Thyroid Disorders Flashcards Preview

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Flashcards in Thyroid Disorders Deck (20):
1

What regulates the amount of thyroid hormone that reaches the fetus?

placenta

2

Thyroid hormone abnormalities negatively affect what aspects of growth/aging in children?

bone
mental age
height

3

What are common symptoms (or patient complaints) associated with hypothyroidism?

1. fatigue/weakness
2. dry/coarse skin
3. feeling cold
4. hair loss
5. memory
6. constipation
7. wt gain (poor appetite)
8. menorrhagia

4

What are common physical signs associated with hypothyroidism?

1. puffy face/hands/feet
2. diffuse alopecia
3. bradycardia
4. peripheral edema
5. carpal tunnel syndrome
6. serous cavity effusions
7. delayed tendon reflex relaxation

5

What are common symptoms (or patient complaints) associated with hyperthyroidism?

1. fatigue/weakness
2. hyperactivity
3. irritability/dysphoria
4. heat intolerance or sweating
5. palpitations
6. wt loss with increased appetite
7. diarrhea
8. oligomenorrhea
9. loss of libido

6

What are common physical signs associated with hyperthyroidism?

1. tachycardia
2. a-fib in elderly
3. tremor
4. goiter
5. warm/moist skin
6. muscle weakness, prox myopathy
7. lid retraction

7

What labs are used to assess thyroid function? (Which of these is most useful?)

TSH***
T4 (total + free)
T3 (total + free)
T3 index

8

What are possible causes of inappropriate TSH labs, which point to hyperthyroidism?

TSH secreting pituitary adenoma

isolated pituitary resistance to thyroid hormone

9

What are possible causes of inappropriate TSH labs, which point to euthyroid?

systemic illness

generalized resistance to thyroid hormone

assay interference

10

What are possible causes of inappropriate TSH labs, which point to hypothyroidism?

central hypothyroidism

11

Why don't you see changes in T4 quickly in response to therapy?

T4 has a long half life, 6.2 days

12

Why do you see changes in T3 quickly in response to therapy?

T3 has a short half-life, 1 day

13

What are endogenous causes of hyperthyroidism?

1. Graves
2. toxic multinodular goiter
3. toxic adenoma
4. activating mutation of TSH receptor or Gs(alpha)
5. strauma ovarii
6. thyroiditis
7. secondary hyperthyroidism

14

What are the causes of primary hypothyroidism?

1. thyroiditis
2. RIA trx for Graves
3. thyroidectomy
4.excessive iodine intake
5. iodine deficiency
6. inborne errors of TH synthesis
7. drugs

15

What drugs cause primary hypothyroidism?

Li
amiodarone
interferon-alpha

16

How is thyroiditis classified?

1. acute
2. subacute
3. silent
4. Riedel's thyroiditis

17

Causes of thyroid enlargement:

--Diffuse nontoxic (simple) goiter
--Nontoxic multinodular goiter
--Toxic multinodular goiter
--Hyperfunctioning solitary nodule
--Thyroid neoplasm/cancer

18

How is thyroid cancer classified?

--Well differentiated (Papillary, Follicular)
--Anaplastic
--Thyroid lymphoma
--Medullary thyroid carcinoma

19

What are the risk factors for thyroid cancer?

--Hx of head/neck radiation
--M, < 20 or > 45 y/o
--New or enlarging neck mass
--Hoarse voice/vocal cord paralysis
--Iodine deficiency
--Family history of thyroid cancer or MEN 2

20

What characteristics of thyroid nodules are at increased thyroid cancer risk?

--nodule >4 cm
--fixed to adjacent structures
--new/enlarging
--Extra-thyroidal extension
--Suspected lymph node involvement