Thyroid Gland Diseasex Flashcards
What’s the thyroid gland
T.b is a butterfly shaped s a small, butterfly-shaped gland located at the front of your neck under your skin. It’s a part of your endocrine system and controls many of your body’s important functions by producing and releasing (secreting) certain hormones.
Anatomy
Located in neck
• lobes
• isthmus
• Relations
• Larynx
• Trachea
• Recurrent laryngeal
nerves
• Parathyroid glands
• Carotid sheath
• Blood supply
• Sup. thyroidal a.
• Inf. thyroidal
Histology of TG
oid follicles
• Simple cuboidal-
columnar
• Colloid
– Thyroglobulin
• Rich vascularization
• Parafollicular
Physiological effects of thyroid hormone
Increases oxygen consumption and heat production
• Positive chronotropic and inotropic effects on heart
• Increase sensitivity to adrenergic effectors
• Up-regulates -adrenergic receptors
• Increase gut motility
• Increase bone turnover
Increases reflex response
• Increase hepatic glycogenolysis and gluconeogenesis
• Stimulates lipolysis
• Developmental effects
• Growth
• Brain development
Hyperthyroidism definition causes and symptoms
High thyroid hormone production
Causes
hyrotoxicosis
• Graves’ disease
• Toxic Adenoma
• Toxic Multinodular
Goiter
• Chronic Thyroiditis
Symptoms
Tachycardia/arrhythmia
• Muscle tremors
• Hyperreflexia
• Increased core & skin temp./
Heat Intolerant
• Exophthalmos
• Muscle wasting
• Loose stool
• Osteoporosis
• Hair loss
• Oligo-/amenorrhea
• Irritability, Restlessn
Hypothyroidism definition causes and symptoms
Low thyroid hormone production
Causes
Hashimoto disease
Iodine deficiency
Symptoms
I’m Newborn
• Cretinism
• Lack of myelination
• Children
• Retarded Growth
• Disproportionate
Adult
• Muscle weakness
• Mental slowness
• Tired/fatigued
• Cold
• Slowed intestinal
peristalsis
• Impaired renal function
• Anemia
• Myxedema
Indication for surgery
Hyperthyroidism
Compression syndrome -pressing organs and thyroid
Cancer and suspicion of cancer
Complications after surgery
Hypo parathyroidism
More importantly thyrotoxics cross
Hematoman
Bleeding
Damage of laryngeal nerve
Diffuse toxic goitre definition symptoms tests treatment
Diffuse tixic goitre is an autoimmune disease characterised by immune changes and no hormonal disorders just structural changes
Symptoms
Loss of weight
Exaphathalmos
Tearing eyes
Bad sleep weakness of muscle
Emotional liability
Tachycardia reduced work capacity
Test T3 T4 tests
Treatment operation
Other types of goitre
Endemic - spread across has to do with iron deficiency
Sporadic - doesn’t spread across no iron deficiency
Damages of laryngeal never after thyroidectomy symptoms
Vocal fatigue
Hoarseness
Shortness of breath
Weak voice
Difficulty swallowing
Coughing hole swallowing aspiration strider shortness of breath
Thyrotoxic crisis definition and treatment a
Life threatening condition that repertoire a extreme state of hyperparathyroidism
Nite that glucocorticoids levels are low so it leads to hypoxia and causes adrenal insufficiency
Treatment- corticosteroids
Beta blockers propanol
Iodine supplement
Anti thyroid medication propyyhiaouracal
Support care
Oxygen therapy
Temp control
Electrolyte management
Sedation
Thyrotoxic crisis symptoms and causes of death
Tachycardia
High fever
BP increases then decreases
Nausea vomiting
Profuse sweating
High tremor
Weight loss
Psychosis
Adrenal insuffi
Jaundice
Agitation
Sopor
Hyperemia of face
Confusion
Causes of death
Cardiovascular collapse
Multiple organ failure
Cardiac arrest l
Thyroid cancer definition and symptoms
Disease in which cell grow abnormally and have the potential to spread to the other
Can be benign or Malignant
First Stage presentation of a thyroid nodule painless mass in the region of TG
Second Stage
.pain
Hemoptysis( coughing out blood
Raped enlargement
Hoarseness
Stridor cainwaysound
Risk factors TG
Thyroid exposure to irradiation
Age sex
• low
• Benign nodules occur most frequently in women 20-40 years% of these are malignant
• Men have a higher risk of a nodule being malignant
Family History
• History of family member with medullary thyroid carcinoma
• History of family member with other endocrine abnormalities (parathyroid,
adrenals)
• History of familial polyposis (Gardner’s syndrom
Evaluation of the thyroid Nodule
(Physical Exam
Examination of the thyroid nodule:
• consistency - hard vs. soft
• size - < 4.0 cm
• Multinodular vs. solitary nodule
• multi nodular - 3% chance of malignancy (Goldman, 1996)
• solitary nodule - 5%-12% chance of malignancy (Goldman, 1996)
• Mobility with swallowing
• Mobility with respect to surrounding tissues
• Well circumscribed vs. ill defined borders Examine for ectopic thyroid tissue
• Indirect or fiberoptic laryngoscopy
• vocal cord mobility
• evaluate airway
• preoperative documentation of any unrelated abnormalities
• Systematic palpation of the neck
• Metastatic adenopathy commonly found:
• in the central compartment (level VI)
• along middle and lower portion of th
Blood Tests) of TC
Thyroid function tests
• thyroxine (T4)
• triiodothyronin (T3)
• thyroid stimulating hormone (TSH)
• Serum Calcium
• Thyroglobulin (TG)
• Calcitonin
Evaluation of the Thyroid Nodule
(Radioimaging
Ultrasonography)
Radioactive iodine
(Fine-Needle Aspiration) the best
Classification of Malignant Thyroid
Neoplasms
Papillary carcinoma
• follicular carcinoma
• Hurthle cell carcinoma
• Anaplastic carcinoma
•
• Medullary Carcinoma
