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مقدمات غدد > Thyroid Gland/Hypothyroidism > Flashcards

Thyroid Gland/Hypothyroidism Flashcards

(47 cards)

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1
Q

Hypothyroidism symptoms

A

Delayed reflex relaxation time

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2
Q

Thyroid gland is derived from………….begins to develop around…………weeks of gestation , largely completed between……….and………weeks of gestation.

A

Embryonic floor of pharynx
4
10-20

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3
Q

The recommended daily intake of iodine is………..for adults and ………..for children and …………for pregnant women
Urinary iodine is ………..in sufficient population

A

150
90-120
200
>10

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4
Q

Primary secretory product of thyroid gland

…………….is the biologically active form of thyroid hormones

A

T4

T3// 80% from deiodination of thyroid hormones in peripheral tissue ,20% direct from thyroid secretion.

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5
Q

Conversion of T4 toT3

A

Mainly takes place in liver and kidney.

T4……..>D1+D2………..>T3……..D3……..>T2
لةيكم تفاعل يۆدیگ لەحلقەی خارجی کەنیمنەو ، دووم تفاعل يوديگ لة حلقةي داخلي

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6
Q

Plasma proteins that bound to thyroid hormones

A

Thyroxine binding globulin TBG
Transthyretin
Albumin

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7
Q

Conditions that increase TBG

A

Pregnancy
Infection (chronic+active)/Early hepatitis
Biliary fibrosis
Acute intermittent porphyria
HIV infection
Genetic factors

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8
Q

Drugs that increase TBG

A

Estrogen (OCP , HRT, Tamoxifen).
Methadon /Heroin
Clofibrate
5-fluro-uracil

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9
Q

Drugs that decrease serum T3 +T4

A

Glucocorticoids +Androgens /(جماعت ادرینال)
L-asparaginase (ALL)
Salicylates =old NSAID /ex/Aspirin
Mefenamic acids =An NSAID
Furosemide /loop diuretic /edema
Anti-seizures (phenytoin - carbamazepine)

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10
Q

Conditions that decrease serum T3 or T4

A

Genetic factors
Acute +Chronic illness
Liver disease (late)

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11
Q

Total T3 or T4

A

Are the hormones bound to TBG

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12
Q

Auto regulation of thyroid hormones

A

Reflects the available levels of iodine.

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13
Q

Wolff-chaikoff effect

Jod-basedow effect

A

👆iodide ……>hypothyroidism

👆iodide ……>hyperthyroidim

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14
Q

TSH secretion is sensitive to

A

Plasma free thyroid hormones

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15
Q

وقتی TBG زیاد بوود ،
T3+T4 زیاد دیاردةن
ولكن ……نورماله

A

TSH

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16
Q

Checking reverse T3 at

A

Acute illness
ICU

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17
Q

T3 resin uptake test in suspension of👇or👆of TBG

👆TBG

👇TBG

A

Inversely proportional

(👇T3resin uptake) (👇THBR) (fT4 index=nor)(👆total T4)

(👆T3resin uptake) (👆THBR) (fT4 index=nor)(👇total T4)

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18
Q

Radio-active-iodine uptake

A

راستةوانةية مع نشاط الغدة الدرقية

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19
Q

Clinical manifestations of hypothyroidism

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A

عرق كردن👇
پوست سةرد و وشك و شاحب
Non-pitting myxedema due to 👆dermal glucosaminoglycan.
Pale with yellow tinge to skin due to carotene accumulation.
تخلف نمو الأضافر والشعر
Diffuse alopecia
Vitiligo /وةك بيماري همراه
👆in aminotransferase
Miscarriage
Carpal tunnel syn
Slow relaxation of tendon reflexes (psedomyotonia).
Reversible cerebellar ataxia
Paranoid or depression
Myxedema coma
Dementia
رةقبوون و تشنج بوون والم عضلات💪
Impaired Hearing
Hoarse voice

20
Q

Thining of the outer third of eyebrows

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A

If present is specific to hashimoto

21
Q

Other autoimmune diseases associated with hashimoto disease

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A

Vitiligo
Pernicious anemia
Addison’s disease
Alopecia areata
DM1
Celiac disease
Dermatitis herptiformis
Chronic active hepatitis
RA +SLE+Sjogren’s syn

