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45 Cards in this Set
- Front
- Back
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What are the 3 cardinal disease states that occur with the thyroid?
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overproduction
underproduction abnormal growth which includes thyroid cancer |
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Which disease is characterized by an excessive amounts of circulating throid hormone?
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hyperthyroidism
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What are common symptoms of hyperthyroidism that pt's c/o?
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nervousness
diaphoresis heat intolerance palpitations fatigue wt. loss tachycardia dyspnea |
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What are the most common signs of hyperthyroidism, that you often find?
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tachycardia
goiter skin changes bruit over thyroid exopthalmos |
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Grave's disease, toxic multinodular goiter, and thyroiditis are all types of ?
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hyperthyroidism
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Thyroid storm is a rare life threatening complication of __?
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hyperthyroidism
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What events may precipitate a thyroid storm?
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infections
surgery trauma |
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What are the presenting symptoms of thyroid storm?
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fever
restlessness confusion and occasionally frank psychosis |
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What is the tx for a thyroid storm?
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Beta blockers
glucocorticoids P.O. or NGT PTU Iodide is given to block thyroid hormone synthesis and peripheral T4 to T3 conversion |
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__ is the most common cause of hyperthyroidism and accounts for 60-90% of all cases of hyperthyroidism?
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graves' disease
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What is the pathogenesis of toxic multinodular goiter?
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really kinda unknown, but...
men=women usually >40 y.o. usually benign adenomas do not inc. risk of CA |
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Does toxic multinodular goiter usually occur acutely or chronically?
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chronically over months to years
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What will a radionuclide scan show of toxic multinodular goiter?
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increased uptake or "hot" nodules
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What is the treatment of choice for toxic multinodular goiter?
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Iodine 131
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__ is a group of disorders that damage the thyroid, usually by inflammation.
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thyroiditis
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What is the natural course of thyroiditis?
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hyperthyroidism to
hypothyroidism to euthyroid state |
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__ thyroiditis is thought to be a viral or postviral syndrome that causes inflammation and damages they thyroid.
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subacute
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What characterizes subacute thyroiditis?
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acute onset severe pain in the anterior neck
fatigue fever malaise |
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Subacute thyroiditis is usually preceded by..?
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viral or postviral syndrome that causes inflammation and damages the thyroid
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What do lab results show in a subacute thyroiditis?
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low TSH
high T4 elevated ESR |
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In subacute thyroiditis, is the neck painful or not?
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diffusely enlarged and tender
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What will the radionuclide uptake scanning show in subacute thyroiditis?
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greatly reduced uptake, as a result of thyroid damage
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What is the tx of a mild case of subacute thyroiditis?
More severe cases are tx'd with what? |
mild-ASA or NSAID's, and B-blockers
severe-NSAID's, glucocorticoids |
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T/F
Anti-thyroid drugs are NOT used in the tx of subacute thyroiditis. |
True; they are not as the pathology of thyroiditis is not overproduction of thyroid, but release of preformed thyroid hormone.
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What is the tx of painless thyroiditis?
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supportive...
beta blockers |
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Chronic autoimmune thyroiditis is also called?
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hashimoto's thyroiditis
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What is the most common form of hypothyroidism?
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hashimoto's thyroiditis
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What is the most common cause of goiter in women?
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hashimoto's thyroiditis
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What is hashimoto's caused by?
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an autoimmune process directed against the thyroid gland
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With hashimoto's, is the thyroid tender or not?
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not tender-but with goiter
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What are the clinical manifestations of hypothyroidism?
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weakness
cold intolerance fatigue dry/coarse skin lethargy myxedema-facial |
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__ is the result of a lack of circulating thyroid hormone.
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hypothyroidism
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Does hypothyroidism affect men or women more?
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women
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Which form of hypothyroidism is caused by failure of the thyroid to make adequate amounts of thyroid.
primary hypothyroidism secondary hypothyroidism |
primary hypothyroidism
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Which form of hypothyroidism is a result of the pituitary not producing enough TSH to stimulate adequate hormone production.
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secondary hypothyroidism
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__ is the most common cuae of hypothyroidism in adults and most common cause of goiter in women.
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hashimoto's thyroiditis
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More than 90% of pt's with hashimoto's dx have high serum concentrations of __ antibodies.
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antithyroglobulin antibodies
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What is the treatment of hashimoto's hypothyroidism?
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L-thyroxine replacement
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What is the most frequent complaint in hypothyroidism?
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fatigue
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Physical exam findings that occur commonly in hypothyroidism are all except..
-fatigue -myxedema -dec. DTR's -inc. DTR's |
no increase in DTR's, only decreased
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Thyroid nodules of the neck that are associated with inc. risk of malignancy are characterized as:
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<20 or >60 y.o.
men>women compression sx's (dysphagia, hoarseness) hx of neck irradiation family hx of medullary cancer |
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Physical exam of a thyroid nodule will show what?
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solid nodule that appears "cold" on nucleouptake scan (5-10%) cancerous
rapid growth or nodule fixation lymphadenopathy |
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What will lab findings of a thyroid nodule show you?
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euthyroid state
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A suppressed TSH indicates a nodule with __ function.
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autonomous function-these are rarely cancerous, so a suppressed TSH should lead you to further investigate hyperthyroidism
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What is the way to ultimately diagnose a thyroid nodule?
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FNA of the nodule.
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