Thyroid/Parathyroid 2

Question 1

What types of abnormalities are seen in thyroid dysfunction?

Answer 1

• functional

- anatomic

Question 2

Functional thyroid abnormalities (of the gland)

Answer 2

• hyperfunction

- hypofunction

Question 3

Anatomic abnormalities of the thyroid

Answer 3

• thyroiditis
• goiter
• tumor

Any anatomic abnormality may or may not be associated with abnormalities of hormone secretion

Question 4

Susceptibility to thyroid disease: risk factors

Answer 4

• family hx
• age over 50
• female

Question 5

Susceptibility to thyroid disease: Why is it more difficult to detect after age 60?

Answer 5

masquerades as other problems such as

• heart disease
• depression
• dementia

Question 6

Susceptibility to thyroid disease: % incidence in females?

Answer 6

7%

Question 7

Susceptibility to thyroid disease: Alterations in thyroid can produce changes in these

Answer 7

Virtually everything

• hair
• nails
• skin
• eyes
• GI
• respiratory tract
• cardiovascular
• NM
• MSK

Question 8

Susceptibility to thyroid disease: prevention and tx

Answer 8

Although cannot prevent thyroid conditions, respond well to tx.

Question 9

Thyroid cancer prevalence, metastasis

Answer 9

• Relatively rare and slow-growing

- Rarely metastasizes

Question 10

Thyroid cancer risk factors

Answer 10

• Caucasian females over 40
• Iodine deficiency
• Family history
• Being exposed to radioactive iodine (I-131)

Question 11

4 most common types of thyroid cancer

Answer 11

• Papillary
• Follicular
• Medullary
• Anaplastic

Question 12

Most common type of functional hypothyroidism

Answer 12

Graves’ disease

85% of cases

Question 13

Graves is an autoimmune condition that increases production of

Answer 13

T4

Question 14

Common s/s of Graves’ disease

Answer 14

• Enlarged thyroid
• Protruding eyes
• Inflammation of ocular muscles
• Tachycardia
• Fatigue
• WL
• Hyperactive reflexes
• Sweating
• Heat intolerance
• Tremor
• Nervousness
• Polydipsia
• Dyspnea

Question 15

What cardiac problems can occur as a result of Graves’ disease?

Answer 15

• A-fib can be induced, precipitating CHF
• increases risk for MI
• Need to monitor for this!

Question 16

Action of thyroid gland is (inhibitory/stimulatory)

Answer 16

Stimulatory

Question 17

A goiter is an enlargement of the thyroid, commonly due to:

Answer 17

• lack of iodine in diet
• inflammation
• tumors

Question 18

What does a goiter do to normal thyroid function?

Answer 18

• Inhibits normal thyroid hormone production

- Causes hypersecretion of TSH due to lack of negative feedback loop

Question 19

Goiter: What does hypersecretion of TSH result in?

Answer 19

secretion of huge amounts of thyroglobulin into the gland follicles

Question 20

goiter prevalence

Answer 20

Almost eradicated in the US due to iodized salt

Question 21

goiter s/s

Answer 21

• increased neck size
• pressure on trachea and esophagus
• dysphagia
• hoarseness
• difficulty breathing

Question 22

Thyroiditis =

Answer 22

Inflammation of thyroid gland

Question 23

thyroiditis: Can be acute, subacute, or chronic. Which types are uncommon and what are they caused by?

Answer 23

• acute and subacute uncommon

- caused by bacterial/viral agents

Question 24

Most common form of thyroiditis

Answer 24

Hashimoto’s thyroiditis

Question 25

Hashimoto’s thyroiditis is (acute/chronic) and is related to

Answer 25

• chronic

- related to autoimmune response

Question 26

Hashimoto’s thyroiditis: seen most commonly in this group

Answer 26

• women

- 30-50 yo

Question 27

Hashimoto’s thyroiditis: progression

Answer 27

can destroy the thyroid and result in hypothyroidism

Question 28

Hashimoto’s thyroiditis: sx

Answer 28

highly variable and include:

• dysphagia
• tight sensation while swallowing
• respiratory distress

*over time, sx consistent with those of hypothyroidism!