Thyroid Disease

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1
Where is the thyroid located?
between the thyroid catilage and sternal notch
2
What does the thyroid gland produce?
T3 (Triiodothyronine)
T4 (thyroxine)
calcitonin
3
Where is the recurrent laryngeal nerve located?
lateral border
4
Which hormone important to thyroid regulation is released from the hypothalamus?
TRH
5
Where is thyroid stimulating hormone release?
anterior pituitary
6
What is iodide?
the ion form of iodine
7
What is iodine?
element found on the periodic table
8
What is needed to make thyroid hormones?
iodide
9
What is caused by abnormal hypothalamic/pituitary developlment which results in loss of normal TRH/TSH pathways?
central hypothyroidism
10
What is the term for abnormal thyroid gland development?
dysgenesis
11
What is the term for abnormal thyroid hormone synthesis or processing?
dyshormonogenesis
12
What are the clinical manifestations of congenital hypothyroidism?
prolonged jaundice
feeding issues
hypotonia
enlarged tongue
delayed bone maturation
umbilical hernia
13
Normal TSH excludes ____ hypothyroidism?
primary
14
Lab values for primary hypothyroidism
TSH high
T4 is low
15
Thyrotoxicosis is
the sate of excess thyroid hormone
16
What causes toxicosis
graves disease
toxic multinodular goiter
toxic adenomas
17
Graves disease is linked to which genetic factor?
monozygotic twins
18
High active antiretroviral therapy or alemtuzumab is associated with causing?
graves disease
19
Patients are at risk for which disease 3x during the post partum period?
graves disease
20
What is graves disease caused by?
thyroid stimulating immunoglobulins
21
Patient with Grave's disease will also have high levels of
thyroid peroxidase and thyroglobulin
22
S/S of Grave's disease
hyperactivity
irritability
insomnia
impaired concentration
tremor
hyper-reflexia
23
What is the most common cardiovascular manifestation of grave's disease?
tachycardia
24
If a patient has new onset a-fib and they are over 50 what shoudl you suspect?
grave's disease
25
What usually begins a year before thyrotoxicosis onset?
ophthalmopathy
26
What lab values will you see with Grave's disease/hyperthyroidism?
TSH decreased
T4 increased
27
What is the treatment options for grave's disease?
methimazole
propylthiouracil
28
What is the first line treatment for graves?
methimazole
29
When is propylthiouracil indicated?
patient in first trimester
thyroid storm
patient has documented reaction to methimazole
30
s/s of thyroiditis
painful and enlarged thyroid with radiation to the ear
maybe fever
malaise and URI syptoms (sore throat)
31
What is the treatment for thyroiditis?
NSAID
prednisone
beta blockers
32
Do you give antithyroid medications for thyroiditis?
no
33
Estrogen causes a rise in
thyroid binding globulin
34
hCG in the first trimester stimulates _____
TRH
35
Women who have a low dietary intake of iodide are more likely to give birth to a child with
hypothyroidism
36
Which drug can supress thyroid function?
amiodorone
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