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Clinical Science > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

Total WBC count

A

4.5 - 11.0 x 10^3/uL

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2
Q

% of neutrophil count

A

50-70% of WBC count

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3
Q

Absolute neutrophil count calculation

A

1.8-7.9 x 10^3/uL

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4
Q

Platelet count

A

150-450 x 10^3/uL

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5
Q

RBC count males

A

4.6-6.0 x 10^6/uL

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6
Q

RBC count females

A

3.9-5.5 x 10^6/uL

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7
Q

Hgb Male

A

13.6-17.2 g/dL

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8
Q

Hgb Female

A

12.0-15.0 g/dL

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9
Q

Hematocrit Male

A

41-50%

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10
Q

Hematocrit Female

A

35-45%

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11
Q

Total iron binding capacity %

A

66% (250-400mcg/dL)

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12
Q

sodium

A

136-142 mEq/L

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13
Q

potassium

A

3.5-5.0 mEq/L

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14
Q

glucose

A

70-110 mg/dL

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15
Q

BUN

A

8-23md/dL

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16
Q

Creatinine male

A

0.7-1.3 mg/dL

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17
Q

Creatinine female

A

0.6-1.1 mg/dL

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18
Q

Bilirubin (total)

A

0.3-1.2 mg/dL

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19
Q

HgbA1C

non diabetics

A

4.0-5.6%

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20
Q

HgbA1C diabetic diagnosis

A

greater than or equal to 6.5%

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21
Q

HgbA1C

poorly controlled diabetic

A

> 8%

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22
Q

HgbA1C goal for diabetic pt

A

7%

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23
Q

Troponin I

A

<0.03ng/mL

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24
Q

Troponin T

A

<0.1ng/mL

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25
Q

Cholesterol

A

<200mg/dL

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26
Q

ESR

A

0-20mm/hour

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27
Q

TSH

A

0.5-5.0 uIU/mL

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28
Q

Iron deficiency anemia

A

decreased iron in body

blood loss, pregnancy, poor diet, gastric bypass

most common

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29
Q

Vitamin deficiency anemia

A

low levels of B12/folate (required for erythropoesis)

poor diet

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30
Q

Aplastic anemia

A

body stops making new RBCs

chemicals, drugs, autoimmune disease

rare

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31
Q

Hemolytic anemia

A

destruction of RBCs

multiple causes (genetics, infection)

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32
Q

Anemia of chronic disease

A

decreased RBC production in bone marrow

chronic inflammatory and neoplastic states–impair RBC production

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33
Q

Sideroblastic anemia

A

abnormal production of RBCs preventing iron from binding to Hgb

multiple causes

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34
Q

Thalassemia

A

abnormal alpha/beta chain of Hgb

genetic cause

more common in certain ethnic groups

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35
Q

Normocytic anemia

A

Hgb/Hct decreased but MCV normal

acute blood loss, anemia of chronic disease

most frequently encountered anemia

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36
Q

Microcytic anemia

A

MCV decreased <80fl

thalassemia

most common cause of iron deficiency anemia

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37
Q

Macrocytic anemia

A

MCV increased >100fl

alcoholism, B12 folate deficiency, liver disease

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38
Q

White blood cells

A 
monocyte
eosinophil
basophil
lymphocyte
neutrophil
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39
Q

WBC count purpose

A

measure all white blood cells

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40
Q

Elevated WBC count

A

leukocytosis

bacterial infections, steroids, smokers

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41
Q

Decreased WBC count

A

leukopenia

viral and parasitic infections, some bacterial
decreased production 2/2 cancer, chemo, B12 deficiency, alcohol abuse, poor nutrition
African American descent

