Thyroid Flashcards
0
Q
What shape is thyroid and location
A
Butterfly shape. Located in middle of neck
1
Q
Any protein bound to a hormone is
A
Inactive
2
Q
Parathyroid location
A
Embedded in the posterior aspect of the thyroid
3
Q
Parathyroid gland secretes which hormone
A
PTH. Parathyroid hormone
4
Q
PTH regulates what
A
Calcium & phosphate levels
5
Q
What is necessary for PTH function
A
Vitamin D
6
Q
Hormones are what kinds of messengers & how are they transported?
A
chemical; transported by the blood stream
7
Q
thyroid c-cells produce
A
calcitonin
8
Q
thyroid follicles (sac structures) function
A
remove iodine from blood to make thyroid hormones
9
Q
If the serum calcium level drops….PTH will increase or decrease
A
PTH will increase to get more circulating calcium
10
Q
Regulation of Thyroid in order
A
Body stimulus–>Hypothalamus:TRH–>Anterior Pituitary:TSH–>Thyroid Glad:Thyroid Hormone
11
Q
Thyroid Hormone
A
T3 & T4
12
Q
Things that will make us have an increase in thyroid hormone
A
Cold environment, Hypoglycemia, high altitude, pregnancy
13
Q
Anterior pituitary gland produces?
A
TSH
14
Q
Thyroid Hormone regulates
A
metabolic rate
15
Q
Thyroid Hormone increases?
A
protein synthesis, carb & fat metabolism, oxygen consumption, bone growth
16
Q
Thyroid Hormone is necessary for
A
growth & mental & sexual development
17
Q
Difference between T3 &T4
A
T4 has 4 atoms, T3 has 3 atoms. T3 is more powerful, T4 is more prevalent
18
Q
TSH normal values
A
2-10 mU/ml
19
Q
Secondary hypothyroidism is related to
A
pituitary problems
20
Q
FT value
A
1.0-2.3 ng/dL
21
Q
T4 value
A
5-12 mcg/dL
22
Q
FT what kind of hormone
A
unbound to protein, active hormone
23
Q
hyperthyroidism = High or Low TSH
A
Low TSH
24
T3 Values
80-200 ng/dL
25
When people develop thyroid antibodies they can develop
graves disease, Hashimoto's thyroiditis, chronic thyroiditis
26
Who can get thyroid antibodies?
people with viral infections
27
An RIA ( radioactive iodine uptake) test
They inject or give this PO & look to see how the thyroid takes it up. Any iodine in the system the thyroid will take
28
warm spots taking up less radiation
benign lesions
29
cold spots taking up less radiation
Malignant tumor
30
What is the DR looking for if he does a thyroid biopsy?
cancer
31
3 alterations in thyroid function
hyperthyroidism (excess thyroid hormone); hypothyroidism (low thyroid hormone); Goiter (increase in thyroid size)
32
euthyroid
normally functioning thyroid
33
Hyperthyroid signs
everything is going to speed up. Tachycardia, anxiety, restlessness, fatigue (bc their working so hard), menstrual changes, negative nitrogen balance, weight loss
34
Exophthalmos
forward protrusion of eyeball; sclera visible above iris (might need surgery to fix this)
35
Ophthalmopathy
related to hyperthyroidism; TSA interacts with orbital tissue behind the eyeball & the extraoccular muscles that move the eyeball (bulging of eye), they can get blurred vision, eye pain, exophthalmos
36
Effects of Exopthalmos
eye dryness, irritation, infection& ulceration bc eyelids can not close over protruding eye
37
Pretibial myxedema
form of graves disease which is a form of hyperthyroidism. Plaques & nodules forming over legs & feet.
38
hyperthyroidism lab values
TSH decreased everything else increased
39
causes of hyperthyroidism?
Graves Disease, Toxic multinodular goiter, pituitary neoplasm, Thyroiditis, Tyroid Storm, Increased iodine ingestion
40
Graves disease
most common hyperthyroidism, autoimmune disorder, increase in iodine intake can contribute to this. TSA binds to TSH which increases thyroid production
41
Toxic Multinodular goiter
They have little nodules on the thyroid which secrete thyroid hormone, gradual onset, no opthalmopathy,
42
Pituitary neoplasm
Pituitary tumor stimulates thyroid to synthesize thyroid hormone.
43
who is at risk for toxic multinodular goiters?
elderly females c a history of goiters get this
44
What form of hyperthyroidism is pituitary neoplasm?
