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vanessa endocrine ppnp > thyroid pathophysiology > Flashcards

thyroid pathophysiology Flashcards

1
Q

what is the clinical diagnosis of child with too much growth hormone?

A

gigantism (before fusion of the bone)

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2
Q

what is the clinical diagnosis of adult with too much growth hormone?

A

acromegaly (after fusion of the bone )

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3
Q

what is the clinical diagnosis of a child with too little growth hormone?

A

dwarfism

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4
Q

what is the clinical diagnosis of adult with too little growth hormone?

A
  1. loss of muscle strength
  2. sometimes affect cognitive and affective changes
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5
Q

how does thyroid hormone form in the body?

A
  1. hypothalamus produces TRH
  2. stimulates the pituitary gland to produce TSH
  3. stimulates thyroid gland to combine iodine and tyrosine to produce T3 and 4
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6
Q

what is the function of thyroid hormone?

A
  1. controls the body’s metabolism
  2. proper development of differentiated cells
  3. heat generation
  4. regulate, long bone growth, mental development , sexual maturity,
  5. regulate protein fat and carbohydrate metabolism
  6. regulate glucose oxidation to provide energy
  7. regulate blood pressure and increase body sensitivity to catecholamines
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7
Q

what is the clinical diagnosis if baby have too little thyroid hormone?

A

cretinism

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8
Q

what is the clinical diagnosis when adults have too little thyroid hormone ?

A

myxedema

endemic goiter if lack of iodine

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9
Q

what are the symptom of hypothyrodism?

A
  1. intolerance to cold
  2. weight gain with poor appetite
  3. edema
  4. fatigue, general weakness
  5. dry skin
  6. slow pulse rate
  7. constipation
  8. poor memory and concentration
  9. pleural effusion (fluid in the lungs)
  10. decreased sense of smell and taste
  11. hair loss
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10
Q

what is the clinical diagnosis of patient with hyperthyroidism?

A

graves disease (auto immune disease where body produces antibodies that activate the TH secreting cells)

thyroid storm

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11
Q

what are the symptoms of hyperthyroidism?

A
  1. heat intolerance
  2. increase in appetite but weight loss
  3. goiter
  4. nervousness
  5. budging eyes
  6. finger clubbing
  7. facial flushing
  8. frequent bowel movements
  9. insomnia
  10. fine tremor
  11. tachycardia and palpitations
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12
Q

what are the causes of hypothyroidism?

A

Primary hypothyroidism

  1. iodine deficiency in diet (cause goiter)
  2. thyroidectomy (removal of gland)
  3. chronic autoimmune thyroiditis (hashimoto)
  4. exposure to radioactive radiation
  5. use of radioactive iodine
  6. disorder in pituitary gland or hypothalamus
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13
Q

what is primary hypothyroidism?

A

when the thyroid gland is the reason

  • hashimoto thyroditis
  • removal of thyroid gland
  • radiation therapy
  • iodine therapy
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14
Q

what are the reasons for acquired hypothyroidism?

A

primary

  • thyroidectomy (removal of thyroid gland)
  • hashimoto
  • radiation therapy
  • iodine deficiency

secondary

  • disorder in pituitary gland or hypothalamus
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15
Q

what is hashimoto disease?

A

when your immune system produces antibodies against your own thyroid tissue

therefore your body does not produce enough thyroid hormones and overtime thyroid may enlarge, painless goiter, will shrink many years later

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16
Q

who is hashimoto disease more relevant in?

A

female 30-40 due to hormonal changes that produces antibody and attack the thyroid

especially pregnant women

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17
Q

what is the myxedema?

A

severe hypothyroidism where it might cause coma if severe

Primary signs and symptoms of myxedema coma are altered mental status and low body temperature, hypoglycemia, low blood pressure, edema of face, legs and tongue, waxy consistency of skin, weight loss

18
Q

what will result when there is not enough iodine which causes hypothyroidism?

A

endemic goiter will be present due to the lack of iodine to produce T3 and T4

therefore the thyroid gland will try to produce more thyroid therefore it will be swollen

19
Q

how to test for endemic goiter?

A

ask patient to swallow and feel the presence of nodules

20
Q

what is the treatment for endemic goiter?

A
  1. get enough iodine (150mg per day is the requirement)
  2. use iodized salt or eat seafood or seaweed
21
Q

what is the result of children with hypothyroidism?

A

cretinism

22
Q

what are the symptoms of cretinism?

A
  • prolonged jaundice
  • poor feeding
  • constipation
  • sleepiness
  • decreased crying
  • dry rough skin
  • protuberant tongue and abdomen , hernia
  • mental retardation
23
Q

what is the diagnostic test for hypothyroidism?

A
  1. lab investigation
  2. radiological investigations
  3. biopsy of gland
  4. radioiodine uptake study
24
Q

what are the lab investigation results to diagnose hypothyroidism?

A

Primary hypothyroidism (low t4 and high TSH)

Secondary hypothyroidism (low T4 and low TSH)

For autoimmune : check serum antithyroid antibodies

25
Q

what are the radiological investigations that can be done to test for hypothyrodism?

A
  1. ultrasound of gland
  2. skull xray
  3. ct scan of thyroid gland
  4. MRI of thyroid gland
26
Q

what are the treatment for hypothyroidism

A

compensate for lack of hormone

provide iodine

27
Q

what are the causes of primary hyperthyroidism?

A
  1. auto immune (graves disease)
  2. toxic multinodular goiter
  3. toxic thyroid adenoma
28
Q

what is graves disease?

A

autoimmune disorder by thyroid stimulating antibodies where it binds to thyroid to produce hormones and produce excess T3 and T4

29
Q

what is toxic multinodular goiter ?

A

when one or more nodules in the thyroid gland make thyroid hormones without responding to the signal to keep thyroid hormone balanced

many swollen parts of the thyroid gland

30
Q

what is toxic thyroid adenoma ?

A

increased hormone production coming from a single nodule in the gland

one single swollen part of the thyroid gland

31
Q

what is the secondary cause of hyperthyroidism?

A

hypersecretion of TSH

32
Q

what is thyroid storm?

A

it is the hypermetabolic state induced by excessive release of thyroid hormones

it is acute and life threatening if left untreated, treatment is critical

33
Q

what are the symptoms of hyperthyroidism?

A
  1. increased heart rate (tachycardia)
  2. increased BP (hypertension)
  3. increase body temperature
  4. neurological
  5. GI abnormalities
  6. may lead to congestive heart failure
34
Q

what are the diagnostic test for hyperthyroidism?

A
  1. lab test
  2. thyroid 123 scan
35
Q

what are the lab results that diagnose hyperthyroidism?

A

primary hyperthyroidism: high T4 and low tsh level

secondary hyperthyroidism: high T4 and high tsh and TRH level

autoimmune : check thyroid stimulating anti bodies

36
Q

what is the treatment for hyperthyrodism?

A
  1. drug therapy (PTU and meth)
  2. radioactive iodine therapy
  3. surgery to remove thyroid
37
Q

the body produces more T4 or T3?

A

more T4, however T3 is more potent so T4 is converted to T3

38
Q

Which hormone is released by the hypothalamus and controls thyroid hormone secretion?

A

Thyrotropin-Releasing Hormone (TRH)

39
Q

Which hormone is released by the pituitary gland and controls thyroid hormone secretion?

A

Thyroid Stimulating Hormone (TSH)

40
Q

How are TRH and TSH secretions controlled?

A

Negative feedback by T4 and T3

vanessa endocrine ppnp (8 decks)

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