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thyroid/parathyroid Flashcards

1
Q

what is the function hormone of the thyroid?

A

TH

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2
Q

what controls TH

A

TSH

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3
Q

T3 is ____ times more potent than T4

A

five

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4
Q

what are some things that thyroid hormone does?

A

-increase BMR
-increase growth
-stimulate protein synthesis
-INSULIN ANTAGONIST

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5
Q

what is secreted in response to high calcium levels

A

calcitonin

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6
Q

what increses calcium deposition in bone

A

calcitonin

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7
Q

enlargement of thyroid gland

A

goiter

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8
Q

what is primary hypothyroidism called?

A

Hashimoto’s

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9
Q

what classifies primary hypothyroidism

A

no TSH responding

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10
Q

what is hyperthyroidism called?

A

grave’s disease

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11
Q

what happens when antibodies want to sit on receptors and make lots of hormones

A

hyperthyroidism (graves)

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12
Q

what is an extreme complication of hyperthyroidism

A

thyroid storm (thyrotoxicosis)

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13
Q

inspection and palpation involving thyroid glands

A

throat thickening (swallow), breathing, size, symmetrical, tender

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14
Q

which thyroid test is an accurate indicator of thyroid problems

A

T3 resin uptake

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15
Q

what measures rate of idoine

A

radioactive iodine uptake

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16
Q

what does a fine needle aspiration biopsy do?

A

look for cancer

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17
Q

patho of secondary hypothyroid

A

inc. TRH -> dec. TSH = dec. T3 T4

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18
Q

what are some meds that affect thyroid testing

A

-amiodarone
-aspirin
-cimetidine
-estrogens
-furosemide
-glucocorticoids
-heparin
-lithium
-phenytoin

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19
Q

what is deficiency of TH

A

hypothyroidism

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20
Q

characteristics of hypothyroidism

A

-slowed metabolism
-decreased heat production
-decreased oxygen consumption by tissues

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21
Q

what is primary hypothyroidism

A

-autoimmune thyroiditis (hashimoto)
-95% of cases
-involves actual gland

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22
Q

what is secondary hypothyroidism

A

-overtreatment of hyperthyroidism
-thyroidectomy (replace hormones)
-radioactive iodine
-something else causes it, not a gland problem

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23
Q

clinical manifestations / symptoms of hypothyroidism

A

-intolerance to cold
-dry skin
-hair loss
-anorexia
-lethargy
-muscle cramps/wekaness
-apathy
-facial/eyelid edema
-blank expression
-brittle nails and hair

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24
Q

what is a major problem from hypothyroidism

A

myxedema

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25
Q

describe myxedema

A

-elevated cholesterol
-life threatening and rare
-undiagnosed/undertreated
-can be exacerbated

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26
Q

what other complications come from myxedema?

A

-hyponatremia
-hypercalcemia
-hypoglycemia
-water intoxication
-hypoventilation

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27
Q

what are some symptoms of myxedema?

A

depression, diminished cognitive status, lethargy, and somnolence

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28
Q

which symptoms of myxedema are life threatening and require intensive support

A

-hyponatremia
-hypoglycemia
-hypoventilation
-hypotension
-bradycardia
-hyponatremia
-CV collapse
-shock

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29
Q

pharmacologic therapy for hypothyroidism

A

levothyroxine (replacing TH, not TSH)

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30
Q

how do you manage hypothyroidism?

A

administer thyroid hormone

31
Q

what are interventions for myxedema?

A

ventilation, control co2, maintain vs, not too much fluid

32
Q

what do hypothyroidism meds effect and what kind if effects

A

-increase warfarin effectiveness
-CV effects of adrenergic agents

33
Q

what does graves disease (hyperthyroidism) have?

A

toxic, difffuse, goiter

34
Q

three hallmarks of hyperthyroidism (graves)

A

goiter, hyperthyroidism, exopthalmos

35
Q

average age of graves (hyperthyroidism)

A

-

36
Q

hat antibodies are made in graves disease?

