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37 Cards in this Set
- Front
- Back
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what is the difference between anti-Tg, anti TPO and anti TSH
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the antithyroglobulin and antithyroid peroxidase destroy the thyroid (spew the thyroid open and pt need hormone replacement the rest of their life), anti TSH increase the production of hormones (aka thyroid stimulating immunoglobulins)
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if you lack TSH, what is the problem
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hypermetabolism (indicates: hyperthyroidism)
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too much TSH causes
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hypometabolism (indicateds hypothyroidism)
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what is cretinism
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problems with developing brain because of congenital hypOthyroidsm
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why do we measure the level of iodine in new borns
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to prevent the adverse effects of iodine deficiency (cretinism)
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what is the major PREVENTABLE cause of mental retardation
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screen for iodine deficiency in newborns
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what should you screen for in women over age 50
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hypo and hyperthyroidism
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what is the best test for diagnosing thyroid dysfunction
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serum TSH measurements
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a new patients gets a blood work for completeness of their history, you are suprised to find an elevated TSH and low T3 and T4, what is on your differential diagnosis
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primary hypOthyroidism
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becareful... increase in TSH = hypofunction of thyroid, but increase in T3 or T4 indicates.....
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hypERfunction
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cause of tertiary hypothyroidism
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means something is wrong at the HYPOTHALAMUS
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cause of secondary hypothyroidism
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means something is wrong at the pituitary gland
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if iodine is not deficient, what is the most common cause of hypothyroidism
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Hashimoto's disease (anti-TPO and anti-Tg)
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what is the most common cause of hyperthyroidism
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grave's disease
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what is the most common imaging study for patients with thyroid dysfunction suspected
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ultrasound
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Fatigue
Weakness Feels cold Constipation Weight gain Mental slowness Poor appetite Hoarse voice Hair loss Menstrual irregularities |
hypOthyroidism
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signs of: Dry skin
Bradycardia Puffy face, hands, feet Pretibial edema Delayed deep tendon reflex Coarse ,brittle hair Carpal tunnel syndrome Nonpitting edema Myxedema |
hypOthyroidism
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at patient comes into the ER with:
Severe hypothyroidism Life-threatening Hypothermia, bradycardia ,hypotension, altered mental status and multisystem organ failure. |
myxedema coma
Tx-Administer IV thyroxine (T4) 200 to 400 µg followed by daily doses of 50 to 100 µg, and IV triiodothyronine( T3) 5 to 20 µg intravenously followed by 2.5 to 10 µg every 8 hours. |
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treatment of hypothyroidism:
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supplement thyroid hormone (levothyroxine) and recheck TSH 6 weeks later, then annual follow up (note: does depends on age and health condition)
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symptoms:
Nervousness Fatigue Weakness Palpitations Heat intolerance Excessive sweating Dyspnea Diarrhea Insomnia Poor concentration Oligomennorrhea |
hyperthyroidism
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signs:
Weight loss Hair loss Tachycardia Atrial fibrillation Proximal myopathy Warm, moist skin Stare, lid lag Exophthalmos Goiters Fine tremor |
hyperthyroidism
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in elderly patients that have atrial fibrillations, what tests should you get
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TSH levels and EKG and heart tests.... hyperthyroidism may only show up as afib in elderly... called apathetic hyperthyroidism
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life-threatening Thyrotoxicosis
Tachycardia @ 140 beats/min, congestive heart failure Hyperpyrexia to 104 to 106ºF Agitation, delirium, psychosis, stupor, or coma are common. |
thyroid storm
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what are the two life threatening conditions that thyroid dysfunction can cause
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thyroid storm (hyperthyroidism) and myxedema coma (hypothyroidism)
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how do you tx thyroid storm
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beta blocker (to control HR), Iodinated radioconstrast agent and glucocorticoids (blocks T4, T3), iodine solution (blocks hormone release), diuresis, antipyretic, digoxin
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what is the most common malignant thyroid nodule
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papillary
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prognosis of a solid nodule or mixed (solid/cystic)
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malignant (more likely)
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cystic nodule status
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benign (mostly)
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warm nodule status
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more likely benign
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cold nodule status
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5% malignant
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what factor increase the malignant risk of thyroid nodules
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age, all become more aggressive in elderly (papillary, follicular, medullary, anaplastic)
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Risk Factors
FHx of thyroid/autoimmune disease Down’s /Turners’ syndromes Hx of head/neck irradiation Postpartum Lithium, Amiodarone, thioamides |
hypothyroidism
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african americans have more prevelance with
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hypothyroidism
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asian have more prevalance for .....
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hyperthyroidism
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smokers and people with Fhx of thyroid disease are at risk for
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hyperthyroidism
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young women are more likely to have
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grave's disease
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older women are more likely to have
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TMG (toxic multinodular goiter)
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