Thyroid disorders Flashcards

(15 cards)

1
Q

What is the number 1, almost always cause of hypothyroidism

A

Hashimoto thyroiditis

Other causes: Dietary deficiency in iodine, amiodarone

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2
Q

What are the symptoms of hypothyroidism

A

Everything slowed down except menstrual flow, which is increased

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3
Q

What is the order of tests you should do with hypothyroidism

A

First get TSH level. If this is low, then get T4 levels

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4
Q

What is the treatment for hypothyroidism

A

Thyroxine (synthroid)

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5
Q

What is the main complication of hypothyroidism and how is it treated

A

Myxedema Coma - thyroid storm equivalent

When infection happens with hypothyroidism, become hypothermic
Treatment: High dose T4 and now give T3 too, corticosteroids, IV fluids, and warming blankets

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6
Q

What are the five causes of hyperthyroidism and hints on the exam that these will be the causes

A
  1. ) Graves disease - Proptosis and skin findings, TSH receptor antibodies
  2. ) Subacute thyroiditis - Tender thyroid
  3. ) Painless silent thyroiditis: Nontender, normal exam
  4. ) Exogenous thyroid hormone - gland becomes small to the point where it is non-palpable
  5. ) Pituitary adenoma - high TSH
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7
Q

What is common between all forms of hyperthyroidism from all causes

A

Elevated T4 (TSH tests this time will be different because pituitary adenoma has increased TSH)

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8
Q

What is the difference between all forms of hyperthyroidism in terms of radioactive iodine uptake

A

Graves disease - elevated

Everything else - decreased

Pituitary adenoma - not done

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9
Q

What are diagnostic tools you can use to distinguish forms of hyperthyroidism

A

Graves - positive antibody testing

Subacute - tenderness

Painless - none

Exogenous thyroid - unpalpable gland

Pituitary adenoma - MRI of head

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10
Q

What is the treatments for hyperthyroidism in its chronic states

A
Graves - radioactive iodine
Subacute - aspirin
Painless - none
Exogenous thyroid - stop use
Pituitary adenoma - surgery
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11
Q

What is the treatment for acute hyperthyroidism

A

Propanolol - blocks target organ effect and peripheral conversion of T4 to T3

Methimazole and propylthiouracil - blocks hormone production
Iopianic acid and ipodate - blocks release of hormone and conversion of T4 to T3 (iodinated material)

Hydrocortisone
Radioactive iodine

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12
Q

What is the order of treatments if someone presents with graves opthalmology

A

Steroids - initial therapy
Decompressive surgery - if refractory

Find out if xt for this is different

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13
Q

What are thyroid nodules

A

Benign 95%, very rarely hyperfunctioning or hypofunctioning

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14
Q

What is the first step you must do if you discover a thyroid nodule

A

Measure TSH and T4 - if T4 high, then biopsy not needed because cancer is not hyperfunctioning

If TSH and T4 normal, then proceed to fine needle aspiration with biopsy

Ultrasound can be done but does not change treatments

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15
Q

After fine needle aspiration, what is the next step of the thyroid nodule management based on the results of the aspiration

A

Indeterminant: Remove nodule
Cancer: Remove nodule

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