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HPIM 19th Endo > Thyroid Diseases > Flashcards

Thyroid Diseases Flashcards

(67 cards)

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1
Q

Most physiologic marker of thyroid hormone action

A

TSH

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2
Q

Major POSITIVE regulator of TSH

A

Thyrotropin Releasing Hormone (TRH)

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3
Q

May artificially SUPPRESS TSH

A

Thyrotoxicosis
hCG secretion in early pregnancy
High dose GC therapy
Treatment with dopamine

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4
Q

Critical first step in the synthesis of thyroid hormone

A

Uptake of iodide

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5
Q

Mental and growth retardation in children due to severe iodine deficiency

A

Cretinism

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6
Q

Autosomal recessive disorder characterized by goiter and sensorineural deafness caused by DEFECTIVE ORGANIFICATION of iodine

A

Pendred Syndrome

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7
Q

May raise serum Total T4 and T3 levels by causing elevation of serum thyroxine binding globulin (TBG)

A

Estrogen

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8
Q

Characteristic distinguishing T4 from T3

A

100% produced directly from the thyroid

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9
Q

Transient inhibition of thyroid iodide organification in response to excess iodide

A

Wolff-Chaikoff phenomenon

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10
Q

Venous distention over the neck and difficulty breathing upon raising the arms caused by large retrosternal goiters

A

Pemberton sign

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11
Q

Lid lag that occurs with exophthalmos in thyrotoxicosis

A

Von Graffe sign

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12
Q

Condition in which finding a bruit over the thyroid gland indicates increased vascularity

A

Hyperthyroidism

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13
Q

Thyrotoxic states characterized by a LOW or ABSENT radioactive iodine uptake

A

Thyrotoxicosis factitia

Subacute thyroiditis

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14
Q

MC cause of hypothyroidism worldwide

A

Iodine Deficiency

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15
Q

Associated with Hashimoto’s Thyroiditis

A

Autoimmune Hypothyroidism

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16
Q

Associated with Autoimmune Hypothyroidism

A 
Vitiligo
Type 1 DM
Pernicious Anemia
Addison’s Disease
Alopecia areata
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17
Q

Cause of myxedema with typical non-pitting skin thickening

A

Increased dermal glycosaminoglycan content

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18
Q

Can establish autoimmune etiology for clinical or subclinical hypothyroidism

A

Presence of thyroid peroxidase (TPO) antibodies

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19
Q

Low or normal TSH + Low unbound T4 + Clinical signs of hypothyroidism

A

Hypopituitarism

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20
Q

Masked thyrotoxic features in the elderly, with patients presenting mainly with fatigue, depression and weight loss

A

Apathetic thyrotoxicosis

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21
Q

MC cardiovascular manifestation of Grave’s disease

A

Sinus Tachycardia

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22
Q

Indurated plaque-like lesions with an “orange skin” appearance on the anterior or lateral aspects of the lower legs seen in thyrotoxicosis

A

Pretibial myxedema

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23
Q

“Thyroid acropachy”

A

Clubbing

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24
Q

Pt with Normal FT4 + very low TSH and with suspected thyrotoxicosis, what should be the next diagnostic test?

