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Thyroid Disorders Overview
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Thyroid Disorders Overview

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Questions and Answers

What is the main mechanism of action of thiocyanate in relation to iodide?

  • Blocks thyroid hormone synthesis
  • Enhances iodide uptake
  • Competitive inhibition of iodide transport (correct)
  • Stimulates thyroid gland activity

    • Which type of hypothyroidism is characterized by the autoimmune destruction of the thyroid?

  • Drug-induced hypothyroidism
  • Dyshormonogenesis
  • Hashimoto’s thyroiditis (correct)
  • Iodine deficiency

    • What is the typical degree of hypothyroidism associated with radiation-induced thyroid damage?

  • Mild to severe
  • Severe, requiring levothyroxine indefinitely (correct)
  • Mild to moderate
  • Mild

    • Which condition is associated with sodium perchlorate in terms of thyroid function?

    <p>Blocked thyroidal uptake of iodine</p> Signup and view all the answers

    What type of hypothyroidism is generally absent of goiter?

    <p>Radiation therapy-induced hypothyroidism</p> Signup and view all the answers

    What is the consequence of the destruction of thyroid cells?

    <p>No production of T3 and T4</p> Signup and view all the answers

    What characterizes Grave's disease?

    <p>Production of antibodies against TSH</p> Signup and view all the answers

    Which condition is primarily associated with a prolonged action of TSH antibodies?

    <p>Grave's disease</p> Signup and view all the answers

    What is a notable ocular symptom associated with TSH?

    <p>Ophthalmopathy</p> Signup and view all the answers

    What triggers the release of thyroid hormones in response to environmental challenges?

    <p>Cold, acute psychosis, or severe stress</p> Signup and view all the answers

    Which statement is true regarding hyperthyroidism?

    <p>It results in increased production of T4 and T3.</p> Signup and view all the answers

    What effect does a lack of thyroid hormones have on the body?

    <p>Hypothyroidism</p> Signup and view all the answers

    What is the role of thyroid peroxidase in thyroid hormone production?

    <p>Catalyzes the synthesis of thyroid hormones</p> Signup and view all the answers

    Which medication is a combination of T4 and T3 used in the short-term suppression of thyroid function?

    <p>Liotrix</p> Signup and view all the answers

    What is the shelf life of Liotrix when stored properly?

    <p>Two years</p> Signup and view all the answers

    What is the primary action of thioamides like Methimazole and Propylthiouracil?

    <p>Inhibit thyroid peroxidase</p> Signup and view all the answers

    Which of the following is a potential adverse drug reaction (ADR) associated with thioamides?

    <p>Agranulocytosis</p> Signup and view all the answers

    What is the major benefit of using iodides in treating thyroid conditions?

    <p>Reduce gland size and vascularity</p> Signup and view all the answers

    Which condition is treated with the combination medication Liotrix?

    <p>Thyrotoxicosis</p> Signup and view all the answers

    What is the potency comparison between Methimazole and Propylthiouracil?

    <p>Methimazole is 10x more potent than PTU</p> Signup and view all the answers

    Which of the following medications is used for preparation in surgical thyroidectomy?

    <p>Lugol's solution</p> Signup and view all the answers

    What cardiovascular effect is commonly associated with thyrotoxicosis?

    <p>Increased stroke volume</p> Signup and view all the answers

    Which treatment is contraindicated in patients with asthma who have thyrotoxicosis?

    <p>Propranolol</p> Signup and view all the answers

    What neurological symptom is typically seen in hypothyroidism?

    <p>Lethargy</p> Signup and view all the answers

    In thyrotoxicosis, the gastrointestinal system's typical response includes increased:

    <p>Appetite</p> Signup and view all the answers

    What is a common musculoskeletal symptom of thyrotoxicosis?

    <p>Weakness and muscle fatigue</p> Signup and view all the answers

    What renal change is typically seen in hypothyroidism?

    <p>Decreased glomerular filtration rate</p> Signup and view all the answers

    Which cardiac condition is associated with hypothyroidism?

    <p>Bradycardia</p> Signup and view all the answers

    What respiratory complication is commonly associated with thyrotoxicosis?

    <p>Hypoventilation</p> Signup and view all the answers

    Which of the following is a potential disorder resulting from thyrotoxicosis-related bone changes?

    <p>Osteoporosis</p> Signup and view all the answers

    What is a common gastrointestinal symptom of hypothyroidism?

    <p>Decreased bowel movements</p> Signup and view all the answers

    What finding on an ECG is commonly associated with hypothyroidism?

    <p>Prolonged PR interval</p> Signup and view all the answers

    What outcome is associated with hypercalcemia in the context of thyrotoxicosis?

    <p>Bone resorption</p> Signup and view all the answers

    Which condition does hypoproteinemia often indicate in the context of thyroid diseases?

    <p>Chronic liver disease</p> Signup and view all the answers

    What physiological change in the cardiovascular system occurs during thyrotoxicosis?

    <p>Increased heart rate</p> Signup and view all the answers

    In hypothyroidism, what is the expected change observed in deep tendon reflexes?

    <p>Decreased deep tendon reflexes</p> Signup and view all the answers

    What condition is associated with congenital hypothyroidism and characterized by mental retardation in infants?

    <p>Cretinism</p> Signup and view all the answers

    In which condition is the secretion of TSH absent due to pituitary disease?

    <p>Secondary hypothyroidism</p> Signup and view all the answers

    What is the emergency treatment for myxedema coma?

