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23 Cards in this Set
- Front
- Back
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Hashimoto's Thyroiditis & lab values
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Antibodies to thyroid tissue, resulting in decreased hormone production
Primary hypothyroidism Decreased T3/T4 Increased TRH Increased TSH |
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Secondary hypothyroidism
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Diminished stimulation of thyroid by TSH because of pituitary failure
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Tertiary hypothyroidism
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Diminished stimulation of thyroid because of hypothalamus failure
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Levothyroxine
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Synthetic thyroid hormone
T4 |
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Levothyroxine clinical use
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Hypothyroidism
TSH suppressed therapy in patients with thyroid cancer Non-toxic goiter |
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When might you want to use T3?
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In an urgent situation -> Myxedema coma
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Typical characteristics of hypothyroidism
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Fatigue
Constipation Cold intolerance Weight GAIN Edema Goiter |
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Typical characteristics of hyperthyroidism
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Weight loss
Energetic Increased HR & BP Exopthalamos Tremor Goiter |
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Methimazole
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Thioamide
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Propylthiouracil
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Thioamide
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What enzyme catalyzes the reaction between iodide and the coupling reaction between MIT & DIT to form T3/T4?
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Thyroid Peroxidase
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What enzyme is involved in the conversion of T4 to T3 in peripheral tissue?
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Thyroid Hormone Deiodinase
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Methimazole MOA
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Inhibits thyroid peroxidase -> blocks iodine organifcation (production of DIT/MIT) & iodotyrosine coupling (T3/T4 production)
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Propylthiouracil MOA
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Also partially inhibits the peripheral conversion of T4 to T3
Inhibits thyroid peroxidase -> blocks iodine organifcation (production of DIT/MIT) & iodotyrosine coupling (T3/T4 production) |
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Thioamide clinical use
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Control hyperthyroidism while waiting for remission of Grave's disease
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Which thioamide is used for thyroid storm?
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Methimazole
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Thioamide adverse effects
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Maculopapular pruitic rash
Arthralgias Fever AGRANULOCYTOSIS & HEPATOX |
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Thioamide contraindications
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Pregnancy
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What is the difference in using high levels of iodide salts vs radioactive iodide to treat hyperthyroidism?
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Salts -> Fast & Reversible
Radiation -> Permanent |
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Iodide salts clinical use
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Thyroid storm -> Rapid improvement within 2-7 days
Preoperative -> Decrease vascularity & size of thyroid |
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Should iodide salts be used before or after radioactive iodine?
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After
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Radioactive iodide clinical use
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Destroy some thyroid tissue
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What is the biggest side effect of radioactive iodide?
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Hypothyroidism
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