Thyroid Gland

Question 1

Thyroid gland produces and secretes two hormones

Answer 1

Tri-iodothyronine (T3)

Thyroxine (T4)

Question 2

What do the thyroid hormones regulate

Answer 2

Positive inotropic (increase myocardial contraction force)
Positive Chronotropic (Increase HR)
Increase metabolism
Increase body temperature
Increase secretion of growth hormone

Question 3

Normal thyroid function

Answer 3

hypothalamus releases thyroid-releasing hormone (TRH)
stimulates pituitary gland to produce and release thyroid-stimulating hormone (TSH).

TSH causes thyroid to make t4 and t3

Question 4

When T3 and T4 levels increase, they prevent release of

Answer 4

TRH and thus TSH

Question 5

What happens when T3 and T4 levels drop

Answer 5

Hypothalamus releases TRH stimulating TSH stimulating prodction of T3/T4

Question 6

Function of thyroid gland

Answer 6

Absorb iodine and amino acid tyrosine to create t3/t4

Question 7

How much iodine needed per week from diet

Answer 7

1mg/week

Question 8

T4 vs T3

Answer 8

T4 is mainly inactive in the body, unable to affet cells until it is converted into t3 which can enter cells

Question 9

Examples of iodine rich food

Answer 9

1. Kelp
   2 Yogurt
   3 Cows milk
   4 Strawberries
   5 Mozzarella cheese
   6 Iodized salt

Question 10

Hypothyroidism primary reason

Answer 10

Thryoid disorder

Question 11

Most common cause of hypothyorididsm

Answer 11

Hashimotos Thyroiditis.

autoimmune - body attacks thyroid reduceing it’s funciton

Question 12

Hypothyrdism results form

Answer 12

hashimotos disease
Surgical removed
Overtreatment of hyperthyoidism
Goiter often caused by insufficient iodine

Question 12

SS of hypothyroidsm

Answer 12

Wt gain (decrease metab)
Fatigue
Cold intolerance
Course dry hair
Dry rough pale skin
Muscle cramps/weakness
Constipation
Depression
Irritability

Question 13

Hypothyroidism will cause TSH to be

Answer 13

High, bc it senses decrease in T3/T4 and tries to stimulate thyroid to produce more

Question 14

If thyroids are not working properly and left untreated in new borns this could affect

Answer 14

Brain development

• thyroid replacement therapy started within 6 wks as tx

Question 15

Cretinism

Answer 15

Congenetial

• Neonate appears normal at birth but cant producce T3/T4 i
• if not treated, child will have profound developmental deficiets

Question 16

Myxedema

Answer 16

Myxedema (acquired in late childhood, early adulthood) – characterized by slowing of metabolic processes, mucous accumulation in connective tissues

Question 17

Lab tests for hyperthyroidsm

Answer 17

High T3/T4

Question 18

General SS of hyperthyroidsm

Answer 18

Increased metabolic rate
Wt loss
Increased body temp
Heat intolerance
Insomnia
Tachycardia
HTN
Exothalmus: Bulging of eyes (immune system attacks muscles and fatty tissue around the eyes

Question 19

Graves disease

Answer 19

Autoimmune disorder causesing antiobodys to bind to and stimulate TSH receptor on thyroid

Question 20

Hyperthyroidism

Answer 20

Palpitations
Diarrhea
Nervousness
Irritability
Tcardia
Altered menstrual flow
Sleep disorders

Question 21

Diseases causing hyeprthyroidsm

Answer 21

Graves
Plummers diseaes (Usually benign tumor on thyroid)(
Thyroid storm (Caused by infections, glucose changes, recent surgery on gland, trauma, withdrawl from antithyroid hormones)
- High mortality

Question 22

Tests for thyroid disorder

Answer 22

Tests for presence of antibodies

(Graves and Hashimotos)
Fine needle biospy - cancer
Ultrasonography
CT scan, MRI
Radioactive iodine uptake test

Question 23

Tx hypothyroid disorder

Answer 23

Replace missing T3 and T4 with levothyroxine (T4)

Therapy initaited ASAP

Serum TSH should decrease in response

Question 24

Levothyroxine (Synthroid Uses

Answer 24

T4 replacement Increases metabolic rate thereby increasing oxygen consumption, respiration, and heart rate Increases rate of fat protein and carb metabolism Promotes growth and maturation

Question 25

Is T3 given?

Answer 25

No, just T4, since it is converted to T3

Question 26

When would Levothyroxine be used

Answer 26

Thyroidectomy Surgical removal of the thyroid gland Radiation or antithyroid drugs Congenital defect Management of thyroid cancer Treatment of coma related to myxedema Given in morning at same time every day on EMPTY stomach to work effectively

Question 27

AE of levothryoxine

Answer 27

Overexxpression of T3/4 CNS excitiablitliuy Tremors Insomnia D/V TCardia - Cardiac arrest

Question 28

Assessment during levothyroxine therapy

Answer 28

Obtain baseline ECG AND LFTs

Question 29

What serum levels and other signs to monitor for someone recieving T4

Answer 29

Monitor VS for sudden increases (indicating toxic levels of Thyroid hormones) Monitor for wt loss and signs of hyperthyroidism monitor serum levels: T3/4, TSH, and BG Hyperthyroidism INCREASES blood glucose

Question 30

What does hyperthroidism due to BG

Answer 30

Increases BG levels

Question 31

Hyperthyroidism requires what sort of nutrition

Answer 31

HJigh calorie diet 6 full meals with snacks Caffeien to be avoided

Question 32

Two major tx of hyperthyroidism

Answer 32

Radioactive Iodine - Reducing T3/4 production Antithyroid drugs

Question 33

PTU (Propylthiouracil )

Answer 33

Tx of hyperthyroidism caused by overproduction of thyroid hormone Establishes normal thyroid state prior to sx or radioactive iodine tx Palliative tx of toxic nodular goiter Does not effect already synthesised hormones

Question 34

AE of PTUq

Answer 34

Leukopenia, myelosuppression Hypersensitivity reactions, rash, urticaria Arthralgia, joint swelling Glomerulonephritis Headache, vertigo, neuritis, paresthesia Nausea Serious adverse effects Aplastic anemia Liver impairment

Question 35

WHat to know abt thyroid meds

Answer 35

NEVER stop taking thyroidism (Hyperthyroid meds) suddenly - Body depends on this TSH high suggests that thyroid is producing TOO much and vis versa