Endocrine disease (Thyroid gland) Flashcards
(30 cards)
- What is the embryologic origin Thyroid gland?
Develops from invagination of endoderm, which arises at the base of the tongue, in the region of the foramen cecum.
- What is the most common causes of Hyperthyroidism?
Graves Disease (diffuse toxic hyperplasia)
- What are other causes of Hyperthyroidism?
i. Hyperfunctional multinodular goiter
ii. Ingesting too much exogenous Thyroid hormone
iii. Hyperfunctional thyroid adenoma
iv. TSH-secreting pituitary adenoma (this is rare)
* H I H TSH
- What are 2 significant clinical symptoms associated with hyperthyroidism?
i. Hyper-metabolic state
ii. Over-activity of the sympathetic nervous system
* Other symptoms may include:
a. Exophthalmos (bulging of the eye)
b. Tachycardia, Papitations, Irritability
c. Can’t sit still (hypermobility)
d. Overactive GI, malabsorption, diarrhea
e. Weight loss but No loss of appetite
f. Can’t stand heat and sweat a lot
g. Staring gaze with eyelid lag
- What is Exophthalmos and what can cause it?
Bulging of the eyes
Caused by Graves Diseases
- Why would someone with hyperthyroidism experience clinical symptoms such as nervousness, irritability, proximal myopathy, diarrhea or heat intolerance?
Thyroid produces hormones that regulate the RATE at which the body carries out the necessary (metabolic) functions (think of it as a thermostat).
If the thermostat is broken, the body will be hyperfunctional almost as though the body is experiencing over stimulation of sympathetic nervous functions.
- How can stress cause hyperthyroidism?
This is called “Thyroid Storm,” which is an abrupt or sudden onset of hyperthyroidism, usually triggered by stress, can be a medical emergency.
Patients can die of cardiac arrhythmia (if left untreated).
- How would you diagnose hyperthyroidism?
i. Elevated Thyroid Hormone and
ii. Decreased Thyroid Stimulating Hormones (because TH works opposite of TSH)
- How can reactive iodine be used to treat hyperthyroidism (Graves Disease)?
Reactive iodine can be used to destroy overactive thyroid tissues.
- Grave’s Disease is an autoimmune disease with genetic component that affects bodily function through…
Production of auto-antibodies to TSH receptors, which results in receptors being constantly stimulated.
- What is the segment of the population that is often affected by Grave’s Disease?
Predominatly affects females (7:1 :: Female:Male)
- What are 4 significant clinical manifestation or symptoms associated with Grave’s disease?
i. Skin lesions
ii. Hyperthyroidism
iii. Exophthalmos (40%)
iv. Scaly thickening of skin overlying shins
v. Pre-tibial myxedema (mucopolysaccharides deposition in the dermis)
* “S H E (has) Scaly Pre-tibia”
- What are 3 common causes of hypothyroidism or decreased thyroid hormone production?
i. Hashimoto Thyroiditis
ii. Removal of thyroid by surgery or radiation therapy
iii. Iodine deficiency
* “Hashimoto Removed Iodine”
- What are 2 major clinical manifestations associated with hypothyroidism?
i. Cretinism (in childhood or early childhood)
ii. Myxedema (in older children and adults)
- What are some clinical manifestations of Cretinism (hypothyroidism)?
i. Impaired skeleton development
ii. Impaired CNS development (severe mental retardation)
iii. Coarse facial features
iv. Short statures
v. Protruding tongue
- Patients with Myxedema may also experience symptoms similar to patients with Cretinism such as mental sluggishness, coarse facial features, or enlarged tongue. What are clinical features that make Myxedema different from Cretinism?
i. Depression (due to mental sluggishness)
ii. Obesity
iii. Generalized apathy
iv. Accumulation of mucopolysaccharide-rich edema
v. Cold-intolerance
vi. Constipation
vii. (Late) cardiac effects
* “D O G Accumulated Cold Constipation and Cardiac defects”
- Patients with hypothyroidism (Cretinism or Myxedema) often have increased serum TSH level but what are 2 situations where this is not true?
i. Primary hypothalamic or
ii. Pituitary Diseases
- How would you treat patients with hypothyroidism?
Thyroid Hormone Replacement Therapy (Synthroid)
- What is the population that is often affected by Hashimoto Thyroiditis?
Predominantly females (10:1 :: Female:Male)
- What is a common etiology of Hashimoto Thyroiditis?
Insufficient iodine in diet
- What kind of pathophysiology is associated with Hashimoto Thyroiditis?
It is an autoimmune disease with progressive destruction of parenchyma with inflammatory infiltrate (involves CD4+, CD8+ and Natural Killer cells).
It exhibits a marked lymphocytic infiltrate with germinal center formation.
- Patients with Hashimoto are usually at risk for what kind of neoplasm?
B-cell Non-Hodgkin Lymphoma
- When you see a patient with diffuse and multi-nodular goiters, what kind of abnormalities would you see among these patients?
Impaired synthesis of thyroid hormone
- What is a common cause of Goiter? Other causes?
Often due to dietary deficiency
Other causes may include:
i. Impaired TH synthesis
ii. Increase serum TSH
iii. Hypertrophy and Hyperplasia of thyroid follicular cells
iv. Gross enlargement of gland
