Thyroid Lecture Flashcards

1
Q

Thyroid gland location

A

Small saddle-shaped gland that wraps around the anterior portion of the trachea

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2
Q

Thyroid hormone regulates:

A
Metabolic rate
heart function
digestive function
muscle control
brain development
bone maintenance
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3
Q

Used to produce hormones:

A

iodine

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4
Q

Serum TA Normal Value

A

Negative to 1:20

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5
Q

Serum TSH (sensitive assay) Normal value

A

0.35-5.5mU/mL

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6
Q

Serum T4 Normal Values

A

4.5-11.5 mcg/dL

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7
Q

Serum T3 Normal Values

A

80-200 ng/dL

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8
Q

T3 uptake Normal Values

A

25-35 relative percentage

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9
Q

Thyroid Suppression Findings in Hyperthyroidism

A

^ RAI uptake and T4 levels

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10
Q

Serum TA Test Findings in Hyperthyroidism

A

Increased

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11
Q

Serum TSH (sensitive assay) Findings in Hyperthyroidism

A

Decreased in primary hyperthyroidism

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12
Q

Serum T4 Findings in Hyperthyroidism

A

Increased

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13
Q

Serum T3 Findings in Hyperthyroidism

A

Increased

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14
Q

T3 Uptake findings in hyperthyroidism

A

Increased

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15
Q

Sympathetic Nervous System

A

fight or flight

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16
Q

Hyperthyroidism ________metabolic rate.

A

Increases

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17
Q

Hyperthyroidism is caused by an excessive delivery of_____.

A

thyroid hormone

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18
Q

Hyperthyroid_______SNS.

A

Increases

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19
Q

Hyperthyroidism Risk Factors

A
Women 10x
Genetic Factors
Family History of Graves
^ Iodine intake
20-40 age
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20
Q

Hyperthyroidism S/S

A
  • ^ appetite w/ weight loss
  • hypermotile bowels
  • heat intolerance
  • insomnia
  • palpitations
  • ^ sweating
  • hair changes
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21
Q

Most common cause of hyperthyroidism

A

Graves Disease

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22
Q

Graves disease is an ______.

A

autoimmune disorder

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23
Q

Autoimmune disorder:

A

antibody in serum binds to TSH receptors in thyroid follicles causing hyperfunction

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24
Q

Goiter:

A

Enlarged thyroid gland in the neck

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25
Q

Graves disease S/S:

A
Exophthalmos
eye pain
blurred vision
diplopia
lacrimation 
photophobia
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26
Q

Graves Disease ^ risk of:

A

corneal dryness
irritation
infection
ulceration

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27
Q

Another most common hyperthyroidism

A

Toxic Multinodular Goiter

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28
Q

TMG develops:

A

slowly, usually in women in 60s and 70s

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29
Q

TMG:

A

small, independently functioning nodules

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30
Q

TMG does not have signs of:

A

opthalmopathy, dermopathy

31
Q

Subacute granulomatous thyroiditis

A

viral infection

32
Q

acute thyroiditis

A

bacterial or fungal infection

33
Q

What is thyroiditis?

A

acute disorder that may become chronic, resulting in a hypothyroid state as the repeated infections destroy the thyroid gland tissue

34
Q

T3 and T4 levels in thyroiditis:

A

initially elevated but over time become depressed

35
Q

Thyroiditis delivery:

A

weeks or months

36
Q

Bacterial thyroiditis treatment:

A

antibiotics or surgical drainage

37
Q

Thyroiditis Meds:

A

NSAIDS progressing to corticosteroids if needed

38
Q

Thyroiditis meds r/t cardiovascular S/S:

A

Propanolol or Atenolol

39
Q

Thyroid Storm:

A

Thyrotoxic Crisis

•extreme state of hyperthyroidism

40
Q

Thyroid Storm is considered:

A

a life threatening emergency, death rare when treatment started earlier

41
Q

Thyroid storm manifestations:

A

Sever tachy, hf, shock, hyperthermia (105.3), restlessness, agitation, seizures, abd pain, N/V/D, delirium, coma

42
Q

Thyroid storm treatment:

A

decrease circulating thyroid hormone levels with drug therapy

43
Q

Thyroid storm supportive therapy:

A

managing resp distress
fever reduction
fluids
elimination/management of stressors

44
Q

Excess TSH Stimulateion is a ______ form of hyperthyroidism.

A

Secondary and it is rare

45
Q

Excess TSH Stimulation caused by:

A

overproduction of TSH by the pituitary gland and usually stimulates the thyroid gland to produce excess of thyroid hormone

46
Q

Antithyroid drugs:

A

Pylthioruacil

Methimazole

47
Q

Hyperthyroidism drugs:

A

iodine SSKI

Beta Blockers

48
Q

Thyroid Treatments

A

antithyroid meds
RAI therapy
Subtotal thyroidectomy

49
Q

Radioactive Iodine Therapy:

A

damages or destroys thyroid tissue

50
Q

RAI Outpatient:

A

given orally

51
Q

RAI Treatment S/E

A

dryness, irritation of mouth and throat during treatment

52
Q

80% of RAI cases experience

A

hypothyroidism in post-treatment

53
Q

Two types of thyroidectomies

A

Subtotal

Total

54
Q

Subtotal Thyroidectomy:

A

leaves about 10% of thyroid gland and the remainder will produce adequate TH

55
Q

Total Thyroidectomy:

A

Total removal of gland, pt will have lifelong hormone replacement.

56
Q

Hyperthyroidism Surgery Post-Op complications

A
  • Hypothyroidism
  • Hemorrhage
  • Damage to Parathyroid gland - hypocalcemia
  • Injury to laryngeal nerve - vocal cord analysis
  • Infection
  • Resp Distress
57
Q

Post-Op Protocols

A

Semi fowlers, suppor head and neck
avoid flexion
watch for tracheal compression

58
Q

Hyperthyroidism Evaluation:

A
cardiac stabilize
regains visual acuity
appropriate calories
feelings body image
med requirements
59
Q

Hypothyroidism TH production:

A

decreases

60
Q

Thyroid gland _______ in attempt to produce more hormone.

A

Enlarges

61
Q

Hypothyroid state leads to:

A

myxedema

62
Q

Hypothyroid Primary Etiology:

A

Defects in gland (congenital), loss of thyroid tissue, antithyroid meds, thyroiditis, endemic iodine deficiency

63
Q

Hypothyroid Secondary Etiology:

A

Pituitary TSH deficiency or peripheral resistance to TH, meds can cause it, common in women 30-60

64
Q

Hypothyroidism: Serum TA Normal Values:

A

None to 1:20

65
Q

Hypothyroidism: Serum TA Findings:

A

Normal

66
Q

Hypothyroidism: Serum TSH Normal Values

A

0.35-5.5 mU.mL

67
Q

Hypothyroidism: Serum TSH Findings

A

Increased in primary hypothyroidism

68
Q

Hypothyroidism: Serum T4 Normal Values

A

4.5-11.5 mcg/dL

69
Q

Hypothyroidism: Serum T4 Findings

A

Decreased

70
Q

Hypothyroidism: Serum T3 Normal Values

A

80-200 ng/dL

71
Q

Hypothyroidism: Serum T3 Findings

A

Decreased

72
Q

Hypothyroidism: Serum T3 uptake Normal Values

A

25-35 relative percentage

73
Q

Hypothyroidism: T3 uptake Findings

A

Decreased

74
Q

Hypothyroidism: Thyroid Depression Findings:

A

No change in RAI uptake of T4 levels