A

IgG antibodies

37
Q

what is hyoerthyroidism

A

excess thyroid hormone (grave’s)

38
Q

what are common forms of hyperthyroidism

A

-toxic multinodular goiter
-toxic adenoma
-thyroiditis
-grave’s

39
Q

clinical manifestations (signs) of hyperthyroidism

A

-intolerance to heat
-oily skin
-weight loss
-bulging eyes
-tachycardia
-breast enlargement
-inc. systolic
-tremors
-clubbing

40
Q

complications of hyperthyroidism

A

-exopthalmos
-heart disease
-thyroid storm

41
Q

what are other names for thyroid storm

A

thyroid crisis
thyroid toxicosis

42
Q

what is medical management for hyperthyroidism

A

-anti-thyroid meds
-SSKI (lugols solution)
-radioactive iodine
-thyroidectomy

43
Q

what are antithyroid meds?

A

PTU and methimazole (tapazole)

44
Q

nursing interventions for hyperthyroidism

A

-maintain high calorie high protein
-daily weight
-maintain cardiac output

45
Q

enlargement of the thyroid gland after swallowing/breathing

A

goiter

46
Q

where do goiters come from

A

hypothyroidism or hyperthyroidism

47
Q

are goiters malignant

A

could be either

48
Q

types of goiters

A

-endemic (iodine deficient)
-nodular

49
Q

what are endemic goiters and where do they come from?

A

-iodine deficient
-from hypothyroidism

50
Q

what is a nodular goiter

A

-benign but can turn malignant
-from hyperthyroidism

51
Q

risk factors for thyroid tumors

A

-external radiation
-smoking
-sedentary
-unhealthy eating
-high stress

52
Q

pre-op care fro thyroid cancer

A

CBC, anemia, calcium, thyroid level, what to expect, yankaur

53
Q

post op care for thyroid cancer

A

-inc. HOB for edema, dont move head (sandbags), look for blood behind head, monitor complications

54
Q

what is important to monitor after a thyroidectomy

A

calcium

55
Q

how many parathyroid glands are there?

A

4, up to 12

56
Q

what does PTH do

A

regulate calcium

57
Q

secondary hyperparathyroidism causes _______

A

increased clacium in blood

58
Q

over activity of one or more parathyroid glands

A

hyperparathyroidism

59
Q

excess parathyroid hormone = ______

A

increased serum calcium

60
Q

what can hyperparathyroidism lead to?

A

-inc. calcium (in blood)
-bone decalcification (pulled from bone)
-renal calculi

61
Q

how old are hyperparathyroid patients

A

> 60

62
Q

s/sx hyperparathyroidism

A

-anorexia
-n/v
-constipation
-abd pain, bone pain
-bone cysts
-dysrhythmias
-fatigue

63
Q

what is a complication of hyperparathyroidism?

A

hypercalcemic crisis

64
Q

what levels classify hypercalcemic crisis?

A

> 13 mg/dl

65
Q

what do pts with hyperparathyroidism need

A

rapid rehydration (calcitonin)

66
Q

medical management of hyperparathyroidism

A

-surgical removal (hypoparathyroidism)
-hydration therapy
-mobility
-diet and meds

67
Q

what meds are used in hyperparathyroidism

A

calcium chelators
phosphates
calcitonin

68
Q

nursing care for hyperparathyroidism

A

monitor for stones
VS
strain urine
limit fluids with calcium

69
Q

what are causes of hypoparathyroidism

A

-iatrogenic (treatment-induced)
-idiopathic (unknown)

70
Q

s/sx of hypoparathyroidism

A

n/t
cramps
spasms
seizures
mental changes
muscle contractions
chvostek (facial) and trousseau (wrist/hand)

71
Q

complications of hypoparathyroidism

A

-respiratory obstruction (spasms)
-calcification of eyes/basal ganglia

72
Q

hoe to diagnose hypoparathyroidism

A

EEG, labs (PTH), CT

73
Q

in hypoparathyroidism, focus on correcting…

A

-hypocalcemia (replace magnesium) CALCIUM GLUCONATE!
-vit. D deficiency
-hypomagnesemia

Adults (35 decks)

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