    <p>Levothyroxine IV</p> Signup and view all the answers

    Which clinical feature is NOT typical of myxedema coma?

    <p>Hyperactivity</p> Signup and view all the answers

    What is the primary medication used to treat hyperthyroidism?

    <p>Methimazole</p> Signup and view all the answers

    During pregnancy, how much should the thyroxine dose be increased to normalize TSH levels?

    <p>30-50%</p> Signup and view all the answers

    Which laboratory finding is typical in hyperthyroidism?

    <p>Elevated T3 and T4</p> Signup and view all the answers

    What is the first-line treatment for patients with very large thyroid glands?

    <p>Thyroidectomy</p> Signup and view all the answers

    Which autoimmune condition stimulates antibodies to thyroidal antigen, resulting in hyperthyroidism?

    <p>Grave's disease</p> Signup and view all the answers

    What is the primary symptom of severe hypothyroidism?

    <p>Shock and death</p> Signup and view all the answers

    Study Notes

    Thyroid Disorders

    • Hypothyroidism: A condition where the thyroid gland does not produce enough thyroid hormones (T3 and T4).

      • Causes:
        • Hashimoto's thyroiditis: Autoimmune destruction of the thyroid gland.
        • Drug-induced: Blocked hormone formation.
        • Dyshormonogenesis: Impaired synthesis of T4 due to enzyme deficiencies.
        • Radiation exposure: Destruction or removal of the thyroid gland.
        • Congenital (cretinism): Athyreosis or ectopic thyroid, iodine deficiency, or TSH receptor blocking antibodies.
        • Secondary (TSH deficit): Pituitary or hypothalamic disease.
      • Symptoms:
        • Skin & Appendages: Macroglossia, hypoproteinemia, decreased bowel movements, ascites.
        • Cardiovascular: Increased peripheral vascular resistance, decreased heart rate, stroke volume, cardiac output, and pulse pressure. Low output heart failure, bradycardia, prolonged PR interval, flat T wave, and low voltage in ECG.
        • Respiratory: Pleural effusions, hypoventilation, and CO2 retention.
        • Gastrointestinal: Decreased appetite, decreased frequency of bowel movements.
        • Central Nervous System: Lethargy, general slowing of mental processes, neuropathies.
        • Musculoskeletal: Stiffness and muscle fatigue, decreased deep tendon reflexes.
        • Renal: Impaired water excretion, decreased renal blood flow, and decreased glomerular filtration rate.
        • Metabolic: Decreased basal metabolic rate, slight positive nitrogen balance.
      • Management:
        • Levothyroxine: The main medication for hypothyroidism.
        • Myxedema coma: End state of untreated hypothyroidism.
          • Symptoms: Weakness, stupor, hyponatremia, hypoventilation, hypoglycemia, hypothermia, water intoxication, shock, and death.
          • Treatment: IV levothyroxine (loading dose 300-400 mcg, followed by regular dose of 50-100 mcg).
        • Hypothyroidism during pregnancy: Increase levothyroxine dose by 30-50% to normalize TSH levels.

    • Hyperthyroidism: A condition where the thyroid gland produces too much thyroid hormone.

      • Grave's disease: An autoimmune disorder where antibodies against TSH receptors stimulate thyroid hormone production.
        • Symptoms: Nervousness, hyperkinesia, emotional lability, increased appetite, increased frequency of bowel movements, weakness and muscle fatigue, increased deep tendon reflexes, mild polyuria, dyspnea, increased basal metabolic rate, hyperglycemia, and negative nitrogen balance.
        • Lab tests: Elevated T3, T4, FT3, FT4, suppressed TSH, presence of anti-thyroglobulin, thyroid peroxidase, and TSH-R antibodies.
      • Management:
        • Antithyroid medications: Methimazole and Propylthiouracil (PTU).
        • Surgery: Thyroidectomy (DOC for patients with very large gland or multinodular goiter).
        • Radioactive Iodine (RAI): Causes destruction of the thyroid gland.
        • Beta blockers: Propranolol (adjunct treatment for thyroid storm, hypertension, tachycardia, and atrial fibrillation).

    Thyroid Medications

    • Thioamides: Inhibit thyroid peroxidase and block organification (methimazole, propylthiouracil, and carbimazole).
      • Fatal ADR: Agranulocytosis.
    • Iodides: Inhibit organification and hormone release, reduce gland size and vascularity.
      • Uses: Preparation for thyroidectomy.
      • Examples: Lugol's solution and Potassium iodide.
      • ADR: Cholestatic jaundice.
    • Beta blockers: Propranolol (used to manage symptoms of hyperthyroidism).
    • Liotrix: Combination of T4 and T3 (ratio 4:1).
      • Use: Short-term suppression of TSH.
      • Shelf life: 2 years.

    Thyroid Tests

    • TSH (Thyroid Stimulating Hormone): Used to assess thyroid function.
    • T3 and T4: Measure thyroid hormone levels.
    • FT3 and FT4: Measure free thyroid hormone levels.
    • Anti-thyroglobulin and thyroid peroxidase antibodies: Used to diagnose autoimmune thyroid diseases.
    • TSH-R antibodies: Used to diagnose Grave's disease.

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    Description

    Explore the key aspects of thyroid disorders, particularly hypothyroidism. Learn about its causes, symptoms, and various factors that influence thyroid function. This quiz is designed to reinforce your understanding of thyroid health.

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