Thyroid Disorders (Exam 3) Flashcards
Thyroid
2 inch butterfly - shaped gland located in the neck
Thyroid secretes 2 hormones
Triiodothyronine T3
Thyroxine T4
Thyroxine
T(4) hormone secreted by by the thyroid that is the regulator of body metabolism that influences almost every body system
Iodine importance
is a necessary component in the synthesis of thyroid hormone
Thyroxine forms
Bound and Unbound
Become ubound and activates triiodothyronine (t3) which is active forum of thyroid hormone
When hypothalamus sense our body needs to be reved up in realeases
TRH (Thyroid releasing hormone) which tells our anterior pituitary to release TSH (Thyroid stimulating hormone) which stimulates the thyroid gland and increases thyroxine (T4 inactive forum)
T4 is converted into T3 which is the active forum out in the body
Thyroid Dysfuncitons
More common in women. Enlargment (goider) can occur in both
Goiter
Is an enlargement of the thyroid gland with or without symptoms of thyroid dysfunction
If there are no symptoms of thyroid dysfunction the goiter is considered
Non Toxic Goiters
Goiter causes by (3 reasons)
Excess pituitary TSH
Low iodine levels (when the pituitary sense this it increases TSH)
goitrogens (Foods and meds that promote thyroid enlargement)
Hypothyroidism
Insufficient levels of T3 and T4
Primary and secondary
Primary Hypothyroidism
Most common cause.
Thyroid itself is not secreting T3 or T4.
Increase TSH and Decrease Levels of T3 and T4
Secondary hypothyroidism
Pituitary is not secreting enough TSH
Not enough stimulus for the thyroid to secrete more T3 and T4
Hashimotos thyroiditis
an autoimmune disorder, is the most common cause of hypothyroidism
Low T3 and T4. TSH = high
This is primary
What do we test for in Hypothyroidism Hashimoto’s
Antithyroperoxidase antibody
Antithyroglobulin Antibody
Hypothyroidism: RF’s
Woman
Older than 50
Caucasian
Pregnancy
History of autoimmune disorders
Fx
Hypothyroidism Manifestations: early
DECREASE IN BODY METABOLIC ACTIVITES
Cold intolerance
Weight gain
Lethargy
Fatigue
Memory deficits
Poor attention span
Increased cholesterol
Muscle cramps
Raises cramps
Raises carotene levels
Constipation
Decrease firtility
Puffy face
Hair loss
Brittle nails
Hypothyroidism Manifestations: Late
Low temp
Bradycardia
Weight gain
Decreased LOC
Thickened skin
Cardiac complications (cardiomegaly)
Hypothyroidism Affects All Body Organs
Raises cholesterol: HLD
Raises carotene: Yellow
Causes anemia
Decreases filtration by kidney (Medication toxicity)
Can cause hoarse voice
Myxedema
Severe hypothyroidism (COMA)
Dermatological changes that occurs with hypothyroidism
Life threatening and low of brain function
Diagnosis of Hypothyroidism
HIGH TSH level
Low T3
Low T4
Antithyroglobulin (anti-TG)
Antithyroperoxidase (anti-TPO) antibodies
TSH also low in secondary
Hyperthyroidism (Thyrotoxicosis)
Excessive secretion of T3 and T4
Primary Hyperthyroidism
Thyroid issue
Graves disease
Low TSH High T4 High T3
Secondary Hyperthyroidism
PItuitary gland is secreting to much TSH
High TSH high T4 high T3
Tertiary Hyperthyroidism
hypothalamus to much excretion of TRH (increase in all)
Graves Disease
Most common cause, an autoimmune stimulation of the thyroid gland
Too much T3 and T4 by the thyroid stimulating antibodies.
Hyperthyroidism: Risk factors
Family History of Graves
Age > 40
Women
Caucasian
Medications
Excessive Iodine Intake
Pregnancy
Graves Disease: Clinical Manifestations
INCREASE TURN UP
Nervousness
Insomnia
Sensitive to heat
Weight loss
Gland is enlarge and palpable
Audible burit because of high blood flow
Atrial fibrillation
Myxedema (also hypo)
Exophthalmos
Exophthalmos
Hyperthyroidism
Periorbital edema and bulging of the eyes termed graves ophthalmopathy
Women are more affected than men
Diagnosis of Graves Disease
Low TSH
High T3
High T4
antithyroglobulin
antithyrotropin receptor antibody
Ultrasound with color-Dopple evaluations
Radioactive iodine scanning and measurements of iodine uptake
Thyrotoxic Crisis
Thyroid storm: Hyperthyroidism
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
