Thyroid/Parathyroid 2 Flashcards
What types of abnormalities are seen in thyroid dysfunction?
- functional
- anatomic
Functional thyroid abnormalities (of the gland)
- hyperfunction
- hypofunction
Anatomic abnormalities of the thyroid
- thyroiditis
- goiter
- tumor
Any anatomic abnormality may or may not be associated with abnormalities of hormone secretion
Susceptibility to thyroid disease: risk factors
- family hx
- age over 50
- female
Susceptibility to thyroid disease: Why is it more difficult to detect after age 60?
masquerades as other problems such as
- heart disease
- depression
- dementia
Susceptibility to thyroid disease: % incidence in females?
7%
Susceptibility to thyroid disease: Alterations in thyroid can produce changes in these
Virtually everything
- hair
- nails
- skin
- eyes
- GI
- respiratory tract
- cardiovascular
- NM
- MSK
Susceptibility to thyroid disease: prevention and tx
Although cannot prevent thyroid conditions, respond well to tx.
Thyroid cancer prevalence, metastasis
- Relatively rare and slow-growing
- Rarely metastasizes
Thyroid cancer risk factors
- Caucasian females over 40
- Iodine deficiency
- Family history
- Being exposed to radioactive iodine (I-131)
4 most common types of thyroid cancer
- Papillary
- Follicular
- Medullary
- Anaplastic
Most common type of functional hypothyroidism
Graves’ disease
85% of cases
Graves is an autoimmune condition that increases production of
T4
Common s/s of Graves’ disease
- Enlarged thyroid
- Protruding eyes
- Inflammation of ocular muscles
- Tachycardia
- Fatigue
- WL
- Hyperactive reflexes
- Sweating
- Heat intolerance
- Tremor
- Nervousness
- Polydipsia
- Dyspnea
What cardiac problems can occur as a result of Graves’ disease?
- A-fib can be induced, precipitating CHF
- increases risk for MI
- Need to monitor for this!
Action of thyroid gland is (inhibitory/stimulatory)
Stimulatory
A goiter is an enlargement of the thyroid, commonly due to:
- lack of iodine in diet
- inflammation
- tumors
What does a goiter do to normal thyroid function?
- Inhibits normal thyroid hormone production
- Causes hypersecretion of TSH due to lack of negative feedback loop
Goiter: What does hypersecretion of TSH result in?
secretion of huge amounts of thyroglobulin into the gland follicles
goiter prevalence
Almost eradicated in the US due to iodized salt
goiter s/s
- increased neck size
- pressure on trachea and esophagus
- dysphagia
- hoarseness
- difficulty breathing
Thyroiditis =
Inflammation of thyroid gland
thyroiditis: Can be acute, subacute, or chronic. Which types are uncommon and what are they caused by?
- acute and subacute uncommon
- caused by bacterial/viral agents
Most common form of thyroiditis
Hashimoto’s thyroiditis
Hashimoto’s thyroiditis is (acute/chronic) and is related to
- chronic
- related to autoimmune response
Hashimoto’s thyroiditis: seen most commonly in this group
- women
- 30-50 yo
Hashimoto’s thyroiditis: progression
can destroy the thyroid and result in hypothyroidism
Hashimoto’s thyroiditis: sx
highly variable and include:
- dysphagia
- tight sensation while swallowing
- respiratory distress
*over time, sx consistent with those of hypothyroidism!
