Thyroid Disorders (pathophys) Flashcards
pretty bad deck - hard to make something useful from the ppt
signs & symptoms of hypothyroidism
Symptoms: Fatigue, weakness Dry skin Feeling cold Hair loss Memory Constipation Weight gain with poor apetite Menorhagia
Signs: Dry, coarse skin Puffy face, hands and feet Diffuse allopecia Bradycardia Peripheral edema Carpal tunnel syndrome Serous cavity effusions Delayed tendon reflex relaxation
Signs and symptoms of hyperthyroidism
Symptoms: Fatigue and weakness Hyperactivity, irritability, dysphoria Heat intolerance and sweating Palpitations Weight loss with increased appetite Diarrhea Oligomenorrhea, loss of libido
Signs: Tachycardia, atrial fibrillatioin in the elderly Tremor Goiter Warm, moist skin Muscle weakness, proximal myopathy Lid retraction
characteristics of TF test
Reproducibility is low, but Sn and Sp are high
how much of T4 and T3 are bound?
99.8, 99.9
Hyperthyroidism TSH increase cause
pituitary adenoma, isolated pituitary resistance to T3/4
Low TSH
central hypothyroidism
Euthyroid conditions with inappropriate TSH tests
Systemic illness
Generalized resistance to thyroid hormone
Assay interference
possible etiologies of endogenous hyperthyroidism
Endogenous Graves disease Toxic multinodular goiter Toxic adenoma Activating mutation of TSH receptor Activating mutation of Gs(alpha) Struma ovarii Thyroiditis Secondary hyperthyroidism
Etiology of primary hypothyroidism
Thyroiditis RIA tx for Graves disease Thyroidectomy Excessive iodine intake Iodine deficiency Inborne errors of TH synthesis Drugs (lithium, amiodarone, interferon-alpha
Etiology of secondary/tertiary hypothyroidism
Destruction of the pituitary gland
Hypothalamic dysfunction
Peripheral resistance to thyroid hormone
4 Classifications of thyroiditis
Acute
Subacute
Silent
Riedel’s thyroiditis
Thyroid enlargement (5 types)
Diffuse nontoxic (simple) goiter Nontoxic multinodular goiter Toxic multinodular goiter Hyperfunctioning solitary nodule Thyroid neoplasm/cancer
Classifications of thyroid cancer
Well differentiated Papillary Follicular Anaplastic Thyroid lymphoma Medullary thyroid carcinoma
Risk factors for thyroid cancer
History of head/neck radiation Age < 20 or >45 years Increased nodule size >4 cm New or enlarging neck mass Male gender Hoarse voice/vocal cord paralysis Nodule fixed to adjacent structures Extra-thyroidal extension Suspected lymph node involvement Iodine deficiency Family history of thyroid cancer or MEN 2
age dependence of thyroid cancer?
very little.
