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ADT Module 5-8 > Thyroid > Flashcards

Flashcards in Thyroid Deck (58)
1

Prevalance of thyroid disease ___ with age and is more prevalent in ___ than in ___.

increases, women, men

2

In the negative feedback system, the ___ is regulated by the ___ gland, which secretes ___. TSH then stimulates the thyroid to produce ___ and ___. These 2 then feedback on the ___.

thyroid, pituitary, TSH, T3, T4, pituitary

3

All ___ is secreted by the thyroid, but only about 20% of ___ is secreted. 80% of circulating ___ is produced by conversion of ___.

T4, T3, T3, T4

4

T4 iodine molecule has ___ atoms, whereas T3 has ___.

4, 3

5

Thyroid hormone is highly ___ bound (99%). Changes in plasma protein concentrations affect the total ___ hormone. Want to measure ___ T4 and ___, but not ___ T4.

plasma, thyroid, free, TSH, total

6

Autoimmune thyroiditis (aka ___) is where the immune system attacks the ___ gland as if it does not belong.

Hashimoto's, thyroid

7

___ disease is characterized by antibodies that stimulate ___ production and therefore secretes an excess amount of ___ hormones.

Graves', TSH, thyroid

8

Hypothyroidism is ___ of thyroid hormone and can be brought on by: ____, ____ or ___, or ___-induced (amiodarone, lithium, interferon, sunitinib).

lack, hashimoto's, thyroidectomy, radioactive iodone, drug

9

The weight gain associated w/hypothyroidism is, at most, ___. More associated w/___ retention.

modest, fluid

10

The easiest test to test for hypothyroidism is ___. Elevated ___ will indicate hypothyroidism. TSH > ___-___.

TSH, TSH, 10-12

11

Subclinical hypothyroidism indicates an ___ TSH w/___ thyroid hormone levels in an otherwise healthy and ___ pt.

increased, normal, asymptomatic

12

Indications for tx of subclinical hypothyroidism: TSH > ___, if they have a ___, a significant titre of ___ autoantibodies, or if they are attempting ___.

10, goiter, thyroid, conception

13

Mainstay tx for hypothyroidism is ___. Only proper treatment option.

thyroxine (T4)

14

Treatment options to avoid: ___ thyroid, ___, ___-___ combinations.

dessicated, triiodothyronine (T3), T4-T3

15

___ thyroid is an example of dessicated thyroid and should ___ be recommended.

Armour, never

16

Thyroxine medication increases ___ O2 consumption, so to be cautious in pt's w/___disease.

myocardial, cardiac

17

Instructions for thyroxine replacement: take on ___ stomach, do not take at same time as ___ or ___ supplements, if a dose is missed it is okay to ___ dose, keep pills ___ and ___, be ___ loyal.

empty, iron, calcium, double, dry, dark, brand

18

A lower dose of thyroxine is often sufficient for ___ thyroid disease. Recheck ___ and ___ every ___-___ weeks after starting on thyroxine therapy.

mild, TSH, Free T4, 6-8

19

Every pregnant pt will need ___ thyroxine dosage.

increased

20

Monitor for postpartum ___ every 6-12 wks for the first year postpartum.

thyroiditis

21

Hyperthyroidism (aka ____). Causes include ___ disease, toxic ___, toxic ___, ___, ___-induced, TSH-producing ___.

thyrotoxicosis, graves', goiter, adenoma, thyroiditis, iodine, adenoma

22

Typical symptoms of ___ include: anxiety/irritability, insomnia, palpitations, heat intolerance, wt loss, hyperdefacation. Signs include: lid lag, exopthalmus, goiter.

hyperthyroidism

23

Symptoms of ___ include: fatigue, depression, cold intolerance, constipation, menstrual irregularities, modest wt gain. Signs include: brady, hair changes, myxedema.

hypothyroidism

24

Hyperthyroidism will typically cause a ___ TSH level, so you will see a normal-high TSH in a TSH-producing ___ ___.

decreased, pituitary adenoma

25

When is the only time to use the test thyroglubilin for?

when testing for factitious hyperthyroidism

26

Medications to tx hyperthyroidism include:___ and ___. Both ___ thyroid hormone synthesis.

methimazole (MMI), propylthiouracil (PTU), inhibit

27

MMI has serum half-life of ___ hrs, whereas PTU has half-life of ___ hrs. MMI appropriate for ___ administration, and PTU requires ___ administration.

