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8 Cards in this Set

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Differentiate Hashimotos from Graves Disease in terms of Autoimmune mechanisms
In graves Dx, the thyroid gland is under continuous stimulation by circulating autoantibodies against the thyrotropin receptor, and pituitary thyrotropin secretion is suppressed b/c of the increased production of thyroid hormones.
In hashimotos: the immunologic attack appears to be typically aggressive and destructive, the AB is against thyroid peroxidase. The TPO antibodies are complement fixing and may be cytotoxic.
Characterize multinodular goiter in terms of pathogenesis, gross and micro appearance
Pathogenesis: impaired synthesis of thyroid hormone, caused by iodine deficiency, resulting in goiter. Changes in this similar to benign neoplastic changes.
Gross: multilobulated asymmetrically enlarged glands.
Micro: colloid rich follicles lined by flattened inactive epithelium and areas of follicular epithelial hypertrophy and hyperplasia
List and describe several types of hypothyroidism
Hashimotos
Idiopathic myxedema
Previous Tx of Hyperthyroidism
Subacute Thyroiditis
Radiation therapy of the neck
Iodine deficiency or excess
Drugs/congenital
Secondary/tertiary hypothyroidism
List 2 tests recommended in dx hypothyroidism
elevated TSH in primary hypothyroidism
Decreased Free T4
Describe the signs, symptoms and physiological effects of hypothyroidism
Children: Retarded growth and evidence of mental retardation - cretins.
Adults: Easy fatiguability, coldness, weight gain, constipation, menstral irregularities, muscle cramps.
Define Cretinism and Myxedema
Mental retardation, short stature, puffy appearance of the face.
Myxedema: extreme symptom of hypothyroidism. Develops when there is increased filtration of fluid out of the capillaries and edema due to accumulation of osmotically active mucopolysaccharides in interstitial fluid
Define several causes of hyperthyroidism
Graves Dx
Toxic multinodular goiter
Toxic Adenoma
Pituitary tumor
Thyroiditis
Exogenous thyroid hormone
Describe 3 tests useful in dx hyperthyroidism
Suppressed TSH and elevated Free T4. I123 scan can evaluate the size of the gland as well as hot/cold nodules.