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20 Cards in this Set
- Front
- Back
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what's the MCC of hyperthyroidism?
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90% of cases are caused by:
Graves disease Toxic multinodular goiter Toxic solitary goiter |
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this disease results from IgG antibodies against the TSH – receptor
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Grave's disease
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Pt over 60 y/o with A-fib, weight loss, and HF, what do you think?
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Hyperthyroidism
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what are the cardinal signs of Graves’ disease?
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Diffuse goiter
Vascular bruit over goiters Pretibial myxoedema Tachycardia with a bounding pulse Exophthalmos Lid lag Lid retraction Peri-orbital puffiness Increased lacrimation Conjunctival edema and ulceration |
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Name some Anti-thyroid drugs
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Carbimazole
Propylthiouracil Methimazole |
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How do you treat hyperthyroidism?
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Treatment Options
Anti-thyroid drugs: Carbimazole or methimazole followed by propylthiouracil Beta-blocking drugs in the initial stages of management Sub-total thyroidectomy Radioactive iodine therapy THE CHOICE OF THERAPY DEPENDS UPON A NUMBER OF FACTORS, ESPECIALLY THE PATIENTS AGE AND PREVIOUS HISTORY |
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MCC of Hypothyroidism
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Hashimoto's (auto-immune) accounts for over 90% of cases
Drug induced (lithium carbonate inhibits the release of thyroid hormone); results in goiter |
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> TSH
< T3, < T4 Sign & symptoms of hypothyroidism, Which physical finding would you expect to find? |
Enlarged thyroid gland due to Hashimoto's
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S/Sx of Hypothyroid
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Constipation
Bradycardia Weight gain Cold intolerance < in growth velocity(children) Pericardial & pleural effusions |
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How do you diagnose hypothyroidism?
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Clinical suspicion
< DTRs Low EKG voltage T4 & TSH levels Thyroid antibody assays |
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How do you treat hypothyroidism?
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Thyroxine - start very slow 25 ug and increase every 4-6 weeks
sudden > in T4 will casue MIs in pts that have h/o ischemic heart disease |
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what is the function of PTH
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regulates release of the calcium from bone, absorption of calcium in the intestine, and excretion of calcium in the urine
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On a routine blood test, you find a high level of calcium, what do you suspect?
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HPT
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What are the mild symptoms of HPT?
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often mild and nonspecific, such as:
weakness fatigue With more severe disease, a person may have: anorexia nausea/vomiting constipation confusion or impaired thinking and memory, and increased thirst and urination depression aches and pains |
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how does hypoparathyroidism effect calcium and phosphorus?
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Calcium levels in the blood fall, and phosphorus levels rise
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what is the MCC of hypoparathyroidism?
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injury to the parathyroid glands during head and neck surgery
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What is DiGeorge syndrome?
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congenital absence of the parathyroid glands
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what are the S/Sx of HypoPTH?
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Parasthesia
Tetany/larynx spasms (diff.breathing) Convulsions/seizuers Dry hair/skin Catarats |
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What is the treatments of HypoPTH?
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Oral calcium carbonate and Vit D
High calcium/low phosphorus diet Periodic monitoring of blood calcium levels |
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what are some complications of HypoPTH?
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acute tetany-resp.obstruction
growth/mental retardation kidney function impairment, from hypercalcemia increased risk of pernicious anemia, Addison's disease, cataract development, and Parkinson's disease |