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42
Q

WBC count fluctuations

A

exercise
pain
pregnancy
emotional responses

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43
Q

WBC w/differential

neutrophils purpose

A

60% of WBCs are neutrophils

important to get % as well as actual count

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44
Q

Elevated WBC w/diff neutrophils

A

leukocytosis

left shift–higher presence of immature cells (band)

occurs in infection

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45
Q

Decreased WBC w/diff neutrophils

A

leukopenia

severe neutropenia= high risk of life threatening bacterial infection

mild and moderate risks

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46
Q

WBC w/diff lymphocytes purpose

A

measure T, B, and NK cells

form body’s immunity
20-40%

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47
Q

Elevated WBC w/diff lymphocytes

A

lymphocytosis

mostly viral (mono, CMV, HIV, pneumonia, MMR, varicella)

some bacterial (pertussis, bartonella)

levels higher in infants/children

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48
Q

Decreased WBC w/diff lymphocytes

A

lymphocytopenia

bacterial/fungal sepsis

post-op state, chemo, radiation, malignancy, steroids, immunosuppressants

immature lymphocyte=blast

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49
Q

WBC w/diff monocytes purpose

A

measure monocyte level

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50
Q

causes of elevated WBC w/diff monocytes

A

bacterial, viral, parasitic infection

hematological/myeloproliferative disorder, hemolytic anemia, autoimmune

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51
Q

monocytes

A

precursor to macrophage, fxn to remove damaged/dead tissue

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52
Q

WBC w/diff eosinophils purpose

A

measure eosinophils

not really sure

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53
Q

Elevated WBC w/diff eosinophils

A

eosinophilia

parasites and allergic disorders

milde: 500-1500

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54
Q

Decreased WBC w/diff eosinophils

A

eosinopenia

acute bacterial infections

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55
Q

WBC w/diff basophils purpose

A

measure basophil count

least used part of CBC

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56
Q

Elevated WBC w/diff basophils

A

parasitic infection and allergies but uncommon

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57
Q

Decreased WBC w/diff basophils

A

uncommon

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58
Q

Platelets purpose

A

important to determine coagulation disorder

any bleeding/bruising should be thought of as platelet fxn issue

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59
Q

Elevated platelet count

A

thrombocytosis

reactive: infection, post-op, malignancy, post-splenectomy, acute blood loss
autonomous: malignancy

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60
Q

Decreased platelet count

A

thrombocytopenia

lab error, drug induced, infection, HIV, HCV, Epstein Barr, sepsis, parasites

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61
Q

RBC count purpose

A

measure RBC count

anemia

Panel includes quantity, size, weight, volume, width of RBC

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62
Q

Elevated RBC count

A

cigarette smoke, Dehydration, polycythemia (abnormally high RBC and Hgb count)

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63
Q

Decreased RBC count

A 
anemia
bleeding (GI and GYN)
hematopoietic failure
poor nutrition (lack of B6, B12, folate, iron)
drug induced (abs, NSAIDs)
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64
Q

Hemoglobin (Hgb) purpose

A

HB carries O2

useful test

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65
Q

Elevated Hgb

A

tobacco, COPD, alcohol abuse
dehydration (false elevation)

increased in newborns

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66
Q

Decreased Hgb

A

acute blood loss, malnutrition, renal failure, disorders of Hgb structure (thalassemia, sickle cell)

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67
Q

Hematocrit (Hct)

A

% of whole blood made up of RBCs

packed cell volume

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68
Q

Mean corpuscular volume (MCV)

A

average volume of RBC

classify types of anemia

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69
Q

Elevated MCV

A

macrocytic

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70
Q

Decreased MCV

A

microcytic

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71
Q

Mean corpuscular hemoglobin concentration (MCHC)

A

portion of RBC taken up by Hgb

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72
Q

Elevated MCHC

A

increased Hgb
increased iron

increased color of RBC=hyperchromatic

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73
Q

Decreased MCHC

A

hypo chromatic (decreased Hgb)

less red color

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74
Q

Mean corpuscular hemoglobin (MCH)

A

weight of hemoglobin in RBC

rises and falls w/MCV

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75
Q

RBC distribution width (RDW)

