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Q4 Clin Lab II thyroid, rheum, coag, LFT, body fluids > Thyroid Labs (lec 2) > Flashcards

Thyroid Labs (lec 2) Flashcards

1
Q

TSH regulated by what?

A

Negative feedback of T3

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2
Q

T3/4 circulate how?

A

99% protein-bound

(U) to TBG

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3
Q

Thyroid hormones are the only substances in the body that contain what?

A

iodine

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4
Q

Primary thyroid disorders affect what?

A

thyroid gland

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5
Q

2° thyroid disorders affect what?

A

Ant pituitary

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6
Q

3° thyroid disorders affect what?

A

hypothalamus

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7
Q

Hyperthyroidism due to?

A

Overproduction of thyroid hormone

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8
Q

Thyrotoxicosis is?

A

Clinical result of excess thyroid hormone,

not necessarily due to over prdxn -> could be leak of hormone from thyroid gland or ingestion of hormone

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9
Q

Hypothyroid due to?

A

Fxnl inactivity of thyroid gland

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10
Q

Causes of Hyperthyroid?

A 
Graves
Toxic Nodular Goiter
Thyroiditis
Postpartum thyroid
Excess iodine
High TSH
Ectopic thyroid tissue
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11
Q

Hyperthyroid sxs? (7)

A 
Nervous
Sweating
Heat intolerant
Fatigue/Weak
Irreg menstruation
Palpitation
Frequent BMs
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12
Q

Hyperthyroid signs? (10)

A 
Stare
Lid lag
Ptosis
Goiter
Warm/Moist skin
Weight loss
Tachycard
Systolic murmur
A fib
Tremor
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13
Q

Causes of Hypothyroidism:

Primary?

2°?

3°?

A 
Primary (dz of gland):
Hashimoto (autoimm destr) *most common
Iodine deficiency in diet   *most C outside US
Latrogenic (surgery/radiation)
Postpartum

2°: Pituitary dz

3°: Hypothalamus dz

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14
Q

Hypothyroid sxs? (6)

A 
Fatigue/weak
Cold intolerance
Arthralgia/Myalagia
Constipation
HA
Depression
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15
Q

Hypothyroid signs? (8)

A 
Puffy face
Periorbital edema
Dry skin
Hair loss (esp lat eyebrow)
Weight gain
Hoarseness
Slow speech
Menorrhagia/Galactorrhea
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16
Q

Best screening test for thyroid dysfxn?

Hyperthyroid levels?

Hypothyroid levels?

A

TSH (3rd generation)

Hyper < 0.10

Hypo > 7

17
Q

Best test for Hypothyroid?

Best test for Hyperthyroid?

A

Plasma TSH

Free T4

18
Q

Normal TSH excludes what conditions?

A

Hyper

Primary Hypo

19
Q

Plasma T4 used to confirm?

A

1) Hypo in pts w/ high TSH

2) Hyper in pts w/ low TSH, also tells us severity

20
Q

T4 assays measure?

A

total T4 (free and bound)

21
Q

Thyroid Hormone-Binding Globulin (TBG) increased by what hormone?

Decreased by?

A

Estrogen

Androgens

22
Q

Free T4 most helpful when?

A

pts w/ abnormal proteins

23
Q

T3 Resin Uptake (T3RU) tells us?

A

If total T4 really indicates Hyper, Hypo or if issue is w/ TBG

T3RU inversely proportional to TBG

24
Q

Relationship b/w Total T4 and T3RU:

If move in same direction?

If move in opposite direction?

A

Same direction = thyroid issue

Opp direction = TBG (binding) issue,
If this then run Free T4

25
Q

T3-RIA (Free T3) used when?

A

signs/sxs of Hyper w/ normal TFT

26
Q

Antithyroglobulin Antibodies (Anti-Tg Ab) occur when?

A

thyroglobulin acts as immune-stimulating antigen ->

Ab’s attack thyroglobulin -> inflamm/destruction of thyroid gland

27
Q

Antithyroid Peroxidase Antibodies (Anti-TPO Ab) occur when?

A

Ab’s made to microsomes from thyroid epithelial cells ->

Microsomes act as antigens ->
stim Ab prdxn ->
Inflamm/Toxins to thyroid follicle

28
Q

Thyroid-Stim Immunogloblulins (TSI) are?

A

IgG Ab against thyroid TSH receptors

90% of Grave’s have these

29
Q

Screening TSH:

If normal?

If high?

If low?

A

Normal = no more tests

High = Free T4, all Ab’s

Low = Free T4/3, Ab’s

30
Q

Radioactive Iodine Uptake (RaIU) tells us:

Hyper w/ decreased uptake?

Hyper w/ increased uptake?

A

early thyroiditis

Grave’s

31
Q

Radionuclide Scan tells us?

A

Function of thyroid gland (size, hot/cold areas)

32
Q

Thyroid US tells us?

A

Size of gland
Nodule presence and composition
Follow dz

33
Q

Hyperthyroid tx? (3)

A

PTU/Methimazole (blocks I-)
Lithium Iodide (blocks T4 release)
β-block (block T4 to T3, helps sxs)

34
Q

Asympt thyroid nodule w/ normal Labs and RaIU, next step?

A

Radionuclide Scan

Cold nodules U don’t take up iodine
If cold then Fine Needle Aspiration

35
Q

Hypothyroid tx?

A

T4 on empty stomach
Check TSH in 6 wks:

If TSH high -> need to ↑T4
If TSH low -> need to ↓T4

36
Q

Risks of over-treating Hypo?

A

a fib

bone disease

37
Q

Use of T4 to tx CA/Goiter?

A

T4 to ↓ TSH to very low levels

Q4 Clin Lab II thyroid, rheum, coag, LFT, body fluids (14 decks)

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