Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Acute Care II > Thyroid Hormone > Flashcards

Thyroid Hormone Flashcards

1
Q

Thyrotoxicosis is what?

A

Systemic syndrome d/t exposure to excessive thyroid hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hyperthyroidism refers to those forms of thyrotoxicosis caused by what?

A

excessive production of thyroid hormone d/t stimulus or autonomous thyroid function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hyperthyroidism Etiology - Hyperthyroidism

A

Antibody mediated stimulation of thyroid tissue (graves disease - younger women)
Excessive secretion of TSH
Autonomously functioning Thyroid tissue (Toxic multinodular goiter, toxic adenoma, iodine exposure, struma ovarii, metastatic thyroid cancer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Nonhyperthyroid thyrotoxicosis - Etiology

A

Ingestion of exogenous thyroid hormone (meds, supplements, meat)
Inflammation (subacute thyroiditis, autoimmune thyroiditis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Graves Diseases is an autoimmune process

A

Thyroid stimulating immunoglobulins bind to/activate TSH receptor > thyroid hormone secretion, gland growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Graves Disease is characterized by what?

A

Diffusely enlarged thyroid
ophthalmopathy
Exophthalmos
EOM involvement
vision loss
Dry, gritty eyes
pain
diplopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hyperthyroidism Clinical Manifestations

A

Anxiety
Emotional lability
Weakness
Tremor
Palpitations
Tachycardia
Heat intolerance
Increase perspiration
Hyperreflexia
Increased appetite
Nervousness
Weight loss
Warm, moist skin
Thin, fine hair
Exophthalmos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hyperthyroidism in elderly may present differently with s/sx like

A

weight loss
tachycardia
constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hyperthyroidism Diagnosis
Physical Exam components

A

Thyroid (size, tenderness, symmetry, nodularity)
Pulmonary, Cardiac & Neuromuscular function
Peripheral edema
Optho signs
periorbital myxedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hyperthyroidism Diagnosis
Ultrasound can show?

A

anatomy
lesions
nodules
goiters
masses
inflammation
flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hyperthyroidism Diagnosis
TSH initial screening test
TSH will what? d/t what?
If TSH low check what?
Sometimes T4 is normal but T3 is what?

A

low; elevated levels of T3 & T4 inhibiting secretion of TRH by hypothalamus & TSH by pituitary
free T3&T4
elevated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hyperthyroidism Diagnosis
Additional Labs to help diagnosis

A

Thyrotropin receptor antibody (TRAb)
Radioactive iodine uptake (RAIU)
Thyroidal blood flow via US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If TSH is low and Free T4 is High it is?

A

Thyrotoxicosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If TSH is low and Free T4 is normal is is?

A

T3-thyrotoxicosis
Subclinical thyrotoxicosis
Nonthyroidal illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If TSH is normal and Free T4 is elevated it can be?

A

TSH-secreting adenoma
Pituitary resistance to thyroid hormone
Generalized resistance to thyroid hormone
Familial dysalbuminemic hyperthroxinemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If TSH is normal and Free T4 is normal it is?

A

normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hyperthyroidism Management
Beta blockers for who? why?

A

all (ameliorate symptoms of hyperthyroidism caused by increased beta-adrenergic tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hyperthyroidism Management
In Graves disease possible treatments are?

A

Antithyroid drugs (Methimazole, Propylthiouracil (PTU)
Radioactive Iodine
Thyroidectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Antithyroid drugs
Inhibit function of thyroid peroxidase which does what?
1st go to med? for how long?
What med is safer in pregnancy?
Side effects include?

A

reduces oxidation & organoification of iodine
methimazole (MMI) x 12-18 mo)
PTU (inhibits peripheral conversion of T4 > T3)
agranulocytosis, skin rash, elevated LFTs, vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Thyroid Storm Clinical Manifestations

A

Tachycardia
CHF
Hyperthermia
Agitation
Delirium
Psychosis
Stupor
Severe N/V or diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Thyroid Storm Precipitating Factors

A

Long Standing untreated hyperthyroidism
Infection
Trauma
Surgery
Acute Iodine Load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Thyroid Storm Differential Dx

A

Sepsis
Cocaine use
PAID
Pheochromocytoma
Neuroleptic malignant syndrome
Hyperthermia

23
Q

Thyroid Scoring system results of >/=45 indicates?
25-44 is suggestive of?
< 25 is suggestive of?

A

highly suggestive of thyroid storm
impending storm
unlikely to represent thyroid storm

24
Q

Thyroid Storm Management
PTU dosing?
MMI dosing?
Propranolol dosing?
Iodine dosing?
Hydrocortisone dosing?