A

measure variation in RBC volume

earliest manifestation of iron deficiency anemia

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76
Q

Anisocytosis

A

cells of varying size

elevated RDW

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77
Q

Reticulocyte count

A

not part of CBC

reticulocytes=immature RBCs (should be 1%)

f/u abnormal CBC

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78
Q

Increased reticulocyte count

A

hemolytic anemia
acute blood loss
severe anemia (reticulocytes released prematurely, more in circulation)

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79
Q

Decreased reticulocyte count

A

vitamin deficiency anemia, iron deficiency anemia, bone marrow failure, decreased EPO production

renal disease/failure

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80
Q

Hemoglobinopathies

A

alpha/beta thalassemia
Hb S–sickle cell
Hb C–mild anemia
Hb E–mild anemia (Asians)

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81
Q

Components of CMP

A

electrolyte fxn–sodium, potassium, chloride, carbon dioxide, anion gap

renal fxn–BUN, creatinine

liver fxn–bilirubin, alkaline phosphatase, AST, ALT

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82
Q

Reasons to order CMP

A

abdominal pain
glucose levels
potassium/renal fxn (HTN tx)
liver dysfunction/toxicity

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83
Q

Ion distribution

A

intracellular fluid: potassium

extracellular fluid: sodium

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84
Q

Plasma water increased

A

sodium and osmolality decreased
ADH secretion decreased
collecting renal tubule impermeable to water (water not reabsorbed)

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85
Q

Plasma water decreased

A

sodium and osmolality increased
ADH secretion increased
collecting renal tubule reabsorbs more water

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86
Q

Elevated sodium

A

hypernatremia

unreplaced water loss (elderly pt/people w/o free access to water)

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87
Q

Decreased sodium

A

hyponatremia

thiazide diuretics, renal insufficiency, inadequate sodium

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88
Q

Elevated potassium

A

increased intake
ACE inhibitors
crush injuries/infection

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89
Q

Decreased potassium

A

fluid/electrolyte loss
diuretics
decreased intake

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90
Q

Elevated glucose

A 
diabetes
acute stress response
pregnancy
pancreatitis
corticosteroid therapy
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91
Q

Decreased glucose

A

insulinoma
insulin OD
starvation

92
Q

Elevated BUN

A

high protein diet
GI bleed
dehydration

93
Q

Decreased BUN

A

low protein diets
starvation
overhydration

94
Q

Elevated creatinine

A 
disorders of renal function
urinary tract obstruction
diabetic nephropathy
rhabdomyolysis
gigantism/acromegaly
95
Q

Decreased creatinine

A

debilitation

decreased muscle mass

96
Q

Elevated calcium

A

hypercalcemia

hyperparathyroidism
vitamin D toxicity
tumors
acromegaly

97
Q

Decreased calcium

A

Hypocalcemia

hypoparathyroidism
vitamin D deficiency
hypoalbumin
malabsorption

98
Q

Elevated serum protein

A

Hyperproteinemia

dehydration
malignancy
infection
over production of immunoglobulins

99
Q

Decreased serum protein

A

Hypoproteinemia

hepatic failure/disease
malnutrition/malabsorption
renal failure/disease

100
Q

Elevated albumin

A

hyperalbuminemia

dehydration

101
Q

Decreased albumin

A

hypoalbuminemia

malnutrition
pregnancy
hepatic disease/failure
renal damage (kidneys spill protein)

102
Q

Elevated ALP (alkaline phosphatase)

A 
cirrhosis
biliary tract obstruction
liver tumors
drugs toxic to liver
cancers metastasizing to bone
primary bone cancer

elevated in any condition of bone formation (normal or abnormal)

103
Q

Decreased ALP

A

malnutrition state

104
Q

Elevated AST (aspartate aminotransferase)

A

liver disease (hepatitis shoots this value through the roof)
liver tumors
mono

105
Q

Elevated ALT (alanine aminotransferase)

