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41 Cards in this Set

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Define hyperthyroidism
It is the clinical and biochemical syndrome that results when tissues are exposed to excessive quantities of thyroid hormone. Hyperthyroidism produces multiple system abnormalities because the hormoone affects all organs and the metabolic processes. Hyperthyroidism result from the excessive secretion of T4 (thyroxine) and/or T3 triiodothyronine)
What makes the hormones T3 and T4 unique
They contain Iodine molecules bound to the AA
What is the role of Iodine in the body?
It is essential to the thyroid gland for synthesis of its hormones.
What regulates the secretion of T3 and T4
Thyroid-stimulating hormone
TSH
Explain negetive feedback and how it pertains to the thyroid
TSH controls the relase of thyroid hormone, in turn the serum level of thyroid hormone determines the release of TSH. For example if the thyroid hormone concentration in the blood is decreased the release of TSH increases causing the release of T3 T4.
What is the primary function of the thyroid hormone?
To control the cellular metabolic activity.
What is Calcitonin
Another hormone secreted by the thyroid gland. It is secreted in response to high plasma levels of calcium, and reduces the plasma level of calcium by increasein its deposition in bone.
Thyroid function tests

Serum T4 and T3
You will see an increase in T4 and T3 levels with hyperthyroidism.
Thyroid function tests
TSH
Measurement of the serum TSH levels is single best screening test of thyroid function as well as thyroid
hormone replacement therapy
If problem is with thyroid gland (independent) TSH will be high as it is trying to stimulate the thyroid to produce thyroid hormone.
If problem is secondary, TSH serum tests will be low
Thyroid function tests

T3 Resin uptake
Measures the amount of thyroid hormone bound to TBG(thyroxine-binding globulin), and number of receptor sites. This test is a good indicator of the amount of thyroid hormone already present in circulation.
Thyroid function tests

Radioactive Iodine (I123) Uptake
Measures the radioactive iodine uptake by the thyroid gland.
Pt's with hyperthyroidiam exhibit a high uptake and pts with hypothyroidism exhibit a very low uptake.
Other diagnostic tests used are Ultrasound, CT and MRI. Why?
they clarify or confirm results of other studies
Independent or Primary
Problem with the thyroid gland
Dependent or Secondary
Problem with the pituitary of hypothalamus
Normal Function of the thyroid gland
Cardiovascular
Maintains rate/force and output
Hypo
S/S
Cardiovascular
Increased capillary fragility
Decreased pulse rate
varied changes in BP
Cardiac hypertrophy
Weak contractility
Distant heart sounds
Anemia
Tendency to develop CHF, Angina, MI
Hyper
S/S
Cardiovascular
Systolic HTN
Increased rate and force of cardiac contractions
Bounding, rapid pulse
Cardiac hypertrophy
Dysrhythmias
A-fib
Angina
Normal function of thyroid

Respiratory
Effects rate and O2 utilization
Hypo
Resp
Dyspnea
decreased breathing capacity
Hyper
Resp
Increased resp rate
Dyspnea on mild exertion
Normal thyroid function

GI
Promotes normal GI motility and tone. Increases secretion of digestive juices
Regulates the metabolism of CHO, Protein and fat
Hypo

GI
Decreased appetit
N/V
weight gain
constipation
distended abdomen
enlarged, scaly tounge
Hyper

GI
Increases appetite and thirst
(4-5000 kcal to maintain wt)
weight loss
increased peristalsis
increased BS
Splenamegaly
Hepatamegaly
Normal thyroid function of

Integumentary
Promotes normal hydration and secretory activity of skin
Hypo

Integumentary
Dry thick, inelastic skin
thick brittle nails
dry, sparse, coarse hair
Poor tugor
generalized interstitial edema
puffy face
decreased sweating
pallor
Hyper

Integumentary
Warm moist smooth skin
Thin, brittle nails, detached from nail bed
hair loss (may be patchy)
Clubbing (due to low o2)
Palmar erythema
Diaphoresis
Normal function of thyroid

Musculosketetal
Promotes normal muscular development and function. Promotes normal growth and maturation of the skeleton.
Hypo

Musculoskeletal
fatigue
weakness
Muscular aches and pains
slow movements
arthralgia
Hyper

Musculoskeletal
Fatigue
Muscle weakness, esp. proximal
proximal muscle wasting
dependent edema
osteoporosis (ca+ is taken out of bones b/c of increased metabolism)Can lead to pathological fx
Normal function of thyroid

Nervous
Promotes normal adult function of nervous system
Hypo

Nervous
apathy
lethargy
forgetfulness
slow mental process
hoarseness
slow, slurred speech
prolonged relaxation of deep tendon muscles.
stupor/coma
paresthesias
anxiety
depression
Hyper

Nervous
Difficultly in focusing eyes
nervousness
fine tremor of fingers and tounge
insomnia
labile of mood, delirium
restlessness
personality changes
exhaustion
hyperflexia of tendon reflexes
depression,fatigue,apathy
lack of ability to concentrate
stupor, coma
Normal function of thyroid

Reproductive
Promotes normal female reproductive ability and lactation
hypo

reproductive
prolonged menstrual period
decreased libido
infetility
hyper

reproductive
menstrual irregularities
amenorrhea
decreased libido
impotence in men
decreased fertility
HYPO-other
increased susceptibility to infection
increased sensitivity to narcotic, barbituates and anesthesia
intolerence to cold
decreased hearing
sleepiness
GOITER
HYPER-other
Intolerance to heat (pt is in catabolic state-produces more heat)
Increased sensitivity to stimulant drugs
elevated basal temp
LID LAG
eyelid retraction
GOITER
rapid speech
Patho- hyper
tumor or ca of thyroid gland
autoimmune disease
Increased production of T3 T4
Patho-hypo
familial
lack of iodine in diet
surgical or medical treatment of hyperthyroidism
idiopathic
decreased production of T3, T4
Common medication to treat
hypothyroidism
Synthroid. effects T4
should be given on empty stomach. Best practice is 1h before breakfast to help prevent insomnia
What is the most common disease resulting from hyperthyroidism
?
Graves Disease
believed to be autoimmune