Thyroid (mine Flashcards
Exophthalmos
bulging of the eyes
most common cause Graves (hyper)
TPOAB
thyroid peroxidase antibody
what is the first and primary test done to check thyroid function
TSH
- esp if no history of thyroid illness but have symptoms
- if it is high or low, then consider checking thyroid panel
what condition would you expect in a person with a HIGH thyroid stimulating hormone (TSH)
high TSH indicates that you have low thyroid hormones
TSH is from the pituitary
what condition would you expect in a person with a HIGH thyroid stimulating hormone (TSH)
high TSH indicates that you have low thyroid hormones
TSH is from the pituitary
Conditions:
HYPOthyroidism (congenital=cretinism and primary)
secondary HYPERthyroidism
pituitary adenoma
hashimoto’s thyroditis (autoimmune)
amiodarone/ dopamine antagonist= drugs
ectopic TSH producing tumors
TSH producing pituitary adenoma
what condition would you expect in a person with LOW TSH
primary HYPERthyroidism
secondary HYPOthyroidism
- TSH near zero!!
Tertiary HYPO thyroidism
graves disease (autoimmune)- has no effect on TSH levels
glucocorticoids= drugs
excessive exogenous thyroid hormone
high levels of chronic gonadotropin
how much more active is T3 than T4
4-5 X more active
what are the indications of performing a TSH test
screening for congential hypothyroidism
diagnose hypothyroidism, hyperthyroidism, pituitary or hypothalamic dysfunction
differentiate primary (thyroid) hypothyroidism from secondary (pituitary) and tertiary (hypothalamus) hypothyroidism
what are the indications of performing a TSH test
screening for congential hypothyroidism
diagnose hypothyroidism, hyperthyroidism, pituitary or hypothalamic dysfunction
differentiate primary (thyroid) hypothyroidism from secondary (pituitary) and tertiary (hypothalamus) hypothyroidism
what is TSH also called
thyrotropin
what is the best test for screening of hypothyroid and hyperthyroid
!!!!
TSH
what is the best test for screening of hypothyroid and hyperthyroid
!!!!
TSH
if normal= no other test needed
what is it called when we treat hypothyroidism
levothyroxine treatment
aka the medication
what is it called when we treat hypothyroidism
levothyroxine treatment
aka the medication
what are the indications for Total T4 test
evaluates for hypo and hyper
newborn screening of congenital hypo
monitor therapy response for hypo or hyper
what is the drawback to Total T4 test
con be influenced by elevations or declines in serum proteins giving false assumption of low or high levels
what causes high total T4
excessive intake of iodine
hyperthyroidism (graves)
high doses of levothyroxine meds (for hypo Tx)
familial dysalbuminemic hyperthyroxinemia
hepatitis
what decreases total T4
hypothyroid
pituitary, hypothalamic and iodine insufficiencies
protein def
- nephrotic syndrome
- reduced TBG and albumin = reduced protein bound to T4
what are the indications for getting a free T4 test
evaluate signs of hypo or hyper
monitor Tx response of hypo or hyper
what causes elevations in free T4
primary HYPERthyroidism (graves)
acute thyroiditis (hashimotos) - initial excess T4
fictitious hyperthyroidism
what is fictitious hyperthyroidism
caused by treatment for hypo by too much levothyroxine
what causes decreased T4 levels
primary hypothyroidism
pituitary/hypothalamic/iodine insuf
Total T3
rarely checked
influenced by non thyroid diseases like liver problems
why check Total T3
mainly to assist in diagnosis of hyper
suspected T3 toxicosis (rare)
administering drugs that interfere with conversion of T4 to T3 (amiodarone)
