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28 Cards in this Set
- Front
- Back
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1. S/S of hyperthyroidism?
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a. Excessive sweating
b. Cutaneous vasodilation c. Fine resting Tremor d. Enlarged thyroid gland e. Weight loss f. Tachycardia. g. May have irregular heart beat/palpitations h. Progressive nervousness i. Dyspnea on exertion j. Difficulty concentrating |
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2. How is blood pressure affected by hyperthyroidism?
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a. The systolic pressure increases to a greater extent than the diastolic pressure, creating a wide and pulse pressure hypertension
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3. Most common cause of non-iatrogenic hyperthyroidism?
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a. Graves disease
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4. Pathophys of Graves?
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a. IgG Autoantibodies to the TSH receptors on the thyroid gland.
b. Commonly occurs in reproductive-aged females c. Much more common in women than men. |
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5. What percentage of patients with Graves' disease have exophthalmos?
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a. 50%
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6. Tx of Graves disease?
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1. Anti-thyroid drugs: propylthiouracil, methimazole, carbimazole.
2. And/or β-blockers b. To block some of the peripheral effects of excessive thyroxin c. These are only temporary measures. d. The definitive treatment is radioactive iodine, which destroys the thyroid gland o thyroidectomy . |
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7. When is thyroidectomy considered for Graves' disease?
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a. Is often reserved for pregnant patients
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8. Side effect of radioactive iodine?
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a. At least 40% of patients who receive radioactive iodine eventually become hypothyroid and will need thyroid hormone replacement
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9. In whom is radioactive iodine contraindicated?
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a. Pregnant women, as the isotope can cross the placenta and cause fetal thyroid ablation.
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10. Thyroid storm?
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a. In acute hypermetabolic state associated with a sudden release of large amounts of thyroid hormone into the circulation
b. Leads to autonomic stability and CNS dysfunction such as altered mental status, coma, or seizures. c. A significant mortality risk |
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11. Symptoms of thyroid storm?
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a. Fever
b. Confusion c. Restlessness d. Psychotic like behaviour |
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12. Thyroid storm on physical exam may present with?
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a. Tachycardia
b. ↑ BP c. Fever d. Dysrhythmias e. Patients can also have other signs of eye out for such as dyspnea on exertion and peripheral vasoconstriction f. May exhibit signs of cerebral cardiac ischemia. |
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13. 2nd most common cause of hyperthyroidism?
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a. An autonomous thyroid nodule that secretes thyroxin.
b. These nodules do not rely on TSH stimulation is needed secrete large amounts of thyroxin despite low or non-existent circulating TSH levels |
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14. Note: hyperthyroidism can also be caused by the acute release of thyroid hormone in the early stages of thyroiditis
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14. Note: hyperthyroidism can also be caused by the acute release of thyroid hormone in the early stages of thyroiditis
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15. How does Graves' disease appear with thyroid uptake scan (99mTC or 123I)?
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a. Diffuse hyperactivity large amounts of uptake
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16. How does thyroiditis appear with thyroid uptake scan (99mTC or 123I)?
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a. Thyroiditis demonstrates patchy uptake with overall reduced activity of existing hormone rather than the overproduction of thyroxin
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a. Thyroiditis demonstrates patchy uptake with overall reduced activity of existing hormone rather than the overproduction of thyroxin
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a. Detection of serum thyroid receptor antibodies
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18. MOA of PTU, methimazole, and carbimazole?
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a. These drugs work by inhibiting the organification of iodine.
b. Although PTU also prevents peripheral conversion of thyroxin to triiodothyronine, it's more active form |
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19. What is the most serious potential side effects antithyroid drugs?
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a. Agranulocytosis
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20. Which of the antithyroid drugs is preferred in pregnancy?
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a. PTU
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21. In whom are anti-thyroid drugs particularly useful?
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a. In treating adolescents, and Graves' disease may do a few spontaneous remission after 6-18 months of therapy.
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22. Treatment of thyroid storm?
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a. Administration of high doses of PTU and beta blockers to control tachycardia or other peripheral symptoms of thyrotoxicosis
b. Hydrocortisone is given to prevent adrenal crisis! |
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23. S/S of hypothyroidism?
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a. Lethargy
b. Weight gain c. Hair loss d. Dry skin e. Slowed mentation or forgetfulness f. Constipation g. Intolerance to cold h. Depressed affect i. In older patients, hypothyroidism can be used in Alzheimer's disease and other conditions that cause dementia. j. In women it is often confused with depression |
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24. Physical findings with hypothyroidism?
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a. Low blood pressure
b. Bradycardia c. Nonpitting edema d. Hair thinning or loss e. Dry skin f. Diminished relaxation phase of reflexes. |
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25. Most common cause of hypothyroidism in the US of A?
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a. Hashimoto's thyroiditis
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26. Other causes of hypothyroidism?
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atrogenic
b. Secondary hypothyroidism related to hypothalamic or pituitary dysfunction (typically in patients received a cranial irradiation for surgical removal of a pituitary adenoma. |
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27. TSH primary hypothyroidism?
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a. ↑
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28. TSH in secondary hypothyroidism?
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a. Low or undetectable
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