A

liver abnormality
hepatitis
hepatotoxic drugs
cirrhosis

106
Q

Potassium general notes

A

secreted but not reabsorbed by kidney

minor change has dramatic effect on membrane potential (esp in muscle cells)

important in cardiac muscle and skeletal muscle nerve excitability

107
Q

Glucose levels general notes

A

increase after eating
cells in islets of Langerhans secrete insulin to decrease glucose level

hormones affect levels

108
Q

BUN general notes

A

50% urea reabsorbed in renal tubule (rest excreted in urine)

reflect metabolic function of kidneys/liver, excretory function of kidneys

109
Q

Creatinine general notes

A

secreted by kidneys at constant rate

increased level appears later in renal disease

doubling of level = 50% decrease in GFR

110
Q

Calcium general notes

A

50% of calcium is free, rest is protein bound/complexed

111
Q

Parathyroid hormone (PTH)

A

increases calcium levels

comes from parathyroid gland

112
Q

Calcitonin

A

decreases calcium levels

comes from thyroid gland

113
Q

Unconjugated bilirubin

A

indirect bilirubin

can pass through BBB (cause mental retardation/encephalopathy)

seen in newborns

114
Q

Conjugated bilirubin

A

direct bilirubin

conjugated w/glycuronide in liver

115
Q

Causes of indirect hyperbilirubinemia

A

hepatocellular dysfunction (hepatitis, cirrhosis, neonatal hyperbilirubinemia)

diseases increasing RBC destruction (transfusion rxn, sickle cell, hemolytic anemia)

meds

116
Q

Causes of direct hyperbilirubinemia

A

gallstones

obstruction of extra hepatic ducts by tumor

liver metastases

117
Q

Albumin general notes

A

60% of serum protein

regulates osmotic pressure

118
Q

BMP

A

tests electrolytes, kidney, glucose

no liver function tests

119
Q

BUN/Creatinine ratio

A

manually calculated, not on CMP

if both levels normal, don’t have to calculate

Normal– 10:1-20:1

120
Q

Pre-renal disease

A

ratio >20:1

volume depletion, sepsis, hypotension, CHF

121
Q

Intrarenal disease

A

ratio <10:1

glomerulonephritis

122
Q

Postrenal disease

A

Early disease ratio >20:1

Late disease ratio <10:1

123
Q

GGT (gamma glutamyl transpeptidase)

A

not included on CMP

liver disease increases level, not very specific

infants have 6-7x normal range

124
Q

HgbA1C test

A

dx/monitor diabetes (binds most readily to sugar)

indicate glucose level over 3-4 months

determine mean plasma glucose level

125
Q

Insulin level

A

dx insulinoma/cause of hypoglycemia

increased: insulinoma
decreased: insulin dependent diabetes

126
Q

C-peptide level

A

determine pancreatic function/ability to make insulin

links alpha/beta chains of proinsulin (C-peptide not found on synthetic insulin)

127
Q

low C-peptide

A

Type I diabetes

128
Q

high or normal C-peptide

A

Type II diabetes

129
Q

Amylase

A

elevated in acute/chronic pancreatitis, pancreatic cancer, bile duct obstruction, cholecystitis (damage to pancreas)

level back to normal in 12 hours (chronic elevation = severe disease)

130
Q

Lipase

A

released w/pancreatic damage (see amylase)

stays elevated longer (5-7 days)–more helpful in dx

131
Q

Uric acid level

A

increased in gout, alcohol abuse, renal failure, dehydration, increased protein/purine diet

132
Q

CHF presentation

A

pitting edema
fluid in lungs
cardiomegaly

133
Q

BNP (brain natriuretic peptide)

A

aid in dx of CHF (levels will be elevated in CHF, MI)

get echocardiogram in addition

released from ventricles during stretch of ventricles

134
Q

Creatinine Kinase (CK)

A

found in high energy tissues

CK-MM (skeletal muscle, increased total CK likely due to CK-MM)
CK-BB (brain)
CK-MB (heart)

