Thyroid and Adrenal gland

Question 1

Another name for hyperthyroidism

Answer 1

thyrotoxicosis

Question 2

hyperthyroidism mc form

Answer 2

Graves disease(autoimmune disorder most often seen in women 20-40)-antibodies attach the thyroid

Question 3

Thyroid storm

Answer 3

Thyroid storm (an medical emergency) symptoms like feeling hot, sweating, heart palpitations, and weight loss.

Question 4

Hyperthyroidism symptoms/signs

Answer 4

symptoms: nervousness, emotional lability, sweating, HEAT intolerance, fatigue, increased appetite, diarrhea, wt loss., irregular menses, palpitations, A-fib in elderly
Signs: goiter, warm moist sking, thin hair, hair loss, fine tremor, tachycardic at rest, hyperreflexia, exophthalmos, gynecomastia

Question 5

hyperthyroid labs

Answer 5

Low TSH/TRH

High T4

Question 6

Normal TSH and T4 levels

Answer 6

TSH 0.4-4.8

T4 0.8-1.7

Question 7

hyperthyroid tx

Answer 7

radioactive iodine is first line
Propylthiouricil (PTU) blocks T4 concersion to T3 (active form) 100-150 mg/day PO divided q8h
surgery (euthyroid first)
BB for thyroid store, tachy, or a-fib

Question 8

Hypothyroid causes

Answer 8

hashimotos thyroiditis, thryroidectomy, radiation therapy

Question 9

hypothyroidism s/s

Answer 9

opposite of hyperthyroid

Question 10

hypothyroid labs

Answer 10

High TSH

Low T4

Question 11

hypothyroid tx

Answer 11

Levothyroxine (Synthroid) (synthetic T4)
50-100 mcg PO qd
Elderly only 25mcg
once euthyroid maintain on same brand

Question 12

Hypoparathyroidism

Answer 12

seen after thyroidectomy
manifests as hypocalcemia
occurs w/ mg deficiency

Question 13

Chvostek sign

Answer 13

Seen in hypoparathyroidism
It is the hyperirritability of facial nerve when tapped (due to low Ca++)
“stek is like steak, shove steak in face, facial nerve”

Question 14

Trousseau sign

Answer 14

seen in hypoparathyroidism
carpal spasms seen w/i two minutes of inflating BP cuff over systolic pressure
‘trousseau is like trousers, use my hands to put on trousers, causes my hands to spasm, carpal spasm”

Question 15

hypoparathyroidism labs

Answer 15

low Ca++
Low parathyroid hormone Low 
low serum mg (maybe) 
high serum phosphate 
normal alk phos

Question 16

hypoparathyroid tx

Answer 16

oral calcium and vit d

mg

Question 17

Vitamin D helps absorb what

Answer 17

Calcium

Question 18

what does PTH (parathyroid hormone ) do

Answer 18

brings Ca++ into the blood by taking it from bone, reducing loss of ca++ in urine, and by increasing absorption of calcium from intestines

Question 19

hyperparathyroidism classic symptoms

Answer 19

“bones, stones, moans, abdominal groans”
Classic symptoms: Painful bones, renal stones, ab groans, and psychic moans
other: malaise and fatigue before classic sx

Question 20

Hyperparathyroid causes

Answer 20

parathyroid adenoma, hyperplasia, carcinoma

Question 21

hyperparathyroid labs

Answer 21

High ca++ and PTH

Question 22

hyperparathyroid tx

Answer 22

surgical

hydration, inhibit bone resorption, diuretics

Question 23

Addision disease is characterized by what

Answer 23

High ACTH and low cortisol

“A for addision, A for ACTH”

Question 24

Addison dz mc cause

Answer 24

autoimmune inflammation of the adrenal cortex

Question 25

addison dz labs

Answer 25

high ACTH and low cortisol diagnostic others: high- ca++, K+ low- na+, glucose, urea

Question 26

Addison dz s/s

Answer 26

depression, salt cravings, gi, wt loss, orthostatic hotn, delayed DTR, hyperpigmentation, vitiligo, fatigue

Question 27

addison dz tx

Answer 27

5 S's: Salt, sugar, steroids, search, support search for underlying cause "add for addision, add all the s's"

Question 28

Cushings dz

Answer 28

High cortisol due to excess ACTH by pit | "cushings i think a lot of something"

Question 29

Cushings syndrome

Answer 29

too much corticosteroid drugs

Question 30

Cushing dz and syndrome diagnostic lab and other test

Answer 30

Excretion of free cortisol in urine of >125ug/dL in 24 hours is diagnostic Dexamethasone suppression test: 1gm dexa at 11pm, blood draw at 8am, should have 50% reduction in plasma cortisol

Question 31

Cushings s/s

Answer 31

Buffalo hump, Moonface, obesity, purple striae on skin, think skin, skeletal growth reatrdation in children, HTN