Thyroid Correlates Flashcards Preview

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Flashcards in Thyroid Correlates Deck (18)
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1
Q

HypoT CM

generalized

matrix glycosaminoglycans accumlate in

look for labs w

A

slowing of metabolic processes

interstitial space of many tissues

high TSH, low T4, elevated thyroid AB

2
Q

Iatrogenic causes of HypoT

Iodine

Drugs

Infiltrative dz

A

thyroidectomy, radioiodine therapy, external radiation

deficiency/excess

Li/Amiodarone

Hemochromatosis, sarcoid

3
Q

Tx hypoT w

why not T3

A

levothyroxine (synth T4)

body converts T4 to T3 in peripheral tissues

4
Q

Levothyroxine

converted to active metabolite

T4/T3 will bind to

exert effects through

A

L-triiodothyronine (T3)

nuclear, thyroid receptor

control of DNA trxn and protein synthesis

5
Q

lab test indicating Euthyroid sick syndrome

treating myxedema coma considered

has ____ MR

A

low serum T4, free T4 and T3 and TSH

IV hydrocortisone, IV T4 high dose

high

6
Q

Graves dz on iodine uptake scan

High uptake indicates

Low uptake indictes

possible cause of high uptake

possible cause of low uptake

A

diffuse uptake w enlargement

new hormone synth by thyroid

release of preformed hormone, exogenous ingestion, extrathyroidal synthesis

Graves, toxic adenoma/goiter, pituitary ademoma

Thyroiditis, exogenous thyroid hormone intake, ectopic hyperT

7
Q

labs of Graves

thyroid gland growth w thyroid hormone synthesis/release results in

antithyroid drugs include

can cause

tx HyperT

A

suppresed TSH, high T4, anti-TSI positive

inc radioactive iodine uptake

methimazole, propylthiouracyl

agranulocytosis

I131 ablation (destroys gland), total thyroidectomy

8
Q

PTU ihibits ______ by blocking _______

Does not inactivate ______ in blood/thyroid or w replacement hormones

Methimazole inhibits ______ by blocking _______ in thyroid gland

blocks synthesis of ______ but does not ______

A

synthesis of TH, conversion of T4 to T3 in peripheral tissues

T4/T3

synthesis of TH, oxidation of iodine

T4 and T3, inactivate circulating T4/T3

9
Q

Additional problem to consider in pregnant woman w PTU

Methimazole

PPP

A

Teratogenic effects, 1st trimester

2nd trimester

PTU Primary Pregnancy

10
Q

Thyroid storm sx

TX

Thionamide

methimazole is

PPP

A

Fever, CNS, GI effects, HTN

BB (propanolol), supportive, glucocorticoid

in life threatening case
PTU>methimazole

otherwise preferred- lower hepatic toxicity, restores euthyroid more quickly

Propanolol, PTU (peripheral conversion), Prednisone

11
Q

Potential cause of deQuervians thyroiditis

Phases
HyperT presents w, lab values

Damage to _____, breakdown of

lasts until _____, about

Thyroid radioiodine uptake is

A

viral/post viral inflammation

tender, dissue goiter (high T4 w/wo T3)

thyroid follicular cells, stored TG

T4/T3 depleted, 2-6wks

low

12
Q

HypoT phase DT

Followed by

low radioactive iodine uptake w high serum TG leads to damage in the

tx DT

monitor thyroid fxn test every

A

synth of TH is inhibited due to lack of TSH

recovery phase (if not permanent)

thyroid follicle cells w breakdown of TG- releases T4/T3

NSAID or prednisone (severe pain)

2-8 wks to confirm resolution of hyperT, hypoT, euthyroid

13
Q

Ddx for solitary thyroid nodule

A

Benign nodule

Follicular lesion/atypia

Follicular neoplasm

Malignancy

14
Q

Factors that inc likelihood of malignancy

Hx of

Childhood

Total body

FH of

Mass is

Sx include

A

rapid growth of neck mass

H/N radiation

radiation for BMT

thyroid ca, syndromes

fixed, hard

obstructive, cervical LAD, hoarse

15
Q

Factors that inc likelihood of nodule being benign

Gender

Age

A

No malignant features

woman (ca more likely in men)

high in adults >60 or less than 30

16
Q

Malignant tumor

Thyroid follicular epithelial derived cancers

Other malignant dz of thyroid

A

papillary, follicular, anaplastic

MTC, primary thyroid lymphoma, metastases from breast/colon/Renal/melanoma

17
Q

Thyroid nodule work up

Papillary thyroid Ca on US

Thyroid tissue is

Margins are

Look for ____ indicating

Inc

A

US then US guided FNA

darker than normal (hypoechoic)

irregular

microcalcifications, Psammoma bodies

peripheral/intranodal vascularity

18
Q

Tx Papillary/follicular thyroid Ca

Step 1

Step 2

Step 3

who receives step 3

A

total thyroidectomy

post op radioactive iodine ablation

possible TSH suppression w levothyroxine

intermediate/high risk indiv