135
Q

CK-MB

A

rises 3-6 hours post-MI

elevated for 12 hours post-MI

returns to normal 36-58 hours post-MI

not great test for MI, only indicates that damage has occurred

136
Q

Troponin test

A

GOLD STANDARD TO DX MI

Increased sensitivity and specificity

elevated in 2-3 hours post-MI
stays elevated for 7-14 days

indicates cardiac damage/injury

137
Q

Troponin I function

A

actin/myosin interaction

138
Q

Troponin T function

A

binds troponin and tropomyosin

139
Q

Myoglobin

A

released after skeletal/cardiac muscle injury

more sensitive, less specific than CK-MB

not specific for any dx

140
Q

D-dimer

A

used to r/o DVT/PE (identify intravascular clotting, monitor thrombolytic therapy)

highly sensitive, not specific

negative predictor (r/o, not dx)

141
Q

Elevated D-dimer

A 
DIC
sickle cell anemia
surgery
pregnancy
elderly
142
Q

cholesterol

A

HDL + LDL + VLDL

variation can exist up to 15% between tests

143
Q

Triglycerides

A

increased level indicates triglycerides in tissue

familial hypertriglyceridemia, hyperlipidemia, increased carb diet, poorly controlled diabetes

144
Q

HDL

A

25% of cholesterol (good)

protective against CAD (transport cholesterol from body tissues to liver)

145
Q

Factors that increased HDL

A 
genetics
exercise
moderate alcohol use
healthier eating
estrogen administration
146
Q

Factors that decrease HDL

A

metabolic syndrome

genetics

147
Q

LDL

A

75% of cholesterol (bad)
deposits in arterial walls/plaque

calculate by Friedewald formula

148
Q

Factors that increase LDL

A

genetics
increased saturated fat diet
excessive alcohol consumption

149
Q

Factors that decrease LDL

A

genetics
exercise
low fat diet

150
Q

particle test of LDL

A

small and dense: bad (gets into blood vessels); pattern B

big and fluffy: good; pattern A

151
Q

Lipid panel

A

screens diabetics, HTN/smokers, positive family hx

if initial test normal test every 5years
if initial test borderline test every 3 years

Pt >65 w/normal tests can stop being screened

152
Q

Indications for iron studies

A

iron deficiency/overload
iron storage/processing (infants, kids, premenopausal women)

secondary testing after abnormal CBC (Hgb/Hct abnormal)

153
Q

Iron deficient anemias

A

microcytic or hypo chromic

154
Q

serum iron

A

can fluctuate at different times of day (higher in AM), or consumption of excess iron in diet, meds

don’t get level by itself

155
Q

increased iron level

A

rare

beta-thalassemia
EtOH cirrhosis (liver damage releases iron into circulation)
high iron intake
HHC

156
Q

decreased iron level

A

common

iron deficiency anemia, renal dz, inadequate absorption, increased loss, increased demand

have to identify where iron being lost from

157
Q

Serum ferritin

A

gold standard to test iron deficiency anemia
ferritin levels don’t fluctuate as much

stores 15-20% of iron

acute phase reactant

distinguish b/w iron deficiency anemia and anemia of chronic disease

measure at 4 week intervals after given iron supplement

158
Q

Increased ferritin

A

HHC
excess iron intake/poisoning
chronic hepatits
EtOH

159
Q

Decreased ferritin

A

iron deficiency anemia

160
Q

Transferrin

A

can bind 2 iron molecules

33% of binding sites filled normally

161
Q

synthesis of transferrin in infection

A

increases state of iron deficiency, decreases infection (prevents bacteria from using iron to replicate/survive)

162
Q

Total iron binding capacity

A

evaluates anemia
used w/serum iron and ferritin to evaluate and dx anemia

total amount of iron that serum proteins (transferrin) can bind to

163
Q

TIBC test

A

radioactive iron incubated w/human serum (measure amount of iron taken up by transferrin)

