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Endocrine > Thyroid Disorders > Flashcards

Thyroid Disorders Flashcards

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1
Q

Describe the etiology of goiter

A
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2
Q

Describe the presentation of goiter

A
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3
Q

Describe the diagnostics for goiter

A
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4
Q

Describe the treatment of goiter

A
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5
Q

What are the actions of T3 & T4

A
  • increase basal metabolic rate & metabolism
  • stimulate bone maturation & growth
  • ensure proper fetal growth & development (esp CNS)
  • increase cardiac output
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6
Q

What meds can suppress TSH

A

high dose steroids, dopamine

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7
Q

What meds can increase TSH

A

metoclopramide & amiodarone

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8
Q

Describe when to do thyroid screening

A
  • newborn (screen for congenital hypothyroidism ( cretinism, intellectual disability))
  • sometimes in pregnancy
  • high index of suspicion in elderly pts
  • if symptomatic
  • when titrating certain meds (or when using amiodarone, Li, metoclopramide)
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9
Q

Describe the screening for thyroid conditions

A

TSH first (if normal, no further testing)
- if high: free T4, maybe T3 (if sus for hyperthyroidism)
- if low: free T4 & T3

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10
Q

Describe the difference between total vs free T3 & T4

A

Total: highly protein bound, many factors influence binding

Free: corresponds to biologically available hormone pool, unpound

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11
Q

Describe the consideration for biotin (Vit H, B7) in thyroid testing

A
  • can impact TSH results
  • stop at least 18 hrs prior to blood draw
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12
Q

Dx for high TSH & low Free T4

A

primary hypothyroidism (thyroid failure)

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13
Q

Dx if TSH is high but FT4 is normal

A

subclinical hypothyroidism

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14
Q

Dx if TSH is low & FT3/FT4 are high

A

primary hyperthyroidism (thyroid overproducing)

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15
Q

Dx if TSH is low and FT3/FT4 are normal

A

subclinical hyperthyroidism

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16
Q

Dx if TSH is low and FT4 is low

A

Central/Secondary hypothyroidism (pituitary failure)

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17
Q

Dx if TSH is high and FT3/FT4 are high

A

Central/Secondary hyperthyroidism (TSH producing tumor)

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18
Q

Which labs test for Hashimoto’s

A
  • Anti-Tg
  • Anti-TPO (also Graves
  • TSH receptor antibody (blocking in hashimoto’s)
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19
Q

Which labs test for Grave’s disease

A
  • Anti-TPO (also hashimoto’s)
  • Antimicrosomal antibody
  • TSH receptor antibody (stimulating in Grave’s)
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20
Q

Describe radioactive iodine uptake scans

A
  • done in hyperthyroidism or nodule workup
  • iodine collects in thyroid gland
  • overactive/nodule takes up more iodine
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21
Q

Describe the appearance of the thyroid in a radioactive iodine uptake scan in Grave’s

A

symmetrical high uptake

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22
Q

Describe the appearance of the thyroid in a radioactive iodine uptake scan in thyroiditis

A

symmetrical low uptake (underfunctioning, usually not ordered for this)

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23
Q

Describe the appearance of the thyroid in a radioactive iodine uptake scan in Toxic MNG or Toxic adenoma

A

irregular/uneven increased uptake

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24
Q

Describe thyrotoxicosis

A

state of excess thyroid hormone (from gland, meds, etc?)

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25
When is it important to include a T3 in workup of the thyroid?
when HYPERthyroidism is suspected
26
Describe the course of postpartum thyroid conditions
- hyper or hypo - 2-4 weeks of thyrotoxicosis - 4-12 weeks of hypothyroidism - spontaneously resolves - can treat symptomatically or with short term levo when in hypothyroid phase
27
Describe the thyroid considerations prior to surgery
- if hyperthyroidism: achieve euthyroid prior - if hypothyroidism: proceed if taking meds regularly
28
Describe the etiology of goiter
29
Describe the treatment of goiter
29
Describe the workup of goiter
29
Describe the etiology of hyperthyroidism
30
Describe the presentation of hyperthyroidism
31
Describe the treatment for hyperthyroidism
31
Describe the labs for hyperthyroidism
32
Describe the etiology of Grave's disease
33
Describe the triad presentation of hyperthyroidism
34
Describe the diagnostics for grave's
35
What is this a typical presentation of
Graves disease
36
Describe the etiology of a thyroid storm
37
Describe the presentation of a thyroid storm
38
Describe the labs for a thyroid storm
39
Describe the treatment of a thyroid storm
40
Describe the etiology of toxic MNG
41
Describe the presentation of toxic MNG
42
Describe the etiology of toxic adenoma
43
Describe the workup for toxic MNG & toxic adenoma
44
Describe the treatment of toxic adenoma
may develop hypothyroidism after tx
44
Describe the treatment for toxic MNG
45
Describe the etiology of hypothyroidism
46
Describe the presentation of hypothyroidism
47
Describe the treatment of hypothyroidism
48
Describe the workup of hypothyroidism
49
Describe the etiology of thyroiditis
50
Describe the presentation of viral thyroiditis
51
Describe the labs for viral thyroiditis
52
Describe the treatment for viral thyroiditis
53
Describe the etiology of hashimoto's thyroiditis
54
Describe the labs for hashimoto's thyroiditis
55
Describe the etiology of myxedema coma
56
Describe the presentation of myxedema coma
57
Describe the treatment of myxedema coma
58
Describe the etiology & presentation of euthyroid sick syndrome
59
What is important to check in euthyroid sick syndrome
reverse T3
60
What is the most common endocrine cancer
thyroid cancer
61
What are the worst and chillest thyroid neoplasms
Worst: anaplastic carcinoma Chillest: papillary or follicular carcinoma
62
What is this characteristic of
Hypothyroidism
63
What is this characteristic of
hyperthyroidism

Endocrine (10 decks)

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