6, 1.5, daily, TID

28

___ is preffered over ___ d/t lower risk of drug-induced hepatitis. ___ is preffered during ___ trimester of pregnancy or pt's who have allergy to ___.

MMI, PTU, PTU, first, MMI

29

Adverse/serious effect of thionamides is ___, where the pt has a fever and pharyngitis. Pt needs to go straight to ER.

agranulocytosis

30

Thionamide drugs include:

methimazole (MMI) and propylthiouracil (PTU)

31

___-___, such as ___ also can be used to tx hyperthyroidism b/c they block the effect of thyroid hormone. They are the quickest way to relieve symptoms in a pt but do not tx the underlying disease. ___ once thryoid levels are normallized.

beta-blockers, propranolol, D/C

32

Radioiodine is another tx for ___ and delivers a killing dose of local ___ w/little exposure elsewhere. It is given ___ and only ___ time. Contraindicated in ___.

hyperthyroidism, radiation, orally, one, pregnancy

33

___ must be d/c'ed 3-7 days prior to giving radioiodine b/c otherwise it will be ineffective.

thionamides

34

___ or ___ should be used for pain in thyroiditis

NSAIDS, corticosteroids

35

___-___ are most affective initial tx for hyperthyroidism.

beta-blockers

36

___ thyroid hormone is best tx during hypothyroid phase.

exogenous

37

You want to taper ___ gradually over a few months.

thyroxine

38

Tx for iodine-induced hyperthyroidism includes: high dose of ___ medication, ___-___, and ___ once controlled w/medication.

antithyroid, beta-blockers, thyroidectomy

39

Multinodular glands are almost always d/t ___ causes, which includes MNG or thyroiditis. A ___ is typically the best course of tx.

benign, thyroidectomy

40

___, ___, or ___ nodules are a cause of concern for thyroid cancer.

single, dominant, enlarging

41

Risk factors indicative of a malignant thyroid nodule:

firm, hard, irregular, fixed nodule

42

Upon evaluation for thyroid nodules, check ___ and if suppressed, perform a ___. Otherwise do an ___.

TSH, scan, ultrasound

43

___ ___ ___ is the best initial diagnostic procedure for a thyroid nodule > 1cm.

fine needle aspiration

44

If nodule is malignant upon FNA, need to do ___. If benign, just ___-___.

thyroidectomy, follow-up

45

If nodule is < ___ cm and ___, then just follow up. If > ___ cm and ___, then perform biopsy.

1, nonpalpable, 1, palpable

46

Thyroxine should be taken at least ___-___ mins before any other meds or breakfast.

20-30

47

Recheck ___ and ___ every ___-___ wks while on thyroxine therapy. Need ___ half-lives to reach therapeutic state.

TSH, Free T4, 6-8, 5

48

Normal levels for TSH during pregnancy differs and is < ___ during first trimester, < ___ during second, and < ___ during third.

2.5, 3.0, 3.5

49

Increase thyroxine dose by ___-___ mcg once pregnancy is diagnosed.

25-50

50

Euthyroid sick syndrome occurs in everyone who is ___ ___. TSH, T4, and T3 will all be ___.

critically ill, suppressed

51

Major sign of hyperthyroidism is if a pt seems ___ and can't sit still.

hyperkinetic

52

___-___ are the fastest way to make pt's w/hyperthyroidism feel better. They block the excess ___ hormone, but do not tx underlying ___. ___ is used most commonly and is d/c'ed once ___ levels are normalized.

Beta-blockers, thyroid, cause, propranolol, thyroid

53

Wait ___ months to try to conceive after receiving radioactive iodine.

6

54

___ medication can be used to "cool down" Grave's disease, but the definitive therapy for is ___.

antithyroid, ablation

55

___ will restore normal thyroid function in Toxic MNG and adenoma. ___ is best option if size of goiter is an issue.

radioiodine, thyroidectomy

56

Hyperthyroidism can also result in disease of ___ where the thyroid leaks out ___ hormone and you have a roller-coaster of both ___ and ___ states.

inflammation, hyper, hypothyroidism

57

Hx of ___ tx to face or neck, ___, or ___ are risk factors for malignant thyroid nodule.

radiation, dysphagia, hoarseness

58

Giving thyroid hormone to suppress ___ is not an effective diagnostic maneuver.

TSH