164
Q

TIBC in iron deficiency

A

TIBC level increases because there is less iron and more binding sites open

iron deficiency anemia, pregnancy

165
Q

TIBC in iron overload

A

TIBC level decreases b/c there is too much iron and fewer binding sites open

anemia of chronic dz, HHC

166
Q

Transferrin saturation

A

percentage of transferrin binding sites

increase indicates increase in iron absorption

serum iron/TIBC=% of iron saturation

167
Q

Increased transferrin saturation

A

iron overload states

HHC

168
Q

Decreased transferrin saturation

A

iron deficiency anemia

anemia of chronic dz

169
Q

Lab result in iron deficiency anemia

A

increased TIBC

decreased MCV, serum iron, serum ferritin, % transferrin saturation

170
Q

Lab result in anemia of chronic dz

A 
Normal MCV (decreases over time) 
Decreased serum iron
Normal/increased serum ferritin
Normal/low TIBC
decreased % transferrin saturation
171
Q

Elevated albumin level

A

dehydration

172
Q

Decreased albumin level

A 
liver disease
malabsorption/malnutrition
abnormal loss
renal dz
GI loss
skin loss
severe burns
173
Q

Prealbumin

A

better assessment for nutrition status (shorter half life, more sensitive to change)

not accurate in pt w/inflammation, infection, trauma

174
Q

Elevated prealbumin

A

pregnancy

Hodgkin’s lymphoma

175
Q

Decreased prealbumin

A 
renal/liver dz
malabsorption/malnutrition
eating disorders
Chron's dz
low protein diet
severe illness
inflammation
infection
176
Q

Decreased alpha-1-antitrypsin

A

lungs and liver

COPD onset before 40
prolonged jaundice and hepatitis in infants
liver dysfunction in kids
chronic hepatitis
cirrhosis
hepatocellular carcinoma
177
Q

Increased haptoglobulin

A 
infection
inflammation
neoplastic disease
pregnancy
trauma
178
Q

Decreased haptoglobulin

A

hemolytic anemia
transfusion reaction
artificial heart valves

179
Q

Haptoglobulin

A

binds free Hgb when RBCs are destroyed, transports Hgb to liver, heme converted to bilirubin

180
Q

Complement proteins

A

measure for autoimmune dz, recurrent infections

181
Q

CH50

A

total complement activity (screen)

all 9 CP must be present to have normal result

if value is 0, one of pathways is totally absent

182
Q

C3 and C4

A

investigate undetectable CH50 level

test in presence of certain fungal infections, gram negative septicemia, shock

183
Q

Increased C3 and C4

A

cancer

UC

184
Q

Decreased C3 and C4

A

SLE (lupus)

bacterial infection

185
Q

Immunoglobulins

A

produced by B lymphocytes, specific against individual infectious or foreign agents

186
Q

IgA

A

found in secretions/mucosal epithelium

present in saliva, tears, colostrum, mucus

deficiency can cause frequent respiratory infections, GI inflammation, unexplained asthma

187
Q

IgD

A

unknown function

higher levels seen in multiple infections

188
Q

IgE

A

key factor in allergic reactions and parasitic infections

binds to mast cells

measured in primary care

189
Q

IgG

A

major antibody produced when antigen encountered (“I already Got Germs”

crosses placenta, can protect baby from infection

190
Q

IgM

A

initial antibody secreted after immune challenge

half life is 10 days

indicates recent infection

“I Get Meds”

191
Q

IgG and IgM

A 
Epstein Barr Virus
CMV
Herpes I and II
varicella
measles
mumps 
rubella

active vs past infection

192
Q

Protein electrophoresis

A

identify cancer/precancer, immune abnormalities, dysfunction of kidney or liver

193
Q

Protein electrophoresis peaks

A

broad peak in gamma region associated w/ infections, inflammation, reactive processes