A

FT3 determination

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25
Clinical SSx of thyrotoxicosis + Normal or increased TSH + Increased FT4
Pituitary Adenoma
26
Anthithyroid of choice for Grave’s disease during pregnancy
PTU
27
Drug given prior to subtotal thyroidectomy as treatment for thyrotoxicosis to reduce the vascularity if the thyroid gland
Potassium iodide
28
MOA of PTU in thyroid storm
Inhibits conversion of T4 to T3; Inhibit thyroid peroxidase reducing oxidation and organification of iodide
29
Rationale why stable iodide is given an hour after the first dose of PTU in thyroid crisis
To block thyroid hormone synthesis via the Wolff-Chaikoff effect
30
Drug causing painless thyroiditis
Interferon alfa
31
MC clinically apparent cause of chronic thyroiditis
Hashimoto’s thyroiditis
32
Rare thyroid disorder characterized by dense fibrosis of the gland presents in middle aged women with a hard, non-tender, fixed goiter with local compression symptoms
Reidel’s thyroiditis
33
MC hormone pattern in sick euthyroid syndrome
Decreased T3 | Normal T4 and TSH
34
Enhanced thyroid hormone production by autonomous thyroid nodules due to administration of radiocontrast and other iodine-containing agents
Jod-Basedow phenomenon
35
Goiter + mild increased FT4 + low TSH + heterogenous uptake with multiple regions of decreased and increased uptake in scan
Toxic Multinodular Goiter
36
Treatment if choice for the hyperfunctioning solitary thyroid nodule
Radioiodine ablation
37
Iodine deficiency as a risk factor for which type fo thyroid cancer?
Follicular Ca
38
MC type of thyroid Ca
Papillary Ca
39
Presence of psammoma bodies and cleaved nuclei with “Orphan Annie” appearance
Papillary Ca
40
Thyroid Ca with very poor prognosis
Anaplastic Ca
41
Serum marker for recurrent or residual medullary carcinoma of the thyroid
Serum calcitonin
42
Indicated for pts with solitary thyroid nodule + Low TSH + presence of “cold” or indeterminate nodule on scan
FNAB
43
First step in the evaluation of a thyroid nodule in a patient with normal TSH
FNAB
44
Recommended daily iron intake
150-250 ug/d in pregnant and lactating: 250 ug/d
45
Best documented genetric risk factor for Grave’s disease and autoimmune hypothyroidism in Caucasians
HLA-DR3
46
Treatment for clinical hypothyroidism
Levothyroxine 1.6 ug/kg 30mins before breakfast
47
Treatment for subclinical hypothyroidism
Low dose levothyroxine with goal of normalizing TSH
48
Dose adjustment of levothyroxine in pregnant women
Increased by >/=50% during pregnancy and returned to previous levels after delivery
49
State of thyroid HORMONE excess
Thyrotoxicosis (exogenous or endogenous)
50
Result of excessive thyroid function
Hyperthyroidism (endogenous)
51
Accoutnts 60-80% of thyrotoxicosis
Grave’s disease
52
Thyroid disease heralded by viral infections
Subacute thyroiditis/de Quervain’s
53
3 phases of subacute thyroiditis
Thyrotoxic phase Hypothyroid phase Recovery phase
54
Treatment for subacute thyroiditis
Aspirin 600mg q 4-6 hours
55
Thyroid disease most frequently occuring 3-6 months after pregnancy
Silent thyroiditis/painless thyroiditis
56
Major cause of sick euthyroid syndrome
Release of cytokines (drug-induced)
57
Urinary iodine levels supporting a diagnosis of iodine deficiency
<100 ug/L
58
Treatment of choice for toxic multinodular goiter
Radioiodine
59
Definitive diagnostic test for Toxic Adenoma
Thyroid scan (focal uptake)
60
Treatment of choice for toxic adenoma
RAI ablation
61
Neoplasms with increased risk for malignancy
Microfollicular Trabecular Hurthle cell variants
62
MC thyroid lymphoma
Diffuse large cell lymphoma
63
Marker of residual or recurrent disease in medullary thyroid carcinoma
Elevated serum calcitonin
64
Solitary or suspicious nodule with Low TSH, what is the next step?
Thyroid scan Hot nodule: Ablate, resect or treat medically Cold nodule or indeterminate: Biopsy
65
Solitary or suspicious nodule with normal TSH, what is the next step?
Biopsy (FNA or UTZ guided depending on size)
66
With RAI low uptake
Subacute thyroiditis Thyrotoxicosis factitia Toxic MNG
67
With RAI high uptake
Grave’s Toxic Adenoma Toxic MNG

HPIM 19th Endo (10 decks)

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