Week 4 Thyroid Lecture Flashcards
Closely linked with neurologic and immune systems
Endocrine System
Affects most cells, organs, and body functions called
Negative Feedback Mechanism
Peptide
Protein act on cell surface
Steroid
Act inside the cell
Fatty Acid Derivative
Types of hormones
Anterior Pituitary
FSH, LH, Prolactin, ACTH, TSH, GH
Hyper =
Cushings, gigantism, acromegaly
Hypo=
Dwarfism
Posterior Pituitary
ADH, Vasopressin, Oxytocin
Hyper Posterior
SIADH
Hypo Posterior =
DI
Surgery
Hypophysectomy
Tumors are 95% benign
T3 is …. form
Active Form
T4 is …. form
Inactive form
Elevated calcium levels cause release of
Calcitonin and increases osteoblast activity
Calcitonin opposes PTH
Thyroid Hormones
T3,T4, and calcitonin
TSH from the controls the release of thyroid hormone
Anterior Pituitary Gland
T3 is more what compared to T4
More potent
Thyroid Diagnostic Tests
TSH
Serum free T4
T3 and T4
T4 Resin Uptake
Thyroid Antibodies
Radioactive Iodine Uptake
FIne Needle Biopsy
Thyroid Scan, radioscan, scintiscan
Serum thyroglobulin
Thyroid Scintigraphy
Nuclear medicine procedure that displays visible thyroid tissue
Determines location, size and shape and function of thyroid
Severely stunted physical and mental growth owing to untreated congenital deficiency of thyroid
Cretinism
Thyroiditis
Infection/ inflammation of thyroid
Goiter
Abnormally large thyroid- lack of iodine or related to hyperthyroidism
Hashimotos Disease
Chronic Lymphocytic thyroiditis
Autoimmune Disease
Myxedema
Severe hypothyroidism
Used to describe a dermatological change that can occur in hypothyroidism.
Hypothyroidism
Hair Loss
Apathy
Lethargy
Dry Skin
Aches
Constipation
Intolerance to cold
Brittle Hair and nails
Late Clinical Manifestations
Subnormal Temp
Bradycardia
Weight Gain
LOC
Thickened Skin
Cardiac Complications
Myxedema
Lateral eyebrows thin
Periorbital Edema
Puffy dull face with dry skin
Medical Management oh Hypothyroidism
Synthetic Levothyroxine (Synthroid) replacement therapy
Levothyroxine- Synthetic for T4 which is converted to T3
Dose is 12.5 to 125 mcg one or more per day depending on pt weight
Side Effects
Tachycardia
Weight Loss
Trouble tolerating
Sweating
Anxiety
Trouble Sleeping
Medications that should not be taken with levothyroxine
Amiodarone
Antacids
Anticonvulsants
Beta Blockers
Birth Control Pills
Support cardiac Function
Due to alteration in myocyte gene expression. Hypothyroidism.
Hyperthyroidism
Too much T3 and T4
Common cause of this is Graves Disease
Affect women’s 8x more than men
Nervousness: rapid pulse, heat intolerance, tremors, skin flushed, warm, and soft, and moist, exophthalmos, increased appetite, weight loss, elevated Systolic Bp, Cardiac Dysrhythmias
Hyperthyroidism
Intolerance to Heat
Bulging Eyes
Facial Flushing
Enlarged Thyroid
Tachycardia
Weight Loss
Muscle Wasting
Tremors
Finger Clubbing
Propylthiouracil
Thyroperoxidase inhibitor
(Antithyroid)
Methimazole- Thyroperooxidase inhibitor
Long term Steroid Effects
Increased Sugar
Weight Gain
Risk for Infection
Treatment choice for thyroid cancer
Thyroidectomy
Preoperative Goals
Reduction of stress and anxiety and prevent thyroid storm
Pre Operative Education for Thyroidectomy
Dietary Guidance to meet patient metabolic needs, avoidance of caffeinated beverages and other stimulants, explanation of tests and procedures, and head and neck support after surgery
Post Operative Care Thyroidectomy
Monitor respirations, potential airway impairment
Monitor bleeding and hematoma
Assess Pain
Semi Fowlers Position, support head and neck
Assess Voice, discourage talking
Potential hypocalecemia
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