Secondary
45
Thyroiditis
inflammation of thyroid gland, can happen with any viral infection, acute disorder with increased TH secretion
46
If a person has thyroiditis chronically, they can develop a
hypothyroid state
47
Thyroid crisis/storm
extreme state of hyperthyroidism. When a person already has hyperthyroidism & they don't know it & they get a viral infection or have stress
48
What things can cause thyroid crisis/storm in People who have hyperthyroidism
Stress: trauma, infection, pregnancy, co-morbidities or meds, not being treated, manipulation of thyroid gland surgery
49
s/s of thyroid crisis/storm
tachycardia, CHF, angina, MI, atrial fib, systolic hypertension c wide pulse pressure, agitation, restlessness & tremors, confusion, psychosis, delirium, sezures, coma, abdominal pain, vomiting, bone loss fracture, life threatening
50
Thyroid crisis/storm treatment
supportive therapy, respiratory support, treat hyperthermia by using cooling blankets & acetaminophen, IV fluids, hemodynamic support by vassopressors to restore or maintain bp & digoxin & diuretics to treat CHF
51
Adrenergic blockers- propranolol (Inderal)is given to a patient with thyroid crisis/storm in order to?
to slow the hr down, its not to correct hyperthyroidism. it is given to prevent any cardiac problems
52
Anti-thyroid medication is started for a patient with thyroid crisis/storm because it?
inhibits hormone synthesis but doesn't block any thyroid hormone that's already in the gland &partially inhibit conversion of T4 to T3
53
Why do we do plasmapheresis or peritoneal dialysis on a patient with thyroid crisis/storm?
to remove circulating antibodies
54
Treatment of hyperthyroidism depends on what
patient age & physical state, & the case of the hyperthyroidism
55
Treatment of hyperthyroidism
medications, Radioactive iodine therapy or surgery
56
Medications to treat hyperthyroidism
iodine solutions, Antithyroid agents (thioamides); Beta-blocker: Inderal
57
Iodine Solutions: Lugols solution, Potassium Iodine (SSKI)
prevent the synthesis & release of TH. Its a short term effect
58
When are Iodine Solutions: Lugols solution, Potassium Iodine (SSKI) used & why?
Used in thyroid crisis/storm hastens effect of antithyroid meds, the iodine decreases vascularity of the thyroid gland which decreases the release of TH. Its used prior to surgery
59
Antithyroid agents (thioamides) examples & are given when?
Propylthiouracil (PTU) & Methimazole (Tapazole); given during thyroid crisis/storm
60
Propylthiouracil (PTU) effects
N&V, crosses placenta & breast milk in low concentrations, onset 10-21 days c peak effect 6-10 weeks
61
Methimazole (Tapazole) effects
Bone marrow suppression, agranulocytosis, anemia, leukopenia, crosses placenta & breast milk
62
Radioiodine Therapy
Thyroid takes up radioactive iodine which will kill follicle cells in the thyroid gland which will then cause the thyroid gland to produce less TH, can be given orally, no hospitalization & no radiation precautions, Cant do if pregnant
63
Why would radioiodine therapy cause a patient to go on thyroid hormone replacement?
because you could send them into a hypothyroid state because you don't know how much radioiodine they need
64
Dr will do Thyroidectomy if
drug therapy fails, Radiation therapy contraindicated, or patient has thyroid cancer
65
With a Partial thyroidectomy, does patient need Thyroid replacement therapy?
no thyroid replacement is necessary. A partial thyroid can supply adequate TH
66
thyroid follicles function
remove iodine from blood to synthesize thyroid hormones
67
Lithium & Potassium can cause
secondary hypothyroidism
68
Secondary hypothyroidism
something is wrong with the pituitary
69
Primary hypothyroidism
something is wrong with the thyroid
70
Aspirin, steroids, dopamine, heparin & antithyroid therapy can cause
primary hypothyroidism
71
cortisone, thorazine, Dilantin, heparin, sulfonamides, reserpine, testosterone, Inderal, orinase & high doses of salicylates may increase or decrease TH
decrease
72
What do you want to avoid prior to thyroid test
shellfish, no fluid restrictions
73
oral contraceptives, estrogen, clofibrate & trilafon may increase or decrease TH
increase
74
Graves disease, Hasimotos thyroiditis, chronic thyroiditis all have what?
thyroid antibodies
