Hyperthyroid Flashcards Preview

Endocrine-Week 1/2 > Hyperthyroid > Flashcards

Flashcards in Hyperthyroid Deck (24)
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1
Q

Excess of either thyroid hormones or preformed thyroid hormones; examples are Grave’s disease, Toxic Goiter, Thyroiditis and meds

A

Hyperthyroidism

2
Q

Examples of causes of Hyperthyroidism

A
Grave's disease
Toxic Multinodular Goiter
Thyroiditis
Excessive Thyroid Hormone dosage
Excessive Iodine load
3
Q

What is the Jod-Basedow phenomenon?

A

hyperthyroidism following admin of iodine (not a normal phenomenon, should dec. function; sign of abnormality)

4
Q

The signs/symptoms of Hyperthyroidism are due to…

A

Inc. metabolism and target organ hyperfunction

5
Q

Signs/Symptoms of Hyperthyroidism

A
Heat intolerance
Inc. HR
Increased appetite
Hyperactive reflexes
Lid retraction/lag
Increased BP (systolic)
6
Q

Cause of Hyperthyroidism; MOST COMMON; more common in females; thyroid stimulating immunoglobulins (TSIs) activate the TSH receptor on thyroid cells; can also see ophthalmopathy due to proliferation of retro-orbital smooth muscle and fibroblasts

A

Grave’s Disease

7
Q

Ophthalmic issue associated with Grave’s disease

A

Grave’s Ophthalmopathy (proliferation of retro-orbital smooth muscle and fibroblasts)

8
Q

Histology findings for Grave’s Disease (autoimmune hyperthyroidism)

A

Hyperplastic
Colloid is ABSENT
Lymphocytic infiltration

9
Q

Cause of Hyperthyroidism; nodules in thyroid acquire autonomy over time; asymmetric, nodular gland

A

Toxic Multinodular Goiter

10
Q

Histology (can/can’t) distinguish between a Toxic and Non-toxic Nodular Goiter

A

Can’t

11
Q

Ways to help diagnose the cause of Hyperthyroidism

A
Antibody testing (high TSI in Grave's)
Nuclear studies (thyroid scanning)
Thyroglobulin levels (indicate exogenous thyroid hormone ingestion)
12
Q

Inflammation of the thyroid

A

Thyroiditis

13
Q

Subacute inflammation of the Thyroid; PAINFUL, tender and swollen thyroid that can result in HYPERthyroidism; histology shows granulomatous inflammation with replacement with giant cells

A

De Quervain’s Thyroiditis

14
Q

Main treatments for Hyperthyroidism

A

Anti-thyroid drugs (Methimazole, Propylthiouracil)
Radioactive Iodine
Surgery

15
Q

Examples of Anti-Thyroid drugs (used for Hyperthyroidism, like Grave’s) (2 total)

A

Methimazole

Propythiouracil

16
Q

MOA of Anti-Thyroid drugs (Methimazole and Propythiouracil)

A

Blocks all 4 steps!

  1. Blocking Thyroid Peroxidase
  2. Blocks the organification of Iodide
  3. Coupling of MIT/DIT
  4. T4 –> T3 conversion (only by PTU)
17
Q

Side effects of Anti-Thyroid drugs (Methimazole and Propythiouracil)

A

Rash

Liver Damage*
Agranulocytosis*

*uncommon, but very dangerous

18
Q

Extreme example of SEVERE Hyperthyroidism that is precipitated by infection, surgery or drugs; Endocrine EMERGENCY with high mortality; treat with Anti-Thyroid drugs (Propythiouracil) or underlying cause

A

Thyroid Storm

19
Q

Treatments for Thyroid Storm

A

Anti-Thyroid drugs (only Propythiouracil)
Propanolol (for palpitations)
Treat underlying cause

20
Q

Three antibody-mediated clinical features of Grave’s disease

A
  1. Opthalmopathy
  2. Dermopathy (물집)
  3. Acropathy (clubbing of fingers)
21
Q

TSH, T4, T3 levels of primary hyperthyroidism

A

low, high, high

22
Q

TSH, T4, T3 levels of secondary hyperthyroidism

A

high, high, high

23
Q

TSH, T4, T3 levels of subclinical hyperthyroidism

A

low, normal, normal

24
Q

What are the 3 phases of thyroiditis

A

phase 1: hyperthyroid
phase 2: normal
phase 3: hypothyroid

Phase 4: recovery