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Flashcards in thyroid disorders Deck (14)
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1
Q

What is thyroid storm?

A

severe hypterthyroidism induced by infection, surgery, or physiologic strss in pts with preexisting hyperthyroidism
patients have severe diaphoresis, vomiting, diarrhea, tachycardia, fever, and mental status changes

2
Q

Besides T3 and T4, what else is made by the thyroid?

A

calcitonin (made by parafollicular cells)

3
Q

What are medical treatments for grave’s disease? what are the key side effects of these drugs?

A

methimazole, propylthiouracil (thionamides). remember that methimazole inhibits only production of T3/T4 (decr. iodination), while PTU also inhibits peripheral conversion of T4 to T3
both can cause agranulocytosis; methimazole is teratogenic

4
Q

Besides Graves disease, what else can cause hypethyroidism?

A

toxic adenoma, subacute thyroiditis (aka de quervain thyroiditis), silent hyperthyroidism (often occurs post-partum), exogenous intake

5
Q

What is the treatment of thyroid storm?

A

-higher doses of meds, beta blockers, thionamides, IV sodium iodide to block thyroid hormone release, hydrocortisone to inhibit conversion of T4 to T3

6
Q

What are the s/sx of subacute thyroiditis?

A

-painful goiter, mild hyperthyroidism, fever, incr. ESR, decr. uptake on thyroid scan

7
Q

Tx of subacute thyroiditis?

A

self-limited- BBs may help. may have to give thryoid replacement if hypothyroidism occurs during gland recovery

8
Q

What is silent thyroiditis?

A

temporary thyroiditis that may follow pregnancy. these pts have painless goiter, low uptake on thyroid scan, and biopsy confirming inflammation. this is transient and self-limited

9
Q

What are the antibodies seen in Hashimoto’s thyroidits?

A

anti-thyroidperoxidate and antithyroglobulin antibodies with lymphocytic infiltrates and fibrosis on biopsy

10
Q

What are common complications of thyroid surgery?

A

hoarseness and hypocalcemia

11
Q

what are risk factors/findings that increase the likelihood that a thyroid nodule is malignant?

A

male, 20-60 yo, hx of neck irradiation, poor iodide uptake on thyroid scan, single nodule on US

12
Q

How are thyroid nodules treated?

A

-Benign, small cystic: observe
-Benign solid nodules treated with surgery, radioablation to stop thyroid overproduction and decr. risk of malignant conversion
Malignancy requires surgical resection and radioiodine ablation. if nonanaplastic and

13
Q

What is the most common form of thyroid cancer?

A

papillary; follicular variant most common variant, and follicular has slightly worse prognosis

14
Q

What are key features of medullary thyroid cancer?

A

occur in parafollicular cells and produce calcitonin. Also seen as part of MENIIa and MEN IIb syndromes.