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84 Cards in this Set
- Front
- Back
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Graves T3 T4
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inc
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Graves TSH
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low
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sub clin hyper Tsh T3 T4
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TSH low, N T3,4
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Hyper or Hypo: sweating
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hyper
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Hyper or Hypo: onycholysis
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hyper
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Hyper or Hypo: hyperpigmentation
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graves
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Hyper or Hypo:thinning of hair
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hyper
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Hyper or Hypo: pruritis, hives
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hyper
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Hyper or Hypo: tachycardia
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hyper
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Hyper or Hypo:angina
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hyper
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Hyper or Hypo:diarhea
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hyper
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Hyper or Hypo:inc app
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hyper
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Hyper or Hypo: poor sleep
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hyper
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Hyper or Hypo: fatigue
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hyper
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Hyper or Hypo: muscle weakness
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hyper
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Hyper or Hypo: emotional instability
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hyper
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Hyper or Hypo: emotional instability
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hyper
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Hyper or Hypo: heat intolerance
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hyper
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Hyper or Hypo: warm moist skin
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hyper
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Hyper or Hypo: exopthamus, lid lag
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graves
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Hyper or Hypo:systolic HTN
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hyper
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Hyper or Hypo: wide pulse pressure
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hyper
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Hyper or Hypo: tachypnea
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hyper
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Hyper or Hypo:polyuria
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hyper
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Hyper or Hypo:poximal muscle weakness or wasting
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hyper
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Hyper or Hypo: tremor
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hyper
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Hyper or Hypo: hyperreflexia
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hyper
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Hyper or Hypo:anxiety
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hyper
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Hyper or Hypo: elderly pt new atrial fib
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hyper
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Hyper or Hypo: gynecomastia-men
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hyper
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low TSH (very rare to have TSH producing tumor)
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hyper
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high T4 and high T3 (rise in T3 higher than that of T4)
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hyper
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high thyroid uptake ?
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Graves, nodular and multinodular goiter
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low thyroid uptiake?
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exogenous or metastatic lesion
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PTU (propylthiouracil - a thiourea)
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impairs thyroid gland hormone synthesis by inhibiting organification and also inhibits T4 to T3 conversion in the periphery (weak effect).
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Methimazole
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– inhibit thyroid gland hormone synthesis by inhibiting organification.
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BB in hyper
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inhibits catacholamine effect, reduces tachcardia
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Steroids (GC)
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inhibits peripheral T4 to T3 conversion
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iodine
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blocks release of thyroid hormone for short period of time and inhibit T4 to T3 conversion – use pre op
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best long term option hyper?
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radioactive iodine therapy
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. Surgery – thyroidectomy in hyper?
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large gland, pregnancy, refuses radioactive iodine therapy
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proptosis, periorbital edema, inflammation, exposure keratitis, photophobia, eyelid lag
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hyper in graves
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subclinical hyper?
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Low TSH with normal T4 and T3
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thyroiditis with immune basis?
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Hashimoto’s thyroiditis, painless sporadic thyroiditis and painless post partum thyroiditis all have an autoimmune basis.
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Thyroiditis genetic susceptibility?
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HLA-DR3, HLA-DR4 AND HLA-DR5, CTLA-4 AND HLA-Bw35 haplotype.
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hyper or hypo can lead to thyroiditis?
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hypo
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MC thyroiditis?
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hashi
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high in hash?
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serum peroxidase
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Hashi treatment
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LT4
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usually with preexisting condition (thyroid dz, cancer, AIDS)
- very ill ,fever, dyphagia, ant neck pain - TFT’s usually nl, but can get high or low T4 symptoms - increased WBC, ESR |
5. Suppurative Thyroiditis
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drugs that cause thyroiditis?
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amiodarone type 1 and two, lithium, interferon (alpha and interluekin)
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type 1 amiodarone thryroiditis
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synthesis and release problems (iodine induced)
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type 2 amiodarione thyroiditis
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destructive thyroiditis
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Treat type 1 thyroiditis?
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antithyroid drugs, Li, rarely thyroidectomy
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treat type two thyroiditis?
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iopanoic acid, steroids
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Reidel's history
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esophageal or tracheal compression, sx of hypothyroid or hypoparathyroid in late stages
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local manifestation of a systemic fibrosis
- very rare - cause unknown - high serum antibody concentrations - rock hard painless goiter |
riedel thyroiditis
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drugs that cause hypo
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lithium, amiodarone, methimazole, PTU, interferon alpha, interleukin-2
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subclinical hypo
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high TSH with nl T4 and T3
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hypo goiter present
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Hashimoto’s, iodine def, drug goitrogens (lithium, iodine, amiodarone) and food goitrogens, impaired sensitivity to T4, infiltrating disease
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hypo goiter absent
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secondary hypothyroid, postablative with radioactive Iodine
(1-131 Rx), neck radiation and surgery |
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fatigue, weakness,
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hyop
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cold intolerance
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hypo
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bradycardia
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hypo
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consitpation
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hypo
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WG
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hypo
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Hair loss
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hypo
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neuropathy
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hypo
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depression
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hypo
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carpel tunnel
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hypo
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hoarsness
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hypo
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arthralgia myralgia
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hypo
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myxederma caom
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hypo
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dry skin
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hypo
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ataxia slow relaxtion
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hypo
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thin hair coarse
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hypo
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loss of lateral eyebrows
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hypo
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CHF HTN
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hypo
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apathetic
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hypo
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facial edema around eye lids non pitting
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hypo
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TSH hypo
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high
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t4 hypo
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low
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main treatment hypo?
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LT4 (Synthroid, levothroid) not generic
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other treatment hypo?
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LT3 (Cytomel)
3. Dessicated thyroid 4. Liotrix (Thyrolar, Euthroid) – synthetic T4 and T3 combination |
