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Pathophysiology > Thyroid II > Flashcards

Thyroid II Flashcards

1
Q

hyperthyroidism

A

thyrotoxicosis is the state produced by hyperthyroidism

two most common causes are Graves diseases and thyroid adenomas

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2
Q

Graves disease

A

autoimmune disorders associated with an antibody that stimulates TSH receptor

syndrome that
consists of hyperthyroidism, goiter, opthalmopathy, and occasionally a dermopathy referred to as pretibial or localized myxedema

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3
Q

Graves disease: autoantibodies to the thyrotropin (TSH) receptor

A

activate the receptor, thereby stimulating thyroid hormone secretion and thyroidgrowth

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4
Q

Graves disease: Graves opthalmopathy

A

volumes of both the extraocular muscles and retroortibal connective and adipose tissue are increased

possible paralysis of eye muscles, damage to optic nerve and corneal ulceration

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5
Q

Graves disease: Goiter

A

enlargement of the thyroid

hyperthyroidism

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6
Q

Goiter: nodular

A

thyroid nodules are very common (small nodules)

most thyroid nodules are benign (95%) overgrowths of normal thyroid tissue

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7
Q

Goiter: small and large goiters

A

small: sometimes can be detected more easily by having a person drink
large: diffuse enlargement coupled with symptoms of hypothyroidism. Goiter due to elevation in TSH secondary to insufficient iodide in the diet

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8
Q

Hyperthyroidism: eyes

A

hyperthyroidism causes some eyelid retraction (lid lag) and bright eyed stare

^^increased sympathetic activity. Unrelated to the ophthalmopathy that occurs in Graves disease

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9
Q

Hyperthyroidism: skin

A

warm, moist skin due to vasodilation

smooth skin due to decrease in the keratin layer

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10
Q

Hyperthyroidism: cardiovascular

A

rate and force of heart contraction increased

  • pulse pressure widened and CO increased
  • peripheral vascular resistance is decreased
  • Afib in 10-20% of patients
  • if severe, can have CHF
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11
Q

Hyperthyroidism: nervous system

A

behavioral and personai\lity changes

–psyhosis, agitation, and depression

–anxiety, restlessness, irritability, and emotional liability

–insominia also common

–hyperkinesia, tremor

–dementia and confusion

–seizures

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12
Q

Hyperthyroidism: respiratory system

A

respiratory distress

–resp muscle weakness and increased demand

–increased ventilatory drive

–goiter may depress trachea

–increase in breathing frequency

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13
Q

Hyperthyroidism: misc.

A

Increased GI motility and diarrhea

–increased appetite

–heat intolerance

–increased bone loss

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14
Q

Hyperthyroidism: treatment

A

beta blockers

thionamides: methimazole (preferred-1x daily) and propylthiouracil (better during pregnancy but bad for liver)

radioiodine ablation: widely used

surgery

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15
Q

Hypothyroidism: causes

A

postablative (thyroidectomy), iodine deficiency, tx with lithium, and thyroiditis

autoimmune throiditis includes Hashimoto’s disease

female:male ratio 5:1

TSH/goiter- hypothyroidism due to a thyroid defect results in elevated TSH and a goiter

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16
Q

Hypothyroidism: skin

A

myxedema, mucinous material is deposited in skin

skin is pale and cool

thickening of skin

slow would healing

heair may be coarse, loss is common

nails become brittle

17
Q

Hypothyroidism: cardiovascular system

A

–decrease in CO

–possible hypertension secondary to increased peripheral vascular resistance

–peripheral effusion

–hypercholesterolemia

18
Q

Hypothyroidism: nervous system

A

adult (myxedema)- slowed mentation, poor concentration and short term memory, social withdrawal, depressed mood, lethargy, fatigue, psychosis, confusion, and disorientation

congenital (cretinism)-permanent brain damage if not corrected shortly after birth. Cretins are permanently mentally retarded and are short if deficiency is not corrected. T4 and TSH tested at birth.

19
Q

Hypothyroidism: respiratory system

A

fatigue, SOB on exertion

–decreased exercise capacity

–hypoventalation due to resp muscle weakness

20
Q

Hypothyroidism: misc.

A

cold intolerance

dec appetite, only mildwt gain

husky voice

dec gastric emptying/intestinal motility (constipation)

21
Q

Hypothyroidism: treatment

A

-thyroid hormone replacement (thyroxine T4 is tx of choice)

22
Q

Thyroid function assays

A

TSH assays: normal range of serum TSH is about 0.5-5.0 mU/L

serum total T3 and T4: normal T4 is typically 4.6 to 11.2 ug/dL and serum T3 tpically range 75 to 195 ng/dL

Pathophysiology (9 decks)

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