Thyroid Disorders

Question 1

what is the thyroid?

Answer 1

2” butterfly-shaped gland located in the neck

Question 2

what does the thyroid secrete?

Answer 2

secretes triiodothyronine (T3) and thyroxine (T4)

Question 3

what is thyroxine?

Answer 3

regulator of body metabolism that influences almost every body system

Question 4

role of iodine with thyroid

Answer 4

necessary component in the synthesis of thyroid hormone

Question 5

thyroid dysfunctions

Answer 5

–primary thyroid disorders are most common
–more likely in women than men
–enlargement can occur with both types

Question 6

goiter

Answer 6

enlargement of the thyroid gland with or without symptoms of thyroid dysfunction

Question 7

chemicals and goiter

Answer 7

–excess pituitary TSH
–low iodine levels
–enlargement of thyroid gland can also occur from goitrogens

Question 8

hypothyroidism

Answer 8

insufficient levels of thyroid hormones T3 and T4

Question 9

primary hypothyroidism

Answer 9

increase in release of TSH from pituitary

Question 10

Hashimoto’s

Answer 10

autoimmune; most common cause of hypothyroidism

Question 11

patho of Hashimoto’s

Answer 11

–thyroid receptor antibodies
–antithyroglobulin antibody
–antithyroperoxidase antibody (hallmark)

Question 12

risk factors for hypothyroidism

Answer 12

–female
–age > 50
–Caucasian
–pregnancy
–history of other autoimmune disorders
–family hx
–meds
–treatment for hyperthyroidism

Question 13

early symptoms of hypothyroidism

Answer 13

–cold intolerance
–weight gain
–lethargy
–fatigue
–memory deficits
–poor attention span
–increased cholesterol
–muscle cramps
–raises carotene levels
–constipation
–decreased fertility
–puffy face
–hair loss
–brittle nails

Question 14

late symptoms of hypothyroidism

Answer 14

–below normal temp
–bradycardia
–weight gain
–decreased LOC
–thickened skin
–cardiac complications (cardiomegaly)

Question 15

how does hypothyroidism affect all body organs?

Answer 15

–raises cholesterol (HLD)
–raises carotene levels
–causes anemia
–decreases filtration by kidney
–can cause hoarse voice

Question 16

myxedema

Answer 16

–severe hypothyroidism (coma)
–describes dermatological change that occurs with hypothyroidism

Question 17

symptoms of hyperthyroidism

Answer 17

–anxiety
–tremor
–tachycardia
–feeling warm
–loss of weight
–exophthalmos
–a fib
–decreased fertility

Question 18

diagnosis of hypothyroidism

Answer 18

—high TSH
–low free T3
–low free T4
–antithyroglobulin
–antithyroperoxidase antibodies

Question 19

diagnostic for primary hypothyroidism

Answer 19

low hormone secretion by the thyroid gland, which constantly signals the pituitary to secrete TSH

Question 20

what do you treat hypothyroidism with?

Answer 20

synthryoid

Question 21

MOA of synthryoid

Answer 21

converted to T3 in the body

Question 22

synthryoid

Answer 22

replacement hormone therapy with levothyroxine

Question 23

half life of synthryoid

Answer 23

7 days

Question 24

hyperthyroidism

Answer 24

excessive secretion of T3 and T4

Question 25

primary hyperthyroidism

Answer 25

thyroid

Question 26

secondary hyperthyroidism

Answer 26

pituitary

Question 27

tertiary hyperthyroidism

Answer 27

hypothalamus

Question 28

Graves disease

Answer 28

most common cause; autoimmune stimulation of thyroid gland

Question 29

other causes of hyperthyroidism

Answer 29

–thyroid adenoma
–subacute thyroiditis
–toxic multinodular goiter
–excessive iodine ingestion
–excessive thyroid hormone replacement

Question 30

risk factors for hyperthyroidism

Answer 30

–family hx of Graves
–age > 40
–women
–Caucasian
–meds
–excessive iodine intake
–pregnancy

Question 31

components of Graves disease

Answer 31

–autoimmune disorders
–excess levels of T3 and T4
–thyroid-stimulating antibodies

Question 32

symptoms of Graves disease

Answer 32

–nervousness
–insomnia
–sensitivity to heat
–weight loss
–enlarged and palpable gland
–audible bruit (high glandular blood flow)
–a fib
–myxedema
–exophthalmos

Question 33

exophthalmos

Answer 33

periorbital edema and bulging of the eyes
women

Question 34

diagnosis of Graves Disease

Answer 34

–low TSH
–high T3
–high T4
–antithyroglobulin
–antithyrotropin receptor antibody
–ultrasound with color-Doppler evaluation
–radioactive iodine scanning and measurement of iodine uptake

Question 35

treatment of hyperthyroidism

Answer 35

–antithyroid hormone medication –> propylthiouracil (PTU)

Question 36

propylthiouracil

Answer 36

–blocks thyroid hormone synthesis
–suppresses conversion of T4 to T3

Question 37

notes about propylthiouracil

Answer 37

–hepatotoxicity
–can be used in 1st trimester with caution
–radioactive iodine treatment

Question 38

treatment of propylthiouracil

Answer 38

–surgery
–replacement thyroid hormone needed for life (levothyroxine)

Question 39

thyrotoxic crisis (thyroid storm)

Answer 39

–overwhelming release of thyroid hormones that exerts an intense stimulus on the metabolism
life threatening condition
-precipitated by surgery, trauma, or infection

Question 40

parathyroid gland

Answer 40

–four pea-sized glands nestled within thyroid tissue of the neck
–produce and secrete parathyroid hormone
–controls calcium levels in the body
–promotes vitamin D production by the kidney

Question 41

hypoparathyroidism symptoms

Answer 41

–result of insufficient PTH secretion and resultant hypocalcemia
–muscle cramps
–irritability
–tetany
–convulsion
–Trousseau’s and Chvostek’s

Question 42

treatment for hypoparathyroidism

Answer 42

–replace PTH
–normalize serum Ca and Vitamin D levels
–replacement treatment lifelong if parathyroid removed

Question 43

symptoms of hyperparathyroidism

Answer 43

–muscle weakness
–poor concentration
–neuropathies
–HTN
–kidney stones
–metabolic acidosis
–osteopenia
–pathological factors
–constipation
–depression, confusion, or subtle cognitive deficits

Question 44

what are hyperparathyroidism symptoms caused by?

Answer 44

excessive secretion of PTH with resulting hypercalcemia and bone breakdown

Question 45

treatment for hyperparathyroidism

Answer 45

–reduce levels of calcium
–diuretics
–calcitonin
–biphosphonates
–vitamin D
–surgical intervention