194
Q

M protein on protein electrophoresis

A

multiple myeloma

195
Q

SLE (systemic lupus erythematosus)

A 
butterfly facial rash (nasolabial folds unaffected)
fatigue
weight loss
arthralgia/myalgia
lymphadenopathy
multiple organ involvement
196
Q

Progressive systemic sclerosis (Scleroderma)

A 
skin thickening/hardening
fatigue
arthralgias/myalgias
digital ulcers/contractures
multiple systemic manifestations
197
Q

Sjogren syndrome

A

decreased lacrimal/salivary gland function, dry eyes/mouth/vagina, rhinitis, sinusitis, lymphoma

198
Q

Erythrocyte sedimentation rate (ESR)

A

nonspecific marker

frequent false elevation, non-specific

Rouleaux formation 2/2 neutral environment (RBCs not repelling each other)

199
Q

ESR test

A

Westergren tube, measure how well RBCs fall (minimal in healthy person)

200
Q

Increased ESR

A

microcytosis
anemia

inflammatory disease, AI disease, obesity, malignancy, age, serious infection

> 100mm/hr (CALL 911–septic infection)

201
Q

Decreased ESR

A

more RBCs

abnormally shaped RBCs

202
Q

C-reactive protein (CRP)

A

acute phase reactant

mild, moderate, marked classifications (marked indicates bacterial infection or severe trauma)

> 50m/dL indicates bacterial infection

203
Q

ANA (antinuclear antibody)

A

pattern and value reported

95% of SLE pt have high/positive ANA

decreased specificity but good sensitivity

204
Q

Diffuse ANA

A

SLE

205
Q

Peripheral or rim ANA

A

SLE

206
Q

nucleolar ANA

A

SLE or scleroderma

207
Q

speckled ANA

A

SLE, scleroderma, others

208
Q

Rheumatoid factor

A

primary lab to dx RA

IgM autoantibodies directed against IgG autoantibody (Fc fragment)

most RA pt have much higher levels

209
Q

IgM rheumatoid factor

A

good sensitivity in severe disease, less specificity

210
Q

Rheumatoid arthritis vs osetoarthritis

A

systemic manifestations and autoantibody tissue destruction

211
Q

TSH (thyroid stimulating hormone)

A

assess function of thyroid gland

identify origin of thyroid dysfunction

212
Q

Increased T3/T4

A 
myocardial contractility
HR
mental alertness
ventilator drive
bone turnover
GI motility
213
Q

Primary hyopthyroidism

A

defect in thyroid gland

Hashimoto’s thyroiditis (AI)

214
Q

Secondary hypothyroidism

A

decreased TSH or TRH secretion

pituitary source (less common)

215
Q

Tertiary hypothyroidism

A

trauma
hypothalamic tumors

uncommon

216
Q

Hypothyroidism symptoms

A 
fatigue
dull mentation
dry skin
weight gain
bradycardia
constipation
cold intolerance
217
Q

T4 and T3

A

Free T3 more metabolically active

T4 converted to T3

nearly all T4 protein bound

70% of T3 protein bound

218
Q

T4 in hypothyroidism

A

decreased

219
Q

TSH in hypothyroidism

A

elevated

220
Q

TSH and free T4 decreased

A

hypothalamic/pituitary failure hypothyroidism

221
Q

Subclinical hypothyroidism

A

similar symptoms

high normal/mildly elevated TSH w/normal free T4

222
Q

Hyperthyroidism

A

Grave’s disease (AI)

decreased TSH level (inhibits hypothalamic-pituitary axis)

223
Q

Overt hyperthyroidism

A

low TSH

high free T4/T3

224
Q

Hyperthyroidism symptoms

A 
bulging eyes
edema
jittery
unable to gain weight
anxiety
palpitations
perspiration
heat intolerance
hyper-defectation
225
Q

Subclinical hyperthyroidism

A

low TSH (other values normal)

non-specific symptoms

increased CV risk, a-fib

Clinical Science (4 decks)

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