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endo II exam1 > Thyroid part I > Flashcards

Thyroid part I Flashcards

1
Q

decreased levels t3T4 stimulate what

A

release of TRH from hypothalamus and TSH from anterior pituitary

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2
Q

increased T3 T4 levels cause what

A

decreased release of TRH and TSH

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3
Q

42 y.o increased sweating, pounding heart and weight loss

phyiscal exam reveals slightly enlarged nontender thyroid with no nodules

A

enlarged thyroid

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4
Q

signs of hyperthyroidism

A

wide eyed, staring gaze from overactivity SAN

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5
Q

What is Graves

A

hyperthyroidism with protruding eyeballs

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6
Q

what are the studies used in thyroid function testing

A

serum TSH and T4
US and radionucleotide uptake studies
serum Ab

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7
Q

if TSH is low and T4 high what is it

A

hyperthyroidism

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8
Q

if TSH is high and low T4

A

hypothyroidism

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9
Q

what will an US of thyroid tell you

A

cystic or solid

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10
Q

what will a toxic multinodular goiter look like on radionucleotide scan

A

lumpy bumpy in all different areas

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11
Q

what will graves look like on radionucleotide scan

A

increased uptake on both lobes of thyroid

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12
Q

what will a toxic adenoma look like on radionucleotide scan

A

one mass with increased density

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13
Q

what is thyrotoxicosis

A

hypermetabolic state caused by increased levels of free T3 and T4

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14
Q

what are the 3 most common casues of thyrotoxicosis

A 
diffuse hyperplasia (Graves)
hyperfuncitonal multinodular goiter
hyperfunctional thyroid adenoma
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15
Q

what branch of SAN is turned up in hyperthyroidism

A

beta adrenergics

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16
Q

describe signs hyperthyroidsm

A

increased in basal metabolic rate, skin is warm and flushed from inc blood floww (vasodilation) heat intolerance, increased sweating, weigh loss despite increased appetite

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17
Q

what are the cardiac manifestations of hyperthyroidism

A

tachy, palpitations, cardiomegaly
arrhythmias, atrial fibrillation
some have L ventricular dysfuntion and low output HF “thyrotoxic cardiomyopathy”

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18
Q

what are signs from overactivity of SAN in hyperthyroidism

A

tremor, hyperreactivity, emotional lability, anxiety, inability to concentrate and insomnia

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19
Q

what GI Sx can you have if hyperthyroid

A

hypermotlity, diarrhea, malabsorption

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20
Q

what are the ocular changes contributed to hyperthyroidism

A

wide, staring gaze an lid lag

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21
Q

what can hyperthyroidism lead to in skel system

A

osteoporosis from increased resoprtion

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22
Q

what is the thyroid storm

A

short onset of severe hyperthyroidism

usually in Graves from acute elevation catecholamine levels

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23
Q

signs of thyroid storm

A

febrile, tachycardia

medical EM because can lead to cardiac arrhythmia

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24
Q

seondary causes of hyperthyroidism

A

TSH secreting pituitary adenoma

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25
Q

most common cause endogenous hyperthyroidism

A

Graves

26
Q

pretibial myxeema

A

graves disease

27
Q

what causes Graves

A

autoimmune disorder from autoAb against multiple thyroid proteins (TSH R)

28
Q

what is most common Graves Ab subtype

A

TSImmunoglobulin which acts like TSH

29
Q

what cells undergo the hyperplasia in hyperthyroid

A

the thyroid follicular epithelial cells

30
Q

pale follicular lumen with scalloped margins and colloid

A

graves

31
Q

audible bruit on thyroid

A

graves

32
Q

what causes the exopthalmus in graves? complicaiton?

A

fat and inflammation taht push eye forward

can’t close lides- corneal abrasion

33
Q

what is the pretibial myxedema seen in graves

A

scaly thickening and induration of skin on shins

34
Q

patients with graves are at higher risk for what

A

SLE, pernicious anemia, type I DM, and addisons

35
Q

lab findings in graves

A

increased free T3 T4 adn depressed TSH

36
Q

Tx graves

A

beta blockers and thionamides, radioiodine ablation adn thyroidectomy

37
Q

when is surgery used in graves

A

large goiters that are compressing surrounding structures

38
Q

42 y.o weight gain, constipation and feeling cold

enlarged thyroid

A

hypothyroid

39
Q

Lab testing for hashimoto hypothyroidism

A

TPO autoAb, TPO specific T cells, cytokines that lead to thyrocyte damage and thus decrease T4T3 even though increase TSH

40
Q

when do you not do thyroid function testing

A

hospitalized paitent because sick sinus syndrome- will have abnormal values
pregnant women- abnormal thyroid function

41
Q

what are primary causes of hypothyroidism

A 
genetic defects
thyriod hormone resistance syndrome
postablative
autoimmune
iodine deficiency
drugs
congenital biosynthestic defect
42
Q

what are the secondary causes of hypothyroidism

A

pituitary failure, hypothalamic failure

43
Q

what is the ww cause of congenital hypothyroidism

A

endemic iodine deficiency in diet

44
Q

what is the msot common cause of hypothyroidism in the iodine sufficient areas in world

A

autoimmune

45
Q

what is cretinism

A

hypothyroidism that develops in infancy or early childhood

46
Q

clinical features of cretinism

A

impaired development of the skeletal system and central nervous system:
mental retardation, short stature, coarse facial features, protruding tongue and umbilical hernia

47
Q

severity of mental impairment in cretinism

A

related to time at which thyriod deficiency occurs in utero

48
Q

when is a deficiecny in maternal thyroid hormone not at risk to baby in pregnancy

A

once fetal thyroid has become functional

49
Q

myxedema

A

slowing of physical and mental activity
generalized fatigue, apathy, mental sluggishness (mimic depression)
speech and intellectual function slowed
listless, cold intolerant, overweight

50
Q

skin of hypothyroid patients

A

cool and pale

51
Q

wy is SOB a complain in hypothyroid

A

reduced CO

52
Q

why is there an increased CV mortality rate in patients with hypothyroidism

A

promotes increase in total cholesterol and LDL levels

53
Q

what causes nonpitting edema, coarsening facial features, enlargement of tongu and deepening of voice in hypothyroidism

A

accumulateion of gags and hyaluronic acid in skin, subq and viscera

54
Q

what can cause painful thyroid

A

infecitous thyroiditis, subacute granulomatous thyroiditis

55
Q

what are the non painful types of thyroiditis

A

subacute lymphcytic thyroiditis and fibrious thyroiditis

56
Q

what are the 3 most common types thyroiditis

A

hashimoto
granulomatou thyroiditis
subacute lymphocytic thyroiditis

57
Q

what will fine needle aspiration of hashimoto thyroid look like

A

lots of lymphocytes

58
Q

Hurthle cells

A

thyroid follicles in hashimoto

59
Q

what is hashitoxicosis

A

disruption of thyroid follicles, transient thyrotoxicosis before full blown hashimoto

60
Q

hashimoto patients increase risk for

A

DM I, autoimmune adrenalitis, SLE, myasthenia gravis and sjogren syndrome

61
Q

what malignancy are hashimoto patients at increased risk for

A

extranodal zone B cell lymphomas

endo II exam1 (14 decks)

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