A

500-1000mg load, then 250mg q4h
60-80 mg/d
60-80mg q4h
5 drops PO q6h
300mg IV load, then 100mg q8h

25
Q

Subclinical hypothyroidism is characterized by what?

A

Elevated TSH & normal T4

26
Q

Overt Hypothyroidism is characterized by what?

A

TSH > 10 mlU/L + subnormal T4

27
Q

Primary Hypothyroidism Etiology can be from?

A

Autoimmune disease (Hashimoto’s Thyroiditis)
Drugs (lithium, amiodarone, interferon)
Iatrogenic (post radiation, surgery)
Congenital (inborn error of hormone metabolism)
Iodine Deficiency (rare in US)

28
Q

Secondary Hypothyroidism Etiology can be from?

A

Pituitary tumor
pituitary surgery/ XRT
Craniopharyngiomas

29
Q

Hashimoto’s Thyroiditis pathophysiology

A

Infiltration of thyroid by sensitized T lymphocytes & serologically circulating thyroid autoantibodies

30
Q

Hashimoto’s Thyroiditis occurs with increased frequency among other autoimmune disorders such as?

A

DM I
RA
MG
primary adrenal failure
celiac disease
SLE

31
Q

What are the main Clinical Manifestations of Hypothyroidism

A

Intolerance of cold temperatures
Dry, thick skin
Delayed DTR
Carpal Tunnel Syndrome

32
Q

What are other Clinical Manifestations of Hypothyroidism?

A

Fatigue
Weight Gain
Coarse or thin hair
brittle nails
constipation
bradycardia
Puffy hands, face, feet (myxedema)
Menorrhagia/amenorrhea
+/- goiter

33
Q

Differential Dx for hypothyroidism

A

Anemia
Depression
Constipation
Hypothermia
Fibromyalgia

34
Q

Diagnosis of Hypothyroidism is done how?

A

TSH (elevated)
Free T4 (low)

35
Q

Hypothyroidism Management
Primary Hypothyroidism & TSH levels > 10 mlU/L

A

Start Levothyroxine 1.6mcg/kg/d

36
Q

In elderly w/ CAD how is hypothyroidism managed?

A

Start a lower dose & titrate gradually (20-25% less per kg/d; usually 12.5-25mcg/d)

37
Q

With pregnant patients who have hypothyroidism, what precaution must be made?

A

A need for transient increase in their dose.

38
Q

How often should dosage be titrated for hypothyroidism?

A

q4-8 wks (usually by increments of 12.5-25mcg)

39
Q

TSH goal is what?

A

between 0.45-4.12

40
Q

Myxedema is what?

A

thickened, nonpitting edema to soft tissues in markedly hypothyroid state

41
Q

Myxedema Coma is often precipitated by what?

A

infection
meds
environmental exposure
other metabolic-related stresses

42
Q

Management of Myxedema Coma
Hypothyroidism?

Alternative?

A

Large inital IV dose of 300-500 mcg T4, if no response ad T3

Initial IV dose of 200-300mcg T4 plus 10-25mcg T3

43
Q

Management of Myxedema Coma
Hypocortisolism

A

IV hydrocortisone 200-400 mg daily (divided by 4 doses)

44
Q

Management of Myxedema Coma
Hypoventilation

A

Dont delay intubation and mechanical ventilation too long

45
Q

Management of Myxedema Coma
Hypothermia

A

Blankets, no active warming

46
Q

Management of Myxedema Coma
Hypotension

A

Cautious volume expansion with crystalloid or whole blood

47
Q

Management of Myxedema Coma
Hypoglycemia

A

Glucose admin

48
Q

Management of Myxedema Coma
Precipitating even

A

Identification and elimination by specific treatment, liberal use of abx

49
Q

Euthyroid
TSH
Free T4
Free T3

A

Normal
Normal
Normal

50
Q

Primary Hypothyroidism
TSH
Free T4
Free T3

A

High
Low
Normal or Low

51
Q

Hyperthyroidism
TSH
Free T4
Free T3

A

Low
High or normal
High

52
Q

Subclinical Hypothyroidism
TSH
Free T4
Free T3

A

High
Normal
Normal

53
Q

Subclinical Hyperthyroidism
TSH
Free T4
Free T3

A

Low
Normal
Normal

54
Q

TSH-mediated Hyperthyroidism
TSH
Free T4
Free T3

A

Normal or High
High
High

Acute Care II (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions