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36 Cards in this Set
- Front
- Back
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common causes of thyroid hormone overproduction
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graves disease most common
toxic multinodular goiter follicular adenoma |
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potential thyroid autoantibodies
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thyroidal peroxidase antibody
thyroglobulin TSH receptor antibody |
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common causes of thyroid gland destruction
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lymphocytic thyroiditis
granulomatous thyroiditis hashimotos thyroiditis (hashitoxicosis) |
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thyrotoxicosis medicamentosa
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ingestion of excessive exogenous thyroid hormone
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when can hyperthyroidism have high TSH
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if there is a TSH secreting pituitary adenoma (secondary hyperthyroidism)
or hypothalmic disease with excessive TRH production (tertiary) |
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symptoms and signs of hyperthyroidism
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weakness
fatigue nervous palpitation increased appetite weightloss diarrhea heat intolerance signs: rapid speech fine tremor moist skin fine hair (thin) lid lag Afib proptosis fibrillation hypercalcemia low bone mineral density low cholestoerl |
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how to treat tachycardia, arrhythmia, sweat, tremors of hyperthyroidism
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beta blockers
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sex specific hyperthyroidism
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women - oligomenorrhea, decreased fertility
men - impotence, gynecomastia |
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thyroid storm
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untreated hyperthyroidism + illness or surgical emergency
see tachycardia, fever, agitation, nausea, vomiting, diarrhea, reslessness, psychosis |
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graves disease
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most common cause of hyperthyroidism
stimulating antibodies to TSH receptors thyroid gland is symmetrically enlarged with increased vascularity lots of follicular epi cells, columnar lymphocytes infilration often have other autoimmune problems |
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most common cause of hypothyroidism in the US
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hashimoto's thyroiditis
elsewhere might be iodine deficiency |
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drugs that cause hypothyroidism
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potassium perchlorate
thiocyanate lithium |
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most sensitive test for early hypothyroidism
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TSH (elevated in hypothyroidism)
other tests: serum T4 decreased radioiodine uptake |
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symptoms and signs of hypothyroidism
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slow thinking
lethargy dry skin hair loss weight gain constipation menorrhagia cold intolerance signs: puffy face slow speech generalized muscle weakness dry skin bradycardia ankle edema depression |
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autoantibodies in hashimotos
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anti-thyroglobulin
anti-thyroid peroxidase anti-TSH receptor block |
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T/F high antibodies are diagnostic of hashimoto's thyroiditis
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true
moderate levels in graves, multinodular goiter, and thyroid neoplasm |
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postpartum thyroiditis
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within one year of delivery
painless hyperthyroid -> euthyroid -> hypothyroid usually resolves |
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dequervains subacute thyroiditis
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PAINFUL thyroiditis
follows a URI or viral infection see multinucleated giant cells |
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acute thyroiditis
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S. aureus, S, pyogenes most often
often after pharyngeal space infection, or after thyroid surgery |
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riedel's thyroiditis
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fibrosis of thyroid gland
painless goiter see thyroid antibodies often rock hard thyroid |
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T/F a goiter indicates hyperthyroidism
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false - can be hyper, hypo, or euthyroid
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autonomous nodules
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TSH-independent
goiter often transitions form a TSH dependent difuse hyperplasia -> TSH independent multinodular goiter (toxic or nontoxic) |
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symptoms of goiter unrelated to thyroid hormone
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respiratory difficulty
dysphagia |
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plummer's disease
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toxic multinodular thyroid
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most common neoplasm of thyroid
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follicular adenoma
benign usually but can transform to malignant |
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how common is thyroid cancer, what is the most common type
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rare
if they do happen, papillary carcinoma is the most common type |
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biggest risk factor for thyroid cancer
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exposure to radiation
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papullary vs follicular carcinoma of thyroid (how do they spread)
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papullary via LN
follicular via blood |
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medullary carcinoma
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carcinoma of parafollicular cells which make calcitonin
associated with MEN II |
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MEN type 1
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pituitary tumor/hyperplasia
hyperparathyroidism panceratic tumor/hyperplasia |
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MEN type 2A
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hyperparathyroidism
pheocromocytoma medulary carcinoma of thyroid |
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MEN type 2B
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pheochromocytoma
medullary thyroid carcinoma marfanoid habitus ganlioneuromas |
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familial euthyroid hyperthyroxinemia
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autosomal dominant
total T4 increased, free T4 is normal so euthyroid see: 1. euthyroid dysalbuminemic hyperthyroixemia - abnormal binding of T4 (NOT T3) to albumin 2. increased transthyretin 3. alteration in transthyretin increased affinity for T4 |
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pituitary and peripheral resistance to thyroid hormone
congenital TBG deficiency what do you see in both |
euthyroid state
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how does an increased in TBG affect physiologic
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increase in TBG binds more free hormone -> decrease in free hormone
this stimulates TSH which increases production of free hormone |
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euthyroid sick syndrome
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illness can cause a slightly low TSH -> low thyroid hormone
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