Thyroid disease Flashcards
What is the indication of a slow thyroid
High TSH
What is the indication of a fast thyroid
Low TSH
What is goiter
An enlarged thyroid or abnormal growth of thyroid gland
What is the most common cause of goiter
iodine deficiency
What are the types of goiter
diffuse
multinodular
What are the primary causes of goiter
physiological (puberty/preggers)
Iodine deficiency
Goitrogens
Dysmorphogensis
granulomatous disease
What are goitrogen rich foods that can effect thyroid function
broccoli
cauliflwoer
kale
peanuts
red wine
strawberries
peaches
mustard
tea
soy
Which gender is at higher risk for goiter
females
When do sporadic goiter from dysmorphogenesis and endemic goiter generally occur
in childhood
Why does iodine deficiency lead to goiter
It increases the demand of thyroid hormone, causing the pituitary gland to release more TSH
What role does TSH have on the thyroid
stimulates follicular cells and with continuous long term stimulation leads to follicular hyperplasia and thyroid enlargement
What is the biggest concern with goiter
dysphagia
dyspnea
hoarseness
What is Pemberton maneuver
elevating arms may lift goiter into thoracic inlet and cause stridor, dyspnea or enlargement of neck veins
What does it mean if there is non-toxic thyroid or goiter
there is no hyper/hypothyroidism present
What are examples of hyperthyroidism
graves disease
multi nodular goiter
toxic adenoma
What is an example of hypothyroidism
hashimotos
*unless in area with endemic goiter
What is the usual TSH range
.45-4.5
IF there is intervention done for non-toxic goiter, what is the mainstay treatment
thyroidectomy
What is the most common complication postoperatively with a thyroidectomy
hypocalcemia
What is the etiology for hypothyroidism
Autoimmune
previous thyroid surgery
radiation
lithium
PTU
What is the etiology for hyperthyroidism
Graves
toxic adenoma
toxic multi nodular (plummers dz)
Thyroiditis
What is the clinical presentation with hypothyroidism
anorexia
fatigue
anemia
bradycardia
memory impairment
constipation
cold intolerance
Hypo-reflexia
What is the clinical presentation with hyperthyroidism
Nervousness
heat intolerance
sweating
weight loss + increased appetite
tachycardiaa
hyperreflexia
loose stool
What is the most common cause of hyperthyroidism
Graves disease
What is the etiology of graves disease
autoimmune
+FH
HLA association
Female»>Male
What is the patho of graves disease
Caused by Thyroid stimulating immunoglobulin (TSI)
What are some graves disease specific symptoms that may occur
Graves orbitopathy (TED)
Pretibial myxedema
What is an atypical presentation of graves disease in elderly
apathetic thyrotoxicosis
What are signs of extra thyroidal manifestations in Graves disease
Thyroid eye disease
Thyroid dermopathy (thickening of skin, difficult to pinch, peau d’ orange appearance)
Bone involvement (swelling is metacarpals)
onycholysis (Plummers nails)
What is a thyroid storm
sudden onset with severe symptoms of thyrotoxicosis
What is graves ophthalmopathy (thyroid eye disease)
Proptosis
conjunctival irritation
eye dryness
diplopia
What in labs is diagnostic for graves disease
TSI