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15 Cards in this Set

  • Front
  • Back
Symptoms of Hyperthyroidism
Symptoms: nervousness, irritability, poor concentration, muscle weakness, palpitations, heat intolerance, increased appetite, weight loss, diarrhea, sweating
Physical Findings of Hyperthyroidism
hyperkinesia, Rapid speech, fine tremor, hyperactive reflexs, lid lad, stare, (proptosis-graves), tachycardia, artrial fibrillation, moist smooth skin
Lab findings for Hyperthyroidism
Supressed TSH
except in secondary Hyperthyroidism

Elevated T3 and T4, decreased serum cholesterol
DDx Hyperthyroidism
Graves: TSH abs, high rI uptake
Gioter: Patchy rI uptake, nodules make T3/T4
Adenoma: like Goiter, 1 HOT nodule
Thyroiditis: low rI uptake, release of stored hormone from damaged gland.
Exogenous TH, TSH adenoma (pit)
Graves Disease
Pathophys: TSHabs stim thyroid, excessT3/T4. Symetrical enlarged, increased smaller follicular cells, scant colloid, lymphocytes

Clinical findings: enlarged thyroid, wide eye stare- adrenergic tone, proptosis,orange peel skin-infiltrative dermopathy

Lab Dx: low TSH, High T3/T4, TSH-ab, high diffuse rI

Treatment: b-blockers, Methimazole-TPO, Radio I-ablation
Hyperthyroid Storm
loss of TGB or incread in catecholamine R or catecholamines. Associated with Stress, trauma, surgery, MI, Infection.

Fever, sweating, tachycardia, a fib, deliruium, vomiting, diarrhea

supportive measures, antithyroid meds (WC block), b-blockers
DDx Hypothyroidism
Hashimotos: autoimmune, high TSH, low T3/T4, TGB and TPO-abs
Low I: no T3/T4 syn, Elevated, TSH
Ablation: high TSH, low T3/T4
Meds: high TSH, low T3/T4
Dietary: high TSH, low T3/T4,
Secondary: tumor of pit or hypo.
Hypothyroidism: Symptoms
fatigue, slow thinking, lethargy, cold intolerance, weight gain, constipation, Irregualr nenses, decreased libido, muscle cramps, depression
Hypothyroidism: Physical findings
Round puffy face, Periobital edema, slow speech , metal clouding, Hoarseness, Hypokinesis, delayed relaxaion of tendons, bradycardia, enlarged heart, decreased CO, pericardial effusion, and ascites, cool dry skin, bittle hair
Hypothyroidism: Lab findings
increased TSH
decreased T3/T4
eleavated cholesterol
radio I does NOT help
Hashimotos disease
Pathophys: AI destruction of thyroid. TGb/TPO abs, rubby, nodular, smaller gland. destruction of follicles, infiltration

Clinical Signs: transient Hyperthyroid, hypothyroidism predom. associated with Type I diabetes, lupus, addisons

Lab Dx: High TSH, Low T3/T4 abs, low rI

Treat: LT4 converts to T3 in blood, need levothyroxine, increases metabolic turnover
Hypothyroid Emergency (myxedema coma)
End-stage hypothyroidism.

infection, stroke, MI, in pt with hypothyroidism,

Supportive measures, vent, IV LT4, CCSD,
thyroid enlargment, continuous stim of TSH (TRH)

non-toxic: TSH stim, inadquate T3/T4 syn.

toxic: Gioter with hyperthyroidism

compensation adquate vis inadequate
DDx of Goiter
Low I
Goiterogens in diet, meds
Thyroid Tumors
nodules: benign 90%
cancer: rare, FH, radiation, hoarseness, obstuction, cold nodule

Fine Needle asp
Papillary, local spread-good
Follicular, blood-bad
Meduallary, C-cells (parafollicular) aggressive
Anaplastic-very aggresive, resistant