Ch. 568 - Hyperthyroidism Flashcards Preview

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Flashcards in Ch. 568 - Hyperthyroidism Deck (30)
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1
Q

MCC of hyperthyroidism during childhood

A

Graves disease

2
Q

Autoimmune disorder with production of thyroid-stimulating Ig resulting in diffuse toxic goiter

A

Graves disease

3
Q

T/F Subclinical hyperthyroidism carries a risk of late-life atrial fibrillation

A

T

4
Q

T/F Enlargement of thymus, splenomegaly, lymphadenopathy, are well-established findings in Graves disease

A

T

5
Q

Cause of proptosis in Graves

A

Infiltration of retroorbital tissues with lymphocytes and plasma cells; Antibodies

6
Q

Antibody in Graves

A

Thyrotropin-receptor antibody (TRSAb)

7
Q

Action of TRSAb

A

Bind to receptor for TSH > stimulates cAMP > thyroid hyperplasia and unregulated overproduction of thyroid hormone

8
Q

T/F Infiltration of retroorbital tissues with lymphocytes and plasma cells is a well-established finding in Graves disease

A

T

9
Q

Graves Ophthalmopathy appears to be caused by

A

Ab against Ag shared by thyroid and eye muscle

10
Q

Earliest signs in children with Graves

A

Emotional disturbances accompanied by motor hyperactivity

11
Q

Characteristics of thyroid gland in Graves

A

Diffuse goiter, soft with a smooth surface

12
Q

T/F Afib is a rare complication of Graves disease

A

T

13
Q

Hyperthy : Cause of the apical systolic murmur present in some patients

A

MR, prob from papillary muscle dysfunction

14
Q

Hyperthy : Reflexes are brisk, especially the return phase of

A

Achilles reflex

15
Q

Form of hyperthy: Acute onset hyperthermia, severe tachy, heart failure, restlessness

A

Thyroid crisis/thyroid storm

16
Q

T/F Hyperthy may present with extreme listlessness, apathy, cachexia

A

T, apathetic or masked hyperthy

17
Q

T/F Measurement of TSI (thyroid-stimulating Ig) and TBII (Thyrotropin binding inhibiting immunoglobulins) is NOT useful in diagnosis of Graves

A

F, USEFUL

18
Q

Characteristics of thyroid nodule that is suspicious of Plummer disease

A

Palpable or T3 preferentially elevated in a hyperthy patient

19
Q

Initial therapy mostly recommended for patients with hyperthy

A

Antithyroid drugs > radioiodine or subtotal thyroidectomy

20
Q

Gaining acceptance as initial treatment in children >10y/o for hyperthy

A

Radioiodine

21
Q

Methimazole vs PTU: 10x more potent

A

Methimazole

22
Q

Methimazole vs PTU: Much longer serum half-life

A

Methimazole

23
Q

Methimazole vs PTU: Heavily protein bound

A

PTU

24
Q

Methimazole vs PTU: Lesser abbility to cross placenta

A

PTU

25
Q

Methimazole vs PTU: Lesser ability to pass into breastmilk

A

PTU

26
Q

Methimazole vs PTU: Preferred during pregnancy and for nursing mothers

A

PTU

27
Q

Dose of radioiodine

A

300Ci/g

28
Q

Average time course to hypothy in hyperthy patients treated with radioiodine 300Ci/g

A

11 weeks

29
Q

T/F Subtotal thyroidectomy is done only after patients has been brought to a euthyroid state

A

T

30
Q

Known risk factor for thyroid eye disease and should be avoided or discontinued to avoid progression of eye involvement

A

Cigarette smoking