020415 hyperthyroidism in adult Flashcards Preview

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Flashcards in 020415 hyperthyroidism in adult Deck (17):
1

most common type of hyperthyroidism

Graves disease

2

is hyper or hypo thyroidism more common?

hypo

3

symptoms of hyperthyroidism

palpitations
voracious appetite, weight loss
heat intolerance
fine tremor
fine, moist skin
lid lag
proptosis/stare (Graves dis)
tachycardia
etc

4

can you get goiter in hypothyroidism?

yes, in inflam-Hashimoto's-b/c inflammed, thyroid can get big

5

complications around the eye with Grave's disease

enlargement of extraocular muscles
compression of optic nerve (can lose vision)

6

exophthalmos and pretibial myxedema

Graves disease

7

exophthalmos and pretibial myxedema in Graves dis is mediated by

TSH receptor activation resulting in glycosaminoglycan buildup, inflam, fibrosis, and edema

8

what is the radiotracer uptake and scan used for

to determine what type of hyperparathyroidism it is

used after getting TSH and thyroid hormone

9

patterns of radiotracer uptake

increased uptake that is homogeneous (Graves)

solitary toxic nodule (follicular adenoma)

toxic multinodular goiter (mlutiple functioning thyroid nodules)

or if see nothing-could be painless thyroiditis causing hyperthyroidism that then becomes hypothyroidism (you see nothing on the scan b/c the thyroid is damaged during hyperthyroidism and see nothing)

10

tx for hyperthyroidism

methimazole (inhibits synthesis of thyroid hormones by blocking oxidation of iodine in thyroid gland)

propylthiouracil (PTU)-don't use as much b/c it's 3x/day. use is for 1st trimester of pregnancy or an ICU pt w thyroid storm

iodide--use for preoperative period or thyroid storm or to protect thyroid from radioactive iodine fallout after a nuclear accident

radioactive iodine--use for thyroid destruction of overactive or enlargd thyroid and used for thyroid cancer

11

MOA of propylthiouracil

inhibits synthesis of thyroid hormones by blocking oxidation of iodine in the thyroid gland. ALSO partially inhibits peripheral deiodination of T4 to T3 (that's why it's used for thyroid storm pts)

12

MOA of iodide

inhibits hormone release by thyroid
also decreases vascularity, size and fragility of hyperplastic gland, making drugs valuable as preoperative prep

13

TSH and T4 levels for thyroiditis, Graves dis, toxic multinodular goiter, solitary toxic nodule

TSH is low
T4 is high

14

tx for thyroiditis as opposed to Graves, toxic multinodular goiter, and solitary toxic nodule

for thyroiditis, it's supportive care. may be beta blockers

for the others, it's methimazole, radioactive iodine, or surgery

15

prevalence of secondary hyperthyroidism

VERY RARE

16

thyroiditis

generic term referring to destruction of thyroid from inflam

includes:
-subacute/viral (deQuervain's) thyroiditis
-silent/painless thyroiditis

17

after getting TSH and T4/T3, to further support the diagnosis of Graves dis, or if imaging studies can't be obtained, what should you do?

TSI measurement (not always positive in Graves dis pts, but if positive, very specific for Graves)