22
Q

Classification of hypothyroidism

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A

1/with goiter
A-Hashimoto
B-Nodular goitrous

2/Atrophic =End stage of hashimoto

23
Q

Autoimmune hypothyroidism

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A

Mean age 60 / incidence 👆with age .
HLA-DR And CTLA-4 , Account for approximately half of the genetic susceptibility to autoimmune hypothyroidism.
Infections :- congenital rubella + hepatitis C virus.
High iodine intake ,by immunologic effects/ IL2 / Interferon alfa.

24
Q

Pathology of :-

Hashimoto thyroiditis
Atrophic thyroiditis

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A

Oxyphil metaplasia =Askanazy cell
Extensive fibrosis/follicles are absent

25
Euthyoid sick syndrome =non-thyroidal illness syndrome
Eu=good الغدة طبيعية والهرمونات غير طبيعية
26
👆TSH>10/👇T4 👆TSH<10/T4=norm 👇TSH/👇T4 TSH=norm/👇T4 👆TSH<10/👇T4
Primary/overt=clinical Primary/mild=sub-clinical Sec Sec Sec
27
س٢٨
مهم
28
At primary hypothyroidism, should always check
TPO Ab
29
Primary :- TPO+Ab TPO-Ab
Clinical or Subclinical /Always need treatment Clinical (other causes of hypothyroidism)/subclinical (annual followup)
30
Follow up for whom are being treated with levothyroxine
فقط TSH هر دوو مانگ جاريگ =٨حفته مع هر تغير دوز ،هر٦حفته جاريگ
31
كةسيگ خريكة علاج بةد ، نتائج مخبريةي خاسةوبوود،علائمي خاسةو نيود
لازمة ادامةي علاجةگة بيةد مع نفس جرعه ٣-٦ماه
32
Radioiodine treatment as a cause of Iatrogenic hypothyroidism
Transient hypothyroidism in the first 3-4 months. Free T4 is a better measure of thyroid function than TSH.
33
In secondary hypothyroidism, …………..can’t be used to monitor therapy
TSH
34
آزمايش قبل علائم خاسةو بوود
همان دوز ادامه تا ٣-٦ ماه
35
Dose adjustment would be on the basis of ……….Levels
TSH
36
T4 over treatment
Tachycardia Atrial fibrillation 👇bone density
37
Subclinical /no symptoms/TPO+ / But **must treatment**
T4=normal TSH👆>10
38
ادوية تخلينا نحتاج مقدار اكبر من ليڤو ثايروكسين
Ferrous sulfate Calcium PPI =Aluminum hydroxide Amiodaron Carbamazepine Phenytoin
39
جماعت علاج ثايروكسين ، تا چةند روژ نةخوةن مشكلة نييه
٣ روژ Half life thyroxine—7days
40
Before treating subclinical hypothyroidism, we should confirm that any elevation of TSH , is sustained over a …………of period before treatment is given
3 months
41
Difference in treatment of clinical subclinical
Dose 100 25-50 Follow up, when treating ……>فرق نميكنة نيهيليمن TSH فرة كةمةو بوود ، كمتر لة يك
42
Simple non-toxic goiter
Simple=diffuse=No nodule Non-toxic=No hyperthyroidism
43
Most common cause of simple goiter
Iode deficiency/ may become hypothyroidism
44
Simple goiter
Mostly non-symptomatic Mostly normal laboratory results Symmetrically enlarged incidence 👇with age
45
Simple goiter at pregnancy
Due to 👆iodine demand
46
Pemberton’s sign when arms are raised above the head
قرمزبوونةوةي سةر كإشارة الى External jugular venous obstruction
47
Nodular
حميد و خبيث ي هس Incidence 👆with age زيادبووني يۆد، وةيةكجاوة كةدةي هايپر ……>basedow effect اگر ثابت ورةق يا چسپيدةبوود يان ژان بكةد تفيد في ان تكون خبيثة Contrast agents and other iodine containing substances should be avoided

مقدمات غدد (9 decks)

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