symptoms of hypothyroidism

A

fatigue, cold intolerance, constiptation, weight change, depression, menorrhagia, hoarseness, dry skin, bradycardia, delayed return of deep tendon reflexes, anemia, hyponatremia, hyperlipidemia

47
Q

what will FT4 and TSH be in hypothyroidism?

A

TSH will be elevated T4 will be depressed

48
Q

Most common cause of hypothyroidism

A

Hashimoto thyroiditis

49
Q

what drug causes clinically significant hypothyroidism?

A

amiodarone

50
Q

Liver disease associated with increased risk of autoimmune thyroiditis

A

chronic hepatitis C

51
Q

what is a goiter?

A

enlarged thyroid due to elevated serum TSH levels

52
Q

what is the best screening test for hypothyroidism?

A

serum TSH levels

53
Q

lab values for hypothyroidism

A

elevated serum TSH low serum FT4 hyponatremia hypoglycemia anemia

54
Q

Patient has normal serum FT4 and elevated serum TSH, diagnosis?

A

subclinical hypothyroidism

55
Q

two antibodies that will be elevated in Hashimoto thyroiditis

A

antithyroglobulin and antithyroperoxidase

56
Q

prefered medical therapy for hypothyroidism

A

levothyroxine

57
Q

is levothyroxine safe in pregnancy?

A

yes

58
Q

what is the goal of medical therapy in hypothyroid patient?

A

normalize TSH

59
Q

Most common and most benign type of thyroid cancer

A

papillary carcinoma

60
Q

rarest and most deadly type of thyroid cancer

A

anaplastic carcinoma

61
Q

Classification system for Thyroid nodules

A

Bethesda Classification System

62
Q

Hot nodule has ___% chance of being malignant

What type of nodule is malignant?

A

0%

cold nodule

63
Q

Thyroid cancer most commonly associated with ionizing radiation

A

papillary thyroid cancer

64
Q

Rank the following in terms of malignancy: anaplastic, papillary, follicular, medullary

A

papillary → follicular → medullary → anaplastic

65
Q

How does Plummers differ from Graves?

A

plummers has no antibodies → no exophthalmos

66
Q

name of operation to fix thyroglossal duct cyst

A

sistrunk operation

Endocrinology (7 decks)

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